Hand injury

My Rizzetta hammers

by Marcy

hammers

A closer look at my Rizzetta cimbalom-grip angled flexible shaft hammers.

You can see the top half of the grip in my left hand — the bottom half is exactly the same, and the curves fit around my first and second fingers. You can hold them between fingertips, but holding them the way I do requires no gripping at all. My right hand is too tense, too fist-like — I tend to tense up playing fast or difficult passages.

The shafts are flexible and set into the grips at a 45° angle so that my wrists are in a more neutral position.

Bits and Pieces

by Marcy

Sacrificing the visual

One of the main reasons I was excited about this festival was that Jerry Read Smith was going to be there. I haven’t seen him in several years, and I wanted him to look at my dulcimer, sort of give it a checkup, especially to see if anything needed to be adjusted to make tuning easier for me.

Basically he did two things he’d told me I could do myself, but that I hadn’t wanted to do without an expert there in person to make sure it was the right thing to do. First of all, he took a hammer to any pins that were sticking or slipping, seating them further into the pinblock.

Secondly, he moved some of the strings up or down on the side saddles. I confess that I’ve always hated this idea. I find it visually distracting to have some strings not absolutely parallel to the others. And it bothers my idealism — ideally, the strings should all be absolutely parallel and tune just fine. Seems to me there must be something else wrong if they’re straight but not tuning properly. Jerry — and Dan — would like to persuade me that sometimes it’s just the best solution, and that the visual aspect is simply not that important. Sigh.

Loosening up

The first meaning…

Sunday afternoon Dan watched me play with regular hammers, and he thinks the way I play with my left hand is likely to lead to injury. My left hand doesn’t work the way my right does, at least not naturally or automatically. To compensate, I’d developed a finger flick — hitting the back of the hammer grip with a middle finger — that helps me get a nice clear tone and good accuracy with my left hand.

I know there are other players who do this — Nick Blanton and Tim Seaman among them. However, maybe they use their wrists better than I do. I didn’t think I moved either of my wrists while playing, and I didn’t think it mattered. In fact, I thought it was a good thing, preventing carpal tunnel syndrome. Dan said my right wrist does move just a little, nice and loose, but that my left one is locked stiff.

Those of us standing around talked about the whole ergonomics thing for a while, and the consensus seems to be that the more muscle groups involved, the better, and the more loose and relaxed these muscles are, the better. Dan doesn’t even really hold his hammers — they balance on his finger, and his thumb keeps them from falling.

So I need to think about what I can do to loosen up my left wrist, and the grip of both hands on the hammers.

The second meaning…

I tend to think fear is safer than arrogance. I suspect people will like me better if I need to be encouraged, reassured, than if I need to be taken down a few pegs.

It’s not really that simple. Being too fearful is just as annoying — but in a different way. It gets old pretty fast to those who have to do the encouraging and reassuring; the fearful person makes a high-maintenance friend.

The most comfortable people to be around are neither overly fearful nor arrogant, but comfortable with themselves.

For whatever reason — yet another symptom of pregnancy, lol? — I felt just a little bit more comfortable with myself at this festival than I have at similar occasions in the past.

It was nice.

Hammers

Several people noticed my flexible shaft, angled cimbalom grip hammers from Sam Rizzetta. One person who has arthritis thinks she’ll look into getting a pair for herself. Other folks, including Dan and Christie, found them awkward. Dan said it would be impossible to play the kinds of things he plays with those hammers — percussion stuff is too fast, and the flexibility loses too much energy and requires more muscle. Interesting. So far, I still like them for keeping my thumbs loose, but I admit that I miss the sound of my old regular hammers.

No more PT

by Marcy

This week my PT is retiring.

At our appointment, we agreed that since we’re seeing maintenance rather than progress at this point, we might as well stop. If my hands get worse in the next few months, I can get a new referral, but perhaps I can continue the maintenance.

Even though my hands aren’t 100% wonderful, I have made progress since all this started in the fall — as measured by the PT’s pinch tests and a weighted questionnaire and by both of our evaluations. I can play longer, I’ve started knitting again, and when I do hurt it is less severe and doesn’t last as long — of course I still have to be careful not to overwork, to be aware of my hands and when I need to rest and stretch.

First market day

by Marcy

The Ithaca Farmers Market has been going since the first weekend in April. I made my first appearance today, and was fortunate to be able to play.

There are still lots of empty booths, but soon enough the market will be full.

It was a lovely sunny day, even though a stiff wind from the lake kept me chilled, standing in the shade of the market’s pavilion.

I was able to play about three hours, which is exciting, considering the tendinitis situation. I might have even played longer, except I was cold and running out of ideas and thought it would be better not to push it just yet. After all, since the Christmas season I haven’t played longer than an hour, even practicing at home.

It was nice to be back at my favorite venue. To see the friendly crowd and some familiar faces of vendors and visitors. And the chicken curry over udon noodles was a lovely lunch for a windy day.

The hand specialist

by Marcy

My first appointment with the physical therapist with the hand specialty was today.

Yes, they will watch me play and tune more regularly to make sure I adapt appropriately. They, meaning my PT and another one in the office who is a musician.

Yes, they taped my left thumb to support that fallen joint that Martha noticed last weekend, and it feels pretty good so far — we’ll see how it works when I tune today and play tomorrow. The PT says I have hypermobile joints in general, and that works against me in this case.

We also checked various pinch strengths, did ultrasound again followed by nice massage, modified the nerve glide exercise I was doing, and emphasized putting my hammers down, shaking my hands out, stretching, and rolling my shoulders back between tunes. I might also be able to get some pipe foam (the stuff you use to insulate water pipes) to make the grips on one pair of hammers bigger, so that I can alternate grips as I play, so as to avoid having the muscles in the same position all the time.

She shares my concern that the new finger-hold, wrist-motion hammers might just exchange one kind of problem for another, but perhaps alternating using both the new hammers and my regular hammers might be good.

I feel fairly hopeful.

UPDF

by Marcy

This weekend was the spring Upper Potomac Dulcimer Fest in Harpers Ferry, WV. I have been going to the fall fest for several years, but I hadn’t been to the spring one since my first festival ever in 2001. It turns out that several of us who had been in Rick Thum’s advanced beginner class that year were in the same room again for T. J. Osborne’s advanced solo technique class this year — Judith, Shelley, Rick, was it Steve? — and me.

I got a ride with Jody, one of my students, who enjoyed Sam Rizzetta’s Beyond the Melody class.

Thursday afternoon we arrived and checked in, then out with Rick to Shepherdstown for a visit to O’Hurley’s General Store and Kazu, the Thai place. Mmmm… Thai.

The festival takes place at the Hilltop Hotel, with classes on the two lower floors and across the street at the annex. Most folks stayed at the hotel, too. In exchange for some volunteer work (helping with the store and helping lead a slow jam Friday evening), I got to share a room with three other women, which was fun.

The festival really started on Friday morning, with classes running until late afternoon, with a break for lunch. Unlike the fall fest, the spring festival classes last the whole weekend — it’s a chance to explore the topic in more depth.

In our class, we looked at using paradiddles to develop ease in hitting two consecutive notes with one hand (useful for playing chromatic music or music in odd keys), separated hands using alternating or Alberti bass or Travis patterns, and tremolos with hammer flipping to add melody notes to a tremolo droning pattern.

I couldn’t play much, but it gave me the opportunity to see what the others in the class were doing and get to know some of them better, particularly Shelley’s friend Danielle and Bill Mitchell, half of the band Peat and Barley. I’m also grateful to all the folks who helped me carry things or who tuned for me.

Between classes and dinner were mini classes. Friday I sat in for part of Dave Reber’s class on rhythmic patterns for developing the weaker hand; they also seem useful for developing ease with syncopation and double strokes.

On Saturday I went to Sam Rizzetta’s class about hammers. Sam is responsible for a lot of characteristics of the modern dulcimer, including bridge markers, dampers, and extra bridges. He’s also experimented with a variety of hammer designs over the years.

Of particular interest to me were a style with angled finger grips. The grips have two cutouts to fit between the first two fingers, so no thumb action is necessary. The shafts are inserted at an angle so that the hands can be held in a neutral position. Thanks to a discussion at EverythingDulcimer.com a year or two, I briefly tried this kind of hold with regular hammers, but found it difficult to control and uncomfortable. Sam’s hammers, however, felt better, mostly because of the angled and shaped grips.

These hammers also have a flexible shaft made of some kind of fiberglass composite. I could play more cleanly than I expected to with them, but it would still require a lot of basic hammering exercises to develop control. It’s definitely a weird feeling to play with flexible hammers after being used to the regular kind.

I wonder what stiff shafts with these angled finger grips would be like, but I suspect that it would be more difficult to control them because the movement comes from the wrists or forearms instead of the fingers.

Sam and Lucille Reilly and Martha Marsey (an occupational therapist who was attending the festival) all agree that it is better to do repetitive motion with larger muscle groups. I confess that this is not at all intuitive to me. It seems to me that you should conserve motion as much as possible, so that a tiny movement should be done with tiny muscles. Perhaps the conservation principle still applies, so that even if I use wrists or forearms I shouldn’t move them more than necessary.

I am ordering a pair of these hammers. They’re quite expensive, which is daunting. But if it means being able to play without further injury, it would be worth it. On the other hand, perhaps with proper therapy I can learn to play with regular hammers without further injury either. Still, it’s worth a good try, and I’d like my physical therapist to see them.

Martha also pointed out that the first joint of my left thumb seems sort of fallen — I forget how she described it. She says I should ask my therapist about wraps I can use to support that joint in a proper position.

Anyway, after mini classes was dinner. All meals included an open mic opportunity; not very many people played, but it was cool to hear those who did.

Friday evening, after a panel discussion, Rick, Cindy, and I helped lead a slow jam downstairs. It was a full, loud room, but I think we all managed to have a good time anyway.

Saturday evening featured a Civil War themed concert, with Sheila Kay Adams telling stories and singing a few songs, playing one medley on banjo with husband Jim Taylor on the hammered dulcimer, and reading from her novel with guitar and vocal accompaniment from Jim. I think they plan to record the whole book with music, and it sounds like it will be really lovely. However, I was disappointed to hear dulcimer on only one medley! Sparky and Rhonda Rucker took the stage in the second half, with Sparky’s historical commentary and both of them singing songs with guitar and harmonica. It was a very entertaining concert.

The festival came to a close with brunch on Sunday, and we got home in the evening.

Back to PT

by Marcy

I hurt my left hand last fall. Something in the crease between the thumb and the rest of the hand, so that it hurt to grip anything, which meant playing and especially tuning dulcimer was not much fun.

When it still wasn’t better after a few weeks, I went to the doctor who referred me to physical therapy (PT), which really reduced the pain through ultrasound and paraffin treatments at their office and ice massage, Advil, and some stretches at home.

I thought it was nearly healed, or as nearly as could be expected, in January and February. But when I started playing more, trying to gear up for the coming season, it started bothering me again. It’s still not nearly as bad as it was, but it seems weak and sometimes still rather painful.

Sunday it was especially bad — perhaps a delayed reaction to tuning Wednesday and Saturday and rehearsing on Friday.

I’d had a reevaluation at the doctor’s in February, which set up an appointment with an orthopedist, which I just got home from. They’re sending me back to PT.

What will happen next? Who knows… if all goes well, I think the best I can expect is that with several months of PT, including a strength-building program, I’ll still be able to keep up my career. At worst, I may have to quit playing for some long period of time (a year?) and get some other job.

Whatever happens, God is good; even if my circumstances are not what I’d like them to be, I know his character, and that’s enough for me to trust him even when it doesn’t look like he’s playing very nice.

After twenty-two days

by Marcy

After a break of twenty-two days, I played the dulcimer today.

The break was to help my left hand heal from an inflamed tendon that has been bothering me since the fall. For the most part, it didn’t bother me too much over the holidays. It is still a little uncomfortable to wrap presents, do the dishes, sweep, read, and do other things that require the same kind of gripping or pinching motion. And now that I’ve been home and back at work — music work on the computer and housework — it’s been bothering me more. Oh well; we’ll see what the PT says at my appointment later this week.

First I tuned. It wasn’t as bad as I thought it would be, probably because I’d kept it in the case.

Then I played.

It was so nice to play again.

I played “Spootiskerry” for no particular reason, then the original pieces The Hanshaw Trio is thinking of playing in a benefit the weekend after next: “Irksome Girl / Midnight Maze,” “Winter East and Kensington,” and “Harper’s Waltz” (all mine), and “Cherry on Top” (Craig’s).

Then I quit and wrapped my hand in the microwavable heating pad for a while.

I’ve been asked to accompany a choir on a Gaelic song at the end of the month, along with our trio fiddler Jerry, my Pas de Deux partner Lisa, and a few other musicians. That, the trio benefit, and the nursing home gig coming up next week are what motivated me to get out the dulcimer today.

I’m nervous about this Gaelic piece because it involves a lot of tremolos. This is not a technique I have used much (really only on “Fallen”), and I’m not good at it. A percussionist would use multiple bounces per stroke, which would be less hard on the hands. Since I haven’t developed the kind of control needed to do nice even multiple bounces, I either have to develop it in a hurry or move my hands super fast.

Neither sounds like a good way to reduce inflammation.

Slooooooowing down

by Marcy

I have one more “gig” — playing the offertory in church this Sunday (“Jesu, Joy of Man’s Desiring” with Camille on flute) — and one more recording session on Tuesday (Craig’s tune “Cherry on Top”), and then that’s it for this holiday season.

It’s been a nice full one this year, starting with the weekend craft show at Mom’s Place in mid-November. The busiest time was the weekend before last, when the trio had two gigs in Corning (about nine hours including travel and a dinner break) and then a gig near Albany the next day (about twelve hours for that one, yikes!).

Though I’m a little sad to be almost done with playing for a while, it’ll be good to have a break.

For one thing, we can get back to the trio CD. I’ve burned copies of what we’ve got so far for me and the guys to listen to and evaluate. I think I need to revisit some of the mixes — many seem to need more volume on the guitar and some need more dulcimer, too. I’ve also started thinking about possible track orderings, and I’ve been experimenting with traycard designs. At some point I’ll have to think about how to actually make the booklets and traycards — maybe buy software and paper myself, or maybe see about having them done at a local printer.

By the way, here’s a track list, in alphabetical order for now:

  • Banish Misfortune / Swallowtail Jig
  • Carolan’s Welcome
  • Cherry on Top (© Craig Higgins)
  • Down the Brae / Ballydesmond Polkas #2-3
  • Dubuque / Spootiskerry
  • Hills of Lorne
  • Irksome Girl / Midnight Maze (both © Marcy Prochaska)
  • O’Keefe’s Slide / Derrane’s / Trip to Durrow
  • Out on the Ocean / Morrison’s Jig / Kesh Jig
  • Star of Munster / Old Copperplate
  • Staten Island / Julia Delany
  • Winter East and Kensington (© Marcy Prochaska)

For another, it’ll give my hands a rest. I’ve been dealing with an inflamed tendon in my left hand since October or so — tuning and playing the dulcimer aggravate it a little. I’m not convinced the dulcimer caused the problem, but there might be ways I can adjust my methods to be easier on my hands.

One thing I’ve noticed is that the nail side of the tip of my thumb sometimes hurts while I’m playing; when I demonstrated the dulcimer for my physical therapist, she noticed that I tend to overarch the left thumb. I think this has to do with the finger-flick technique I use to compensate for being right-handed. By flicking the back of the hammer grip with my ring finger, I can get a clearer, stronger sound. Having a big arch in my thumb seems to help with that technique, perhaps by providing a nice shape for the hammer grip to rotate around, which seems to also help me keep the hammer from wobbling sideways. Perhaps there’s a way I can be more aware of that thumb — maybe I can keep it arched but not overarched, and keep it relaxed and not rigid.

Or perhaps I can train my left hand to do what my right hand is doing.