warm up marimba.pdf | Carpal Tunnel Syndrome | Hand

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Stretching for Pain-Free Performance BY ANDY HARNSBERGER Imagine life without the use of your hands. We use our hands so instinctively in our day-to-day life (especially as percussionists) that it is natural to sometimes take their health for granted. But because they are made up of a complex structure of muscles, bones, ligaments, tendons, and nerves, your hands are prone to damaging conditions such as repetitive stress injury, carpal tunnel syndrome,
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  Stretching for Pain-Free Performance BY ANDY HARNSBERGER Imagine life without the use of your hands. We use our hands so instinctively in our day-to-day life (especially as percussionists) that it is natural to sometimes take their health for granted. But because they are made up of a complex structure of muscles, bones, ligaments, tendons, and nerves, your hands are prone to damaging conditions such as repetitive stress injury, carpal tunnel syndrome, and tendonitis. The inside of the wrist contains tunnels, called carpal tunnels, through which the major nerves median, ulnar, and radial pass. This “median” nerve, which controls motor and sensory distribution in the hands and fingers, is sometimes compressed. Constant pressure on the carpal tunnel can obstruct proper blood flow and nerve transmissions to the hands and fingers causing numbness and tingling. This condition is referred to as Carpal Tunnel Syndrome. Compression of the median nerve can be caused by tendonitis or a combination of flexed wrist with significant grip force requirements and repetitive movements – the same types of motions we use as percussionists. These stresses are commonly associated with cumulative trauma disorders of the hand and wrist, known as Repetitive Stress Injury. Carpal Tunnel Syndrome and Repetitive Stress Injury symptoms are marked by pain, inflammation, and numbness and tingling. RSI can be the result of repetitive finger motions and/or extended muscle contractions in the forearm and wrist; it can be aggravated by playing percussion instruments, as well as other daily activities .  In a previous article, “Don’t Forget to Warm Up!” I discussed daily warm-ups and technical exercises for the marimba. I mentioned that you are using very delicate muscles and these muscles   need to be warmed up BEFORE you use them. Just as athletes incorporate stretching into their warm-up routine, so should you stretch before you start to play. I am speaking from experience. Throughout my career, I have had numerous problems with my hands and wrists. I have had Ganglion Cysts on both of my wrists, torn the muscles in both thumbs, and been diagnosed with Carpal Tunnel Syndrome and Repetitive Stress Injury - all of which can be the “kiss of death” if you make your living as a performer. After talking with several specialists, I attributed most of my problems to not stretching and/or not warming up and practicing properly. I knew that if I wanted to continue performing often, I would have to change my habits. Now I follow these three simple rules: stretch/warm-up slowly, practice slowly, and ice my hands at the end of the day to take care of any swelling that has accumulated during the course of practice sessions. When I do these things consistently, my symptoms disappear, and I can practice and perform for hours. When I neglect these things, my hands and wrists get overworked and I experience the pain associated with the ailments listed above. In our profession, our wrists and hands are going to be overworked on a daily basis. That is just the nature of our business. Exercise cannot prevent these injuries – and if you are in the midst of a flare-up, a workout or a practice session may aggravate it. However, if you are NOT already experiencing symptoms, stretches for the hands, arms, and shoulders can help. I am not a medical doctor, so if you are experiencing problems, you should consult a professional. I have found that putting ice on my hands and wrists is an excellent way to decrease the symptoms of Carpal Tunnel Syndrome, Tendonitis, and Repetitive Stress Injury. Taking a small amount of vitamin B-6 (50 mg) will also help increase circulation to the nerve endings. The following stretches were designed by Michelle Hill, OTR/L, a certified occupational therapist in Nashville, TN. These are stretches that have worked wonders for me. Do these moves before your practice sessions, before you pick up a stick or mallet. You should never feel pain when doing these exercises, just a gentle stretch.    Stretching for Pain-Free Performance 1. Shoulder and Hand Stretch: Lace your fingers together and turn your palms away from your body as you extend your arms forward at chest level, keeping your shoulders back and down. Hold for 10 seconds, then lower your arms to your sides and repeat 5 times. Stretches the shoulders, forearms, and fingers. A 2. Overhead Stretch: Lace your fingers together and turn your palms away from your body [A], then extend your arms overhead, allowing your elbows to bend slightly [B]. Hold for 10 seconds, then lower your arms and repeat 5 times. Stretches the upper torso, shoulders, and fingers. B   3. Arm Stretch: Hold your right arm straight out in front of you and bring it across your chest toward your left shoulder. With your left hand, grab behind your right elbow and stretch your arm across your chest. Hold for 10 seconds, lower your arms, and repeat on the opposite side. Repeat 5 times. Stretches the back of the arms and shoulders. A 4. Wrist Warm-up: Sit with your arms at your sides and your elbows bent to 90 degrees. Without moving your upper arms, turn your hands so your palms face upward toward the ceiling [A], then downward, toward the floor [B]. Repeat 5 times. Gently warms up the wrists and forearms. B    A 5. Advanced Wrist Warm-up: Extend your arms in front of you, turn your hands so your palms face the ceiling, turning your elbows as far as they can go [A], then in the opposite direction, so that your palms are facing opposing walls [B]. Stretches the wrists, elbows, forearms, and shoulders. B 6. Wrist Stretch: Extend your right arm in front of you and bend your wrist back. With your left hand, reach across and grab the tips of your fingers on your right hand. Gently pull the fingers back toward your body. Hold for 10 seconds, lower your arms and repeat on the opposite side. Repeat 5 times. Stretches the wrists, forearms, and fingers.
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