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#2070604 - 04/25/13 11:55 AM Exercises for rehabilitation
unnormaldude68 Offline
Junior Member

Registered: 05/07/09
Posts: 18
Loc: New York
I realized after that I posted this in the wrong section..I apologize. Please move it if possible. Thanks.

Hey guys,
I haven't posted here in a few years. I've been playing the piano on cruises around the world for a while. I never thought that I would ever find a full-time job that I loved with my music degree. I am very happy.

My problem now is, I have been home on a break for a few weeks, enjoying the nice spring weather, and stupidly got into an accident on my motorcycle. I hurt my hand pretty badly. Luckily, no breaks but it was swollen for a while. It's been almost a month now since it happened and all that's left is pain in my fourth and fifth finger when I press down on them. The muscle on the outside of my hand near my fifth finger is also still pretty sore. Moving my fingers does not hurt.

I go back on a ship in three weeks from today and I was wondering if there anyone had any advice on exercises I could do to strengthen my fingers again to prepare me for the next coming year. Surely others have injured themselves like this and needed to make the best of it to get back to work. I will be performing every day until the beginning of November (unfortunately we get zero days off), with only a three week break in between in June.

Regardless of the pain, I do need to work so I will have to just make the best of it, but anything I can do to help the process would be just great.

Thanks everyone!

Also, yes, I am aware that it was foolish of me to be riding a motorcycle as a musician. I sold it immediately. I have learned my lesson.


Edited by unnormaldude68 (04/25/13 12:03 PM)

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#2070629 - 04/25/13 12:16 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Minnesota Marty Offline

Platinum Supporter until October 5 2014


Registered: 05/15/12
Posts: 7439
Loc: Rochester MN
I would think the best approach is to consult with a neurologist and set up an exercise program recommended by a physical therapist.

Sorry about your accident.
_________________________
Marty in Minnesota

It's much easier to bash a Steinway than it is to play one.

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#2070649 - 04/25/13 12:45 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Rickster Offline


Registered: 03/25/06
Posts: 8585
Loc: Georgia, USA
Sorry to hear of your accident and your circumstances.

I wanted a motorcycle (still do smile ) but my wife, who is also severely disabled (and I am her primary care provider) did not like the idea one bit. She’s afraid I’ll get hurt and won’t be able to take care of her, and it seems that a lot of riders are hurt or injured on motorcycles at some point in time.

In regards to your injury, and, since you make a living playing the piano, I would suggest seeking out professional help. No need to take any chances there…

Good luck!

Rick
_________________________
Piano enthusiast and amateur musician: "Treat others the way you would like to be treated". Yamaha C7. YouTube Channel

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#2070661 - 04/25/13 01:01 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
beethoven986 Offline
3000 Post Club Member

Registered: 01/20/09
Posts: 3367
Sorry to hear about your accident. As far as rehabilitation exercises go, while that may be tempting, don't push your body to do things it isn't ready to do. You could very well end up making it worse.
_________________________
B.Mus. Piano Performance 2009
M.Mus. Piano Performance & Literature 2011
PTG Associate Member
Certified Dampp-Chaser installer

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#2070694 - 04/25/13 01:57 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Ataru074 Offline
Full Member

Registered: 06/22/11
Posts: 390
Loc: Houston, TX
Pay a specialist to take care of it asap. Your hands feed you, you need to take the best care of them.
_________________________
===============================================
working on:
Brahms: Op 118
Mozart: Kv330
Beethoven: Op 14 #2
===============================================

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#2070753 - 04/25/13 03:41 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Derulux Offline
5000 Post Club Member

Registered: 06/06/05
Posts: 5375
Loc: Philadelphia
I agree, professional care is the best option for you.

At a bare minimum, some therapeutic stretching, and rolling exercises, combined with a lot of ice when you're not using your hands will help a lot. Also, I would avoid using your hands as much as possible so they have time to heal.
_________________________
Every day we are afforded a new chance. The problem with life is not that you run out of chances. In the end, what you run out of are days.

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#2071736 - 04/26/13 06:00 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
JohnSprung Offline
1000 Post Club Member

Registered: 08/02/11
Posts: 1645
Loc: Reseda, California
Go to the web site for your health plan and find a doc in your network who specializes in sports medicine.

Drink plenty of water. Not coffee, not soft drinks, just plain water. That's what carries away the waste products from your muscles. Be sure you get enough protein, too. You may be able to massage the sore muscles, but check with the doc first.

Go through your charts and work out some arrangements that take as much of the load as you can off of the 4 and 5 fingers. I have permanent nerve damage on the 1, 2, and 3 of my right hand, especially 2, so I tend to finger things a little differently than most players.
_________________________
-- J.S.

Knabe Grand # 10927
Yamaha CP33
Kawai FS690

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#2071871 - 04/27/13 12:01 AM Re: Exercises for rehabilitation [Re: unnormaldude68]
Dave B Offline
1000 Post Club Member

Registered: 08/01/11
Posts: 1974
Loc: Philadelphia area
It's only been a month. Be patient. Be careful. The swelling should go down in a few weeks.

As already stated, what does your doc say?

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#2072162 - 04/27/13 02:34 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Hi Unnormal,

Did you ever go to a doc or ortho and get any imaging done? What were the results?

It sounds like what you have left over is the mid-stage healing of blunt trauma to those tissues. If you didn't strain any ligaments, and the bruising that occurred in the surrounding soft tissues is actually healing, then you got off real easy.

I strongly suggest that you run, not walk, to a really top physical therapist in your area. This is not the kind of rehab you can do on your own or without the right information. If you do the wrong thing, you could easily end up losing function in your fingers or hand.

After assessing you, a good PT will probably do palliative care first using passive modalities. These include diathermy (heat/cold), electrostimulation, ultrasound, and some forms of massage if you are far enough along in your healing. These will all promote blood flow into the affected tissues and speed healing intracellularly. You'll heal a lot faster with them.

They will probably do that first. When you're healed enough, and the swelling and bruising has gone down, and things don't hurt nearly as much as they do now, they might try to do more active things like myofascial release, light stretching and some exercises IF YOU NEED IT. However, those small muscles in the hand and forearm don't benefit from strengthening or work hardening unless there's been actual wasting of the tissues, the limbs present a great decrease in the range of motion, or there's been some other loss of function. Don't do that kind of thing on your own, or you could really get into trouble. If you try to strengthen too early for example, you'll just end up damaging the tissues more.

Different tissue types heal at different rates depending on their blood supply:

1- Skin and Muscles and Non-cartilaginous Membranes, lots of blood flow - days to weeks.
2- Tendons and Fascia and Synovia, less blood flow - weeks to months.
3- Ligaments, even less blood flow - months to years.

You probably injured all these types of tissues in your finger and hand, so you should not expect an overnight cure. There isn't one for the tissues with poor blood flow like ligaments. That's why you need all the help you can get.

You haven't said, but does it hurt to play the piano? If it does, it's probably still going to be hurting when you get back on that ship. There's still plenty of time to make new arrangements that favors your current limitations, ones that don't hurt at all to play. I know, you're making a face right now. Nobody's going to hear it except the other musicians.

Here's one worst-case scenario I hope you avoid: You don't get any care before you leave. But you still get a bit better. It's only sort of uncomfortable to play, so you get on the ship, change one or two things, but stick pretty much to the old song book in every other way. Several days or a week after your departure, you suddenly get serious pain in your fingers/hands accompanied with a noticeable swelling somewhere. Now you really can't play! You try, but it just gets worse. You are now the one-armed bandit on a cruise ship where the director is annoyed with you. They let you off at the first stop. You come home, they don't ask you back, and it takes much, much longer to get better this time.

If you're not seriously better before you leave, could you possibly skip this trip and do the next one?

A last word about your diet. As long as you have noticeable swelling, bruising/contusions, or a lot of pain, you are still healing. You'll need to increase you intake of a few micronutrients during this period:

Vitamin C- 2 to 4 grams/day
Calcium- 1 gram every day
Magnesium- 400 mg every two or three days
Protein- 1 gram/pound of body weight

You'll also need to restrict alcohol consumption and stop smoking altogether if you do smoke. Too much alcohol, and any cigarette smoke at all, suppresses the immune response so that it takes much, much longer to heal.
_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2072275 - 04/27/13 04:48 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Rickster Offline


Registered: 03/25/06
Posts: 8585
Loc: Georgia, USA
Originally Posted By: laguna Greg
Hi Unnormal,

Did you ever go to a doc or ortho and get any imaging done? What were the results?

It sounds like what you have left over is the mid-stage healing of blunt trauma to those tissues. If you didn't strain any ligaments, and the bruising that occurred in the surrounding soft tissues is actually healing, then you got off real easy.

I strongly suggest that you run, not walk, to a really top physical therapist in your area. This is not the kind of rehab you can do on your own or without the right information. If you do the wrong thing, you could easily end up losing function in your fingers or hand.

After assessing you, a good PT will probably do palliative care first using passive modalities. These include diathermy (heat/cold), electrostimulation, ultrasound, and some forms of massage if you are far enough along in your healing. These will all promote blood flow into the affected tissues and speed healing intracellularly. You'll heal a lot faster with them.

They will probably do that first. When you're healed enough, and the swelling and bruising has gone down, and things don't hurt nearly as much as they do now, they might try to do more active things like myofascial release, light stretching and some exercises IF YOU NEED IT. However, those small muscles in the hand and forearm don't benefit from strengthening or work hardening unless there's been actual wasting of the tissues, the limbs present a great decrease in the range of motion, or there's been some other loss of function. Don't do that kind of thing on your own, or you could really get into trouble. If you try to strengthen too early for example, you'll just end up damaging the tissues more.

Different tissue types heal at different rates depending on their blood supply:

1- Skin and Muscles and Non-cartilaginous Membranes, lots of blood flow - days to weeks.
2- Tendons and Fascia and Synovia, less blood flow - weeks to months.
3- Ligaments, even less blood flow - months to years.

You probably injured all these types of tissues in your finger and hand, so you should not expect an overnight cure. There isn't one for the tissues with poor blood flow like ligaments. That's why you need all the help you can get.

You haven't said, but does it hurt to play the piano? If it does, it's probably still going to be hurting when you get back on that ship. There's still plenty of time to make new arrangements that favors your current limitations, ones that don't hurt at all to play. I know, you're making a face right now. Nobody's going to hear it except the other musicians.

Here's one worst-case scenario I hope you avoid: You don't get any care before you leave. You get a bit better. It's only sort of uncomfortable to play, so you get on the ship, change one or two things, but stick pretty much to the old song book in every other way. Several days or a week after your departure, you suddenly get serious pain in your fingers/hands accompanied with a noticeable swelling somewhere. Now you really can't play! You try, but it just gets worse. You are now the one-armed bandit on a cruise ship where the director is annoyed with you. They let you off at the first stop. You come home, they don't ask you back, and it takes much, much longer to get better this time.

If you're not seriously better before you leave, could you possibly skip this trip and do the next one?

A last word about your diet. As long as you have noticeable swelling, bruising/contusions, or a lot of pain, you are still healing. You'll need to increase you intake of a few micronutrients during this period:

Vitamin C- 2 to 4 grams/day
Calcium- 1 gram every day
Protein- 1 gram/pound of body weight

You'll also need to restrict alcohol consumption and stop smoking altogether if you do. Too much alcohol, and any cigarette smoke at all, suppress the immune response so that it takes much, much longer to heal.

Excellent post, Greg!

When I first saw the OP, I thought about you. I’m glad you decided to chime in with your excellent advice and expertise.

Rick
_________________________
Piano enthusiast and amateur musician: "Treat others the way you would like to be treated". Yamaha C7. YouTube Channel

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#2072285 - 04/27/13 05:01 PM Re: Exercises for rehabilitation [Re: Rickster]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Rick,

Thanks so much for the kind words!

BTW I saw your blues song. That video is great, you have the perfect voice for that kind of thing, and your C7 sounds absolutely amazing!

_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2072420 - 04/27/13 08:51 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Rickster Offline


Registered: 03/25/06
Posts: 8585
Loc: Georgia, USA
Originally Posted By: laguna greg
Rick,

Thanks so much for the kind words!

BTW I saw your blues song. That video is great, you have the perfect voice for that kind of thing, and your C7 sounds absolutely amazing!

Thanks, Greg.

Yes, I do like blues and boogie-woogie (for better or worse smile ). The thing about blues is that if you are feeling depressed already, it does seem to make you feel better. And, if you are not feeling depressed already, it can put you in that frame of mind… smile

In regards to the OP, I like your suggestion about not playing if it hurts, and to allow time to heal.

I have some trouble with my right shoulder at times, (due to heavy lifting and hard work in the past) and playing the piano can aggravate that sometimes. When it flairs up, I take anti-inflammatory medication and use an ice pack every night. The ice pack seems to help a lot.

Plus, getting older doesn’t help either. smile

Rick
_________________________
Piano enthusiast and amateur musician: "Treat others the way you would like to be treated". Yamaha C7. YouTube Channel

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#2072449 - 04/27/13 09:55 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
unnormaldude68 Offline
Junior Member

Registered: 05/07/09
Posts: 18
Loc: New York
Thank you so much everyone for your input. It's great to know we have such helpful members around here smile

It doesn't hurt TOO much to play piano anymore. My pinky and fourth finger are weak and just ache a bit if I press too hard.

The only imaging I had done were X-rays. I saw a hand specialist and he said that it should heal on its own and to do some light stretching. They did not give me an MRI.

I have basically just been using a stress ball and light hand grip. I can really only hope for the best here and take it as easy as possible before I go back to work.

I'll update as it gets closer. Thanks everyone.

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#2072771 - 04/28/13 11:39 AM Re: Exercises for rehabilitation [Re: unnormaldude68]
unnormaldude68 Offline
Junior Member

Registered: 05/07/09
Posts: 18
Loc: New York
Also, thank you so much Greg for your very detailed response. I unfortunately cannot skip this trip...but I will take everything you said and try to follow your advice. Thanks for the nutritional recommendations. I will make sure to follow that. It's really appreciated!

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#2072834 - 04/28/13 01:58 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Hi Un,

That is all very good news, and I'm very happy to hear it. The doc must have thought that you did not seriously tear or stress the ligaments.

You do not say specifically what you mean by "pressing" on your fingers. I'm assuming you mean when you "press" on them when you play. Or do you mean pressing on them with the fingers of you other hand?

In either case, stop doing that! Don't stress those tissues any more than they already are. They are healing, and this just constitutes further abuse and will prolong recovery if you do it a lot.

As you re-work your charts, keep in mind that the substitute arrangements you come up with MUST NOT HURT AT ALL TO PLAY. When the tissues are perfectly healthy, the physical stresses of playing are minimal and your hand can withstand them just fine. But if the tissues are not perfectly healthy, discomfort or pain means you are damaging the tissues further, and carnage will ensue.

This is not a permanent thing, but you'll have to use your best judgement about when to go back to the original arrangement. That may be a few months. You'll know when to go back to the old arrangements because certain moves will stop hurting. Like my mother used to say, if it hurts, don't do it! Be very patient.

Now, about that exercise ball. Does it cause you any discomfort when you use it? If it does, stop doing it for the time being. You haven't lost any actual strength or coordination because of this injury. But tissue function is compromised because it's been damaged and is still healing, so it will seem to you like you have. Myself, I'd ditch the ball for now.

But having said that, how does it feel to do the dishes? Activities of Daily Living (ADLs) are the real test of a recovery. When doing the dishes, or cleaning the toilet, or carrying the bagged groceries, et cetera, doesn't hurt, then you are well in to recovery. If you really want to do something to increase the range of motion, or strength, or test your coordination, clean the house until it starts feeling uncomfortable. Then stop.

OK, I'll stop bossing you around now. I really hope your recovery goes well, Un. Write back and let us all know how you're doing.
_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2072839 - 04/28/13 02:13 PM Re: Exercises for rehabilitation [Re: Rickster]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Originally Posted By: Rickster


Plus, getting older doesn’t help either. smile

Rick


Rick, that's not aging. That's abuse.

I have just the thing for you: (look at me dispensing free advice and bossing people around today!)

http://www.activerelease.com/

I've sent several hundred RSI cases to these people in CA over the years, most with good outcomes. It's the perfect alternative first-round of treatment for overuse injuries. ART saved my shoulder when I strained rotator cuff muscles in the gym trying to do something I shouldn't have.

You'll need to find a good practitioner, somebody who can also diagnose as well as treat. That's why I usually refer to a chiropractor as they are actually doctors, with good diagnostic training as well as experience in physical medicine. Nevertheless, use your judgement in picking a provider. There's a providers' search page where you can find one in your area. If you don't have any nascent arthritis, and the joint capsule is in fair to good condition, then this could be a effective therapy option for you. Send me a PM or email if you have any questions.

Cheers!
_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2072961 - 04/28/13 05:10 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
unnormaldude68 Offline
Junior Member

Registered: 05/07/09
Posts: 18
Loc: New York
Hey greg.

By "press" I mean pressing on the keys of the piano. It's not too bad but I do feel a little aching when I do it. When I use the stress ball, I do feel slight discomfort, but not quite pain. I do feel like I've lost strength, because in my left hand, I can bend my pinky individually down to touch my palm, but cannot get anywhere close with my right (injured) hand. You do seem to know very much what you are talking about so I will stop my use of the stress ball for a while until it gets even better.

ADL's don't hurt much, it's really a residual ache that I feel in that area. The worst part is the muscle on the side of the hand (closest to the pinky). It's very sore still, but if I massage it the pain goes away temporarily, so I have been doing that.



Edited by unnormaldude68 (04/28/13 05:11 PM)

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#2072990 - 04/28/13 05:55 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
LFL Offline
Full Member

Registered: 12/06/12
Posts: 72
In terms of regaining strength and flexibility, in addition to what you are already doing, I might recommend the Schmitt preparatory exercises for the piano. I have an old book from Schirmer's that I use once a week or so. Don't know what the availability is now.
_________________________
Shigeru Kawai SK5L

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#2073008 - 04/28/13 06:18 PM Re: Exercises for rehabilitation [Re: laguna_greg]
bennevis Online   content
5000 Post Club Member

Registered: 10/14/10
Posts: 5526
Originally Posted By: laguna_greg
That's why I usually refer to a chiropractor as they are actually doctors, with good diagnostic training as well as experience in physical medicine.



Chiropractors (and osteopaths) are not qualified doctors - they don't have medical degrees, unless they're already doctors who also do chiropractic as a sideline, and have done a course in the latter.
_________________________
"I don't play accurately - anyone can play accurately - but I play with wonderful expression. As far as the piano is concerned, sentiment is my forte. I keep science for Life."

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#2073100 - 04/28/13 08:27 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Minnesota Marty Offline

Platinum Supporter until October 5 2014


Registered: 05/15/12
Posts: 7439
Loc: Rochester MN
As in the many fields of clinical medicine, the credentials and certification must be understood. A Chiropractor may or not be a "doctor." If (s)he holds a DC - Doctor of Chiropractic Medicine - (s)he is most certainly a medical doctor. It is a different field of practice, but that does not mean that it is invalid.

A PA-C or Nurse Practitioner is not a "doctor," but they hold full clinical status.

An interesting consideration is that an MD or DC is not the equivalent of a PhD. That is the true doctoral level of mastery.
_________________________
Marty in Minnesota

It's much easier to bash a Steinway than it is to play one.

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#2073136 - 04/28/13 09:12 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
Anne'sson Offline
Full Member

Registered: 11/25/12
Posts: 158
Loc: El Paso, TX
I'll add to Marty's comment that in the United States, at least, the D.O. (Doctor of Osteopathy) is fullly the equivalent of the M.D. In fact, the training for the two degrees is virtually indistinguishable.
_________________________
Anne'sson
El Paso, TX

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#2073150 - 04/28/13 09:26 PM Re: Exercises for rehabilitation [Re: bennevis]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Originally Posted By: bennevis
Originally Posted By: laguna_greg
That's why I usually refer to a chiropractor as they are actually doctors, with good diagnostic training as well as experience in physical medicine.



Chiropractors (and osteopaths) are not qualified doctors - they don't have medical degrees, unless they're already doctors who also do chiropractic as a sideline, and have done a course in the latter.


Ben, it is important that one finds a good provider. The news is full of providers who are as ambitious as they are lacking in talent. There are ways one can use to find someone who will actually help instead of just fleecing your pocket. That goes for MDs too.

However, what you are saying is not entirely true. I can tell you that you definitely should not say that to a DO, or you'll get your face slapped.
_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2073182 - 04/28/13 10:29 PM Re: Exercises for rehabilitation [Re: unnormaldude68]
laguna_greg Offline
1000 Post Club Member

Registered: 04/02/13
Posts: 1382
Loc: guess where in CA and WA
Originally Posted By: unnormaldude68
Hey greg.

By "press" I mean pressing on the keys of the piano. It's not too bad but I do feel a little aching when I do it....I do feel like I've lost strength...


Originally Posted By: unnormaldude68
ADL's don't hurt much, it's really a residual ache that I feel in that area.


Hi Un,

Look, you don't know me at all, and you haven't asked me to consult with you. So whatever I tell you, feel free to take it or leave it. Consider me just another poster here on PW, someone who is full of bile and thinks he knows what he's talking about; these forums are full of us! After all, it's your hand, and your career, not mine. You are not my student, nor am I legally designated your service provider, conservator or fiduciary...

...but if you were my student, and an insurance claim was involved, this is what I would say to you:

1- If you go back to the piano, it cannot hurt AT ALL. If it does, I would not release you to go back to work. In the states in which I consult on Work Comp claims, returns to work are a formal legal procedure that require a (sometimes lengthy) written report from me, a progress note from the physical therapist, a signed form from the doc, and a form filled out and sent to the Work Comp Board of Appeals and the Insurer at the same time. If you couldn't demonstrate to me (and often the nurse case manager as well) that you could play at a minimum 2 hours pain-free, in 30-minute continuous sets with 5-minute breaks in between (no matter how you accomplish it, with your nose even), I could not write such a report or I would be committing fraud. After all, your work day will extend from 6 to 8 hours or more. If you can't play for even 2, the outcome can only be bad.

Can you play for 2 hours pain-free yet? This scenario is called a stress test. I am not there to observe you, so it's entirely up to your own judgement whether you can withstand such a test or not. What would happen if you played for 2 hours solid, today, right now? I don't recommend you try it yet, as the way you describe your condition the outcome probably would not be good.

2- You probably haven't lost strength yet; it's too soon for that. Instead, you've lost function, unless there's some other medical issue you have not disclosed here (which is perfectly fine, you don't need to tell us). As you heal, function will return. If there's been a loss of function after you heal, the proper intervention can probably restore it.

3- When your strength and comfort in your ADLs return to 90% of their pre-injury level, then you can start testing your limits. Until then, get the bag-boy to carry your groceries (which is what I tell everybody). At this point, you are the only one who can make that determination.

4- By the way, have you reported the injury to your employer? In many states, employees are legally required to report such injuries, work-related or not. You realize that if you go back to work not fully recovered, you are creating an increased liability for them if you don't get much better than you are now. It's something to consider. If you go back on the ship and things get worse, they will not appreciate it that you created a potential situation where a claim can be made against them. And that's how they'll see it.

5- HOWEVER, if you make those new arrangements that don't hurt to play (in the way that I mean it), and you work on your recovery, there's nothing to report, is there?

One last thing. That worst case scenario I mentioned is an actual case history of mine, unpublished as yet. The injury was not a blunt trauma like yours, however, it was a bilateral RSI. I started working with the guy just after he got put off his cruise ship. It took 1.5 years of treatments before he was recovered enough to start working at the keyboard again.

Let me know what you think!
_________________________
Laguna Greg

1919 Mason & Hamlin AA
1931 Bechstein C - now sold
http://www.triangleassociates-us.com/about_us (my day job)
http://en.wikipedia.org/wiki/Dorothy_Taubman (a recent article I wrote about one of my teachers)

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#2073281 - 04/29/13 04:55 AM Re: Exercises for rehabilitation [Re: laguna_greg]
bennevis Online   content
5000 Post Club Member

Registered: 10/14/10
Posts: 5526
Originally Posted By: laguna_greg
Originally Posted By: bennevis
Originally Posted By: laguna_greg
That's why I usually refer to a chiropractor as they are actually doctors, with good diagnostic training as well as experience in physical medicine.



Chiropractors (and osteopaths) are not qualified doctors - they don't have medical degrees, unless they're already doctors who also do chiropractic as a sideline, and have done a course in the latter.


Ben, it is important that one finds a good provider. The news is full of providers who are as ambitious as they are lacking in talent. There are ways one can use to find someone who will actually help instead of just fleecing your pocket. That goes for MDs too.

However, what you are saying is not entirely true. I can tell you that you definitely should not say that to a DO, or you'll get your face slapped.



You probably have different criteria in USA, but in the UK, a chiropractor or osteopath is NOT medically qualified and is NOT a doctor - unless he already holds a medical degree. You don't address them as 'Dr.....' here - they'd be quite surprised if you did. Similarly, someone with a PhD (Doctor of Philosophy) can be addressed as 'Dr. so-and-so' but he cannot call himself a qualified doctor.

Do osteopaths and chiropractors treat heart and lung disease or cancers in USA?
_________________________
"I don't play accurately - anyone can play accurately - but I play with wonderful expression. As far as the piano is concerned, sentiment is my forte. I keep science for Life."

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#2073326 - 04/29/13 07:36 AM Re: Exercises for rehabilitation [Re: bennevis]
CC2 and Chopin lover Offline
1000 Post Club Member

Registered: 01/12/06
Posts: 1981
Up to this point I've tried to steer clear of commenting on this thread, but I see that it is veering into some very questionable territory on many different levels. First, I will suggest if the OP would like to PM me, I will be happy to make some recommendations for his rehabilitation. Second, a Chiropractor is NOT a medical doctor, (not even close from the standpoints of level of training and legal position) and a Physical Therapist makes diagnoses/prognoses, relevant to the musculoskeletal condition of his/her patient, as a regular part of their evaluation. An Osteopath, in the United States anyway, certainly IS a medical doctor and can do EVERYTHING an MD can do (surgery, prescribe/order medications, diagnose and treat, oversee other medical professionals). In fact, at the hospital where I work, The Chief Hospitalist, (a physician specializing in the full time treatment of acutely ill patients in a hospital setting and employed directly by the hospital), is a D.O., and supervises over 35 MD's. Thirdly, the idea that a patient cannot return to function until they are completely pain free actually flies in the face of established rehab principles. Most of the early rehab we do is moderately to extremely painful for the patient, especially after surgery or trauma. If we waited until they were pain free before we initiated range of motion, stretching and strengthening activities, they would have already developed contractures and scarring that would make their rehab twice as long and twice as painful to accomplish. The trick is, to be able to understand and diagnose the varying sources and reasons for their pain, and to avoid pain that indicates exacerbation of the originally damaged tissues. Lastly, regarding PhD versus MD, DO or DPT, the statement made was misleading. For instance, in the field of mental health, a Psychiatrist with an MD is considered several levels above a psychologist with a PhD, from the standpoint of level of training, residency and fellowships they do, being able to prescribe antipsychotic, antidepressant, psychotropic and other related medications, and also from the standpoint of holding the position of Chair and Director of the Department of Psychiatry at any major hospital.


Edited by CC2 and Chopin lover (04/29/13 08:57 AM)
_________________________
Piano Technician/Tuner

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#2073353 - 04/29/13 08:54 AM Re: Exercises for rehabilitation [Re: unnormaldude68]
Minnesota Marty Offline

Platinum Supporter until October 5 2014


Registered: 05/15/12
Posts: 7439
Loc: Rochester MN
CC2,

Please see my first entry in this thread. Rather than advice from non-clinicians on a web site, I believe this to be sound advice.

An M.D. is addressed as "doctor," but he does not hold a Doctorate.
A D.O. is addressed as "doctor," but he does not hold a Doctorate.
A D.C. is addressed as "doctor," but he does not hold a Doctorate.

As I mentioned in my second entry, their area of expertise is different and I wanted to counter the unstated implication that an osteopath or chiropractor was a "quack." That is simply untrue.

Anyone, in any field of study, who holds a PhD is rightly addressed as "doctor." A PhD-Music is a doctor, should be addressed as such, but is probably not the best choice for treatment of a hand injury.

A Psychiatrist would not necessarily hold a PhD. They would, however hold an M.D. or D.O. before speciality study. A PhD in a medical or research field of study, would not be a clinician unless a they held an M.D., D.O., or D.C. That would simply be a double degree status. A Psychologist holds a PhD, is a clinician, but their practice is not medical.

This will ruffle some feathers, but a medical degree is technical, and a PhD is academic. Academia is, indeed, confusing.
_________________________
Marty in Minnesota

It's much easier to bash a Steinway than it is to play one.

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#2073364 - 04/29/13 09:10 AM Re: Exercises for rehabilitation [Re: Minnesota Marty]
CC2 and Chopin lover Offline
1000 Post Club Member

Registered: 01/12/06
Posts: 1981
MM, here is an excerpt from the provided link in Wikipedia:

Quote:
Professional
See also: First professional degree
Professional doctorates are awarded in certain fields where scholarly research is closely aligned with a particular profession, such as law, medicine, or psychology. Examples include the US and Canadian degrees of Doctor of Medicine (M.D.), Doctor of Osteopathic Medicine (D.O.) ,Doctor of Dental Surgery (D.D.S.), Doctor of Dental Medicine (D.M.D.), Juris Doctor (J.D.), and Doctor of Ministry (D.Min).
Professional doctorates originated in the United States, with the introduction of the MD at Columbia University in 1767,[13] almost 100 years before a research doctorate—that is, a PhD—was awarded in that country, at Yale in 1861.[14] The JD was introduced in 1870, just a few years after the PhD.[15]
The term Professional Doctorate is used to refer to research doctorates with a focus on applied research, or research as used for professional purposes.[16] Among others, these include the degrees of Doctor of Business Administration (DBA), Doctor of Strategic Leadership (DSL), Doctor of Public Administration (DPA), Doctor of Social Work (DSW), Doctor of Biblical Studies (D.B.S.), Doctor of Law and Policy (Lp.D), Doctor of Practical Theology (DPT),[17] Doctor of Professional Studies (DPS or DProf), Doctor of the Built Environment (DBEnv)[18] and some others in various specified professional fields. Also included in this area is the Doctor of Education (Ed.D.).
In Australia, the term is on occasion applied to the SJD,[19][20][21] and on other occasions that degree is also categorized as a research degree.[22][23]


Here is the full article:

http://en.wikipedia.org/wiki/Professional_doctorate#Professional

MD's and DO's are absolutely considered Academia, and, in fact, are considered faculty in Teaching Hospitals throughout the country.....without being required to hold PhD's! Chiropractors do not possess Doctorates. I have a CLINICAL Doctorate in Physical Therapy, but can also teach in an accredited school of Physical Therapy, although most of the full time teachers at the PT school do go on to acquire PhD's in research or other specialty areas, such as Human Anatomy or Education
_________________________
Piano Technician/Tuner

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#2073370 - 04/29/13 09:25 AM Re: Exercises for rehabilitation [Re: unnormaldude68]
Minnesota Marty Offline

Platinum Supporter until October 5 2014


Registered: 05/15/12
Posts: 7439
Loc: Rochester MN
And your point is?

As I stated, Academia can be confusing. Credentials and licensure are different from degree attained. A clinical doctorate is not a PhD. Neither is an M.D.
_________________________
Marty in Minnesota

It's much easier to bash a Steinway than it is to play one.

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#2073371 - 04/29/13 09:26 AM Re: Exercises for rehabilitation [Re: CC2 and Chopin lover]
CC2 and Chopin lover Offline
1000 Post Club Member

Registered: 01/12/06
Posts: 1981
Here is an additional page from George Washington University's website:

http://www.gwu.edu/practice-based-doctoral-programs
_________________________
Piano Technician/Tuner

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#2073373 - 04/29/13 09:28 AM Re: Exercises for rehabilitation [Re: Minnesota Marty]
CC2 and Chopin lover Offline
1000 Post Club Member

Registered: 01/12/06
Posts: 1981
My point is, you said this:

Quote:
An M.D. is addressed as "doctor," but he does not hold a Doctorate.
A D.O. is addressed as "doctor," but he does not hold a Doctorate.


And you are wrong. Go read your own post, instead of trying to argue with me
_________________________
Piano Technician/Tuner

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