Playing The Violin Has Given Me Repetitive Strain Injury?
I'm violinist and get tremendous pains in my wrist and arms. At night, these sometimes run through my arm like an electric current. Painkilllers don't help. I sometimes bandage my arm, which does give some relief from the pain. Can you help?
You are suffering from what is commonly called repetitive strain injury (RSl). When you play, you hold the bow with your fingers and move the arm repeatedly. These repetitive movements use one group of muscles over and over again. The muscles get strained and then injured because they rarely get a chance to recover properly. Musicians are not the only ones affected. There are many cases of this problem occurring in sportsmen (RSl was often referred to as tennis elbow), writers, typists and other manual workers such as decorators. RSI is also a major problem in offices where computers are used. Many employees have sued their companies for compensation for work-related injury.
If you cause muscles to contract repeatedly, they will do so rhythmically until they reach a point of extreme fatigue. Then they have to rest in order to replenish their energy before starting to work - that is, to contract - again. In order to work, muscles need oxygen, which burns the glucose in the muscles, producing the waste products carbon dioxide and water. In your case, your work demands that they contract all the time with no time to rest and replenish. That means the demand for oxygen is continuous and excessive. The result is that some glucose molecules are only partially burnt off and this leads to the formation of the waste product lactic acid. It is the lactic acid that causes cramps and pain in the muscles.
The extremities of the muscles form cordlike tendons that attach the muscles to the bones. The tendons are usually white in colour because the blood supply to them is poor. (Muscles with an abundance of blood are red.) When muscles contract repeatedly with no recovery time, the tendons get traumatized and inflamed, a condition called tendinitis. While overworked muscles can recover well with rest massage and sleep, overworked tendons often don't recover fully because of their poor blood supply, so they become hard and stringy.
Your night-time problems occur because the muscles relax at night, when muscles are taut they keep tendons stretched. At night, when the muscles relax during sleep, the tendons are loosened. The body then sends blood to rectify the damage done to them by overwork. The tendons swell and pulsate as wave after wave of blood surges to them, which explains the throbbing pain. The pain may also travel down the length of the tendons, causing the sensation of an electrical impulse or current.
My advice is as follows
* Have a break from repetitive work every hour. Get up and walk about repeatedly squeeze and release the hands, wrists and arms for two to five minutes. This stimulates the flow of fresh blood to the area so that lactic acid is removed.
* At the end of the day, massage the arm with Dr Ali's Joint Oil or Weleda Massage Balm with Arnica starting from the shoulder and going down to the hand. Use your thumb to locate the sore tendons that run along the arm and massage these downwards. Using the ball of the opposite hand, briskly rub the sore area up and down so that you cause friction, which warms up the tissue. This is extremely healing.
* Take the Indian herb Haldi capsules - one twice daily for two months - which helps reduce inflammation.
* If you use a VDU, make certain that the mouse is ergonomically designed so that you do not clamp your hand around it like a claw. Or use a computer with a tracker-ball mouse, integrated into the keyboard.
* Ensure, too, that your chair is well designed and is at a height relative to the desk which leaves your fore arms parallel to the desk top and the elbow joint forming a right angle.
* Your screen should be directly ahead of you, ie, not at an angle.
* Acupunture and/or physiotherapy may help.