Shooting pains in my forearms (both), numb tips of thumb, index finger, and middle finger (left hand only), and pain or soreness in my left elbow. These were the symptoms I developed in the first days of 1999. After several years on a 20 button Stagi, I had been playing a "real" Anglo concertina (a 30 button Lachenal) for about 2 months. And now I couldn't go on. It was painful and frustrating. If I rolled onto my arm while sleeping it woke me up. I later learned from the comments and postings on various Internet groups and sites that I was not alone. Many persons new to the concertina or accordion comment on pains and soreness. Some say that it was muscle fatigue and went away before too long. Others are not so lucky. Accordion players commonly mention back problems from heavy instruments, for example.
DISCLAIMER
Neither the author nor concertina.net are giving medical advice. See a medical professional if you are having problems. Every case is different. The purpose here is to give one case study and show that how it was solved. Your problem, and solution, will likely vary. But you have company if playing a musical instrument is causing physical problems, and the resources listed below might help you.
My Experience
For a few weeks I didn't know why I was uncomfortable. Strain while shoveling snow (I'm no youngster) or burned fingertips from grabbing toast out of the toaster crossed my mind as possible explanations. I finally consulted my family doctor, who immediately suspected a problem with the carpal nerve. He sees a lot of it among employees of a well-known manufacturing company in the large city where he practices, so he has seen arm and hand problems many times.
Putting an ace bandage on my wrist and one ibuprofen the first night after seeing the doctor produced enough improvement that I knew he must be on the right track. As the books on these injuries explain, I needed about 6 to 8 weeks (no concertina!) to clear the numbness and shooting pain.
By analyzing what activities flexed my wrist for extended periods I got an idea of the cause of my problem. At the time I was driving 2 hours a day (commute) and was a computer worker like many others. I think together those had my arms irritated, but not enough to hurt, until I added the concertina and that broke the camel's back. It was the lengthy and intense Anglo concertina practice, though other factors had probably set the stage for the inflammation that playing brought on. The driving uses left hand more, so I suspect it is the worst factor. I still get a little soreness but am careful to control/avoid the positions and motions that gave me trouble. The doctor had me fitted with wrist braces. They helped a lot. After about four months I didn't need them for most activities (they attracted all sorts of rude questions at work, I won't miss that). I still put the wrist braces on if I am going to be driving six hours in one day. I very gradually increased my playing and was back to real progress on concertina by September of 1999.
In analyzing my problem, I concluded it was associated with the handle position and straps, causing me to flex my wrist too much. When the straps are snug I can't reach all the buttons, and when I loosen them a little, I (evidently) flex my wrists to keep control of the bellows. My fingers seem to be short for a standard concertina set up. On a separate page, I present photos of this, along with my method for raising the handles with padding. I'm beginning to suspect that these components ideally should be more adjustable than they traditionally are. I know of players who have had handles moved on Anglos and so on.
If there is any doubt that this experience has changed my attitude towards musical instruments, it was recently dispelled. I am learning one-row diatonic accordion for Cajun music (as if concertina weren't enough!). I just got a beautiful new box made for me by Marc Savoy -- he even engraved my name on it. It has incredible tone, response, and dynamic range. But right away my thumb got sore from the very stiff, non-adjustable leather thumb strap. I put the box aside until I was able replace the strap with a length of softer leather like the (comfortable) strap on my Hohner box! I also added a shoulder strap to take some of the weight of the instrument.
Resources
Here is one resource we don't have yet: I'd like to photograph some experienced players from several angles to show how they hold the instrument -- maybe this would be a useful tool. I know a similar set of photographs was a big help to me years ago as a trumpet student.
In the meantime, take a look at the more general site for all musicians at http://eeshop.unl.edu/music.html. This is a site on Musicians and Injuries by Paul Marxhausen. It will direct you to some useful resources (books, clinics, etc.). I have found that support is helpful -- knowing that others have been through something similar, whether it is back pain, wrist pain, neck pain, or whatever your instrument is prone to causing.
Two books I discovered on Marxhausen's site and found useful are:
THE MUSICIAN'S SURVIVAL MANUAL: A Guide to Preventing and Treating Injuries in Instrumentalists. Richard Norris, M.D. International Conference of Symphony and Opera Musicians, 1993. ISBN 0-918812-74-7
This book discusses how various conditions are recognized and treated. It gave me some background on what was happening to me and why it might be happening.
THE ART OF PRACTICING: A Guide to Making Music from the Heart. Madeline Bruser. Bell Tower, 1997 ISBN 0517708221
A great approach to preventing injury by being conscious of playing position. The focus on stretching not only works as a preventative but makes you feel great before otherwise nerve-wracking performances.
Marxhausen's page has lots of other great resources also. These books are not in many stores; you can always get them from Amazon.com.
Some General Lessons
Get an expert opinion if the injury does not clear up right away. You cannot diagnose yourself; that is why the medical profession was created. I thought I had an elbow problem and found it was really my carpal tunnel (in my wrist, that is).
It is fashionable to refer to any arm or hand problem as carpal tunnel syndrome, but there are many other conditions out there, some from static stress rather than repetitive stress. You need a pro to tell you which you have and what to do about it. Show them how you play your instrument if they are willing.
The suggestion, on the squeezebox newsgroup by Jim Lucas, to get a physical therapist (or a sports or performing arts orthopedist) to watch you play is an excellent one. These folks have seen your condition (whatever it may be) before.
Don't hesitate to adjust or change your instrument set up, once you understand what is causing problems. The traditional set up is not sacred, and you are an individual. Teachers are often helpful here. I suspect I could have avoided my problems if I had an experienced teacher/player available to help me move to a new type of instrument.
As Bob DeVellis noted on the squeezebox newsgroup, "Try to identify all sources of wrist strain. It may be the concertina that's the problem but it may be something else instead or in addition."
Finally, let me add my voice to the chorus that says that if the pain is serious or persistent, delay in seeking medical help costs you double. The longer you wait, the worse your injury may get, and the longer the recovery time may be. And diagnosis is not necessarily complicated; I had all sorts of symptoms (numb fingertips, etc.) that mystified me, and my doctor pegged my particular condition right away. I don't know where you're reading this, but here in the U.S. there is a pervasive view (based on advertising, etc.) that you can cure everything overnight by taking a pill. Orthopedic problems like mine, in contrast, are often treated using patience, which can be a hard medicine to take. I know it has been for me, but I finally improved and got back to concertina.
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