Playing Piano with Wrist Pain
I was doing well, getting back to my piano playing after a long break and practicing regularly.
Then, my wrist was injured during an operation and I developed a minuscule ganglion inside the joint and the most dreaded thing in the musical world.
Inflammation of the synovial membrane in and around the wrist - a connective tissue that lines joints and tendon sheathes - seen on an MRI.
Usually caused by overuse or rheumatoid arthritis, or in my case, triggered by being stretched into a bad position (bent fully forward) for hours during an unrelated laparoscopy operation.
At the time of diagnosis, I was devastated.
I couldn't use my right hand at all. I couldn't hold a knife when eating. I couldn't even write.
Playing piano was out of the question.
Note - I am not a doctor, just a sufferer of wrist synovitis. It is really important that you see a specialist to get the correct treatment, before you start playing. Otherwise, you risk causing permanent damage, which may stop you from playing music completely.
Getting professional help
As Gerald Klickstein, author of the Musicians' Way, instructs in a section about musicians and health, I stopped playing, rested and sought help.
The orthopedic surgeon advised that I should wear a wrist brace during the day, especially during activities that put strain on my wrist.
The original brace was very supportive, with solid metal strips both under and over the wrist. It allowed my fingers to move freely, but I couldn't play piano with it on.
There's a lot of wrist movement in piano playing!
Treatment and rest
In the beginning, I had to wear the brace all the time, any time that my wrist might bend even slightly backwards - eating, typing, opening doors, even carrying my handbag could bend it backwards.
During this time, I made sure I kept moving my fingers and stretching them - I didn't want to completely lose what I'd regained in piano playing finger strength.
A course of cortisone helped enormously, and I was able to start stretching the wrist in warm water. Crochet and it's small, smooth and constant circular movements mobilized my wrist joint.
The braces got relegated to more hefty tasks - cleaning, cooking, carrying anything, and water aerobics - actually the most painful of all activities!
Any time my wrist got sore or fatigued, a brace went on.
Several times throughout the day, I gave my hands a hot bath and stretched.
It relaxed me as well as my wrist!
After a few months, I could return to the piano, but only to play easy and relaxed music.
Music with repetitive notes, wide open hand positions, or loud and sharp movements hurt. So I didn't play them - I didn't want to make the synovitis worse.
Recovering from synovitis
- When you first get synovitis, stop playing.
- Seek help - the doctor may prescribe you medication, a brace, and/or physical therapy. Follow their instructions, as this will help you heal faster.
- When allowed and able to, move. Stretch, make gradual even movements, and slowly improve your range of movement. Stop any time it hurts.
- When you have enough mobility without pain, start playing again. But limit your playing time and play easy, relaxed pieces to start with. Keep on stretching and doing range of motion exercises.
- Try to avoid anything that hurts.
- Massage the muscles either side of the joint with synovitis - tight muscles decrease blood flow and cause joints to stiffen up, loose muscles help with recovery.
When it becomes chronic
Unfortunately, the synovitis in my wrist has stuck around - the rheumatologists have said it's part of spondyloarthritis, just like the inflamed sections of my spine and a few other joints. I don't want to give up playing, so I've had to change how, when, and what I play.
And I've had to modify my life so that it will let me play piano.
I use a split keyboard and voice software to minimize repetitive computer usage. When I do anything strenuous, like cleaning, gym, chopping a pumpkin or water aerobics, I always use the brace.
Playing piano seems to make the wrist tired and stiff, so I need to warm and mobilize the joint in warm water, before and after playing.
Plus, every day I crochet, stretch and do exercises to strengthen and improve the range of motion of my wrist.
Unfortunately, I don't think I'll be able to reach my dream of playing cello.
But at least I can keep playing piano.
Gentle and enjoyable piano music
When I first started playing piano after the decades-long break, I focused on building strength with Czerny and Hanon. I can't play these at all now - they hurt and fatigue my wrist too much. Any tension-building scales or repetitive passages, apart from gentle arpeggios cause far too much pain and stiffness. Long trills can be murder.
I adore Beethoven's Sonatas, but they kill my poor wrist now. I'm not even going to think about Brahms - which was once my goal.
I've had to find a selection of music that I enjoy playing, or risk dropping the piano permanently.
Satie has some great soft pieces - Trois Gymnopédies and Trois Gnossiennes were the first to be added to my quieter reportoire.
They are flowing, beautiful and haunting pieces, and they are playable by pianists of all levels of abilities.
A great set of pieces for someone who is struggling to return to the keys and battling a sore wrist.
Watching the move The Hours introduced me to Philip Glass.
His style often includes lots of slow, arpeggio-like passages, which you can play with a soft and relaxed wrist.
In particular, his Metamorphosis series of pieces are fabulous, and you may have heard one played in the "Valley of Darkness" episode of Battlestar Galactica.
The Piano Collection by Philip Glass is the best value for money and includes (almost) all the music from the Hours, the Metamorphosis series and a more difficult trilogy of sonatas.
I went searching for 'piano music like Philip Glass' and found Einaudi.
I now have two of his books, Islands and Islands II.
Although, when played 'properly', the pieces can be fast and overwhelming, they sound just as good when played slowly.
I must avoid the pieces like The Earth Prelude with lots of octave+ work in the right hand.
Nearly all of the pieces in these two best-of collections are playable, and more importantly, enjoyable.
A surprising find was McCreary's piano arrangements of music from Battlestar Galactica.
Not all the pieces are wrist friendly, such as Apocalypse, but a quite a number are playable. And I find they challenge me more than Glass and Einaudi.
There are a number of videos available of Bear performing his arrangements himself, very helpful when checking for difficult wrist positions!
Chopin and Mendelssohn
I've since found that some of Chopin's Nocturnes and Mendelssohn's Songs Without Words are doable when played slowly.
I avoid any movements which causes pain or overly fatigues my wrist, and must be especially careful when pieces include octave or larger spans, or trills.
I find that Chopin is more tiring than Mendelssohn.
The pieces I play very slowly and carefully include:
- Songs Without Words by Mendelssohn: Op.19 No.6, Op.30 No.6, Op.38 No.3, Op53 No.1, Op.85 No.1, Op.102 No.4.
- Chopin's Nocturnes: Op.9 No.1, Op.15 No.3, Op.27 No.1, Op.37 No.1, Op.48 No.2, Op.72 No.1
Have you had an injury or illness that prevented you from playing piano?
My tips for playing piano regularly with wrist synovitis
- Warm up and cool down - begin and end with a warm hand bath, stretching and mobility exercises. A wrist and hand massage can also help a lot.
- Start playing gradually - a short time to begin with, and then slowly, very slowly increase the time.
- Start with easy music - fluid and gentle movements are key.
- Stay relaxed - don't play any music that introduces tension into your hands and wrists.
- Stop when tired or if it starts to hurt - even if you are in the middle of a piece, just stop. Playing when physically (and mentally) tired increases tension and leads to bad posture and injuries.
- Avoid strenuous and repetitive tasks away from the piano - limit computer time, wear a solid wrist brace for house cleaning or cooking.
Your tips or music suggestions
Do you have any tips for playing while battling synovitis?
Or perhaps some favorite composers or pieces?
Let me know - I'd love to increase my gentle piano repertoire!