A Guitarists Experience Of Ulnar Nerve Entrapment/Cubital Tunnel syndrome
First things first, what is this injury? Well, you know the funny bone? It turns out that it is not so humorous after all. In fact it isn’t even a bone; it is a nerve that runs between the bones of the elbow joint (inner/medial side). Sometimes the ulnar nerve becomes trapped between these bones, it travels through the Cubital tunnel at the elbow and can become trapped at various locations within it. It can also become trapped by soft tissue damage either side of the elbow. In the UK we call it Ulnar Nerve Entrapment and in the USA it is called Cubital Tunnel Syndrome.
This blog is mainly for other musicians who are experiencing RSI injuries and want to know more about it. If you are like me you are probably spending many hours trawling the internet in the hope that you might find some answers.
At this point it is worth mentioning that this injury can be really bad and there are no quick fixes. I am finally better but it took 2 years and a lot of patience and if I am honest a lot of pain, depression and soul searching. Did I mention it took 2 years? Yes, good I may well say that again a few times. It takes some people a long time but the chances are you will get better without surgery.
For a musician, RSI type injuries are particularly bad news. If you are a professional musician there are practical issues such as loss of earnings, letting your colleagues down, not being able to do the gigs in your diary, can you still teach your instrument etc. Worth mentioning that I managed to get £2000.00 from HELP Musicians (formerly the Musicians Benevolent Fund) for my loss of earnings and they also provided access to professional medical advice. All musicians will feel a sense of loss from not being able to play their instrument. For me it was particularly hard to step back from music (but you must step back if you are in pain) Music is an outlet for my emotions, nothing else compares to music in this regard. This is compounded if you are feeling depressed because of the injury, sort of a catch 22 really. I could go on but the drift is this; RSI for the musician is a life changing event and one whereby it is hard to remain positive. For me and for a lot of others the only way to remain positive is to invest time (and money) into finding a solution to your injury.
Here is list of things/treatments that I tried:
There are probably more things I could add to that list but the truth is I am not sure how many of these treatments helped me. These are the ones which helped the most: Physiotherapy, Alexander technique, rest, sleeping with the arm straight, general health/ fitness and Yoga.
Did I mention that it took 2 years for me to get better? Over the 2 years, as well as trying all of the above, I came close to having surgery. Very close, 3 times. The 1st time (at about 12 months into the injury) I cancelled it because I wanted to give it a few more months to try and heal naturally; I was very worried about the possible outcomes of surgery. The 2nd time the surgery was cancelled the day before the operation was due to take place. It was cancelled by the hospital because there were issues with some of the equipment. This was a godsend really because I was ready to do it at that point. I then decided to give it another few months to try and heal naturally. In between the 2nd time and the provisional date for the 3rd attempt at surgery, I met a physiotherapist who had a masters degree in musicians injuries. I am so glad I did. She gave me lots of good exercises and ideas about posture, as you would expect. This wasn’t the best thing about meeting Dominique. No, the best thing was this; the moment I walked into her treatment room before she had even said hello she said “you don’t need surgery”. I was pretty dumbfounded, I was ready to have the operation and I felt I had tried everything else. I explained this to her and also that I really agreed with her stance but felt as if I had no options left. She backed this up with scientific studies of other musicians with similar injuries. All of whom got better eventually. She managed to talk me out of having surgery.
It took another 6 months and a leap of faith but it finally happened, I got better. There is still an element of moderation. I have a light touch now when fretting notes, If I have been teaching guitar for several hours I don’t come home and practice for several more hours straight away. No, I have a break and then do some practice. I listen to my body far more, if I notice any twinges I back off until I feel ok physically, and then I practice. If I have a gig that night I don’t practice all day, I save it for the gig and do the necessary practice on the days leading up to the gig. I think about my posture a lot, I do Alexander Technique, allow my body to recover. I keep fit and do Yoga and I don’t eat loads of junk food.
So my advice is this; wait and see, it may take ages but there is more than a good chance that you will recover if you give your body the necessary amount of time to heal. Nerves take ages to heal.
Jesse Molins, guitarist, performer, composer and teacher