Preventing carpal tunnel?

[kaikitano]

I have just returned from my all-state convention and I’m currently feeling better than ever on the trombone!! Most likely as a side effect of all the practicing/rehearsing I’ve been up to, I have wrist pain in both wrists and a slight numbness in the tip of my left middle finger. I have heard that this is a symptom of carpal tunnel and that is something I would much like to avoid. I play with relatively good technique (according to my teacher) so I’m confused with what I can do to further prevent carpal tunnel or any other trombone-related hand injuries. Any advice?

[Doug Elliott]

Wrist and elbow issues are very often caused by carrying a heavy case or suitcase... Think about what you've been doing in that department.

I have it pretty bad but it's from using tools that vibrate or impact.

[2bobone]

Kaikitano : My career was ended by the same symptoms that you are describing so I think I might have some valuable advice to offer. Consider yourself fortunate to be aware of the warnings that have presented themselves. You must act NOW and in a focused manner if you are to continue to pursue an endeavor that seems to give you so much pleasure. Male individuals are conflicted by an urge to show others that you are dominant. Because of this, you will force yourself to "Tough It Out" to show this dominance to all that you are someone to be looked upon as a shining example of masculinity. Believe me, the ergonomics of the trombone were not considered by its early practitioners. I'm reasonably sure that they never had to deal with a 52 week season contract and the physical distress that it wreaks upon the human body. I have not asked, but from your description I am assuming that you are a BASS trombone player. If I am correct I can offer this hopeful bit of advice. When we become enraptured by the music that we create, it is easy to neglect other necessary but seemingly mundane aspects of the craft --- such as --- physical conditioning --- mild weight lifting --- connection with other arts related endeavors --- healthy diet --- . Ed Kleinhammer, the great bass trombonist of The Chicago Symphony once said to me that bass trombonists should consider themselves to be "sedentary athletes". His colleague, Arnold Jacobs [CSO tubist] subjected professional athletes to the same trial as professional brass players and found that they were no more able to perform the breathing tasks required of a professional brass player than an actual professional brass player ! Hence the "sedentary athlete" term. Take the numbness and aching that you are now experiencing as a call to action. As you are now studying with someone, seek their help in fortifying yourself for the long haul. It does NOT get easier ! Another member of the CSO once said, "Once you reach the age of 40 you have to practice as much to stand still as you used to do to advance". That was Adolf Herseth, CSO principal trumpet and my all time favorite brass player. I wish you every success in this journey. As the old military march exhorted, "Onward & Upward". Cheers !! Bob

[Bach5G]

Talk to a physio and get some strengthening exercises. Stretching. Get a brace or strap on your horn and, depending on what your physician/advises, try a brace on your wrist. Maybe a night brace. Best to get some professional advice.

CTS can develop idiopathically and may not have anything to do with playing trombone.

[Burgerbob]

Talk to a physio and get some strengthening exercises. Stretching. Get a brace or strap on your horn and, depending on what your physician/advises, try a brace on your wrist. Maybe a night brace. Best to get some professional advice.

[timothy42b]

CTS can develop idiopathically and may not have anything to do with playing trombone.

Also, playing trombone may be one source of stress, and combined with others (keyboard, woodworking, dart throwing, who knows) you get pushed over the edge. If you teach band and have to play everything, you're probably holding at least half the instruments in some weird wrist position. You might examine the other things you do. Rock climbing maybe?

I think you should try to make the trombone as easy to hold as possible. A lot of wrist tension is caused by the effort to balance, not the effort to hold a weight up against gravity (IMO). So pay attention to counterweighting to resist the tendency to tip both fore and back and side to side. Side to side may be much more damaging long term than front to back.

And then add chinups and deadlifts.

[CharlieB]

Carpal tunnel sufferer here. Been down that road.
Carpal Tunnel Syndrome is not an overworked or strained muscle that will heal with time.
Whole "nother thing that needs to be evaluated by a professional.
Some info:
https://orthoinfo.aaos.org/en/diseases- ... -syndrome/

[baileyman]

I had a nerve conduction test by a neurologist, which showed pretty definitively a degradation across the wrists for both arms, but only the right worrisome enough to snip the ligaments. It worked.

When my elbows are fully flexed some compression of the nerve happens, and the feeling radiates to the fingers. Elbows can cause symptoms that seem like carpal tunnel.

Other activities can cause a flareup that seem like a trombone problem. Mine was caused by hand planing.

As to what to do, first would be to find a way to do things differently. Get the muscles and joints out of their groove.

For trombone, change in balance weights, maybe a strut support, different hand positions, play lefty, something may work.

[Silverbee]

I was diagnosed with carpal tunnel syndrome in my early 30s and have EDS. Carpal tunnel syndrome is one of the symptoms associated with EDS, therefore I don't understand why they would be mutually exclusive. the link between carpal tunnel syndrome and benign joint hypermobility syndrome. Years later, they discovered that the "carpal tunnel" I had was actually a pinched neck nerve. My carpal tunnel syndrome now rarely bothers me because I have never undergone the operation. Obtain some strengthening exercises from a physiotherapist . Stretching. Put a strap or brace on your horn and, per your doctor's recommendations, attempt a brace on your wrist. A night brace, perhaps. It might be best to consult a specialist. Wishing you luck in everything.

[SimmonsTrombone]

Advocates of free weights also say this type of weightlifting strengthens and balances the small muscles which make the joints more flexible and strong. You have suggestions here for help from various professionals. You have a lot of research to do. Your post indicates you are young, so seek out good options.

[kurmisala]

Look into some stretches for wrists, there's a bunch on youtube.
Helped me with my computer related carpal tunnel issues, but you gotta keep doing them regularly

[David123]

Look into some stretches for wrists, there's a bunch on youtube.
Helped me with my computer related carpal tunnel issues, but you gotta keep doing them regularly

I think it is better to consult a physiotherapist and follow their guidelines. Youtube has a lot of videos and often may confuse you. But if you visit a physiotherapist they will examine you completely and provide you with the best tailored solution. Also, it comes with the least side effects. I had severe migraine for years and took all possible kinds of medicines. My body got tired, and I could not work with this migraine. It interrupted my day-to-day activity. So like last hope, I booked an appointment with a physiotherapist. They examined me and created an IMS treatment(https://www.mytorontophysio.com/service ... -needling/). I had a temporarily increased pain that lasted only for 48 hours. Other than that, I did not have to face any side effects. I do not have to intake any medicines. I must say I am feeling better now. Though it is not completely cured, it is not messing up my life like before. Hope it can heal completely.

[Posaunus]

I think it is better to consult a physiotherapist and follow their guidelines.

Welcome back David. You seem to be quite knowledgeable about specialty medical treatments in the Toronto area (ophthalmology, physiotherapy, ...). Are you a marketing representative for these businesses?

Do you work with Kiara Edward (who seems to be the rep for some Toronto dental businesses, and is also not a trombonist)?

As a flutist (and wanna-be violinist), what is your interest in trombone?

Just curious.

[PhilTrombone]

It's entirely possible that something other than trombone playing is a contributing or prime cause of this. Have you thought about other things you are doing with your hands?

Carpal tunnel is a frequent problem for office workers due to poor use of computer keyboards.
I have known dozens of people with this painful problem. None play trombone.

The big culprit is keyboarding with your wrists cocked upwards towards the keys. Your wrists should always be lightly curved downwards into any keyboard (including a piano, btw).

Also, how much time are you spending on your phone, texting and otherwise typing/thumbing?
Also a major cause of repetitive injuries.

Just sayin' it might not be the trombone.