Hopefully I can help you a bit! First, a little background about me - I have broken my wrists twice each and my left elbow twice as well, and I have chipped my mid-lower back before. lol - Too many horse accidents!
Okay, I used to get really bad RSI while I was studying at UNI - I was practicing for about 4-5 hours a day excluding gigs, jams and teaching. The pain would start in my wrist and hand, shooting really painfully up my arms. It is the most uncomfortable, unusual and frightening thing (not to mention painful).
For the short term
the only way to stop it hurting was to put my arms and hands in a sink of warm water for 10mins before playing and then only practicing for short regular busts. After each practice I would rub heating lotion in to my arms to help the blood circulation. I would make sure that I would practice carefully and stop BEFORE it started to hurt (You can tell just as it's starting to push it too much and so stop).
Sometimes I had to put an ice pack on because my arms would get really swollen and hot - this was particularly so during jazz gigs last year when I had to play 'dance' music for 4 hours in a trio and I was the only soloing instrument.
For the long term
cure I went to the music library to do some research and spoke to many different teachers about techniques. Due to my injuries I found that the 'correct' positions (for posture and hands) described in music text books did not work with how my arms and muscles had developed, so I had to work on finding my own posture. I also found that it is as much a mental battle
as it is a physical one.
A technique that really helped me a LOT - and this has really helped for very difficult passages in classical works, such as Liszt, Beethoven Sonatas, Rachmaninov, etc - is to use circles
. Basically this means imagining doing circles with your hands and wrists that move throughtout a phrase or hand pattern.
How to do it (hope this is an OK explanation - if not, post me):
- Make your shoulders and elbows very relaxed so that if someone were to move them, there is freedom of movement
- Try putting your finger tips on the desk and without moving your shoulders do circles with your wrist. Your hand will have to be completely relaxed, and yet your fingers firm to stay stuck to the desk
- Try moving your wrist up and down, side to side, round and round etc. Even your fingers should be free to move in the motion - but don't let go of those fingertips!! Note that when you go down, there is a feeling of weight from your whole arm due to it being relaxed. These are the movements you need to do when you are playing. You use it for phrasing, dynamics, unusual hand positions etc. Everything in other words.
Basically this exercise makes you very aware of tension vs relaxation. You want your fingers to be doing a lot more work, rather than tensing up your hands, wrists and lower and upper arms, which have been effected by RSI.
So in summary, I have no problems with RSI now. And now I can play very difficult pieces without too much trouble becuase my technique is good enough for it. Before it was always the case of understanding and knowing what I want to play, but never being able to play it. Now both playing and knowing are on a par with each other, more-or-less. The only time I get pain now, is if I sit at a new piano and the stool isnt the right height - I just get pains in my back where I broke it!
Hopefully this will help you a bit. I hope so.
"Given how rarely your lh plays scales in 'real' music, should you be trying to tackle the problem by 'strengthening' it?"
Lots of pieces have scales in them and fast linear movements for the LH - Beethoven, Rach, Liszt, etc for example. Strengthening is great (using weights etc) but mainly working on the movements and minimising tension is the best way to play these pieces.