Piano World Home Page Forums Our Most Popular Forums Adult Beginners Forum Odd pain in elbow

Ah, the certainty of youth.

How refreshing

The only thing I'm now certain of is my occasional fallibility

Well, I had epycondilitis and the circumstances, correlation to piano playing, symptoms and general lack of other health problems, makes it almost certainly an epycondilitis. Or better yet, considering the symptoms, within the typical kinds of tendons/muscles damage it is certainly epicondolitis (not tendonitis, not carpal tunell, not tenosynuvitis) But there's a small chance it might be cause by something else like sclerosis, disc compression, herniated disc ... but very unlikely.

I find myself being a virtual desert of medical knowledge, unless it pertains to me. So I will bow to your expertise.

I do however have an unending supply of one-liners.

"All Indians walk in single file. At least the one I saw did."

I pluck out as most apt.

Or could I just be "pulling your tail" metaphorically speaking

Go for it Blackbird.

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Well it's certainly not just a matter of anecdotal personal evidence. When I suffered from it I researched it extensively in order to find out what it was, why it occurred and how to speed up the healing process. Believe it or not, even my physician admitted I knew more than her, and in fact her diagnosis and advices had been very superficial which is why I chose to contact an expert. Even the expert (an orthopedist) didn't seem to know much and actually provided standard information to every patient. I found more luck in consulting an ortho-physiatrist specialized in repetitive strain injury and hands anatomy, from the same clinic where my mother had her carpal tunnel operation.

Maybe "certainly" it's a strong word, but I'm pretty sure that a specialist, rather than a physician, will confirm what I have said. It's certainly not tendonitis nor tenosynuvitis.

Maybe I just needed to say "probably" instead of "certainly" in order to avoid this reproach, but that's being very finicky, expecially in the context of a forum. :p

I'm experimenting with some 18th century technique (playing on fingertips which are kept in a straight line). My elbows are not happy. Interesting but irritating.

I am alarmed to read the posts on here and see that I probably have epicondylitis. Here are some details of my case and I would be delighted to hear any comments.

I started getting slight twinges in my elbow 3 months ago. At the time I was doing about four hard 90 minute practising sessions each weekend. I was also doing some resistance work in the gym. At first I thought the problem was caused by the gym as I felt a slight twinge while doing triceps exercises.

For a couple of months the problem didn’t get better or worse. At times it seemed to be better after the weekend (when I’d had a break from the gym) and at times it seemed to be better after the working week (when I’d had a break from the piano).

For the past month I have stopped playing the piano totally and stopped the exercises. It hasn’t showed any improvement. In fact it is slightly worse. It’s not painful but I get twinges when doing lots of simple things like tying up shoe laces and brushing my teeth.

The problem seems to be in the upward motion of the wrist or fingers, not the downwards one. I feel a stiffness if I lift my hand against strong resistance.

If I press on my elbow in exactly the right spot there is a pain. It’s hard to find the spot but it appears to be exactly where my hand tendons join the humerus.

I saw a doctor today and was advised to take NSAIDS and get some sports massage.
The doctor thought it was a different problem from tennis elbow (as the symptoms are irregular) and didn’t recommend a steroid injection. The only time I have had a problem with piano playing before was tendinitis in the wrist, which was brilliantly cured by a single steroid jab and never returned.

Do you folks think a steroid injection would help? When you talk about a wrist brace, is that specifically to defuse stress while playing the piano or is it for permanent wearing?

I like it that people have shared their experience and the treatments that have helped them; I've had some similar experiences and it sounds to me like the advice is sound. But no one here is able, or really has any business, prescribing steroid injections or diagnosing your problem sight-unseen. You need to be in the care of a specialist qualified to treat injuries of this sort. It could save you a lot of time, limitation, and pain. Besides that, a piano teacher who knows how to work with players who have injuries (which is a lot of us) could be of great help.

What can I say--- welcome to old age. We have to adapt.

NSAIDs, as someone asked, are the class of drugs called NonSteroidal Anti-Inflammatory Drugs: it includes aspirin, ibuprofen, naproxen sodium and some prescription-only drugs, but not acetamenophen (Tylenol). Even though they're over-the-counter, they too have their hazards. Your doc can help you get the most of of them.

The muscles in the arm that bring the back of your hand towards you (extension) are about 10% of the strength of those that pull your hand under (flexor). Flexing the fingers to an extreme causes the hand extensors to work harder (never mind why). Hfffoman, does your hand lie on the keys relaxed? I bet it doesn't, my guess is you shape it. And welcome to PW.

Be very, very careful with this! This is how tendinitis starts. Once it gets bad, the tendon can be damaged and will never heal. Put ice on it and rest for several days.

In my case and possibly in yours, it can be caused by overly-tight muscles in your forearm (the ones that work your fingers). They end up pulling on the tendon and over time cause inflammation and damage. The little twinges you feel come from the tight muscle pulling on the inflamed tendon.

If the problem continues, go see a sports medicine doctor. Treatment usually involves physical therapy to ease the tightness and build up supporting muscles. If you get it taken care of soon and remain careful, it will not plague you for the rest of your life.

In my case, the pain is very rare now and I can play piano as much as I like. Unfortunately, I have been unable to return to the guitar and may never be able to do so thanks to this problem.

tjbsb: I gave up guitar for that very reason
and switched to piano! ...the problem was only in the left forearm..

The mention of Lateral Epicondylitis had me stumped ... so I looked it up ... and it's just the medical word for Tennis Elbow.

Been there, done that. Not from tennis nor from piano. It was from arm exercises at the gym. I guess I over-did it.

The "cure" was an elbow compression strap thingie, and arm rest. It took months to fully resolve. That was at the age of 49. It's been 4 years, and it hasn't returned. (But I don't do arm exercises any more ... maybe that helps.)

Thanks for all your comments.

Keyboardklutz you're right, I was taught (years ago) to work my fingers like little hammers lifting them up before striking. I found it a wonderful way of acquiring control but it does tighten the forearm muscles. I have been trying not to do it but I guess my hand still isn't as relaxed as it should be.

tjbsb, your case sounds very like mine, so I am encouraged. I am glad I caught it before it got bad. The pain is really at a very low level but I am concerned because I have given it 3 weeks rest without it getting better.

It's interesting that L Horwinkle has had trouble caused by arm exercises in the gym and he (she) is the same age as me. I am still not sure how much of my problem was caused by gym and how much was piano. I could sometimes feel the twinge while doing triceps curls and shoulder presses so I have stopped doing those and stopped bicep curls as well. I am still doing chest presses and lateral pulldowns which don't stress the elbow (I hope I am right about that).

So how much time did you spend wearing your elbow / wrist support? does it help while playing the piano?

I saw a very good professional today. He did some massage to loosen the forearm muscles and I felt an immediate difference. It's a good technique called ART (Active Release Treatment). He said I should go back to playing the piano and see what happens. He sounds very positive. One of his patients is a professional cellist who has been unable to play for 3 years with a similar problem, but even that he says is on the way to being cured. He thought the Ibuprofen would have more impact on the symptoms than the underlying injury but I guess I will take it for a while, using the try-everything approach.

Has anyone tried the dietary supplement Cortaflex? It seems to work on horses and I know a sport therapist who takes it all the time, presumably because she is so appalled at the state of the people coming in her door that she is determined not to end up like them.

I bought the DVD and book by - the name escapes me for a moment - a Canadian pianist who focuses entirely on forces and anatomy. It looks interesting but will take a lot of time and effort to try it out.

I have got to get this sorted. I have a new Bluthner 7'6 grand and I want to play it all the time!

FYI -- The pain can persist for a long period of time even when you rest. The massage is a great idea. Icing the painful area a couple times a day is also very effective as it helps reduce the inflamation. Asprin helps too.

As it was explained to me the steps to recovery are (1 & 2 happen more or less at the same time):

1) Get rid of the inflammation. Sometimes this involves a (painful) cortisone shot into the affected area. The brace can be a help with this but it didn't work for me.
2) Release the tension in the muscles that pull on the tendon. Massage does wonders here. You can also apply heat at home and learn some simple techniques to keep the muscles in your forearm loose.
3) Build up other muscles and adjust activities to avoid problems in the future. In my case, strengthening weak shoulder and back muscles was key. Many folks have poor posture at the desk or piano that has to be fixed.
4) Learn to recognize early signs of trouble as it will likely bother you from time to time. Use ice, rest and asprin to help keep inflammation from becomming severe when you feel pain.

That'll be Alan Frazer - a lot of talk, not much in the way of trousers. I may be able to get you in to see this lady: http://www.youtube.com/isstip Though she's not well at the moment. BAPAM used to send their difficult cases to her - they're certainly worth contacting.

Can't help my self. I just skimmed through this thread. I haven't been on the Forum for sometime. I am a piano teacher and teacher of the Alexander Technique. There was a part of the original post that seems to be overlooked. You said that you only experienced the pain when trying to play loud. It seems to me that you have some idea of what you need to do to play loud that needs some examination. Loudness is achieved with speed (acceleration of the descent) not force. See what you're up to. You might discover your own way out of this mess!

First of all sorry for kicking this old topic (and sorry for my bad English).

I already knew this forum but this time Google send me here. Instead of just reading I'll post a reply to ask for some advice
What Hfffoman wrote is exactly my story. Especcialy the "It’s not painful but I get twinges" part.

For me, when spreading my left hand playing octaves, tenths, arpeggio’s, breaking chords gives me an irritating feeling in de left elbow. The problem is that it’s not always hurting or irritating so I can’t "call" the pain... I don't know if it's a tennis elbow or something else. I've seen a doctor but as always when he asked me to do some hand exercises it suddenly doesn't hurt '-_-

I know my technique comes short (only been playing for two years) but if anyone recognizes his story and has a good treatment I would love to hear it!

I really hate this injury and don’t know what to do. Play, play less, don’t play at all… It just doesn’t seem to make a real difference and I just want to play Piano without an irritating elbow!
If I stop playing piano I get very frustrated, feeling horrible and sad and don’t find any rest in my head... So everytime I took one week rest I started to play again. I'm tinking about taking total rest for at least a few weeks from now on (and have my piano lessons concentrate on technique). Hopefully it will have a positive effect..

If your experience is at all the same as his, you're not properly teaching your body (fingers, wrists, arms, elbows, shoulders, torso) how to familiarize with, and execute the technical demands of such pieces.

Let me first point out that nobody addressed this gross negligence the OP admitted to exacerbating:



This is a big misunderstanding regarding how technique is developed. Let me first assume that the pianist in question knows how to position them-self in front of the piano (which is a big if given he came across as self-taught and never posted a video of his playing/practicing for evaluation by forum members nor said he had asked a qualified instructor for a personal, visual evaluation) and move forward from that [major] assumption and quote one such qualified instructor on the definition of piano technique:




As far as how to practice and develop technique in regards to specific pieces? You need to slowly and meticulously practice the demands (often first one hand at a time) perfectly (which is why you have to - and want to - go slow both at first and in 90% of all practicing). If done properly, your brain will process and memorize the information you've been feeding it (neurological, aural, visual, etc.) and speed it up for you both while you sleep and while you're simply just away from the piano doing other activities (http://www.pianofundamentals.com/book/en/1.II.15). This is why you want to practice everything you do perfectly lest your brain memorize things wrong.

"When you think you are practicing very slowly...slow down some more. You spoil everything if you want to cut corners. Nature itself works quietly (I'd like to re-emphasize this point as most everyone underestimates and/or just misunderstands how the brain works). Do likewise. Take it easy. If conducted wisely, your efforts will be crowned with success. If you hurry, they will be wasted and you will fail." - Franz Liszt

Thanks for your reply..
Yesterday night I was a bit desperate.. But when my pianolessons will start again I'll have my Piano teacher focus on technique. I'm also seeing a Physical Therapist for musicians/body posture correction, she gives me all kind of "core muscles" excersises. Someway it is hard to believe that working your core would have influence on your elbow but it's all about posture she says.

I'll spend my time ear training excersises, piano theory and listening for at least the next few weeks. Hope to recover soon and get back on the one thing I love to do more than anything else!

I had pain in my elbow when I re-started my piano playing a couple weeks back. I thought it was due to playing some heavy arpeggios without finger strength, but I consulted my two sisters who are doctors and they showed me that the pain in the elbow is due to the tendons from motion of the wrist only. They are not related to fingers. Moving your wrist up and down is the main cause, but also lateral motion of the wrist if you are keeping your body in a fixed position but moving your arms on either end of the keyboard causing your wrists to not be straight.

You need to let it heal completely before tackling exercises that exacerbate this problem. Although I'm not sure if there is any muscle building that could help, I think it is more important to perform stretches before playing.

You can see some stretching exercises somewhere in this video, can't remember which point exactly: https://www.youtube.com/watch?v=j9h10HLLC9E

Oh, I think it also depends on which part of the elbow. I am referring to the soft fleshy part on the outside of the elbow (between the two main protruding bones).