DeQuervain’s Syndrome is a painful injury that afflicts millions of people worldwide each year.It too affects many clarinetists , oboists, and virtually anyone who plays an instrument by resting it on the right thumb , supporting most of its weight. Symptoms include pain, and overall weakness. The pain is usually on the posterior portion of the thumb joint due to the thumb adductor and flexor muscles becoming too short and tight, therefore causing the joint to shift out of alignment towards the short, tight side. This shift causes the thumb abductor and extensor muscles to become severely strained as they attempt to hold the joint in its correct functional position, resulting in micro-tears of the abductor and extensor muscles at the CMC and MP joints but also the wearing of the anterior portion of the thumb joint which can lead to osteoarthritis. This is quite serious if it happens to you, dear readers. Those of you with discomfort in the right thumb, or those complaining of uncomfortable thumb rests could have this painful and actually, mistake-causing illness.
DeQuervains Syndrome gets ite name from the surgeon who first named it in 1895. It is also called middle-aged women illness from holding and pouring tea and other beverages. Since I have had this illness in my left hand and now in my right, it deserves your serious attention.
I have been a serious student, carefully analyzing problems and attempting to solve them, but this particular ailment caused me a considerable amount of pain. It affected my playing , even on one commercial recording, and so I bring it to your attention.
When it first announces its onset, you will be critical of your thumbrest, calling it uncomfortable, badly designed, all of these things. And you may be correct, however the cause could very well be this very common ailment that causes all kinds of problems and disallowes you from playing your best. It can also influence your choice of music to perform during a recital and give you problems in ordinary orchestra playing. I finally got it fixed after a long diagnostic period by having a surgeon cut a small incision in my left thumb, near an inch above the left wrist. Despite the preparation time, it took all of five minutes for him to make his cut, and I was almost immediately cured. The cut causes scar tissue which, when it heals allows the ligaments to move freely and without pain, because there is now enough room for those ligaments to move normally.
Because we are all quite confident after all those lessons, those endless etudes, the many rehearsals, the many auditions, the successful aiditions, we tend to think we are invulnerable to simple discomfort,like this one. If it does not get your attention, it can lead to al lkinds of pain and finally, severe disability.
As a preventive measure, I recommend the use of a neck strap, which is now no great shame, being used by several of the finest clarinetists in large orchestras. You may feel terrific, and your hands are perfectly fine when playing, but consider the neck strap as a preventive measure. Remember that both your thumbs get more exercise than the other bones in your wrist, and the slight pain, will turn into a real pain because of the overuse of the thumb.
You need to have perfect flexibility in both your hands and certainly the thumb gets the most exercise and the resulting fatigue can cause you trouble you never ever considered.
Start with a neck strap. (Both Morales and McGill use them).
That will assist you by diverting some of the punishing weight on your thumb. If you have to go further, proceed cautiously. There are also a number of exercises you can use to help strengthen these overused muscles. Proceed cautiously.
And keep practicing, painlessly.
stay well, sherman
Sherman Friedland's Clarinet Corner 