[aparametric]

I've had osteoarthritis in these joints, presently worse on left, for several years. The cartilage is gone on both sides and degeneration is now affecting the configuration of my thumb, so that articulation is as much concern as pain. (In another thread, pain on holding and playing soprano was discussed ... but thumbs seem to play a bigger part in playing saxophones than other wind instruments (from what I can tell watching performers, eg, on clarinet - though it is hard to see what is going on on the underside - perhaps members who play other winds can confirm or contradict this...)
HERE IS MY QUESTION - have you heard of a musician having surgery to repair osteoporosis affecting the trapziometacarpal joint? And have you heard whether one retains enough control and articulation to play saxophone after recovering from such surgery? (Several surgical techniques are available; they are said to provide some benefit most of the time, with considerable risk of negative effects. The information available does not address the need for precise, flexible movement in playing a musical instrument.)

 

[-88-]

There is a hand surgeon in San Francisco who has close ties with the San Francisco symphony, plays woodwinds himself and has recently started his daughter on alto saxophone. His name is Robert Markison, if my memory serves me.

Maybe a more pertinent suggestion would be for you to seek out a hand surgeon who also is a woodwind musician. Robert is the only one I know, but likely you will find one near where you live.

Also strongly suggest you continue doing the maximum to self educate yourself on processes, alternate remedies, and don't fail to give particular attention to nutrition in a major way. Another avenue for you would be to seek out an advanced doctor or medical researcher who can add the dimension of your own genetic proclivities -- a vital missing factor necessary for long range health -- and their related offsets as essential corralaries to health care.

 

[captorquewrench]

I do not know of any other sax players aside from myself who have had any hand surgeries. the ones you mention are the next ones we are looking at. But I have the same problem with the loss of cartilage and loose tendons & ligaments around my thumbs. My doctor will not inject any more cortisone because it is not working any more. Basically, the issue is this: live with it until I jsut can't anymore then one of two surgeries: shrink the tendons and reshape the bones. I know a pianist who has had this done. Twice, because the first one was unsuccessful.

My coping has been since the surgeries continued cortisone therapy (which I don't like doing, it suppresses immunity and increases risk of glaucoma, which I already have risk factors in both areas) along with NSAIDs, OTC & Script. I also hate taking pain meds because when I take enough to alleviate the pain on any level, I can't think or feel enough to control my embouchure.

I also removed the thumb rest on my alto. It's actually easier for me without the thumb rest. I have better hand position now and it has greatly reduced my discomfort. SOme of my issues were caused by a long time (say 20+ years) of using bad hand position, and two very reputable nationally known sax teachers did not fix this, so I never knew. I have a good teacher now who helped me figure this out. Also, I gave up my love of playing a lot of bari sax.

He says we just have to baby my hand for now, and yesterday his parting shot was maybe there are activities in your life you should consider giving up. Meaning saxophone.

Myself, I think maybe I need a new doc. There's a group of them in the med center downtown that specialize in musician's health issues. You should ask around with other musicians for a musician specializing doc. Gigging pros or U faculty should be a good start in getting a good referral.

Here's to hoping our hands heal. It's very frustrating.

 

[aparametric]

thumb joint

Thanks for your responses.
The little time I've found for playing recently has been on alto, a 75 year old True Tone Buescher New Aristocrat I bought a couple of months ago, which does play nicer, with better, more even response than the Selmer Signet I've had 30 years. The TT seems a little heavier and the neck is straighter, calling for some adjustment. I stopped playing over 25 years ago but picked the sax up again Summer before last - in some part precisely to give my aging and aching bones some therapeutic fine movement activity. I do not like prescription pain drugs either, also finding they have a negative effect on concentration. Before lessons; sometimes for practice, I take acetaminiphen to reduce interference. As for the hand surgery, it will take long term planning in any case, as I will need several weeks recuperation without use of (in this case, my left hand). I read somewhere that if arthritic degeneration goes too far, surgery may have little to offer.
By the way, this eve, I tried playing some measures with my right thumb out of the rest, laid relaxed on the tube somewhat above the rest and found that I actually could play comfortably this way - though probably not too rapidly (or what is rapid for me!) I'm not ready to have the rest removed, but will experiment gradually with this new posture.
Back to the therapy of playing - it actually seems to work, so that my left, presently the worst thumb actually straightens out effortlessly directly after playing. Pain varies a lot; did not have much while playing tonight. I will never be a pyrotechnic player, but there's enough to satisfy my musical tastes with far gentler pacing than Charlier Parker's or Marcel Mule's. Moreover, the exercise of playing, it seems, can help maintain use of the hands for all other things from which I am no more ready to retire than life itself, including my job teaching math. I don't know whether any local Hand MD's are musicians, but asking may be a unique approach to investigating those who are available in my region.

 

[tenorsong]

It would seem to me that a device could be fashioned that would fit around the forearm of the right arm in a strap like fashion-fitting far enough up the forarm to allow full rotation of the right wrist (something akin to the metal forearm braces used on some crutches). Attached to this would be an extendable arm with a tightening screw that would allow extension or contraction to accomodate an optimal distance to the thumb rest. Attached to the end of the arm would be a flat surface with an upward facing arm finished in threads to allow insertion and locking into a hole drilled into the thumb rest. It would seem that this hole in the thumb rest should be oversized relative to the diameter of this final arm to allow for some movement so as to not interfer with your sublte changes in finger/key geometry as you play.

I think that this would be relatively inexpensive to make and has the potential for subtle refinements to the prototype after initial construction to optimize it for you.

Just a thought.

Good luck

Bob Anram
myspace.com/bobanram