The hand specialist

Friday, March 24th, 2006

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

Monday, March 20th, 2006

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

Wednesday, March 8th, 2006

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.