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I have been playing alto saxophone for about 8 years now and have recently developed carpal tunnel in both my wrists but especially in my right hand. I am wondering if perhaps the alto is too small and perhaps the layout of the instrument is a contributing factor to my having developed this problem, has anyone heard anything about how maybe a tenor because of its greater size and wider layout of finger pads is less likely to cause carpal tunnel?
Also has anyone out there experienced this and what are your stories? I am not in a position to get surgery nor would I want to, I am new to the forum and didn't find any related articles, if this has been covered, apologies. Any advice or info would be great. Thanks.
-V
 

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No thanks. I already have enough problems as it is. :)

Seriously, my wife has had the operation and it made a world of difference. Since carpal tunnel usually is caused by repetitive movements, it would seem to me that whether one is playing the alto or tenor would not make any difference.
 

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Surgery is always the last resort, and done when the pain and possible nerve damage indicate it. The hand specialist who I went to, ( I suggest you see one ) had me wear hand braces while sleeping. That gives the inflammation of the'tunnel' an opportunity to go down, thereby hopefully reducing symptoms when playing sax. Having had it for years, the braces and a very occaissonal cortisone shot have done the trick.
 

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Surgery is always the last resort, and done when the pain and possible nerve damage indicate it. The hand specialist who I went to, ( I suggest you see one ) had me wear hand braces while sleeping. That gives the inflammation of the'tunnel' an opportunity to go down, thereby hopefully reducing symptoms when playing sax. Having had it for years, the braces and a very occaissonal cortisone shot have done the trick.
I've had some experience with carpal tunnel. You need time and patience. Take some time off until the inflammation goes away. Then come back with some exercises to loosen the joints and muscles before you play. A physical therapist can give you some good advice in this situation. After that, you need to play limited amount of time to give the muscles and joints a chance to get used to the repetitive routine again. I struggled with this as a player and a conductor a few years back. The good news is you can get over it. The bad news is that it takes some time. The body can heal itself, but you need a break to let it get well first.
 

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I doubt that your carpal tunnel syndrome is due to the choice of saxophone size. I even doubt the correlation between saxophone playing and carpal syndrome, to be honest. My advice would be to get surgery at the right moment, not to late (chronic pain, muscle atrophy etc)!

Kulos
 

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seriously... in the nicest possible way... the "no pain, no gain" mentality does not apply when learning how to play an instrument. You're supposed to be in a zen state of mental relaxation to try and absorb everything that you are doing. People who have developed this condition at some point in time must have been fully or partially aware that they were doing something wrong. I know that in some circles it is a condition that is almost worn as a badge of honour.

I was fortunate enough to have a teacher when I was younger who experienced this. He was an alto player who was relatively tall... so from early on i was given a bunch of stretching exercises. When i was doing lots of practise I may have repeated these exercises three times a day, i would actually finish practise ten minutes early to complete those exercises before being kicked out of the room. I've only just started getting back into alto and after the first session (30mins) i remembered why I hated alto because of all the tension in my left elbow and my right wrist, it's got much better after about two weeks. RSI can be cruel... i remember thinking after I finally organised to re-do my recital... i had a moment of clarity... some staff were almost hoping that I would actually get RSI because of the practise required to get back on par after not doing as much practise as I used to. I played the first couple of bars of a chordal exercise from a Bach cello suite that Jamie Oehlers had given me in twelve keys slowly over the entire range of the horn for a couple of hours a day for the first week.

at the end of the day? try to do what ever you can to not loose the muscle memory in your embouchure... or that will be another mental hurdle when things improve. (lowest case possible) something i need to do... go to a gym and tell them what the problem is and get exercises to help build strength in those areas. practise things slowly (scales with minums at 50bpm) focus on the eveness of movement... whilst you continue to work on your tone... stretch, do ten minutes and then stretch again. there was a story of Glen Gould who would soak his hands/arms in warm water before a performance to warm up. like Uma Therman says "wiggle the big toe"...
 

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Carpal Tunnel in horn players has nothing to do with whether you play Bari, Tenor, or Alto...Though straight soprano does present some awkward body mechanics, and a lot of stress on the right thumb and wrist.

Physiologically some people are more prone to nerve compression issues such as carpal tunnel. Some people just have a smaller area for all the tendons and medial nerve to pass through, so the nerve gets compressed. Repetitive motions make this irritation worse. I work in the physical therapy field, and deal with carpal tunnel all the time. As much as my boss likes to see the repeat business, the new thoughts are to have surgery sooner rather than later. There are new techniques that don't even leave a scar, and you are in and out of the office in less than an hour! Full unrestricted use of your hand(s) in one week.

If you wait too long, you risk serious muscle wasting, and you can even lose blood supply to the scaphoid bone (pretty important in thumb mobility). If you wait until that point, they just take out the dead bone, leaving you with a void that used to make-up the thenar eminence...That meaty part that is rock hard muscle and bone when you touch tip of thumb to tip of pinky

Sax players are also prone to develop tendinitis (or tendonitis, correct both ways) in their finger flexors and, or extensors. This of course would be felt more toward the elbow...just move your fingers around and look at your upper forearm, right above where you see all the movement below the skin is where all these small muscles attach. If you see someone playing with a strap on their upper forearm, they likely deal with this frustrating and painful problem.

You can help to avoid these types of repetitive stress injuries by playing in good posture and hand positioning (not too flexed or extended at the wrist). STRETCH!!! I like to stretch 2-3 times during a normal practice session, and between sets on gigs. There are plenty of free resources on-line with good finger and wrist stretches. Just don't be too aggressive because you can tear muscle and tendon fibers, especially in these small muscles. If you do have pain, REST! Don't be afraid to use ice, and plenty of it. Play stress free: loose shoulders, neck, elbows, and especially loose wrists and fingers. Oh, and eat protein because it is good for tissue healing.

I hope some of this is helpful. It is all about being good to your body!
 

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This is one of the areas my work pays me to be an expert in.

1. For most of the cases I've worked on, surgery is the right option. Alternate non-surgical methods usually just prolong pain the suffering. You might want to consider going for the surgery now if you can. Recover time is fairly short. Get only one wrist done at a time unless you have someone committed to feeding you and wiping your rear-end for about two weeks.

2. The main cause of these is repetitive motion with the wrist in a non-neutral position. Force-loading of the wrist usually only becomes an issue after the initial damage is caused by the repetitive motion. You should be able to position the saxophone where your wrists are relatively straight and at rest while playing. This is key. Once the damage occurs, stretching exercises will not substantially help. Neither will transferring the saxophone's weight to the neck strap. And neutral wrist position is most often the answer to avoid this.
 

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the technique is a little sloppy. Should have been a little slower. I've uploaded four exercises that I was shown by my teacher who was suffering from the problem of RSI. the ones at the end were just rotating the wrists in both clockwise and counter-clockwise motion. I'd also do basic arm stretches as well.


that all being said, I think in recollection..? he didn't play for a while to recover? he told me he got key clamps and put the horn on a stand and practised overtones. that was about fourteen years ago.
 

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Great topic and lots of useful information, as always. My wife is an Occupational Therapist as well as a Social Worker and knows a LOT about this kind of thing. She's had the surgery on one hand/wrist and it helped immensely. Most of my discomfort is in my thumbs and more related to arthritis than carpal tunnel but some of the same things help__stretching, taking breaks, and simply being aware of my posture, grip, and overall level of tension (as in using a lot more pressure on the keys than I really need to in order to get the job done). I'm too old to expect there will be NO discomfort if I play my horn for a few hours but I do whatever I can to take care of myself and keep my hands and arms in good health. Good luck and keep playing (except when you need to REST).
 

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lol - i was getting paranoid the other day because i could feel a 'tingling sensation' that i thought was the tendons in my right arm. turns out it was only a scratch from the cat. that being said, my left pointer finger was a little stiff the next day after clarinet practice. it's a pitty you can't use key oil the same way as the tinman.
 

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I have been playing alto saxophone for about 8 years now and have recently developed carpal tunnel in both my wrists but especially in my right hand...........
If you have been playing the sax for 8 years but only recently developed carpal tunnel symptoms, can you be sure that sax playing is the cause? Just mentioning this so that you don't ignore other activities which might have more to do with causing this.
 

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I had Carpal Tunnel really bad and had to stop playing for two years. I could hardly wash dishes or open doors. I did a lot of Bikram yoga and it totally fixed my wrists. I tried other types of yoga and stretches but the bikram did the trick. I did it 3 to 5 times a week for over a year. I still do it from time to time. I also took things I learned in bikram and developed some stretching routines to do at home. Good luck. This is a serious thing, do something about asap.
 

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best recuperative device EVER invented the dyna flex or dyna bee gyroscopic hand massager check it out!!!
 

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Just make sure not to overdo it.
Those things are highly addictive, and you can hurt yourself when you do not limit your time or slowly build up the endurance.

They're fantastic. You can exercise fingers, hand and lower arm easily. Just takes a bit to get used to them.
 

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Well it looks like you can add me to this list, I have the nerve conduction test next month. 2 weeks of anti-imflammatories has only helped a bit so it looks like I might need the surgery. I think mine is a result of my early days as a toolmaker and 20+ of house renovations and countless hours using a mouse (my right hand is far worse). I can't play soprano at all right now, tenor is OK with a brace on my RH.

Hopefully they can fix it, if you've had surgery - what was your experience?
 

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Well it looks like you can add me to this list, I have the nerve conduction test next month. 2 weeks of anti-imflammatories has only helped a bit so it looks like I might need the surgery. I think mine is a result of my early days as a toolmaker and 20+ of house renovations and countless hours using a mouse (my right hand is far worse). I can't play soprano at all right now, tenor is OK with a brace on my RH.

Hopefully they can fix it, if you've had surgery - what was your experience?
That stinks man. One thing to keep in mind is a lot of what you feel can start at the neck and as it goes down the arm other problems can start. I think that is one of the reasons I had luck with bikram yoga. It helped stretch and open my whole body and I didn't just focus on my wrist. When I was just doing wrist stretches and exercises I didn't get any better.

Good luck, I hope you get better soon. I will have minor flair ups from time to time but if I do my yoga on a regular basis my whole body does much better.
 

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That stinks man. One thing to keep in mind is a lot of what you feel can start at the neck and as it goes down the arm other problems can start. I think that is one of the reasons I had luck with bikram yoga. It helped stretch and open my whole body and I didn't just focus on my wrist. When I was just doing wrist stretches and exercises I didn't get any better.

Good luck, I hope you get better soon. I will have minor flair ups from time to time but if I do my yoga on a regular basis my whole body does much better.
Thanks mate, yeah I'm onto it with the doc so fingers crossed (pardon the pun), I looked at Matt Ottos videos too, but I don't think I can pull off the yoga pants :twisted::twisted:
 
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