Dr. Timothy Jameson, the owner and creator or
Musicianshealth.com is excited to announce the release of his new
book Reach For the Top!: The Musician's Guide
to Health, Wealth, and Success.
This book will be an
invaluable resource to your growth as a musician, your success in
all areas of life, and even your growth personally and spiritually!
Click here for more information.
Do you have
questions for Dr. Jameson about your health-related problem?
He now offers phone consultations at a rate of $75 USD per call,
1/2 hour maximum time per call. Calls must be paid in
advance by credit card. Contact his office at
510-582-5454 to schedule and pay for your consultation.
This page is
dedicated to people who have questions regarding their health
and would like to have a chiropractic viewpoint on their
condition. If you have a question that you would like answered
by a Doctor of Chiropractic, then visit our referral page
for the Chiropractic Performing Arts
Assn. and find a doctor in your area.
Q: I am a guitarist that
has been playing for twenty years; I am 32 now. I've been
playing professionally for the last 10, and and even though
I don't practice as much now, we're talking many hours.
Well the problem with practicing you see is that my left
wrist has become somewhat of a problem. From what I know
about Carpel Tunnel, it doesn't seem like I've got it. The
problem then---I'm not sure. I have developed a "bump"
on the top of my wrist, that is located about 1/2"
inch from the bone that ordinarily sticks out along the
side of the pinky. This would be just south of that bone
if I were looking at my watch. It feels hard like a bone
in itself, unable to be massaged away. When I play, it becomes
distinct, and usually there is some dull pain, sometimes
a feeling of weakness. Any ideas? I am about ready to see
a doctor, but who, what, where? Thanks for your advice.
A: What you explain sounds
like a ganglion cyst - a small protrusion of a tendon's
sheath. This is a benign problem and responds to deep tissue
massage techniques and other natural therapies. Medical
doctors will typically excise the cyst with a "simple"
surgery. (If you can call any surgical procedure simple.)
Of course, you would need to be examined to determine the
exact nature of the problem. Ganglions develop due to a
prolonged stress on the tendon.
So my thought is this - what is making this develop in
the first place? I would take a look at your playing style
to see if you are stressing your hands in any way. You always
have to look at the underlying stressors to determine why
the problem is developing. If you don't, you'll simply run
the chance of redeveloping the problem again.
As to what doctor to visit - I would recommend chiropractic
care simply because of my knowledge of the body's self-healing
abilities. I would recommend a hand x-ray to rule out any
oddball things that could be causing this bump. I would
implement massage therapy in with the chiropractic care
to help the tendons heal properly. I would recommend a video-tape
analysis of your playing style to determine how you are
stressing your hands.
I recommend the conservative care for about four to six
weeks. If it does not reduce the size of the bump over that
time, than I would recommend a medical consult with a hand
surgeon for more invasive procedures. But always do conservative
care first before considering surgery.
I hope this helps you out. Good luck in your decision-making.
Q: Whenever I play for
periods of time my finger starts to hurt and almost bleed.
What should I do?
A: How long have you been
playing? Are you a beginner or advanced player?
If you are a beginner, then your fingers will need to develop
calluses (a toughening of the skin) through regular playing.
I would recommend playing your instrument just to the point
when you begin to notice some soreness in the fingers -
then STOP. Continue again the next day again just until
you feel your fingertips hurt. After a period of one to
two weeks, the fingertips will begin to callus in response
to the pressure (this is the body's innate response to stress
on the fingertips).
If you have been playing for a long period of time and
are devloping these hand symptoms, you should consider how
much pressure you're placing on the strings. Use this simple
test - push down on the strings at your body's strongest
possible force. Register this pressure in your brain and
give it a 100% rating. Now barely touch the strings with
your fingers and give this a 0% rating. You should be able
to produce a tone with about 30% of your maximum pressure.
(This varies depending upon string gauge and action). Take
a serious look at how much pressure you are using to play.
Q: I am writing to you
for a recommendation about a problem that I am experiencing
related to guitar playing. Six to ten hours after playing
a 40 minute set (normally the next morning) I experience
a sharp pain in the first knuckle of the ring finger of
my left hand (I am right handed). In addition their is considerable
swelling and stiffness which subsides with icings, anti-inflammatory
drugs (aleve), and rest within two days. The pain seems
the worst when their is side to side force on the finger
(eg when string bending). Any ideas you have would be welcome.
A: There's a few things
that can be happening here. Even though it is your finger
that's hurting we have to investigate many sources for this
discomfort. The stresses upon your finger joints from playing
the guitar are most likely responsible for the pain, but
let's look deeper into why your fingers are resonding to
the irritant so severely.
First, you have to take a good look at your overall nutritional
state at this time. Are you getting in your fruits and veggies
every day? Are you balancing your meals to include carbohydrates
(starches, breads, pastas) with proteins (meats, fish) and
fats? Poor nutrition will lead you do developing joint irritation.
I often recommend that people with joint pains begin taking
Essential Fatty Acids, such as Borage oil and flaxseed oil
daily to help their bodies regulate the inflammatory response
better. Secondly, I recommend glucosamine sulfate for joint
pain conditions. This is a substance found in cartilage
and helps to rebuild the joint surfaces.
The second avenue I would look into is the health of your
nervous system. Joint pains can result from irritated nerves
from the neck. The joints receive their nerve supply mostly
from the radial nerve - which stems from the lower neck.
Irritation of the lower neck can result in joint pains down
in the fingers! Think back to any neck injuries or previous
neck complaints. A chiropractor can easily determine if
this is a problem that can be initiating your finger pain.
The third thing to look at is your playing style itself.
How much pressure on your putting on the strings and how
much force is being put into the joints? Sometimes simply
playing with less force can reduce the irritant to the joints
and thus reduce the swelling and pain that follows.
All this must be taken into consideration in providing
an answer to your question. Seek a Chiropractor who looks
at all these factors and you should see beneficial changes
within one to two months.
Q: I am a beginning piano
player and have developed pain in my arms and forearms since
I began taking lessons. I am practicing about 90 minutes
per day since beginning a couple of months ago. Should I
just take a few days off (that is what I dread doing since
I am already addicted to learning to play). Or can I just
put up with the discomfort and continue to practice without
causing "permanent" injury? Should I begin a weight
training or exercise program to help my arms heal?
A: There's much to discuss
here about your new interest in piano playing. To start
off with, what is your sitting posture like while you are
playing? If you are too close due to reading and learning
new music, you may be exerting strain upon the neck, shoulders,
and arms. How are your arms situated? You may be extending
(bending back) or flexing (bending forward) your wrists
too much while hitting the keys. Another important factor
is making sure you have enough light to read the music so
you're not straining your eyes at the same time.
It is common for these tendonitis problems to pop up when
you begin a new
activity that involves a great deal of repetitive motion
over a relatively
short period of time. Think about this - you're going 90
minutes per day of
using your fingertips to hit the keys. You probably have
never done an
activity such as that before. It is not a surprise your
body is screaming at
you. Just imagine if you started hammering nails 90 minutes
per day for five
weeks - you'd be hurting just as bad.
If you keep at the same schedule, most likely your arms
will not have a chance
to heal. In fact, if you keep up your schedule without changes,
guaranteed a more serious problem developing. I wouldn't
training just yet because you're simply going to strain
the already injured
muscles. You need to start off by cutting down just a bit
on your training
schedule - not for a long time, just maybe a two or three
weeks. Do 30 - 50
minutes per day instead of 90. Most importantly though,
STRETCH your hands,
forearms, arms, and shoulders before, during and after playing.
If you are
not aware of stretching routines, there plenty of books
on the topic in your
local bookstore. Do not play for more than 15 - 20 minutes
at a time without
a stretching and relaxation break.
Drink LOTS of water - your muscles are composed of 75%
water. If they are
dehydrated they will strain much more easily. Drink a 10
ounce glass of water
every hour, starting now! You will urinate quite often,
but it's worth the
recuperative powers of the hydration. During every break,
drink some water.
You can speed up the healing process a bit by seeking care
from a chiropractor
or massage therapist who specializes in myofascial release
will reduce the adhesions developing in your tissues due
to the inflammatory
process and allow the muscles to heal faster.
Q: Dear doctor: I have
enjoyed very much your article available on the Internet.
My name is Julia and I am a cellist. I have suffered from
all kinds of problems in my left arm since April of 1998
and so far I have been unable to find the right help or
even a hint of support from any doctor. My main problem
at this moment is a result of a car "accident":
I smashed my left index with a car door. Fortunately the
X-rays show no sing of a bone fracture. However I still
experience a very sharp pain inside of my fingertip when
I try to play and some times when my index is in contact
with something very hot or cold. At the same time all the
area between my last joint and the tip feels sleepy, specially
in the exact spot where the car hit me. Doctors have told
me that there is no possible way of finding out what is
wrong because of the small size of nerves and tendoms in
the fingertip. I want to believe that there has to be a
way of getting a diagnosis and fight this problem. I have
also thought about trying accupuncture, but I don't know
what technique would be good for me . I have just moved
to Calgary and plan to attend The Banff Center of the Arts
in October as an artist in residence. You can imagine how
desperate and how lonely it feels to be here with not a
clue of what to do. I would very much appreciate any suggestions
from you. I hope that maybe you have dealt with similar
cases in your hospital and maybe you happen to know about
a professional that happens to live in Calgary or near by
and who isused to dealing with musicians injuries.
Thank you very much for taking the time to read this letter
and I look forward to your response.
A: I wish there was an
easy answer to your dilemma, but your finger is in the middle
of healing from this injury and it's going to take time
for that process to be completed. When you have a crush
injury, like smashing your finger in a car door, it involves
damage to all of the soft tissues in the finger, including
blood vessels, cells, nerves, tendons, and bone. It's going
to take months for all of these tissues to heal. Playing
the cello with the damaged finger is simply slowing the
process of healing - you're putting continued pressure on
the damaged area and stressing it more.
One of the best healing methods that can aid your body's
healing ability is chiropractic care. A Chiropractor will
check the functioning of your nervous system. Your nervous
system is the controller of all bodily healing - it drives
the healing process. If your nervous system is compromised
in any way by spinal misalignments (subluxations) it will
slow the healing process.
I recently worked with a man who was unable to flex his
fourth finger to his palm. He wasn't sure of the reason
why. By adjusting his spine, restoring nerve flow to the
finger, and performing muscle and tendon massage to his
hand, within five visits he could flex the finger normally
again. This shows the power of a properly working nervous
Acupuncture may be helpful in this situation also by enhancing
microcirculation in the region of the injury.
I personally do not know of any chiropractors in the Calgary
area, but you may want to call around and ask them if they
believe they can help you. Make sure you find a chiropractor
who is subluxation-based and understands how the nervous
system controls your healing mechanisms.
I wish you well and hope that your body's
healing ability is optimized.
Q:I've been a pharmacist
here in San Antonio, Tx for the past 27 years. I'm also
a part-time professional magician working trade shows performing
with a deck of cards. I also enjoy playing fingerstyle blues
guitar on my acoustic. Recently, I've had a few(not many)
hand specialists & neurologists starting to prescribe
prenatal vitamins to their patients with carpal tunnel syndrone.
Seems like these vitamins are loaded with plenty of the
B-complex vitamins and lots of folic acid(1mg). What are
your thoughts on these? I've been diagnosed with CTS; however,
my left ring finger & pinkie tingle but usually at night
when I go to sleep. What helps a lot is sleeping with a
wrist splint. I haven't noticed it much affecting my guitar
playing, but I have noticed that my left hand fingers don't
have the same amount of strength or touch when performing
sleights with a deck of cards. Your assistance/thoughts
would be gladly appreciated.
A: The only problem about
vitamins for CTS is that they can't unpinch nerves. CTS
results from long term nerve irritation either from the
spine or from multiple areas along the nerve's path from
the spine to the hand. I agree that vitamins help the body
heal (if it is already deficient in vitamins) but vitamins
are not the entire answer to healing from CTS. I have found
with ALL cases of CTS involvement of the nerve roots at
the cervical spine level. Once we begin clearing up the
disturbance of nerve function to the arm and hand, healing
begins to take place. This may take 6 months to a year,
depending upon how long you have had the condition and how
severe it is. So my advice to you would be to have a chiropractic
evaluation and have some massage work done to the chest
and upper extremities.
Q: My son is 14 years
old and has been playing guitar since he was 4 yrs old. He
has recently begun working on his speed and playing
complicated pieces such as Guns & Roses guitar solos,
putting more stress on the left hand/wrist/forearm than
normal. He is now experiencing a combination of an ache &
stabbing pain in the left wrist under along the pinky side
of the wrist. The pain is after he plays, and is painful to
apply any pressure on the hand. it extends to about an inch
up into the hand (pinky side) and about an inch up the
forearm. We have been soaking and he has cut down on his
playing extensively over the past couple of days. He is
also extremely upset over this as he wants a career in
guitar/music and this is his main focus. What kind of
treatment/therapy or rest would you recommend? Thank you in
advance for your time. Your piece on Cubital Tunnel
Syndrome was very interesting and helpful
Your son may be experiencing an overuse injury of his
muscles and tendons due to the more challenging pieces
he's been playing lately. The area you're speaking
about that is hurting him has many tendon attachments
and muscle insertions. These muscles and tendons work
hard when performing faster moving solos, especially
involving reaching with the pinky finger to higher
frets. There's a few things you can do at home to try
and remedy this before you seek the help of a
1) You can first easily evaluate your sons muscles by
putting some deep pressure starting in the hand and
working your way up the forearm. Find out which muscles
are sore to the touch. Also check the biceps and
triceps in the arm, and finally, make sure to see if his
shoulder and neck muscles are sore to the touch. Many
times, even though the hand may be the painful area,
these problems can travel all the way up to the neck.
2) Once you've found where the sore muscles are, begin a
daily massage routine of "stripping" the muscles upwards
towards the heart. You may want to do this a couple of
times a day. After that, massage across the muscle
fibers as well. This will help push the swelling out of
the area and release tension in the forearm.
3) Consider giving your child fish oils - you can find
these in your local health food store in capsule form.
They are antiinflammatory in nature, and tremendously
beneficial to the body, and will help the healing
process. Also, if you son isn't taking general
multivitamins and minerals, add those as well. DO NOT
give your child antiinflammatories to remedy the pain
and swelling. These will prevent healing and will simply
mask the problem, making him more prone to serious
injury if he plays while taking the drugs.
4) Have your son drink at least six glasses of pure,
spring water per day. (not from the tap). Muscles are
about 70% water and dehydration will make him more prone
to these types of injuries.
5) Avoid all soft drinks and caffeinated products.
Increase green leafy vegetables and more natural whole
foods to enhance his nutrition to allow his body to
overcome the problem.
6) If you find that after a week of doing this there is
no change in your son's condition, and especially if it
seems worse, then visit a chiropractor on my referral
board located on my
site. Click on the
Chiropractic Performing Arts Network page. If the
problem persists, there may be neurological involvement
that would need to be evaluated by a chiropractor who
can restore the function to the nervous system and to
7) Finally, many of these problems are the result of
poor posture, playing styles, technique, and other
physical factors such as poor diet and nutrition. To
really prevent this in the future, you have to evaluate
that overall state of your son's health and find where
improvements can be made. Make sure a good guitar
instructor helps him improve technique and posture while
playing. I would refer you to another article I've
written "What Makes Musicians Prone to Repetitive
Injuries" that you can find at this link:
. It will give you a new
perspective at injury prevention.