A: You didn't mention your instrument.
Trigger Finger or, stenosing tenosynovitis, is a condition where your finger gets stuck in a bent position and you have to snap it open.
Various tendons originate in your forearm and run down to the tips of your fingers. Your tendons are encased in a sheath and everywhere where there is a bend, like a garden hose, your tendon sheath can kink. Your tendon can also develop scar tissue or nodules on them causing them to get caught in those kinks and this can lock them in place. Your tendons actually glide through the sheath and stretch.
The cause for this scar tissue or nodules or kinks is misuse of the fingers and has nothing to do with overuse. If you move improperly all movement is overuse. Move properly and overuse doesn’t exist.
There are four basic muscles which move our fingers; abductors which spread them apart, adductors which pull them together, flexors which flex your fingers and extensors which straighten them out.
Abductors are weak muscles and when, say, a pianist, abducts and flexes at the same time, most do, they are using two muscles to move one bone in two directions. This creates a dual pull or vector force and one or both of the tendons become strained. This can create tension, cramps, fatigue, pain, uneven playing or micro tears to the tendon. Since tendons don’t have a direct blood supply, they are VERY slow to heal and the body places scar tissue there as a quick fix. Scar tissue does not stretch and the next time you strain the same tendon, it tears further creating more scar tissue. Since the scar tissue is cumulative, eventually the fatigue and uneven playing becomes sharp pain or the fingers lock.
The solution is to learn to move properly by working with a teacher who actually knows what they are doing. This requires a knowledge of physics and anatomy - not just music. Good luck finding such a teacher. Many THINK they know about technique but they don’t. Pedagogy is often rooted in what virtuosos feel and how it appears they are playing, not the actual invisible movements under “the hood.”
An example of this is the Carrezando technique. When a pianist moves properly with in/out, up/down motions, as the arm moves the hand around there is a sensation of caressing the keys. The caressing is the end result of the arm movement but this was not understood so they taught pianists to force caressing into their playing which created tension. Relaxed fingers is the result of other larger muscles working. You can’t relax the muscles you are trying to use. So when a student complains of cramps an unknowing teacher might suggest they relax but, relax what? The better teacher will instruct them on the proper muscles to use so that they can actually relax the improper ones causing the cramps.
Your flexor muscles are strong but fatigable. Your abductors are very weak. Regarding the thumb, if you are a pianist, many pianists are taught to cross the thumb under the palm for scales and arpeggios but the thumb’s tendon intersects with the index finger’s long flexor tendon. When you cross under, they grind together resulting in nodules. In addition, the thumb’s flexor is under the palm. The thumb was designed for gripping and that is why its flexor is there. When pianists play down on a key with the thumb, they use its abductor, its weakest most fatigable muscle.
So instead of using the wrong and weakest muscles, a good teacher will teach the student to use indefatigable muscles to play. For instance, gravity combined with a forward shift, combined with pronation and up/down, the thumb can then play effortlessly and with great speed without using any of its grasping muscles.
Isolating any finger is bad for our anatomy because they are interconnected. That is why playing an instrument must involve the combination of several muscles so that no one single muscle or tendon is misused.
Most musicians’ first teachers often don’t know what they are doing and allow their students to develop these improper motions or bad habits and these errant movements instantly become hardwired into our brains. It has been my experience that most people either don’t have the intelligence, patience, discipline nor dedication to rewire their brains to move properly. It can take time to undo years of misuse.
Another movement never to do is pinching with the thumb. Especially with the index because, again, the intersecting tendons. This also isolates two fingers. All five fingers are designed to move in the same direction at the same time. When a pianist gets that into their playing, they will develop effortless playing. It is sometimes called “tapping.” Likewise, they must never press into a keyboard for when you push into an immovable force, it is pushing back. This will only strain the player. It would behoove a pianist to learn to play to the point of sound, not the keybed. Point of sound is that little “bump” you feel when you slowly depress an ACOUSTIC piano key down without making a sound. You will first feel a point of resistance then it gives way. That is the point to play to. No further. The end result of that? Carrezando.
A good technique is the end result of proper movement. You can’t brow beat it into your hands. A teacher who prescribes exercises, demands more practice or says to relax doesn’t know what they are doing. Problems of technique are fixed by adjustments and fixing what you are doing wrong.
-Malcolm Kogut.
