Showing posts with label syndrome. Show all posts
Showing posts with label syndrome. Show all posts

Monday, April 30, 2018

Point Of Sound

One of the causes for strain, stress, injury and other maladies pianists, organists and typists experience is simply that they press too hard into the keybed of their device or instrument. Let's first take a look at sports and then physics (that HS subject you think you don't use in real life). 

As a baseball player stands at home plate and the ball is hurtling toward him, he back-swings, forward swings, hits the ball, then all the energy left over from the swing dissipates into the follow through.  The same action occurs when an athlete swings a tennis racquet, kicks a ball, swings a golf club, punches someone, throws a ball, etcetera.  That is Newton's third law of physics that every action has an equal and opposite action.  In order to forward swing, one must first back swing.  Even when we walk forward, as one leg is extending up and forward, the other leg is pushing backward.  So according to the laws of physics, in order to type or play the piano down, one must first lift up.  Many of us were trained or taught to play or type from a resting and relaxed position which actually creates tension because holding a position requires effort.  So we know that everything requires an opposite motion and a follow through.  I bet all you smart kids out there know exactly where I'm going with this.

Now imagine that our baseball, tennis, soccer, golf, football players or boxers are standing before a concrete wall and they backswing then forward swing but instead of hitting an object and following through, they strike the immovable wall.  All the energy of the swing, instead of following through and dissipating, ricochets back into the athlete.  That can hurt. 

A piano is much the same.  Many pianists press into the keybed of a piano and not only does that fail to produce any more of a tone but, all the energy of pressing down is being transferred back up into their finger joints and tendons.  We often don't notice this until after an hour or so of practice or the next morning when we wake up with stiff fingers.  We are taught by bad teachers "no pain, no gain."  In this case, it is very much a lie.  No pain, no gain is fine when building muscle but not for bones, joints, tendons, ligaments and certainly not for our technique.  Often poor technique, strain or missed notes are a result of what we are not doing rather than what we are doing and often we are using the wrong muscles.

Sit at any acoustic piano and very slowly, depress a key so you don't play a sound.  At some point you will hit a little bump in the action, then press through it and you will hit the keybed.  That little bump is the point of sound once you actually play. 

As a pianist drops the controlled weight of their arm onto a key, they must use Newton's third law.  As they hit the point of sound, much like an athlete striking a ball, they must then follow through without hitting the keybed.  When they press into the keybed, not only is their energy backfiring but, they are pressing down and according to Newton, we can't set up for the up motion if we are pressing down.  This hinders technique.  You can't play down if you don't play up and you can't play up if you are pressing down.

So, the key and cure to playing without tension or pain is learning to play to the point of sound and simply following through and not pressing into the keybed.  Unbeknownst to most teachers, their students press into the keybed.  It is a motion that is often invisible.  When a student experiences problems with technique or pain, the teacher often says practice more or run exercises to build strength and endurance and the teacher is often oblivious that the way the student practices is what needs to be addressed, not a clock.

Danger Will Robinson. Before anyone tries to learn to play to the point of sound, there are other components of technique which must first be in place.  This includes controlling arm weight, controlling up/down, controlling in/out from the shoulder and elbow, using the fulcrum of the elbow, controlling rotation of the forearm through the use of the pronator and supinator muscles.  Likewise, there are movements to avoid such as abduction, curling the thumb under the palm, isolating a finger, equalizing fingers, radial and ulnar deviation, and trying to play too relaxed, still and quiet.

A virtuoso technique looks like it is effortless and relaxed.  That is true, the fingers are relaxed because the arm does all the work.  Observers are often looking at the pianist's hands and fail to notice the elbow and arm is actually doing most of the work.  Pianists who attempt to play from the fingers and have fatigue, are told to relax so, they relax the same muscles they are continuing to use and they achieve nothing.

Once all of the proper motions are achieved and the improper ones eradicated, point of sound will just happen. Some "techniques" such as the Russian Technique, surreptitiously imbue the pianist with these movements but personally, I would rather learn the physics and ergonomics of movement rather than being tricked through mindless imitation.  Although, it works to some degree. Where it fails is when a pianist encounters a passage they can't execute and if they knew the mechanics of the arm, would be able to figure out what sort of adjustment is required to play that passage.

I once studied with a leading concert pianist in my area who didn't know what he was doing but had a phenomenal natural technique.  His instruction to me was to watch him play then imitate his motion.  That would have been fine but I already had bad habits hardwired into my brain which were getting in the way.  Since he didn't know anything about ergonomics nor physics, he had no idea how to fix me other than prescribing "practice more."

I once gave a lecture on this topic and a pianist disagreed with me about Newtons third law citing that the piano is down, not up.  The finger must come straight down onto a key.  If the pianist is playing with a "still and quiet hand" and they must also play black keys,   note that the black keys are higher than the white keys.  This results in the still and quiet pianist to stretch or twist to reach those keys which in turn create vector forces or, two muscles pulling one bone in two directions simultaneously.  This creates tremendous imbalance in the arm which controls the hand and fingers and this leads to an incoordinate technique.  Keep in mind your fingers have no muscles.  They are moved by the flexor muscles in your forearm so that is where the pianist must first play from. 

If you were to walk up stairs, your ascending leg would lift HIGHER than the next stair, then come straight down onto it.  If you tried to walk upstairs without lifting your foot higher than the step, you'd trip.  Playing the piano is the same.  We must use the larger muscles of the arm to get the fingers higher than the notes we are desirous to play.  Of course as we become more efficient, we minimize the height but make no mistake, although it may appear invisible, it is still there. Hanon knew this and prescribed the pianist to isolate one finger and lift it high but, this isolation engages the flexors and extensors at the same time resulting in strain to the long flexor tendons which leads to median nerve entrapment (AKA carpal tunnel syndrome). Remember the arm, hand and fingers can only move in one direction at a time.  By abducting, for instance, the hand gets pulled in two or four directions despite the pianist trying to play a passage in a specific direction.

I have no conclusion to this post other than don't try this at home.  Find a teacher who knows what a pronator and abductor is and work from there.

Thursday, June 16, 2016

Playing With Fire Workshop

I recently presented a workshop called "Playing With Fire" which was designed to teach people how to move ergonomically whether they are musicians, computer users or stay at home moms who make arts and crafts with the kids during the day.  There is an epidemic of repetitive strain injuries and the current treatment options presented by the medical community are flawed, destructive and unnecessary.

The first thing everyone needs to know is what causes the most common of repetitive strains: Carpal Tunnel Syndrome.  It's medical name is Median Nerve Entrapment.  If someone misuses their hands to the point that they inflame the long flexor tendons in the forearm and wrist, the inflamed tendons which now takes up more space, has no place to go.  There are bones on one side of the wrist and the traverse carpal ligament on the other.  So when the tendon inflames it presses on the only other tissue in the tunnel - the median nerve.  Much like sitting between two overweight people on an airplane.  The symptoms of a crushed nerve are pain, numbness and tingling.  The reasons for the inflammation are quite easy to understand.  The most common is a break in the wrist while performing repetitive tasks.  The other is dual muscular pulls. Obviously we can only move one body part in one direction at a time but we often move our fingers in two directions at a time.  We may flex one and either abduct or extend another. Even though we can do this, the extender and flexor muscles are still interconnected and we are using both at the same time. This act of tension usually puts all the strain on the tendons. In the piano world, our teachers either tell us to practice more, build up the muscles or relax.  That is all bad advice.  Practicing more bad movement, building up the wrong muscles and relaxing the wrong muscles will only create more problems.

When someone develops symptoms of median nerve entrapment they go to see their doctor who then begins to treat the symptom.  They may ask what you think caused the strain and may suggest that you stop doing it for a while.  This logic is greatly flawed.  If you are moving incorrectly and rest for a while, the inflammation may indeed dissipate however, the erroneous movement is still part of you and when you take up the practice again, the problem will still be there and the symptom will come back.  Symptoms are actually good.  They tell us that something is wrong.  Fix what is wrong, not the symptom.

Other treatment options may include anti inflammatory drugs, cortisone injections (which do a lovely job at dissolving tissue), splints which goes against everything we know about movement or, surgery, which is often totally unnecessary.

The actual solution and "cure" is simply movement re-education.  The patient needs only to learn how to move properly.  This could include not bending or twisting the wrist, not moving the fingers while bending the wrist, learning to not use tiny muscles to do some movements but instead use the larger muscles which are naturally designed to do that movement, learn the proper alignment of the arm and how it is the arm that must support the hand and not the hand moving independent of it, avoiding dual muscular pulls which can be crippling to the hand. 

Not everyone has the capacity, patience, intellect or determination to heal.  We've come to beleive that a doctor can fix our problems and we all want a quick fix.  Who wants to spend months or even years learning to undo bad habits when a doctor can make a slice with a scalpel and like magic, the issue seemingly disappears.  As I said, doctors tend to treat symptoms and not the problems. If the problem is we are moving incorrectly, we shouldn't be seeing a doctor.  My favorite analogy to use is if your wheels are out of alignment and wearing down your tires, you don't just get new tires, you have to fix the alignment.  If your body is out of alignment and wearing down the soft tissue in your wrists, you don't just make room for the inflammation by having surgery, you need to fix the alignment.

Thursday, December 24, 2015

Healing from Repetitive Stress Injuries Naturally


Healing from Repetitive Stress Injuries Naturally

The original video was an hour long so I made copious cuts to shorten it.  Unfortunately, the many cuts caused an audio sync issue.  Deal with it.  Close your eyes, don't watch my lips.