Welcome to Flute Friday!
As I am currently in bed suffering from the traditional pre-holiday winter cold, I was inspired this week to discuss one of the most common performance related conditions: Tendonitis. Sometimes referred to as “tennis elbow” or “golfer’s elbow,” Tendonitis is an inflammation or irritation caused by microscopic tears of the tendons (tough, flexible, fibrous bands of tissue that connect muscles to bones). Prolonged repetitive movements of smaller muscles often cause this condition, such as those used in sports, performing a musical instrument, or prolonged practice of the Ibert Concerto. The type of pain associated with Tendonitis may vary from general, localized soreness to shooting pains up and down the inner arm, depending on severity. It is not a fun condition to encounter. Tendonitis has become prevalent in music schools throughout the country and deserves to be discussed, dissected, and dismantled.
Several years ago, when I was an eager college freshmen music performance major, I developed Tendonitis in my left arm after countless hours practicing Mozart in preparation for the school’s annual concerto competition. What started out as a mild soreness in my wrist quickly developed into persistent shooting pains beginning at the base of my elbow moving throughout the length of my forearm. I performed a painful version of my concerto for the competition but soon after was instructed by doctors to rest my arm until the pain subsided, however long that may be. That turned out to be 4 months. For 4 months at the beginning of my music school career, I hobbled around campus with my left arm in brace, observing lessons and rehearsals from the balcony as a spectator rather than a participant. I went to physical therapy, took some much-needed Alexander Technique lessons, and stuck to my evening ice pack like glue. Although I eventually regained use of my left arm and could return to performing, to this day whenever I have been practicing too long without taking a break, I can still feel the pains in my left arm reminding me to stop. Damaged tendons stick with you forever, therefore it is imperative to act ASAP whenever you begin to feel any performance-related pain.
Have you been experiencing pain in your wrist or elbow? What steps can you take to improve the situation?
1. MOST IMPORTANTLY – Take a break. This should be the golden rule of flute playing. Do not practice more than 1 hour without taking a 15-minute break to stretch and relax. I know how easy it is to become fixated on a passage (one more time! I can nail it this time!) but it is not worth the pain or physical harm that will develop later.
2. ICE IT! I was never a big fan of ice melting down my arm each night while I was trying to heal but this step was crucial to the rehabilitation process. Invest in a reusable ice pack or use a bag of frozen peas applied directly to your forearm. Apply for 15-20 minutes at a time.
3. Take an anti-inflammatory medication. Anti-inflammatory over-the-counter drugs such as Advil help target pain in the tendons. 3 pills every 4-6 hours does the trick.
4. Sign up for Alexander Technique lessons. This was extremely important to my healing process. With the help of my instructor, I could pinpoint exactly how I was misusing my arms, back, and neck in daily practice and retrain my body to hold itself properly to avoid future discomfort.
5. Switch to an offset G. I purchased a new flute shortly after my Tendonitis subsided, switching from an inline G (which required my small ring finger to over-stretch to reach the G key) to an offset G which did not require as much physical work to achieve the same results. Today, you may purchase extenders for the G key as a temporary fix until you can switch permanently to an offset G.
6. Rest it. This is difficult (I know) but give yourself ample time to rest your arm if you are in pain and slowly return to practice in 15 minute increments.
7. Participate in physical therapy if required by your doctor. This part was very painful for me because the doctor would test the limits of my strength each week, but it was also very helpful in measuring my healing progress. Discuss reasonable goals and timelines regarding your return to performing.
8. Find the beauty and simplicity IN listening to music if you are benched. This is also very difficult because you will want nothing more than to hop on stage and rejoin your group as quickly as possible, but if you are assigned to the balcony while you heal, use your time to observe what works well in your performing groups and what you can learn simply by witnessing the music making process.
9. Wear an arm or wrist brace. Make sure to get one with a decent metal or plastic support rather than the cheaper braces that fit over your wrists. There is a significant difference in comfort and the supportive frame will help you recuperate faster.
10. Stretch before playing. Simple wrist and arm stretches will strengthen your muscles and increase flexibility before a long practice session.
11. Accept that the healing process will take time. Do not try to force your body to heal faster than possible because it will not listen to you.
Have you ever been diagnosed with Tendonitis? What were your strategies to heal and return to performance? What worked well? What was challenging? Please comment below!
Take care of yourselves and your flute playing!