Musicians with Dupuytren’s Contracture Can Slow Dupuytrens Progress

Musicians with Dupuytren’s contracture have an option to play 

How musicians might delay Dupuytren’s contracture and help their career

Musicians with Dupuytren's contracture cause low-grade inflammation over the years and make hand problems worse. Musicians with Dupuytren’s contracture know they are in trouble.  After working so hard, for so long, DC can take away their music, and ruin careers.  Dupuytren’s contracture does this by limiting finger spread, finger accuracy, fluidity and more.  It humbles and embarrasses a musician’s playing skills.

However, musicians with Dupuytren’s Contracture have non-surgical options.  Especially musicians.  These options take their direction from a single realization. Musicians, more than most people, fuel their DC with bad mechanical habits and soft tissue stress.  That is not to say structural and mechanical stress is the cause of Dupuytren’s contracture.  Only that, in many cases, chronic low-level soft tissue inflammation in the hand and arm can usher Dupuytren’s contracture into someone’s life.  Changing bad playing habits, controlling and reducing soft tissue stress and inflammation can slow the progression of DC.

Some anatomical and mechanical stresses that lead to DC are sudden and traumatic.  Such as carpal tunnel surgery, or an arm fracture.  Other stresses are gradual, endlessly repeated and subtle.  Like a potter at the wheel, or a musician straining every part of the arms for personal perfection.

How do you want to do it?

Anatomical and mechanical stress is not the stress of the activity itself, but how the activity is done.  Actually, the activity is not very important.  It can be anything.  What is important is how the activity is done.

Two butchers carve, chop and carry meat. One ends the day exhausted, with tight and achy hands, arms and shoulders.  The other feels great, and is refreshed.  Two musicians put in eight intense hours of practice.  One musician is exhausted, with tight and achy hands, arms and shoulders.  The other, feeling good, later goes to a small club to play in a trio until closing.

You can do it easy, or you can do it hard.  How do you want to do it?

Take control of the problem

Musicians with tense and stressful playing technique are often in pain, and risk developing Dupuytren's contracture. Dupuytren’s Contracture Institute started in 2002.  Since then, I have questioned countless musicians from around the world about their DC and hands.  I always ask how they use their bodies when they make music.  Apparently, musicians commonly become tense, from the shoulders down, in two common situations:

  •     When fatigued and stressed
  •     When playing unfamiliar and complex music

Seldom is there a musician who cannot reduce this kind of situational tension.  They know where this tension and stress is located in their body.  And, they know when it happens.  This makes changing these response and habits easier.  It also makes slowing Dupuytren’s contracture easier.  Keep in mind, “It is me tensing my body.  Twisting and bending my fingers and arms in a weird way.  I am doing it.  I can stop it.”

Why this is important if you have Dupuytren’s contracture

Not all Dupuytren’s continually worsens to a crippling state. Some DC fades away completely.  It just disappears for some reason.  Other cases advance slowly, and then become stable for decades.  There are certain internal mechanisms and responses, explored very little, that apparently slow and even stop the progression of cord and palm lump development.

Many people with DC instinctively use common sense to control and slow their DC.  They stretch out, relax and use their arms and hands in different ways until they find something that relaxes the tension they feel.  For some it helps a little, for others it does wonders, and somewhere between for most.

This article presents detailed ideas and suggestions to help musicians with Dupuytren’s contracture know how to do this more often and with better results.

What I learned at the U of I School of Music about Dupuytren’s contracture

For several years, I practiced chiropractic in Champaign-Urbana, where the University of Illinois is located.  There, I began to treat several professors in the School of Music.  Most had chronic upper body problems common to musicians.  Because of the extensive soft tissue work I did, they referred their students with similar complaints.  Musicians became a large part of my practice.

Previously, my patients were farmers, factory workers, the elderly and car accident victims.   As a group, musicians presented a different clinical picture.  In many ways, they were physically distressed in an unusual way.

Common injuries start with one sudden impact or force, often to a large area.  Music-related injuries, I learned, are micro-injuries.  They build over time.  Small and repeated stresses applied daily for years, cause tiny isolated injuries and low-grade inflammation in the hands, arms and shoulders.

Many cases of DC start without genetic tendency, diabetes or drug side effects – and no trauma either.  What I learned working with these musicians applies to these situations. There is no overt or obvious trauma.  However, there is plenty of trauma in the form of daily music practice.   Namely, repetitious soft tissue stress of playing of a musical instrument can be so traumatic as to trigger a Dupuytren’s contracture response.

Musicians and the Dupuytren’s contracture connection

Pushing the limits of musical ability, all of the upper extremity suffers repeated stress injuries. Inflammation and Dupuytren's contracture can result. eteh hands and playiing abouFor some people, everything they do is like a boy killing snakes.

It is common for musicians to put everything on the line, especially when striving to play a tiny bit better.  Many, perhaps a majority, play their instrument like a boy killing snakes. They squint their eyes.  Their nostrils flare.  Their knuckles get white.  They brace themselves internally in preparation for doing something difficult. They hold their fingers, hands, wrists and arms tense with effort, pushing themselves to create a better sound.

The trouble is, they are always trying to do a little better.  Good musicians push themselves.  However, in time, the body shows signs of all this intense effort.  It takes a toll.  Fibrous knots and “triggers” appear in the shoulders, around the elbows, throughout the wrists and forearms.  The arms and hands become tight and uncooperative from knotted soft tissue and muscles.

Medically, all this soft tissue tension reduces blood flow, and increases white blood cells and various enzymes in the area.  This sets up a complex cascade of mast cell and macrophage infiltration into the injured area.  They signal a fibrous tissue infiltration into the area.  This is a classic low-grade tissue inflammation response.  In DC, it is a wildly excessive response.  Medicine has been investigating it for 50 years plus, and they still do not understand it completely.

Bottom line:  For people with a hereditary predisposition, low-grade tissue irritation and inflammation is the perfect situation to develop Dupuytren’s contracture.   Avoid it.

Evaluate playing technique 

Years of prolonged practice and intense effort, pushing for personal excellence, takes its toll on the upper extremities.  The longer it continues, the worse it gets.

Sore violin and guitar fingers and hands are common among players.
  What other tissue changes have       taken place inside the hand?

Musicians with Dupuytren’s contracture should evaluate the various tensions they create while playing.  With DC as the motivation, changing structural memories and habits can reduce the tensions in the soft tissues.  This will allow some level of healing to occur.  In turn, this slows the progression of Dupuytren’s contracture.

If you have DC and play music, it is wise to assume you have one or more localized areas of body tension.  You simply have to discover it and control it.  Frequently stop your play.  Locate the tenseness and rigidity of joints and muscles, from your shoulder to your fingers.  Names of muscles are not important.  You only need to know where, and when, you hold yourself tight for no good reason.

Genetic factors, and past medical history cannot be controlled or changed.  However, how the upper body is used,  and tension in the hands and arms, can be controlled and reduced.  Doing so should give your body a chance to function better, and reduce chronic low-grade soft tissue inflammation that feeds Dupuytrens.  This should improve your local circulation and muscle metabolism, which in turn could slow down your Dupuytren’s contracture.

Work hard to play with soft hands   

Musicians should learn to play less tense and tight to avoid hand problems like Dupuytren's contracture. d
Little up a little, please !

Your music teachers taught you good mechanics and posture.  Have your good mechanics and posture regressed over the years?  How much does your posture and finger technique change right before that difficult chord or complex passage?  How much do you tense up when you push your limits?   As the hours of practice pass, how does your touch and tension change?

Look for your bad habits and tenseness, and change.  In short, loosen up.  Start practice loose, and stay that way.  Practice being light and easy during difficult passages and sections.  Focus more on you, and less on the music – at least for a while.

Recognize you are probably:

  • Pressing on strings, frets and keys harder than necessary to get the same sound
  • Holding your bow or pick with more tension and force than necessary
  • Tensing hand and forearm muscles in ways that might help your technique, but hurt the muscles, joints and ligaments
  • Practicing beyond fatigue, causing your posture to falter, tensing from the shoulders down
  • Abandoning good mechanics for the sake of better sound

Because of bodily excesses your musicality is not as good as it could be.  When you play hurt, you cannot possibly play at your best.  Ironically, what you are trying to improve and accomplish in your music with these excesses only diminishes it.

Strategies to reduce upper body stress and tension 

Experiment with different ways to reduce muscle tightness and tensions that will benefit your fingering technique.  (Remember, what you do way up in your shoulder influences your fingers.)  Large changes are not necessary.  Tiny shifts in angles, degrees and muscle contraction can greatly improve how the body operates and performs:

  • Change the angle of a bent wrist, or straighten it completely
  • Straighten a finger that is usually bent
  • Bend a finger that is usually straight
  • Intentionally roll the shoulder a little forward, first the left, then the right
  • Deliberately push the shoulder back just a tad, first the left, then the right
  • Sit further back, or further forward, in the chair
  • Sit with a small towel under just one butt cheek, then the other; change the towel thickness
  • Stand with one foot forward, and then the other.
  • Stand with the toes slightly turned in, then slightly turned out, more than usual

Musicians with Dupuytren’s must experiment 

Make just one change at a time.  Try it for a whole practice session, or longer.  Do not rush the process of experimenting with new ways of doing old things and postures.  Give each a fair chance to loosen achy and tense hands and arms.  Do not be too quick to say something is not helping.  It takes time.

Experiment with all aspects of your finger and hand music technique, and playing posture.  See what happens.  Little goofy tweaks in posture and arm position – how you do what you do – can have a positive ripple effect up and down the chain.

See how good it feels to stop beating yourself up.

Get help

Your chronically abused upper extremities – and Dupuytren’s contracture – need more help than you can provide.

Seek out a great professional massage therapist; they were once known as body workers.  A person who identifies and eliminates chronically tight and contracted soft tissue associated with a variety of pathologic states.  Someone who has gifted hands.  This is not someone who does nicey-nicey full-body massage. A serious massage therapist can sometimes make you feel uncomfortable.  It is worth it to make dramatic deep soft tissues changes that are permanent.

Or, look for a chiropractor who does a lot of manual soft tissue work.  Someone with extensive training and experience in kinesiology, orthopedics or sports medicine.  Lots of experience.

Note:  Be careful who you ask for a referral name.   Ask people who have a reason to know who is best in your area:

  • Yoga teachers (not just a yoga student)
  • Martial art instructors (not just a  martial art student)
  • Owners and managers of fitness and exercise centers
  • Gymnast coaches
  • Seasoned body builders
  • Seasoned ballerinas, professional dancers and those who teach them

These people are connected to a select community you do not know about.  They know who has the special skills and gifted hands you need.

Once you find someone to help you, they can do more than work your tissue.  Ask to bring your instrument into the office to watch your play.  Get advice and suggestions about changing various postures while you play.  Small, but important, things to do while you play:

  • Raising or lowering your elbow or shoulder
  • Bringing your instrument closer or further away
  • Holding your instrument at a different angle or direction
  • Finger placement on your instrument

I did this all the time with my U of I musicians.  The benefits were often dramatic.

Stretching Dupuytren’s contracture gently is important

Also, it is critically important to stretch this tense soft tissue gently.  How to do it safely and effectively is a large subject.  DCI discusses simple gentle stretching methods here.  How to safely stretch Dupuytren’s contracture

Forced to stop doing what you love

Dupuytren’s contracture is a lousy problem.  It can take you in a horrific direction no one wants to go.  Over the years, I have talked to many musicians who could no longer play.  Professional musicians who had to quit music.  How sad.

If all this is a difficult imposition to your art, so is being forced to quit.  You have sensible and conservative options to play.  Do not stop what you love to do without first vigorously exploring all possibilities.

These ideas and suggestions are often helpful at least to a small degree, and sometimes to a great degree.  Success depends on how well you use these ideas.  When these ideas do not help, it is typically because Dupuytren’s contracture surgery complicated the situation too badly.

You will never know unless you try.

If you are a musician with Dupuytren’s Contracture please send an email to info@naturalheatlheducationllc.com to discuss reducing your upper extremity stress.

 

For information about natural Peyronie‘s disease treatment.

Stretch Dupuytren’s Contracture

7 ways – stretch Dupuytren’s contracture safely and effectively

Dupuytren’s Contracture stretches – anywhere, anytime

Stretch Dupuytren’s contracture fingers and cords, and the palm nodules, in two key ways:

  • Use a gentle and light touch
  • Stretch as often as possible

Look at a finger bent over by Dupuytren’s contracture.  The first thing you want to do is to stretch Dupuytren’s contracture good and hard to straighten it.  Not so.  Aggressive stretching can do more harm than good.  Tiny tears, or micro-trauma, can develop that can result in even more Dupuytren’s contracture, or worsening of an existing problem.

Stretch Dupuytren’s contracture gently, and often, to be effective. 

How gentle is gentle?

Do Dupuytren’s contracture stretches with the idea of sneaking up on it.  Use so little stretching force that it is not really a force, but more like a little pull or nudge.  The touch should be so gentle that the tissue does not offer resistance to the light stretch.

People report they can feel when the gentle stretching is correct.  When the finger stretching is just right, they feel a pleasant tugging or gentle glow sensation across the palm.

Never produce pain.  Do not even get close to feeling the beginning of pain.  Keep stretching light and gentle.

How often is often?

Some people smile often. Other people hum all day long.  Some chew gum, check their iPhone, or say “you know?” all day long.  It is what they do.  For some reason, they developed a habit.  They now do their habit easily, frequently without much thought.  Like smiling while while waiting for an elevator.  Or, chewing gum while doing a crossword puzzle.  You get the idea. They do their habit while doing other things.

Get into a finger stretching habit.  Stretch your Dupuytren’s contracture while doing other things. Do it often. Whenever and wherever you have an opportunity. Two minutes here, 30 seconds there, can really add up. The total time can easily be – with no effort – an hour or two each day.

You cannot overdo, or hurt yourself, if you do the stretches gently. The more time you stretch in a day, the better your results should be.

Places and times to stretch Dupuytren’s contracture

You are awake 16 hours a day.  Look for all the times and places you can do two things at once:

  • Watching television – Huge
  • At all those stop lights
  • While trying to fall asleep
  • Reading the newspaper
  • Walking down the street
  • Waiting for an elevator
  • Waiting at the restaurant
  • Listening to the radio
  • In line at McDonald’s
  • Doing a crossword puzzle
  • Sitting in the bathroom
  • Anytime your hands are idle
  • Talking on the phone – Huge
  • Waiting at the dentist’s office
  • At church or synagogue
  • Waiting for an oil change
  • Down-time at work
  • Sitting around with friends
  • Waiting for the bus or train
  • Riding on a bus or train
  • Relaxing with a cup of coffee
  • On long car rides
  • Getting a haircut
  • Standing in line – Huge
  • Stuck in a traffic jamb
  • At the toll booth
  • Waiting for the microwave
  • Pumping gas
  • While fishing and hunting
  • Your biggest personal time waster – Huge

Before starting to stretch Dupuytren’s contracture  

  • None of these instructions say how long to stretch. You can do them as briefly or as long as you wish.  Do the stretches a few seconds, a few minutes, or a few hours.  The more time you put into it – the more you get out of it. You cannot hurt yourself by doing them too long, or too often. The important thing is that you do them.
  • If you feel even a little ache or discomfort when stretching, ease up and do it easier. Avoid pain to avoid injury.  Do not make your Dupuytren’s contracture worse.
  • Do not do the same favorite 1-2 exercises repeatedly.  Use them all during the course of a day.  No matter where you are or what you are doing, you can probably do one of these seven stretches.
  • Stretch both palms and all fingers. Even if you have DC in only one finger, it is important to stretch all parts of both hands.
  • Dupuytren’s contracture is difficult to treat. It defies standard medical treatment.  No one natural therapy – no matter how good – will change DC.  Do not stretch Dupuytren’s contracture tissue as a solo or stand-alone therapy.  You will get nowhere.  No one gets rid of DC by stretching it away.
  • Stretch Dupuytren’s contracture as part of a standard DCI treatment plans for best results.

Stretch Dupuytren’s contracture – 7 ways for safe and effective DC stretches 

The beauty of these stretches is that several do not require any work.  Just set them up, and relax.

In the following Dupuytren’s contracture stretches, we assume the DC finger(s) are straight enough not to be a problem.  However, severe DC finger flexion might prevent you from doing several stretches.  In that case, do your best, but still do them.  Keep the bent finger out of the stretch.   By stretching one or two fingers next to the bent finger, you will help the bent finger indirectly.  Modify the exercise as needed.

  1. Praying hands stretch –

Put fingers and palms together as if you are praying.  Gently push the finger pads against each other.   Keep all ten-fingertip pads together, as you move your palms 3-6 inches away from each other. At the same time, raise the elbows up and away from the side of the body.  Spread your fingers 1-2 inches apart.  All ten-finger pads should still be touching, with wrists bent.   You should feel only a very slight and mild pull across palms – no discomfort anywhere.

This is a great Dupuytren’s contracture stretch.  It stretches the fingers, palms and even the forearms that are often tight in so many people with DC.

  1. Table top stretch

Put the DC hand on a table, palm down.  While sitting, you can use your thigh.  Straighten the fingers and flatten the palm, as much as possible. Keep the DC hand relaxed.

Place the fingertips or palm of the good hand on the back of the DC hand.  Simply, one hand is on top of the other.   The weight of the good hand puts light pressure on the DC hand.

 

 

 

  1. Knuckles to elbow stretch –

Bend the wrist of the DC hand backwards, by bringing the knuckles up toward the elbow.  Straighten the fingers.  Cup the fingers of the good hand around the DC fingers. Relax the DC hand.  With the good hand, gently push the DC hand toward the elbow.

You should feel very mild pulling in the palm if you are doing it correctly.

 

 

 

  1. Sleep on it –

In bed, lie on our back. Before falling asleep put your hands – palm-up or palm-down – just under the outside edge of your thighs.  Experiment to see if palm-up or palm-down does a better job of stretching where you need it. Slide the fingertips a short way under the thigh, not too far.  Only go so far as to apply gentle and slight stretching of the fingers and palms.   The pressure should be so comfortable and mild that you have no trouble falling asleep.

 

 

  1. Sit on it –

While sitting, put your hands – palm-up or palm-down – just under the outside edge of your thighs.  Slide the fingertips a little just a short way under, not too far.  Only go so far as to apply gentle and slight stretching of the fingers and palms.   Experiment to see if putting the hand palm-up or palm-down does a better job of stretching the DC.

Do this stretch on any kind of chair or surface, but works best on soft padded chairs.

 

 

  1. Doorbell stretch –

Put a fingertip of the good hand on the middle of the DC palm lump.  Apply a few ounces of downward pressure with the fingertip onto the DC lump, as if you are ringing a doorbell.   Keep the DC palm relaxed and cupped; do not flatten the DC palm or hold it stiff.

Continue applying gentle downward force.  At the same time, gently push outward and around with the fingertip.  Try to move the lump around in a circle.

Do not rub your fingertip around on the surface of the palm lump.  You should see and feel that you are gently moving the palm lump around in a small circle.

 

  1. Side-to-side cord stretch –

Use two fingers of the good hand to hold, lightly but firmly, the middle of the DC cord.  While gently grasping the DC cord at the mid-point, push or nudge it over a little toward the thumb-side of the hand.  Hold it there for 10-15 seconds.  Then push or nudge it in the opposite direction, toward the little finger-side of the hand.  Hold it there for 10-15 seconds.  Continue reversing the side-to-side stretch.

 

 

 

Learn about Peyronie’s disease.

Summary

  • Stretch Dupuytren’s contracture gently, for best results.  At no time during or after doing Dupuytren’s contracture stretches should you feel discomfort.  Please, keep it gentle and easy.
  • Do all these stretches as often as possible.  Use all the big and little times in a day to help your hands.
  • Make these stretches a part of a larger internal and external DCI therapy plan.

For more information about DCI non-drug non-surgical treatment of Dupuytren’s contracture.

Please take these Dupuytren’s contracture stretches to your treating doctor to review and get approval before you start doing them.   Dupuytren’s Contracture Institute and Natural Health Education LLC want your doctor to know what you are doing to help yourself.

Information provided above should not be taken as personal medical advice or instruction.  Statements, information and opinions expressed throughout the entirety of this website have not been evaluated by the Food and Drug Administration nor are all of the materials or products presented herein intended to treat, cure or prevent disease.

© Copyright 2004-2020 Natural Health Education LLC and Dupuytren’s Contracture Institute, Arlington Heights, IL 60004.  All rights reserved.  Unauthorized use or copyright infringement prosecuted to the full extent of the law.

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