Just a quick entry here to verify that my recent wrist injury was the direct result of carpal tunnel syndrome. I had encountered this problem in my left hand previously and took effective measures to address the problem. CTS is caused by pressure on the nerves (the medial and ulnar in my case) that pass through a narrow boney tunnels in the wrist & elbow. The pressure is caused by inflammation of the tendons that share space in those narrow tunnels. The inflammation and pressure is exacerbated by:
- Bending the wrist beyond 30 degrees from the neutral position
- Overrotation (supination/pronation) of the wrist (instead of lifting the elbow on downbows)
- Tense muscles anywhere from the neck, shoulder, upper arm, or forearms
- Prolonged postures that elongate the nerves (which extend from the side of neck through the shoulder and down the back of the arm)
The first one on the list (overuse, aka “repetitive motion”) is usually the one that gets the most credit, however the endurance of the human body can be dramatically increased when you follow proper form combined with active relaxation techniques & good hydration. Having addressed #2, #3, and most of #4 with my teacher’s guidance, I was still experiencing frustrating tingling and numbness after only two hours of practice yesterday. As I was intently looking down at the bow dancing on the string trying to make a solid contact for a tricky double stop decrecendo from tip to frog, it dawned on me that I had been violating the 5th item all night long! Since the nerves in the hand are rooted at the spinal column at the neck, by tilting my head to look down at the strings I was actually shortening the chain of nerves leading from my neck to my hand! Immediately I lifted my head, stacked the bones supporting my head to relax the neck muscles, and kept my eyes focused on the image in my practice room mirror. Almost instantaneously I felt the pressure in my wrists subside and blood and sensation began creeping back into my fingers on both hands. I was able to continue practice for almost a full hour after that and was only forced to quit from normal muscle fatigue.
In tonight’s practice session, having more completely addressed all 5 items on that list, I was able to go 2.5 focused hours with minimal discomfort. I am counting this as a victory considering I began playing while exhausted and accompanied by a throbbing headache which made focusing on my problematic form more challenging. I think what this situation needs now is ongoing vigilance, gentle CTS specific stretches, ample hydration, ice, and a good deal of rest.