wrist

[Ryan]

Hey all, I haven't posted in a long time and really took a break from CST. I recently purchased Intu-Flow® and Flow Fit. I began Intu-Flow® and started practicing some of the exercises of Flow Fit. My spine is becoming much freer and feeling better. I am having a problem with my left wrist.

I play the bass and practice often. I have developed pain in my left wrist that also goes up my thumb. I practice the beginner's wrist and finger mobility often and have tried adjusting the strap of the bass to change the angle of my wrist as I play on the fret board. When I've practiced Flow Fit, putting pressure on my wrist seems to irritate it as well. There have also been a few times that I wake up in the middle of the night with numbness in my third and forth fingers

Any ideas or suggestions? I really don't want to stop playing bass. I think I may put my Flow Fit practice on hold until my wrist feels better.

Thanks and nice to be back.

[Coach Bentz]

How long has it been since you started experiencing that, Ryan?

[Ryan]

I've been experiencing the wrist pain for the last couple of weeks. It began when I started practicing the bass more. I made sure to do more wrist and finger mobility. In fact, I do it several times throughout the day.

I've noticed in the past that when I'm holding the fretboard with my wrist in a bent position and start to press the ring finger down, there's sort of a lateral "clunk". I had 4/10 pain with it. I first experienced this (when I wasn't neglecting my health ;)) when I was doing basic swings with arm cast on 10lbs. Clubbells. My wrist would reach a point where it would kind of "clunk" over.

Thanks for the reply and looking forward to hearing back.

[Coach Bentz]

Is music your profession also? If not, what do you do during the day?

To start, make sure you're working mobility at least from the elbow, preferably shoulder. I would agree that backing off Flowfit for the time being is a good idea, at least until you find out what this is.

To that end, I would first call my chiropractor or osteopath and make a visit in the very near future. There may be a misalignment of the carpals or something that is causing the numbness, and a good D.C. can not only put that back in place, but also recommend rehab exercises to help stabilize the 'clunking'.

If you do that, I'd be happy to suggest some things that can help you develop your wrist lock for Clubbell work, and begin to compensate for your playing. But you'll see improvement tons faster if you get it looked at first.

[Ryan]

Thanks Coach, I'll go to a DC near me and have him/her look at me and report back as a reply on this thread.

I'm not a musician by trade, but I do a lot of paperwork as I work in a hospital. Fortunately, I'm right handed so no worries about that wrist. One thing I will say is that I have very narrow wrists, which I've heard puts me at a higher risk for having an inflamed carpal tunnel.

I'm kinda bummed about not doing Flowfit® but, all in good time. I'm really enjoying recommitting myself to mobility and wellness!!

Have a great Cinco de Mayo everyone!

[Coach Bentz]

which I've heard puts me at a higher risk for having an inflamed carpal tunnel.

Or, you could say that your body gives you great feedback on your technique. If it starts to slip, things start to hurt. Inconvenient in the short term, but a *gift* in the long run, in my opinion.

[Ryan]

Thanks for encouraging me to change to a positive model of thinking. I'll report back soon!!

[Ryan]

So I ended up going to an orthopedist, especially as DCs are not available on my insurance plan ;). I had him check out my wrist as well as my right hip.

My right hip has been declining in ROM and within the last month a baseline of 1-2 of 10 on pain scale. When set in motion it would go to 4 and at very rare times if I pushed off of it wrong a 5. I've had no specific injury I can remember.

Anyway x-rays were taken of both. Given the nerve testing, the ortho stated that I have early signs of carpal tunnel and for me to simply watch and see how it feels over the next 6-8 weeks. I am continuing to be diligent in Intu-Flow® practice as well as periodic Shoulder, Elbow, Wrist, Fingers throughout the day.

The hip x-ray was not entirely conclusive, however given the symptoms and what little showed, the ortho suspects that the culprit may be a labral tear with chondral pathology. I'm getting a MRI Arthrogram on Friday. Basically, the way I understand it, this issue refers to tissue that connects seamlessly to the cartilage lining the hip socket. If the labrum tears or detaches, it will cause increasing discomfort and impinge range of motion. Of course, if untreated it will get worse over time.

If this is the case, the MD states that there is a minimally invasive arthroscopic procedure that can be performed which will repair the tissue and within 4+ months time, will be back to normal. If it is not and is more an issue of joint inflammation, a steroid shot into the hip may be indicated.

Anyway, that's it; I'll give a report on the MRI Arthrogram. I'm continuing to do Intu-Flow® being very careful to maintain proper protocols for my wrist and hip.

Thanks all and any thoughts/suggestions?

[Coach Bentz]

First off, I'm glad you went in. You can't really get that kind of feedback any other way.

I used to have pretty severe wrist pain from carpal tunnel from my career choices, among lots of other folks who've been on the forum. Recovery is absolutely in the cards.

When I first started working with Intuflow, I stopped all other physical activity that irritated my wrist. Within weeks, I was in a pain-free state, but only so long as I practiced Intuflow daily. (Experimentally, I skipped days, and the pain would gradually return.) What helped make that change permanent was kicking up my nutrition a notch. (I started focusing on food more for potential vitamin/mineral quality, than caloric content) Which makes sense - one purpose of joint mobility practice is to wash nutrition in, and waste material out. So that's something to consider.

When you're looking at carpal tunnel syndrome symptoms, in my experience, there are two sets of muscles that are often heavily used that contribute to that. Wrist flexors, and pronators. If you're sitting in front of a keyboard, your palms are turned down, that's pronation. If you're doing a wrist curl, that's flexion)

One good sign to check your wrist flexors is to straighten your arm, face your palm away from you, and bring your hand back toward you, like you're going doing a pushup in the air, and then look at it to see how close you can get to 90 degrees. I've worked with some of my dad's musician friends with carpal tunnel pain, and they don't get so close.

To begin unravelling those things with Intuflow, pay extra attention to your elbow circles, and when you're rotating to the outside, make sure you turn your palms up and over (supinate) as far as you possibly can, don't cheat on that. When you get up into wrist infinities, really concentrate on bringing your fingers and hand back (like that air pushup) back toward your forearm. It'll probably 'burn' a little bit, which means you're doing it right.

*IF* your orthopedist approves it, you might also want to take a look at the yoga pose upward dog and its variant, seal pose. The screwing pushup would also be excellent when you're ready to train a little. But don't be in a hurry for that, the last thing you want is to irritate/compress the joint more just now.

[Ryan]

Thanks for the quick reply. I think I may start posting in the training blogs to give a comprehensive, incremental view of my recovery/progress. It would probably help me keep track of it as well. The hip thing is mildly concerning, as it is stopping me from completing full range on Spinal Rocks amongst other things. I do feel good about offically investigating it and taking an intelligent approach to addressing the issues.

So I'll keep posting and working!

Thanks again for the support.

[Luke Chohany]

Ryan,

As a musician, I know how frustrating carpal tunnel syndrome can be. Hang in there. It sounds like you are doing the right things.

After practicing IntuFlow for about one year I no longer have any symptoms. Can I attribute 100% of that to IntuFlow? Maybe, and maybe not, but I do know it has helped greatly.

In my opinion, the best thing to do in the initial healing stages is to greatly reduce of stop the aggravating activity (I'm not sure what stage you are at now). It's hard, I know, but there are plenty of other things you can work on to become a better musician--your right hand technique (I'm assuming your injury was to your left wrist), theory, composition skill, ear training, voice, etc.

After you get back in action, probably after doing the things Coach Bentz recommended--especially elbow mobility, you might try some of the following:

--Shake out your arms during and after playing, especially during challenging exercises or pieces. I like to grab my fingers with the opposite hand and vibrate rapidly to send waves up my arm. The general arm shakes taught by Scott in RESET are great.

--I'm not sure how much you practice technical things, but it's obviously best to balance and intermix right and left hand techniques to reduce stress on one or the other.

--You can end a session with some exercises that strengthen your fingers in the extension direction (the opposite direction that is required to bass playing). Just use you other hand to provide resistance. I don't think these are specific to preventing CTS but I always thought they were important.

--In general, and it sounds like you are already doing this, keep your wrists straight when playing and sleeping. This won't solve everything but it definitely helps reduce those nasty 'clunks' that feel like nails on the chalkboard.

If you figure out anything else I'd love to hear too.

with care,
~Luke

[Ryan]

My CTS seems to be getting worse. Some days my wrists feel normal. Other days, I wake up at night with either half or all of both of my hands numb. My hands, wrists, and up to my elbows ache or tingle moderately. The wrist are especially weak.

I've minimized most activities with my hands and wrists. I don't practice the bass at all these days and probably play one 45 minute session 3-4 times a month. No Clubbells, no pressing off the floor, no lifting or carrying heavy things around unless necessary.

I've been very diligent with Intu-Flow® at level 2, and like I said above, the relief is inconsistent. I'm also very mindful of slow, proper technique.

Does anyone have advice on any books they've read, practitioners (i.e., massage therapy, hand specialists, chiropractors, etc...) they've seen, or other joint mobility drills that can be done? Do you guys think that I haven't given my Intu-Flow® practice enough time?

I really want to get back to activity, whether that be playing the bass, picking up my daughter, Clubbell®® training, and Flowfit®®. There's got to be a way to work through this and come out the other side strong and pain free. I know I can do it!

Thanks everyone!

[Joseph David]

Ryan,
I would start with a DO, an osteopathic physician, that specializes in manual therapy. Chiropractors can be excellent if they have a background in manual work as well. If your lucky you can find a gifted massage therapist that has a tool box that will address your issues. The thing about wrist work is that it could be in the neck, shoulder, elbow or the wrist in different combinations. Most towns have a RSI clinic. Those who deal with repetive strain injuries often are versed in helping patients get the right care.
Hope you find what you need :)

[Kathryn Woodall]

Ryan,

It really isn't a matter of giving the IntuFlow enough time. IntuFlow, and all of CST, is for prehab and post-rehab. You have an active problem with your wrists and you are trying to resolve that problem, which means that you are trying to do rehab. That IntuFlow isn't helping only further supports that. So what you need is to find a health care practitioner who will work with you to find out why you are having problems and to direct you in how to resolve them. Until you know WHY the problem exists, it is very difficult to offer direction to the type of practitioner that will be most helpful. Finding out why is done through a portal of entry doctor...a doctor of chiropractic, osteopathy, or medicine. Also keep in mind that a diagnosis is often a description of the symptoms instead of an explanation as to what is going on.

Carpal tunnel syndrome occurs when something within the wrist (Brian did a nice job of explaining this in his article on carpal tunnel syndrome) narrows the tunnel enough that nerve function is decreased from the point of restriction on. In true ct, nerve function prior to the restriction will not be affected. That isn't to say that it can't cause other issues above the wrist, but the nerve itself is affected only from the point of restriction on. You are having tingling as high as the elbow...so that would at least raise the suspicion of altered blood flow/nerve function somewhere before the carpal tunnel. Perhaps the stress on the muscles is causing them to restrict at a higher point so you have that and ct going on, and perhaps not. You need a doctor to run tests so that it can be determined why you are having symptoms. It isn't enough to know that there is altered nerve function - in order to form an effective treatment plan, it is also necessary to know why there is altered function and where the problem begins. Until those two things are known, treatment is centered on resolving symptoms.

Symptoms can be massively deceptive...all they really say is that something isn't right. It could be as complex as cancer or a pending heart attack to as simple as a pillow that doesn't properly support your head at night or a lack of the right foods causing a nutritional deficiency. That is a pretty wide range and if it were me, I'd certainly want to know why the symptoms were there instead of just how to make them go away.

Going to a doctor isn't like dropping your car off at the shop. Your car is massively less complex, can be hooked up to a computer for a full analysis that does not require complex interpretation, can be replaced, and will probably have the mechanic's full attention for about 3x as long as you will have a doctor's before a diagnosis is made. If you are leaving a doctors office and don't know the answers to why you are having symptoms and where the source of the problem is (and appointments aren't being made to run tests to answer those questions), you are leaving basically no better off than when you entered. It is your job to make sure that you are at least more informed by the time you leave than when you came in.

When someone tells me, "Maybe it will go away, lets just give it time" what I hear is, "I don't know what is wrong or how to fully diagnosis you yet, please come back when the symptoms are severe enough that I can. Maybe we will both be lucky and that won't happen." The reason I hear that is because if they knew what was wrong they could offer me treatment or else tell me that there isn't a known treatment...if one of those isn't happening, they really don't know what is wrong and my health is being left to chance.

And now I must apologize because I am ranting, but I am going to post this anyway. I'm attending a funeral on Monday so the consequences of not finding out the cause of seemingly simple symptoms quickly is very fresh in my mind. In the last year I've heard more cases like this than perhaps in all of my career. It is possible that I am simply more aware of them, that it is happening more, or any number of factors. But in almost every case, if only each person had been more persistent at getting the doc to find out the cause of their problems instead of just covering up symptoms, their lives would have been longer. 'Why?' is such an important question...try to get it answered before it is being asked for different reasons.

[Joseph David]

My condolences Kathryn....

[Ryan]

Thanks to all of you for posting on the topic and trying to assist me. Although, I have no benefit for a DC, I'm going to go see one. We'll see what s/he says.

To Kathryn: I am no stranger to the loss loved ones as I'm a social worker in a hospital. What you say is true about delving deeper to find the root of the issue; so many people in critical and/or terminal situations second guess their approach and timing to their health. Thank you for being open and honest, and I wish you and your family peace as you work through this sad, difficult time.

[Kathryn Woodall]

Thank you Joseph and Ryan. The funeral today was for the father and husband of some of my clients. He was a truly delightful man and it is a big loss that he is no longer here. I've known his wife and children since I first started practice 14 years ago -- so while he is not related to me, I hold a great fondness for all of them. Sitting there today it occurred to me that it would be a worthy goal to live in such a way as to be missed as much as he obviously is.

Ryan,
I'm glad that you are seeking out a doc and I hope that the experience is a good one and that you come away with some answers and solutions. Regarding your profession: it is good that families have someone as compassionate as you seem to be to help them through difficult times. Take care and keep us posted. :)