Fiddle and Alternative Strings Forum

Instruments and Equipment => Banjo-Mando-Pickers => Topic started by: amy on Nov 16, 2005, 02:14:03 PM

Title: carpel tunnel syndrome
Post by: amy on Nov 16, 2005, 02:14:03 PM
Hello All,

Thinking of picking up the banjo.  Used to be a transcriptionist and got out of that because I started getting carpal tunnel syndrome (buzzing hands/forearmes at night, weakness in the hands, etc.). 

Is the bluegrass banjo another path to carpel tunnel syndrome or can it be avoided by proper positioning, etc?  There's a guy in our neck of the woods who was really great (I'm told); he got CTS and now he plays mando because he can't play banjo anymore.   I'd prefer not going down that road. 


Amy Jacques
Title: Re: carpel tunnel syndrome
Post by: twtunes on Nov 16, 2005, 03:30:33 PM
I'd try it and see. Either flat-picking or finger-picking would be quite different from typing in wrist angle, etc.
Title: Re: carpel tunnel syndrome
Post by: PeterG on Nov 16, 2005, 03:33:19 PM
I've played for 25 years with no ill effects. I do know a guy who has CTS who did play but can't play anymore. I don't know if the banjo caused it but I would say if you are prone to CTS you better be cautious about it. It is not too demanding on the left hand but your right hand gets quite a workout, even with proper positioning. Perhaps a talk with your doctor is in order. One other factor with banjo is the weight. It is a very heavy instrument and that can tell on your shoulders and neck.
Title: Re: carpel tunnel syndrome
Post by: postingtoomuch on Nov 16, 2005, 05:48:34 PM
amy, knowing that you know what cts is i would like to suggest to you to look at the situation from another angle.

cts can be classified into 2 big catagories, reversible and irreversible, meaning injury to the median nerve that will heal versus that will not completely recover.  which catagory are you in?  i do not know, you do not know.  i have my guess, but it can be wrong.  so, at the juncture of picking up a new instrument which will invariably require the use of hands and arms, you may want to know about the severity of your condition.  you know what you got, just not how bad it is.

if you end up in the office of the right type of doctor,  the topic of electrodianosis and electromyography will come up.  it is a series of tests that will 1) rule in or rule out the cts diagnosis and more importantly in your case 2)provide severity and prognosis. 

depending on the result of the tests, some people will actually do better with surgery, some will not.  but that is another  topic by itself.

also be aware of a situation called Eaton's Double Crush Syndrome where the median nerve tracts are impinged at the wrist and at the neck area.  this may be important to you since as one poster pointed out the instrument will hang on your neck.

good luck!
Title: Re: carpel tunnel syndrome
Post by: fiddlefour on Nov 18, 2005, 06:50:07 AM
I wonder about the banjo player who switched to the  mandolin to relieve the cts.  To me the banjo plays  alot like a violin for the left hand, very gentle on the left hand, granted the right hand works pretty hard, but intense bluegrass flatpicking on a mandolin is just as hard.  The left hand fingering on a mandolin involves even more strength than a bluegrass guitar.  Flatpicking on a mandolin also involves the whole arm,  tennis elbow anyone?

When playing any of these instruments, correct hand, arm, and body positioning is crucial.

Title: Re: carpel tunnel syndrome
Post by: Nfkfiddler on Nov 18, 2005, 08:51:36 AM
There is a unnatural anticlockwise twist of the left hand on the fiddle that plays havoc.   I can play mando. but my playing time is seriously limited on the fiddle.
Title: Re: carpel tunnel syndrome
Post by: fidla on Nov 18, 2005, 02:09:59 PM
Ask my buddy John Rough he's been playing banjo for many years.
Title: Re: carpel tunnel syndrome
Post by: soundboot on Nov 18, 2005, 02:40:40 PM
I've just ordered one of those Flextend rehabiliation things. I spoke to somebody on the phone and they were very helpful. Suddenly things don't look so bleak for CTS sufferers. It also seems to work well as a finger gym even if you have no injury. When you own one you also have support from specialists by phone or email which makes it sound like a very good deal. I'll be reporting on this forum how it works out when I get mine.
Check out
Title: Re: carpel tunnel syndrome
Post by: amy on Nov 21, 2005, 10:58:18 PM
Been away from the computer for a few days and just had a chance to read all of your imput everyone and it's encouraging.

Reply to: Posting too:  After stopping transcription my wrists/hands healed and normal strength returned in about 7-8 months (able to open doors with knobs  one handed in about 2-3 months.  Can carry scuba tanks = weight (30 lbs.) in one hand at the present (it's been about 10 months).  At this time I have no buzzing at night unless I've been on the keyboard typing non-stop for 6-8 hours.   With that said....I'm thinking I'm in the reversible catagory as everything seems to be back to normal unless I decide to do a long stint on the computer, which I won't.  I have transcription friends who are destroying themselves for a buck.  I am the lucky one who has other employment/money options and am able to take them.   

Thanks everyone for your imput.   I've got a beginner banjo DVD I'm going to start with.  I think just starting slow should be okay and see how it goes.  Though I'd ask someone who's familiar with the territory......I hate reiventing the wheel.

Amy Jacques
Title: Re: carpel tunnel syndrome
Post by: Joe Gerardi on Nov 21, 2005, 11:07:11 PM
If it's because of the computer, I'm going to make some suppositions, that if correct, will help tremendously...

Is your keyboard set back from the end of the desk more than 3 inches? If so, do you rest your wrists on the desk when you type? If so, these 2 things are deadly in terms of CTS. I've been a computer geek for 19 years, doing heavy coding (programming) for 6 of those, with never a hint of CT. I've seen far too many people get CT because of the wrist position when they type, leaning the wrists on the desk, instead of supporting them from the arm.

If the above is true, I strongly urge you to move the front edge of your computer keyboard to the very edge of the desk.  This will force you to support your wrists with the forearms, and CT will never be an issue again.

Title: Re: carpel tunnel syndrome
Post by: Nfkfiddler on Nov 22, 2005, 08:58:05 AM
I may be guilty of this, Joe, although there is a support in front of my keyboard.   Does a similar thing apply to the mouse?

If work is effecting my fiddling I might have to give up........................
What will I do for money? :D
Title: Re: carpel tunnel syndrome
Post by: Joe Gerardi on Nov 22, 2005, 01:18:18 PM
The mouse can do it to some extent, but the angle of the wrist and flexation of the muscles is less.

Resting the wrists on a desk whilst typing causes a hard angle at the wrist. The Carpal nerve is then pinched within the tunnel, causing the damage. As a pianist, I've always typed with my hands above the keyboard, completely off the desk, and never had the slightest twinge of pain, but I was trained from a very early age at the piano never to let the wrists go weak. That said, I do wrest the wrist (:)) on my mouse pad without any ill effects. If you pivot from the wrist and don't have to lift the hand too high to work the mouse, it shouldn't be an issue. That's why I always use the older model of the Microsoft mouse: the back end is very tapered, its height is not tall, and doesn't cause a large wrist angle.

Title: Re: carpel tunnel syndrome
Post by: amy on Nov 26, 2005, 02:59:39 AM
Hey Joe,

Good insight, but not the case for me.  We had extensive training in our year long transcription school that included ergonomics.  It covered everything including the keyboard (Yep, don't rest/drop your wrists).   We covered the height of the chair in relation to the floor and the keyboard, sitting up straight, height of the back of the chair and how far forward it is, the height of the computer screen, screen glare, font size, split keyboards, foot pedals, types of chairs (the good, the bad, and the ugly).  Did you know that they even make chairs with half of the keyboard built into the arm rests?  Those are just a few of the items we covered in the ergonomics catagory.  I've gone through everything to clear up the problem.  I really liked transcription and was good at it.  My employer didn't want me to leave and the money was good.  I really liked it as I could do it at home when I wanted (I was part time.)  However, I can't cripple my of my other part time jobs is as a scuba instructor (seasonal) and the other on-call job is as a log loader operator.  I need my hands for both. 

Joe, I don't know how you're typing that much and not destroying your hands, you're doing something right or it's just an individual thing.

Title: Re: carpel tunnel syndrome
Post by: Joe Gerardi on Nov 26, 2005, 03:24:59 AM

My piano teacher was a wrist and posture nazi. If the wrists drooped, I'd get whacked underneath the wrists, and God forbid I missed a note whilst this was going on. If I slouched at the piano, he'd lean back and give me a mild slap to the kidneys. Believe you me, mild is all it takes! Morning caffeine has nothing on that for wake-up properties! So my position is such that my hands are never resting on the desk, and always hover above the keyboard. I guess that's what's saved me all these years.

Title: Re: carpel tunnel syndrome
Post by: soundboot on Nov 26, 2005, 06:05:22 PM
Well I just received my Flextend yesterday and it seems pretty good. They claim 98% recovery for CTS and RSI so good news! I'll keep you all posted.
Title: Re: carpel tunnel syndrome
Post by: woodwiz on Nov 26, 2005, 08:35:12 PM
There is a unnatural anticlockwise twist of the left hand on the fiddle that plays havoc.   I can play mando. but my playing time is seriously limited on the fiddle.

That didn't sound right to me, so I dug out my old Gibson mandolin and checked.  Anatomies do differ, but in my case my wrist angle is exactly the same when I play fiddle or mando.  I can swing my fiddle or mandolin from mandolin position to violin position without changing  the angle of my wrist or rotating my forearm.  It's seems to be a matter of getting the left elbow far enough over to the right to allow the left hand to operate freely and without strain. Maybe getting your elbow over a little farther will alleviate the problem by eliminating the strain on your wrist? Just a thought.

On another topic, the idea that you can avoid CTS by not resting your wrists on the desk might explain why CTS was virtually unknown among manual typists who had to use a lot more force to actuate ther keys, and typically typed 60 to 100 words per minute all day long on a "non-ergonomic" keyboard.  They didn't have any place to rest their wrists.

I'm changing my keyboard habits as of today.............

Title: Re: carpel tunnel syndrome
Post by: postingtoomuch on Nov 26, 2005, 09:13:25 PM
amy, great to hear about the condition you are in...usually the saying goes like this: the patient knows the best.  no one is in perfect condition after 30, hehe, in my opinion, we do what we can and try to make the most out of it.

i do want to point out one aspect of the cts as it may relate to you down the road.  severe cts will certainly affect hand muscle function, but in some mild to moderate cases which have developed over time, some other hand muscles not affected by the cts (not controlled by median n) will compensate and perform overall hand function quite satisfactorily.  once you have developed cts, even though you have completely recovered (we hope that is your case), you are still much more likely to be affected again than the average person. so, as you said, be very diligent in avoiding motions that you know will do your hands in.  as we age, we repair with less efficiency.

joe, great points on the ergometric part of hand position.  cts can be avoided to a great extent if everyone just exercises some common sense before the tingling starts.  here is my observation.   my wrists feel much less tired if i rest my elbow comfortably on a surface and type, such as the arms of a chair.  however, every time when i rest my wrists on the table right in front of the keyboard, my wrists are in extension and get tired very quickly.  i suspect if i do that repeatedly, esp under pressure for  hours, or worse, for money, i will develop cts. 

i have come across a piece of medical research before.  they got some volunteers ( i suspect starving medical students for 20 bucks) and they stuck a needle with pressure gauge on the end (i feel nauseated just thinking about it) into the wrists and made them position the wrists in different positions, such as neutral, flection, extension, etc (excuse me, i need to get some water. now  i am sweaty and feeling lightheaded)...

what they found is that the pressure is the least when the wrist is flat, with no bending.  now, i would assume your carpal tunnel will be happiest if you keep that in mind.
Title: Re: carpel tunnel syndrome
Post by: amy on Nov 30, 2005, 02:18:27 PM
Hello All,

Hey Joe...Naui.  Thinking the Nazi was a good thing although I doubt I would have tolerated his method.

Soundboot:  Yes, keep me posted about this product.  There are alot of wrist/glove type things out there for CTS.  There are many of them that claim big things, but don't produce.  I have friends who'd like to know about this product if it really works.

Posting too:  You're right, I've kinda noticed the healing process isn't what it used to be. 

Thanks all for your help,


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