The Clarinetist’s Enemy: Tendinitis: Part 1
By Rebecca Rischin
Professor of Clarinet and Woodwind Division Chair
Musicians are athletes. But how often we forget! Preparing for a recital may not be as grueling as training for a marathon but it is certainly similar. Unfortunately, like athletes, musicians sometimes injure themselves in their overzealous pursuit of the finish line. Our musical race thus ends in pain instead of victory.
Among clarinetists, injuries to the upper extremities are common: among them, tendinitis, an inflammation/irritation of the tendons, the fibrous cords that attach muscles to bone. This affliction usually results from repetitive finger motion and is hence sometimes referred to as a repetitive strain injury. While tendinitis occurs more frequently in the right arm due to holding the weight of the clarinet, tendinitis can also impact a clarinetist’s left arm. Pain, soreness, and muscle weakness can ensue in the forearm, hand, and sometimes even extending to the shoulder. It is important for both performers and teachers of the clarinet to know how to prevent this serious condition from occurring and how to treat it if it does occur.
In the first part of this blog, we will discuss how vigilance in your everyday activities can prevent tendinitis from occurring. The second part of the blog will be devoted to treatment.
Before one even examines his/her clarinet technique and practice schedule, it is important to examine everything one does in daily life. We use our hands and arms for so many different daily activities, we tend to take them for granted. Tendinitis can occur from playing the clarinet, but it also can result from any of the activities below. An already-present tendency toward overuse injuries can be aggravated by these activities as well.
One of the most dangerous activities for a clarinetist to engage in, believe it or not, is using a computer, tablet or cell phone. The repetitive typing, thumb texting and excessive moving/clicking on a mouse/touchpad or use of a stylus can cause tendinitis. This is why so many secretaries are in pain! One solution is to use dictation. The dictation function on your laptop, desktop, iPad/tablet, or cell phone allows voice recognition to type for you. Dragon Dictate, a voice recognition software program, is also available for both Mac and PC. Dictation can be a savior! If one prefers to type, then it is important to use an ergonomic keyboard preferably on a pull-out tray, so the arms are at the proper angle and posture is good. Typing on a laptop is very unhealthy. Using a trackball instead of a mouse or touchpad so that one can use both hands equally instead of relying exclusively on the dominant hand can help also. When using a tablet or cell phone, try to alternate hands so that the dominant hand does not get overused.
Injuries to the dominant hand can also be caused by excessive writing. Gel pens rather than ballpoint pens and pencils are essential for putting less pressure on the hand. They save students, teachers and professors from agony when taking notes in class or writing comments for juries and competitions.
Cooking can also be a health hazard. The repetitive stirring and chopping can cause or aggravate tendinitis. Invest in a food processor so that you do not have to chop vegetables and an electric mixer so that you do not have to stir cake or cookie batter. Buy lightweight pots and pans so as not to put excessive weight on your arms and hands. Good Grips also makes various cooking utensils such as knives, peelers and can openers with ergonomically designed handles.
Never buy cheap luggage! It is just not worth it. Invest in an internationally renowned name brand lightweight rollaboard. I bought a cheap rollaboard suitcase at Walmart for a concert tour of Serbia and irritated my arm wheeling it across old cobblestone streets. Fortunately, the concerts were successful, and Walmart allowed me to return the suitcase when I came back, but immediately upon my return, I purchased online a more expensive name brand rollaboard with excellent wheels and comfortable handles. It made a world of difference! Also, travel light! If you must take a rollaboard carry-on on plane, ask your sturdy, strong-looking fellow passenger to place it in the overhead bin for you so that you do not strain your arms doing it yourself. You would be surprised: people are happy to help!
If you carry a purse, purchase a small backpack with padded straps so that the weight is distributed equally on both shoulders. Carrying heavy purses can cause shoulder injuries. Never carry two clarinets if you only need one! Unless you are playing an orchestra gig and need both A and B-flat clarinets, it simply does not make healthful and practical sense to carry two instruments. Invest in a single B-flat clarinet case with padded backpack straps so that you can relieve yourself of unnecessary weight. For that matter, make sure your double case also has padded backpack straps.
Your weekly grocery shopping can also be hazardous. It is better for your arms to carry a well-balanced paper bag with both arms than to carry a plastic bag in each arm which strains the tendons. It is also better for the environment! Take advantage of grocery delivery options or have one of the grocery workers bring the groceries to your car. Not only will this help to prevent injury to your arms, but it will help to prevent injury to your lower back.
Be careful about the type of exercise you do. Anything that uses your arms such as tennis, racquetball, weightlifting, golf, basketball and volleyball can be detrimental. Instead, try a low impact sport like swimming (breaststroke rather than crawl so as not injure the shoulders) or a sport that just uses your legs such as running or walking.
With careful attention to your everyday activities, you can prevent injury to your all-too valuable arms and hands. In our second blog, we will discuss treatment.