Hi,

I have a Grade 8 Piano exam in 4 weeks. I pretty much have 2 of the pieces completed (although far from consistent) and half way through the 3rd piece. I only really started studying these from the beginning of May and am happy with my progress.

Although, these last few days I've started to feel an ache at he bottom of my left thumb. Now, in these pieces I'm having to play hand shapes and fingering I've never played before and wondering if that's the cause.

Should I be resting it now ? The logical answer is yes although I don't want to stop my progress in case it's nothing. Obviously with the exam coming up too I don't want to be under-prepared.

Would be interested to hear people's advice and experiences...


Mike

Ooh, I wouldn't count an ache as nothing; I'd say that's your thumb trying to tell you something. I'd rest it all today, if it were me, and if it is just as bad tomorrow, get it checked out. Far better to miss an exam than do lasting damage, IMHO.

Well I haven't really played much since posting this 2 days ago and now I've started to notice the ache spreading to other areas. I'm wondering if my, now, inactivity is not helping.

I am very very reluctant to pull out of the exam - mostly because it cost so much and I don't have that money to waste. Also, I've spent a lot of time and effort these last few weeks getting 2 of the pieces to a really good standard.

Now though I'm starting to worry.

The odd thing is that I posted a topic along these same lines exactly a year ago with a then Grade 6 piece I was studying. I didn't realise it was my post until afterwards.

I've contacted a highly respected ABRSM examiner who has been around for many many years for help and hopefully some good will come of that.

But at the moment I'm sat here thinking how much time I have and how I'm wasting time by not finishing the 3rd piece.

Sorry, I know it's a bit of a vent but any advice I can get on this I'd appreciate. Resting seems to have made it worse. I've been looking up information on RSI (which I assume it is). and not really had much luck finding any practical solutions (other than dipping my arms in warm water).

The only technical thing I think can be causing this is tension in my hands - but tbh I don't feel tense in them.

It's not like I sit here practising for hours upon hours like I know many of you do. I also wonder how much of this is a pyschological thing.

Any practical advive or other experiences I'd really appreciate to hear.

Thanks

Mike

I think that's highly unlikely. Ignoring injury could do lasting damage and ruin your chances of further progress.

If you get medical advice and evidence that you are unable to play I think you would be able to get a partial refund of fees, but you need to notify the Board before the date of the exam (haven't check the details of this).

Have a look at the Web site of the British Association for Performing Arts Medicine (sorry, haven't got the url).
It's possible to do a lot of useful work without even touching your instrument, e.g. working out the best fingerings, thinking about balance between the hands, planning dynamics, thinking about phrasing.You mentioned that the ache was spreading to other areas. Your whole body is involved in playing the piano, not just your hands.

I hope you get it sorted out successfully. Your long term physical well-being is more important than either money or any exam.

I seem to remember reading somewhere that you might be able to postpone an exam with a doctors note.

I'm not an expert at all, but if it is muscle strain then warmth will help as will get the blood flowing, bring vital nutrients to the tissue, and cart away lactic acid etc. You might want to try Tiger Balm as well (an organic alternative to deep heat rub). While I can not vouch for the results, it might help relax the strain- but dont overdo it. It is hurting for reason. Go see a doctor if it doesnt heal up soon.

Hi Fatar760, I'm by no means an expert, and I am not medically trained, but I do know about problems with tension and pain when playing the piano, so I may be able to help you a bit.

Could you perhaps name the piece you are playing that causes the pain and indicate when during the playing the ache comes on? Also, is it there as soon as you start playing, or does it appear after a while/a certain point? And does it happen when you play anything else? Does it take a long time to go away, or does it start to stop when you put your hands down after playing?

When you say the pain is getting worse and spreading, where to? and is it the same feeling? Finally, is the pain definitely an ache, or is it a sharp pain?

Hi Cadence,

The piece that I believe sparks it off is Cimarosa's Sonata in D Minor (it was actually Sonata in F from Grade 6 last year that caused the same feelings of discomfort). The piece is particularly quick in the last 3rd but it's actually the big stretches that I believe cause it). At the moment though it seems to have stayed with me despite not really playing the piece much for over a week.

The ache itself is coming and going. It initially started at the base of my left thumb. However, I'm now starting to feel it on the base of my little finger and a little in my arms. It's also started in the right side too. It's not a sharp pain by any means. Just a feeling of discomfort (maybe fatigue) that seems to slowly come and go - but frequently enough for me to have concerns about it. I wouldn't say it is coming or going at any particular points of practise...i can feel it when i drive, i can feel it when i sit and eat...I can't relate it directly to a piano activity.

I must say it has been a particularly stressful and emotional time these last few weeks and wonder if its a form of RSI that is being triggered physcolgically.

RSI is rather a vague generic term, and you would probably find it helpful to get a more specific diagnosis from your GP. Tendinitis, synovitis, and carpal tunnel syndrome are all quite common in musicians but require different treatments. Also, they are unlikely to be 'triggered psychologically'.

Instead of vaguely musing on a message board, can I encourage you to get down to your surgery asap!
Best of luck.

That has problems of its own as I've only recently moved to this area and need to find a GP. Felt like asking other musicians their opinions and experiences first might be of more help, particuarly under the time scale. But yes, a trip to the GP is something that needs to be sorted sooner rather than later.

Also, I'm not trying to be vague - I'm trying to be upfront with how I am feeling,

I have just woken up, having had a very vivid bad dream (that included me playing a piano) with my fingers in pain. It's these kind of things that make me think it's partly pyschological.

As I said before, I am by no means a medical expert and I was actually at first reluctant to say anything when I first saw this thread, so please don't take what I say as point.

The discomfort in the base of your thumb and little finger could well be caused by not releasing tension as you are playing, or from a bad or an awkward hand position. But from what you have described, it doesn't sound like this problem is a result of unreleased tension from piano playing. The fact that it is coming and going and indeed that it starts even when you are not playing is significant. Tension build-up can be gradual or intense, but once you have relaxed the muscles in question, it will stop and not continue until those muscles are stressed or tensed again.

Tension from playing also usually occurs in your fingers, hands, forearms, upper back and maybe shoulders. It would be quite difficult for there to be any muscle tension created in you sides unless you were sitting very very oddly!

I would sincerely suggest that you visit a doctor or homeopath. It doesn't matter that you are not registered yet - you can go to a surgery as a walk-in patient and they should sign you on temporarily.

Don't leave this much longer, because aside from the fact that you are in discomfort, if you don't find out what it is, it might end up affecting your playing in the long-term.

If you are able to, please phone a private physio, who will be able to see you today if they have space. My own physio is in Camden and costs £45 for the first visit and then £40 for half an hour follow up treatments. It really is not worth leaving because more damage WILL occur if left untreated. I am not a doctor but speak from personal experience.

OK so update time...

I went to a walk in clinic this morning and saw a GP - Despite numerous communication problems (I had to explain to her what RSI was...!!?) she told me to rest, take Ibuprofen and apply Deep Heat.....these were all the things I was telling her I was doing. I have since registered with a GP.

I've also spoken to the board and they've managed to move my exam date until the week after. THis means I can rest a week and not really be any further behind. They also explained to me the proceedure should I need to withdraw.

I've also managed to find a piano teacher who is also an ABRSM examiner who I'm really hopeful will help guide me in the right direction.

Oh - and I've been to the gym - hoping this will help (maybe transferring muscular pain to a different part of my body )

I understand this is a difficult topic for people to comment on but I still appreciate any advice or people's experiences.


Mike

I had to go to the doctor two weeks ago because I too have ache/pain at the base of both thumbs although the right one is worse because I am right-handed.
He told me I have tendonitis and because I am a pianist, he is recommending me to a Muscular-Skeletal specialist to see if something can be done to help.
In the meantime and this is easier said than done, he told me to rest it as much as possible.
I do notice that when I am not using it as much, eg trying to open cans etc it is not so bad.
I suggest you get some medical advice. It is impossible for women to rest the hands -there is always something to be doing/turning/lifting!
Good luck and hope your exam goes well whenever you decide to do it.

Barbara

Given your impressive list of qualifications, including Grade VI piano and other grades in other instruments not to mention (unless I'm misreading it) Piano coach, I'm somewhat at a loss to understand why you might need guidance from an ABRSM examiner. Still, good luck with the exam, and I hope the pain goes away soon.

Well like I explained to you in your post about your son - I believe anyone can study for an exam. The reason why I enter myself for these exams is to have a focus and an aim to practise. All of my exam results have been over 140. So I'm clearly a capable player and the fact that I work and get positive feedback and results (with regards to my teaching and professional performances) proves I am decent at my job!

However, I don't believe I know EVERYTHING about my instrument and I believe that learning an instrument is a life long thing. I explained in a different thread about my reasons for seeking a teacher (think it was called 'Looking for a Teacher in East London' or words to that effect. )But basically, having someone to sit beside you listening and being objective about your playing and pieces is crucial to improvement. It would be arrogant to think I know everything (a certain son springs to mind at this point )...and who better to guide me than someone who is not just an ABRSM examiner but also an assoicate of the RAM who has taught colleagues of mine and comes highly recommended.

If the pain I am getting is down to problems with technique (which I'm not sure it is) then I can't ask for anyone better to help me, in my opinion. Also, having someone test me on the sightreading and aural tests from the grade is also extrememly beneficial.

Thank you for your well wishes

So is learning to use your body in a way that maximises its potential and does it no harm.

I've now had time to look up the details of the British Association for Performing Arts Medicine, which I mentioned briefly in an earlier email.

http://www.bapam.org.uk/index.php

Extracts from the information for performers on their Web site:

* We run free, confidential health assessment clinics for professional, semi-pro and student performing artists. Clinics are provided by leading specialists in Performing Arts Medicine who volunteer their time. Patients can be referred from our clinics to the best medical, surgical and therapeutic help available.
* We hold an online Directory of medical doctors, physiotherapists and other healthcare practitioners including counsellors, who have special expertise in treating performing artists.
* We have a library of health information resources for performers. Through our health-promotion work, we help artists and those who train them to understand what it means to be a healthy performer.

Are you suffering for your art?

If you are a performing artist you know how important it is to be in peak condition physically and psychologically. Even minor injuries and illnesses can affect your ability to perform at your best. Yet you may make minor health problems worse by carrying on practising or going on stage when you shouldn’t – and storing up problems for the future. Above all, you want to be sure that any medical practitioner you see will understand your particular needs.

Free BAPAM assessments are available in:

Bath
Birmingham
Cambridge
Cardiff
Dublin
Glasgow
Hull
Leeds
London
Manchester
Newcastle
Portsmouth

Call: 020 7404 8444


This person may be ideal for your needs in many ways, but they may not have the type of expertise you need right now. I hope you get your problems sorted out satisfactorily.

That's a really great site dacapo - thank you!

I will get in touch with them today

Ok so big day today. Off to see my new GP this morning and then to my new teacher this afternoon.

I'm starting to feel that pulling out of the exam and just recovering maybe the safest option (I've got a show in late July for 7 weeks that I don't want to cancel!).

So, wish me luck peeps


Mike

Yes Yes Yes Yes Couldn't agree more! And Good luck in buckets. Don't be upset tho, if you are told to rest and pull out of the exam, it could save you a whole lot of pain later and even more inactivity later. Could you consider preparing another piece which does not give you gip?

Thanks Jane!


The GP told me to rest and prescribed some strong anti-inflamatory's. He also advised that i rest and has referred me to a physio with an urgent request for an appointment.

I then went to see my teacher this afternoon. He is brilliant and was increidbly helpful. He says I have good technique and thinks the cause of the injury is just over-playing. He also gave me plenty of suggestions about the pieces and areas that i should focus on.

The most important thing he probably taught me though was how poorly edited this syllabus is....this is particularly useful for my teaching as I'm having to correct lots of the suggestions on the music and wondered if i was right to do so. Another reason this is helpful though is that I don't have to worry about certain things that are suggested that are frankly out the style and crippling to play.

He also says I have natural instinct and am certainly past a Grade 8 standard but that I should get my injury sorted out first.

Good, your teacher has been so helpful. If you don't rest it now, you could severely restrict your abilities in the near future, let alone the long term one.

I've noticed that the some of the music colleges seem to have good research departments, but do not match their findings with their exam material. Don't forget though, that from what my husband has told me from his own experience, what is correct for you, could be incorrect for someone else. Although I must qualify that with the remark that his injury was bought about by overuse of the computer keyboard. He is not a musician. With careful management though it is possible to carry on.

The tutor books for beginners although good resources all seem to focus around middle C. If anyone can remember a book from about 30 plus years ago, Thomson/Thompson (?), yellowish cover, paperback, A4 size and certainly a bit different in material from the current publications, I'd love to hear from you, particularly if you have a copy, and can give me full author/publisher details.

I'm certainly thinking very carefully about advice for beginners and how to get good results, and not necessarily from hours and hours of practise from the first lesson. I tend to say more like 10-15 minutes, and build up slowly over the weeks and months, in short bursts with warm ups, and not too heavy on scales and broken chords/arpeggios, little and often and no pain is ever worth the music. I'm now waiting for a deluge of complaints, but I have to wear splints, not all the time, and no way do I want to pass that little habit on to my pupils.

Ok update time...

I've rested a lot since last Monday and have been taken the prescribed medication. I'm still waiting to hear from the 'urgent' referal to the physio department - despite my frequent chasing up. On Friday I tried doing some simple stretches and felt really great for the rest of the day.

Then, on Saturday morning I woke up at 6.30 with a numb tingling all down my left arm. That stayed with me for about 3 hours and so went to the hospital to get it checked out. The GP I saw there said I didn't have RSI / tendonitus (as the previous GP had said) but that I in fact had tennis elbow. He suggested ice packs (which I'd been taking anyway) and advised I continue with the medication.

I woke up on Sunday night with an horrific cramp in my right arm after suffering another bad dream. This stayed with me most of the day. On Monday I went to Bapam, the musicians clinic that dacapo recommended. There I saw another doctor who carried out tests on my hands and arms and said i didn't have RSI or tennis elbow and that i maybe had a little strain. He advised i go off the medication and that i don't let this become a pyschological thing.

He also suggested that I do regular warm ups / stretches before and after playing. Like any muscle if you train it too hard without warmup you risk injury and I think I've done this too frequently. I'm not so sure how many of us do things like stretches before practise sessions or performances but I know I always do before i act, sing or go to the gym...so then why not before playing piano?

At this moment my arms feel warm and i do get twinges. I think the fact I'm waking up after 'nightmares' and then feeling pain in my arms could suggest part of this is physcological although I am concerned that after seeing 3 doctors they've all told me different things. It's no real wonder I'm confused.

I hope this thread is useful to anyone who may one day go through the same thing.

Thank you for the update. This thread has been useful in that it has made me think again about how I advise beginners, especially, to practise (although I do tell them always that if they ever feel any discomfort they must stop immediately).

I'm sorry you have had such a bad time of it and I do hope things will right themselves soon.

I'm not sure why it should be psychological, though. I'd have thought the nightmares are happening because you are in pain.

Actually it's had the same effect on my teaching too. I'm starting to take more time checking that they are using their bodies correctly along with all the other areas I pay close attention to.

I'm not sure how much I believe what I was told on Monday. The fact is my arms burn when I play and I'm not so sure it is a pyschological thing.

I'm very confused about it all at the moment and think I may go back to Bapam to see a different doctor.

Perhaps you could set up a webcam in your bedroom. Not for anything kinky, but because you might be suffering disturbed sleep and tensing up in some particular way. You have mentioned waking after nightmares.

My husband won't believe me when I tell him he has been wrestling with satan in the night; rigid, jerky grunting, calling out and more than once hitting me quite hard during one of his spasms. I wait for the episode to pass and he wakes up in the morning completely oblivious until I tell him about it- and then he thinks I am the one who is mad. One night he WILL hurt himself.

This may be completely off-centre but it might be worth exploring whether you are generally tense and this is a transferred symptom.

hehe it's a good idea although I reckon having my computer on as I sleep would probably keep me awake anyway

Have decided to pay to see a physio today...and then, no sooner am I off the phone then a physio calls me from the hospital offering me an appointment for next week (this is what my doctor 'urgently' referred me for nearly 2 weeks ago!).

So hopefully today will set me on the right track and then next thursday will continue that and I won't have to cancel the upcoming show.