It can happen to anyone!

It can happen to anyone! I consider myself to be very lucky. Throughout most of my pianostudies, I have had the good fortune to work with teachers who stressedan efficient and effortless technique. As a result, I have felt totallyat ease at the piano and have avoided any playing-related injuries, inspite of a demanding performance schedule. As many of you know, I have also been a long-time musician wellnessadvocate, lecturing on these topics as far back as the 1980s. In 1989, Iinstituted a pioneering course on wellness at Ohio University longbefore it was the "pc" thing to do. Information about healthypracticing and injury prevention strategies is a standard inclusion inmy wellness course and my wellness lectures. Given all my knowledge, how did I recently end up with a diagnosisof carpal tunnel syndrome carpal tunnel syndrome:see repetitive stress injury. carpal tunnel syndrome (CTS)Painful condition caused by repetitive stress to the wrist over time. ? CTS (1) (Clear To Send) The RS-232 signal sent from the receiving station to the transmitting station that indicates it is ready to accept data. Contrast with RTS.(2) (Common Type System) The data typing used in . is the most common peripheral nervecompression nerve compression,n pressure on a nerve or nerves may often be caused by hypertonicity in adjacent muscles. syndrome, caused by the impingement of the median nerve median nerven.A nerve that is formed by the union of the medial and lateral roots from the medial and lateral cords of the brachial plexus and supplies the muscular branches in the anterior region of the forearm and the muscular and cutaneous .Symptoms can include numbness, tingling tin��gle?v. tin��gled, tin��gling, tin��glesv.intr.1. To have a prickling, stinging sensation, as from cold, a sharp slap, or excitement: tingled all over with joy. or burning pain in the firstthree (and half of the fourth) fingers of the affected hand. In my case,I attribute my condition to computer overuse overuseHealth care The common use of a particular intervention even when the benefits of the intervention don't justify the potential harm or cost–eg, prescribing antibiotics for a probable viral URI. Cf Misuse, Underuse. and misuse based on theselikely precipitating factors: Factor 1 If you've ever sent me e-mail, you know that you can expect avery quick response. To put it succinctly, I am addicted to e-mail,regularly checking e-mail from home, at school and on my laptop whenI'm on the road. Factor 2 Many years ago I used to sleep with my hand bent under my chin. Iwould awaken with a "numb" hand. I purchased a splint splint,rigid or semiflexible device for the immobilization of displaced or fractured parts of the body. Most commonly employed for fractures of bones, a splint may be a first-aid measure that allows the patient to be moved without displacing the injured part, or it thatkept my hand in a neutral position and, after a year or so, trainedmyself to no longer do this. Even though this happened years ago,I've been told that a predisposition for nerve impingement nerve impingement,n patholo-gic pressure placed on a nerve by connective tissue, joints, or skin. can be alingering consequence. Factor 3 In January 2007 I purchased a new desktop computer, accompanied bya mouse with a tiny scrolling ball in the center to enable you to movethe cursor with the stroke of a finger. When I showed my physicaltherapist how I used the new computer mouse (the scrolling wheel ismoved by the index finger), it was clear that this motion createdincredible tension in the adjacent middle finger. I believe my currentplight may be due to the use of this new tool that was ironicallydesigned to make it more "ergonomically efficient." Factor 4 As careful as I am at the piano keyboard, focused on properseating, taking breaks in my practicing, warming up and utilizing anatural technical approach, I am not nearly so cautious at the"other" keyboard, where my time has recently grownexponentially. [ILLUSTRATION OMITTED] Factor 5 When the music building at Ohio University was constructed in 1970,the furniture purchased, including my desk, was not designed forcomputer use, although I am still using it today. My desk at home wasalso purchased pre-computer, and is not ergonomically appropriate forcomputer use. When I noticed at the end of April that I was awakening in themorning with a numb right hand, I dug out my old splint and wore it tobed. However, this time, my hand continued to go numb even with thesplint, and the numbness wasn't going away immediately uponawakening. After wearing the splint for a couple of weeks and taking ananti-inflammatory medication with no improvement, I decided to see myphysician. His "tentative" diagnosis was carpal tunnel syndrome.Although that thought had already crossed my mind, I was hoping to avoidhearing those words. He recommended that I try physical therapy andscheduled an electromyogram e��lec��tro��my��o��gramn. Abbr. EMGA graphic record of the electrical activity of a muscle as recorded by an electromyograph.Electromyogram (EMG)(EMG EMGabbr.electromyogramElectromyography (EMG)A diagnostic test that records the electrical activity of muscles. ) and nerve conduction studies nerve conduction studyNeurology A noninvasive method for assessing a nerve's ability to carry an impulse, which quantifies latency periods and conduction velocities; larger peripheral motor and sensory nerves are electrically stimulated at various intervals along toprovide a definitive diagnosis. Meanwhile, I managed to perform a majorpiano trio concert with my string colleagues in early June, even thoughthe tip of my middle finger would periodically begin to go numb. Playingthe piano when you can't feel the edge of the key is definitelydisconcerting dis��con��cert?tr.v. dis��con��cert��ed, dis��con��cert��ing, dis��con��certs1. To upset the self-possession of; ruffle. See Synonyms at embarrass.2. ! (Luckily, this did not occur during the concert!) I have chosen to share this personal saga with you to encourage youto: 1. Carefully evaluate your computer environment and your computinghabits, and 2. Seek medical assistance early, should a problem arise. Ifthis can happen to me, it can just as easily happen to anyone. Here area few basic recommendations: * Make sure that you are seated at the proper height and distancefrom the computer. * Use an adjustable chair with a backrest to maintain the lumbarcurve of your back. * Place the computer and monitor directly in front of you to avoidtwisting your neck or body. * Position the monitor so your eyes are level within range of thetop third of the screen. * Experiment with a wrist pad to help reduce stress on the wrist. * Take advantage of keyboard shortcuts to avoid excessive use ofthe mouse. * Elevate your wrist to allow your fingers to move effortlessly. * Take breaks every hour to rest your hands, body and eyes. In spite of trying every available treatment--physical therapy,cortisone cortisone(kôr`tĭsōn'), steroid hormone whose main physiological effect is on carbohydrate metabolism. It is synthesized from cholesterol in the outer layer, or cortex, of the adrenal gland under the stimulation of adrenocorticotropic injections, acupuncture and massage-the escalating symptomsforced me to conclude that in my situation, the appropriate choice was asurgical solution. By the time you read this, I hope that I will be backto normal, and all of this will be a distant memory. BONUS BYTE You can read MTNA's newly adopted wellness policy by going to:www.mtna.org and choosing wellness from the resource tab. Gail Berenson, NCTM NCTM National Council of Teachers of MathematicsNCTM Nationally Certified Teacher of MusicNCTM North Carolina Transportation MuseumNCTM National Capital Trolley MuseumNCTM Nationally Certified in Therapeutic Massage MTNA president