Index finger tendonitis -any tips?

Ergonomics and Posture for Classical Guitarists, Aches and Pains, Injuries, etc...
Claudiosolares
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Joined: Wed Jan 27, 2016 8:00 pm

Index finger tendonitis -any tips?

Post by Claudiosolares » Wed Jan 24, 2018 4:10 am

Ouch. Have had tendonitis on left index -barring- and need any tips from anyone who is experiencing some kind of it.
Doctors of course, are useless, the most benefit I got was from the advice to apply ice afterwards. That's it.
I warm up 15 minutes doing easy scales then head full on but cannot go for more than one hour, then I need a day's rest and continue. The doc says to play every day but on day 2 of consecutive playing it gets more sensitive and I stop for fear of doing more harm. Any advice on this?
Also I read that after playing it is important to cool down the muscles, like when you go for a run and afterwards walk 5 blocks. But I don't have the slightest idea of what to play... maybe scales like when I warm up??
:merci:
1985 Bertrand Martin: Spruce, Rosewood
2013 Feiga Siedler: Vihuela de Mano after E7048: Spruce, Indian Rosewood.
2014 Francisco Navarro: After Rodriguez: Cedar,Cocobolo
2016 Carlos Trujillo: Baroque guitar after Chechucci: Machiche, Spruce, Chicozapote

soufiej
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Re: Index finger tendonitis -any tips?

Post by soufiej » Wed Jan 24, 2018 2:24 pm

"Doctors of course, are useless ... "


Not all doctors are worthless. Just the ones who don't really have an answer for your problem. I had a case of trigger finger once after doing a day's hard physical work in my older neighbor's yard. The orthopedic who first looked at the Xrays told me I had tight joints. I asked if I wouldn't have had those same tight joints before I did the yard work. He got frustrated and told me to come back after the hand specialist had come on staff. I did, and she diagnosed and treated the injury without a problem. So I would say you just have a doctor who sees lots of people with aches and pains and they don't have the time to spend finding out whether you actually have a specific condition or whether they can brush you off with a few words and move on to the next complainer.

Tendonitis is easily researched and I would encourage you to, at the least, be our own best advocate. Do the research to determine whether your symptoms actually match those of tendonitis. There are numerous issues which may be at the root of the problem you describe. I have a somewhat similar problem though my issue came about after a fall and it is more related to problems further up in my arm. Remember, your arm, wrist and hand are all connected by a series of levers and pulleys with many of those pieces existing inside a sheath that can also be inflamed. Make sure you are treating the right problem.

Most important in treating inflammation is resting the affected area. If you warm up slowly but then attack the rest of your practice as if there isn't a problem, you've defeated the rest period. Step back and take it easy until you can again play without pain. This may be a point where you need to consider your technique and, like a lot of players, begin to simplify and adjust how you approach your music.

Inflammation has many causes, some related to your diet, which is typically filled with 21st century additives which are unnatural to your body. You don't have to believe in "new age" anything to understand that every time you put something unnatural to your body inside your body, your body will fight back. Inflammation is the body's first reaction. Inflammation is a first sign that more serious conditions may follow unless you change tactics.

Treatment beyond rest is typically slow and sometimes a matter of finding what works for your body and your condition. Start with OTC anti-inflammatories which can be anything from NSAID's to natural sources such as Tumeric or Oregano Oil. All anti-inflammatories have some side effects so you simply need to find the one that's right for you. Despite your attitude toward doctors, it might be worth the time to find a holistic practitioner (DO's are better at this than are MD's) who can advise you on the do's and don'ts of anti-inflammatories.

More aggressive treatment begins with massage to the affected area. Look into a "TENS unit" and "transverse friction massage".

https://www.google.com/search?q=TENS+un ... e&ie=UTF-8

https://www.google.com/search?q=transve ... e&ie=UTF-8

Topical ointments can reduce some discomfort when you are not playing. It will probably be helpful to immobilize your finger while you sleep as many people actually work their hands hard during sleep. Your pharmacy probably has a soft "finger sleeve" with a gel insert which can be frozen for icing down after a work out or at night. There's also a device which you can wear during the day which is nearly invisible but provides support to your finger while largely immobilizing your finger. Just put "soft finger splints" into a search engine.

Nothing "out there" about either treatment, both have long been used in physical therapy. If you live in an area where there is an orthopedic doctor who specializes in treating the injuries musicians tend to suffer, give them a try.

Treating such a condition however requires a more holistic approach than just telling the patient to take some aspirin. Begin by looking at any changes to your posture and how you hold your guitar. Often, as pain creeps up on us, we begin to make changes to adjust the position of the guitar which actually leads to further damage being done longterm.

After that, make sure you are not creating more problems by bulling through the pain. Doing so only creates more inflammation which gets you no where. Rest is your best friend now. Take it easy when you play and consider taking longer periods away from the instrument. Icing down afterwards reduces the temporary flare up of inflammation but the damage has been done and is deeper than a temporary application of ice can address.


Mostly, if your doctor has no answer, do your research and find what works for you.

Alexander Kalil
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Location: Germany

Re: Index finger tendonitis -any tips?

Post by Alexander Kalil » Thu Jan 25, 2018 6:27 pm

Claudiosolares wrote:
Wed Jan 24, 2018 4:10 am
I warm up 15 minutes doing easy scales then head full on but cannot go for more than one hour, then I need a day's rest and continue.
For some people practicing continously for 1 hour + 15 minutes can be just too much for the tendons. Try dividing your daily practice workload into shorter sessions of say 30 minutes each, taking an adequate break after each session. I used to have similar problems that completely went away when I began practicing in smaller bits.

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Andrew Fryer
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Re: Index finger tendonitis -any tips?

Post by Andrew Fryer » Thu Jan 25, 2018 6:44 pm

I never get this problem.

I just find that every bone in my hand is in agony, lol!
1975 Calatayud y Gisbert, Yamaha CG131S.

Jules Wilkins
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Re: Index finger tendonitis -any tips?

Post by Jules Wilkins » Thu Jan 25, 2018 7:11 pm

Claudiosolares wrote:
Wed Jan 24, 2018 4:10 am
Ouch. Have had tendonitis on left index -barring- and need any tips from anyone who is experiencing some kind of it.
I developed tendonitis in my barring finger some years ago and it was a major contributing factor to my quitting for many years. I just recently picked up the guitar again and have delved in head on playing at least an hour most days and as many as 8 hours on many Saturdays and Sundays. My tendonitis has not returned and I am pretty sure I know why. Essentially I can thank the internet and the many people who post free lessons/advice/routines on it.
Basically my problem before had to do with applying too much pressure with my fingers most especially the index finger. That comes partially from not having the finger close enough to the fret and having to apply too much pressure to compensate. I now start every practice with a calibration exercise. You put your finger in the ideal position (snugging up to the fret) on every string and press just enough to eliminate buzz. Let up the slightest and it buzzes. There are also similar calibration exercises for barring. You barre two strings, then three etc with the same goal. It requires almost no pressure to fret a single string, and really not that much to barre. My guess is that you are applying too much pressure even in fretting one string, and when you barre it is the proverbial last straw. If we do not overwork the fingers they will not have a problem. Just look at the number of ladies and children who play very well despite having much weaker hands than us men. They accomplish that by putting technique ahead of shear strength.

I have no idea how experienced you are and my advice may not apply to you, but I suspect I have hit the nail on the head. I suggest you google calibration exercises for the classical guitar. I did a quick check and came up empty and apologize for not finding the links but unfortunately I am late for work.
"We all need people who will give us feedback. That’s how we improve." — Bill Gates
"The biggest room in the world is the room for improvement." — unknown

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bergmann
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Re: Index finger tendonitis -any tips?

Post by bergmann » Thu Jan 25, 2018 7:16 pm

I did, and she diagnosed and treated the injury without a problem.
Out of curiosity - how was the spring finger treated?

Lawler
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Re: Index finger tendonitis -any tips?

Post by Lawler » Thu Jan 25, 2018 8:03 pm

Claudiosolares wrote:
Wed Jan 24, 2018 4:10 am
...I warm up 15 minutes doing easy scales then head full on but cannot go for more than one hour...
I think one can rarely go wrong listening to feedback from the hands/body in things like this. Perhaps your hands are trying to tell you that, at the moment, an hour a day is the right amount for you.

Claudiosolares
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Joined: Wed Jan 27, 2016 8:00 pm

Re: Index finger tendonitis -any tips?

Post by Claudiosolares » Sun Jan 28, 2018 9:43 pm

Thanks all, souflej for your long detailed response.
I got this in 2008 and quit playing, like Jules, for three years, had lost hope. Then a friend said don't drop it , keep playing anyways. So I did but on my condition's terms and have done about 15 concerts since 2015.
The catch is I need to progress and we all know 3 hours a week doesn't cut it; new stuff is learnt at snail pace. So I need to find that thin line between working the finger at its max without damaging it more. So I'll follow Jules advice for calibrating that index, and yes I did that cross-fibre massage souflej, but there is no pain. If I don't warm up, forget it, I will injure myself further. In 2014 I warmed up pressing putty first, but I have since dispensed and go straight to the guitar.
How high do you play Jules, meaning the distance between your head and the horizontal fingerboard? I play with a position slightly higher than Segovia's but to calibrate effectively my guess is to place it as high as possible? Probably use a guitar support so the upper bout almost touches your chin?
Thanks once again!
1985 Bertrand Martin: Spruce, Rosewood
2013 Feiga Siedler: Vihuela de Mano after E7048: Spruce, Indian Rosewood.
2014 Francisco Navarro: After Rodriguez: Cedar,Cocobolo
2016 Carlos Trujillo: Baroque guitar after Chechucci: Machiche, Spruce, Chicozapote

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