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# No more PT

by Marcy June 1, 2006

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.

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## 2 thoughts on “No more PT”

1. Marcy,

   I am a left-handed palyer and seem to be experiencing some problems with my left thumb. Playing for as litlle as 30 minutes cause some pain. Has this been aa problem for you? I noticed you had your hammers in a holder of sorts. Does that seem to help? I wouldd be graateful for any hand stretching techniques that you would be willing to share.

   Thanks.

   Allen Macfarlane

2. The pain I experienced was in the crease between the thumb and the rest of my hand — PT said it had to do with the short muscles in the thick part of the thumb and the flexor and abductor tendons. I have some hypermobility in my joints, and it seems the standard double-sided hammer grip (curved both sides) encouraged me to overextend my thumb in a couple different ways. Dulcimer wasn’t the trigger for my injury, but it (among other things) certainly aggravated it.

   My new hammers are from Sam Rizzetta and are designed to be held between the fingers instead of between thumb and finger, and that has allowed my thumbs to rest, and me to keep playing.

   I’ve also started setting my hammers down between tunes, shaking out my hands, and checking my posture, especially rolling my shoulders back. I don’t have any hand stretches, but my PT showed me a nerve glide (not sure exactly what that means) that helps sometimes — start with fingertips together on my shoulder, then extend the arm, palm up, bending the hand down at the wrist, and extending the fingers apart, then returning to the original position, not holding any pose but a continuous motion, maybe a dozen times.

   When the pain was bad, I would do ice massage. Freeze water in a paper cup, and peel away the edge. Rub the ice directly on the pained area, wiping away the water as it melts. Maybe five minutes or so. Maybe followed by heat.

   The holders you noticed — I was experimenting with some foam designed for occupational / physical therapists to make pens and tools have larger grips — it didn’t work out so well, because it made the hammer grip round — hard to keep the hammers straight without gripping hard. I just the other day tried gluing some strips of thin packing foam to one side of some regular double-sided hammers to make the grip larger but still the same shape, somewhat less curved on top. We’ll see — so far I can’t use them long because it’s still a thumb / finger grip.

   Dan pointed out that he doesn’t really hold the hammers at all, but lets them rest on his finger and the thumb just keeps them from falling after hitting the strings. I am going to try a few minutes a day playing with regular hammers, trying to keep my grip that loose. Again, we’ll see.

   How tightly are you gripping? What kind of hammering patterns do you use? I.e. if you have awkward patterns it may strain your left hand more than the right. How’s your posture? Things in your back, neck, and arms can affect your hands. What about your wrists and forearms? Seems it might be best to be loose in all those joints and to use them all, not just finger motion, or wrist motion, or elbow motion alone. How’s the height and angle of your stand?

   I’m not an expert on this stuff by any means, but these are some of the things I’ve had to think about. Whatever you do, stop playing when you get the pain.

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