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Hi, I broke the fist knuckle on my second finger of my right hand when I was a teenager, I’m now 55, this knuckle ever since locks up and I need to crack it at least once a day, usually in the morning, sometimes I feel pain when playing piano but it’s hard to tell if it’s the knuckle or strain from practicing fast passages, it hurts to snap my finger or pull apart my second and third finger, sometimes there’s no pain for years then it flares up, usually after a lot of practice of fast scales, then it takes forever to heal, months or even up to or more than a year. Does anyone else here have a similar issue? Is it strained or arthritis? Is it best to rest or exercise the finger? Any thoughts and advise will be greatly appreciated, thanks,
Rob

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Strain will usually need Rest
Arthritis will usually need Exercise

best to confer with your Family Doctor!
he may XRay to see what is actually going on
it could be a mix of both.


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Were I you, I'd make some inquiries here: https://medicine.tulane.edu/departm...LMZR9H_T17s7dvB_3RMGgOhownUaAthsEALw_wcB

You want somebody who specializes in the hand.


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Thanks, Tulane is close, I’ll check it out …

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You also might want to check in with Faina Lushtak at Tulane University. She is a prof. of piano there. She is a friend and she is very good with technical aspects of playing piano.

If Baton Rouge is not too far, another friend of mine teaches at Southern University. Joao Paulo Casaroti specializes in the Taubman Technique, which is very useful for players who have injuries, difficulties, etc.

Good luck!


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I agree with Seeker. You are going to want to see a hand specialist for the medical side of things. You may or may not need a referral from your primary doctor in order to see the hand specialist, and sometimes the primary doctor may want to do some initial diagnostics (like x rays). This is all fine, but I do think it is important for you to see a hand specialist.
You have a somewhat complicated history with the hand, and it is certainly possible that x rays would show arthritic changes at the joint that was injured previously. But this does not necessarily mean that the arthritic changes on the x ray are causing your pain (many people have arthritic changes on x rays and do not have any symptoms). A good hand specialist will help sort through which anatomical structure(s) is/are causing the problem, and then determine the most appropriate management strategy. Also, think about other activities outside of the piano that may aggravate/contribute to the pain (we use our hands for so many things!)

If there are specific things that cause you considerable pain, I think it’s prudent to rest from those activities until you are able to get an evaluation.

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Originally Posted by Sgisela
I agree with Seeker. You are going to want to see a hand specialist for the medical side of things. You may or may not need a referral from your primary doctor in order to see the hand specialist, and sometimes the primary doctor may want to do some initial diagnostics (like x rays). This is all fine, but I do think it is important for you to see a hand specialist.
You have a somewhat complicated history with the hand, and it is certainly possible that x rays would show arthritic changes at the joint that was injured previously. But this does not necessarily mean that the arthritic changes on the x ray are causing your pain (many people have arthritic changes on x rays and do not have any symptoms). A good hand specialist will help sort through which anatomical structure(s) is/are causing the problem, and then determine the most appropriate management strategy. Also, think about other activities outside of the piano that may aggravate/contribute to the pain (we use our hands for so many things!)

If there are specific things that cause you considerable pain, I think it’s prudent to rest from those activities until you are able to get an evaluation.

I think I've mentioned this here on the forum before, but about 20 years ago I had a severe finger injury at work which almost severed my index finger (finger #2 on the left hand if learning piano music) on my left hand. I was working on a commercial A/C unit and got my hand too close to a moving fan blade. The fan blade hit my hand with some force, and when I looked down at my left hand, it was like I had two index fingers; the fan blade had split my finger down the middle from the finger tip to the second joint/knuckle.

It was an awful sight, and the first thought that came to my mind was that my music career was over. Not that I had a music career, but I did play a few stringed instruments, and had for most of my life from a very young age.

I was taken to the hospital and admitted immediately and scheduled for surgery ASAP. The orthopedic surgeon said he had never seen anything quite like it, because the bone was cut straight down the middle of my finger, basically cutting my finger in half, down the middle.

The surgery was successful and the Dr. was able to save my finger, but I had permanent damage to my first joint and my finger-tip. Over time, with some physical therapy, I had some range and motion in my finger, but my first joint was really stiff, and a severely mutilated fingertip.

And, when playing my stringed instruments, the fingertip and movement of the first joint is extremely important. In fact, the injury actually steered me toward learning to play the piano, which I had never really pursued, other than picking out a few chords on the keyboard whenever I was around a piano.

Speaking of arthritis, I remember when I signed the consent form for the Dr. to do the surgery, he mentioned that I could get arthritis in my finger. Fortunately, I don't think I suffer from arthritis in my finger, but I still have the stiff first joint and an abnormal fingertip.

Yet, and still, even with the finger injury, I've learned to play the piano well enough to have a boat-load of fun, and I enjoy it immensely. I wish I had started learning to play the piano years ago, along with my stringed instruments.

Also, I was able to adapt some and I still play my stringed instruments some, but the injury impedes playing the stringed instruments more so than playing the piano. I'm sure I have some permanent impairment in my left index finger when playing the piano, but not a lot, that I notice.

Real Rob, I hope you can get some answers and some relief with your finger joint, and overcome any hindrances the old injury may cause. But do get it checked out as others has mentioned.

Sorry for the long post, but it is difficult for me to make a long story short... smile

All the best!

Rick


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That’s quite a story, Rick! I haven’t heard it before. I’m glad the surgeon was able to save your finger. I’m also glad you haven’t let it stop you from playing!
My story (which I’ve told before) is that I had a bicycle accident and fractured my wrist a couple years ago. This was a bit more than a year before I started playing again. I was a little worried that playing would aggravate some minor but persistent injury-related issues I was having. Instead, playing has really helped the wrist feel better. But I do pay a lot of attention to it, and I try to be mindful of not overdoing things with the wrist.

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Originally Posted by Sgisela
That’s quite a story, Rick! I haven’t heard it before. I’m glad the surgeon was able to save your finger. I’m also glad you haven’t let it stop you from playing!
My story (which I’ve told before) is that I had a bicycle accident and fractured my wrist a couple years ago. This was a bit more than a year before I started playing again. I was a little worried that playing would aggravate some minor but persistent injury-related issues I was having. Instead, playing has really helped the wrist feel better. But I do pay a lot of attention to it, and I try to be mindful of not overdoing things with the wrist.

Thanks, Sgisela, I'm glad the orthopedic Dr. was able to save my finger too. He did tell me the injury was serious and years ago they would have just amputated it at the nearest joint and threw it into the incinerator.

When he pulled the bandage off of it for the first time, I almost fainted and got sick at my stomach. It was blackish on the outside, and had about 5 steel pins sticking through it along the length of the injury, to pin the bone together, along with the stitches. It was real ugly, and it smelled bad, like dead flesh. Oddly enough, he said it looked good and was healing fine. I mentioned the black skin on the outside of my finger, which I thought was gangrene, and he said that was dead skin on the outside and it was healing from the inside out.

Needless to say, it was a horrifying experience, although it could have been worse.

I see now why some professional musicians have their fingers insured. If they don't they should... smile

All the best!

Rick


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Commiserations on the injury Rob. I can't comment on the 'snapping' of the finger and associated pain, you'll definitely need to get a specialist opinion on that but it sounds more than unpleasant.

Regarding the flaring up of pain occasionally and taking months to heal; this isn't necessarily a choice between strain and arthritis and the inflammation/pain might be due to both going on together. In general I associate long healing periods with ignoring symptoms and pushing on through the pain too long at the onset of the problem so that you pay much larger price afterwards. Therefore as a general policy I suggests that if it hurts stop straight away and do nothing except slow and *very* gentle but frequent stretches (every hour if you can) until the pain goes away.

For arthritis the conventional wisdom is that the best you can do is slow it down, but it's a funny thing and different people react differently to different treatments, but I've been one of the lucky ones and with long term diet changes and herbal treatments short term during the flare ups I have been able to actually reverse the arthritis, which is now better than it was 20 years ago.

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Best to ask a Dr

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Yeah this isn't a question for an Internet forum. Without a medical diagnosis it's impossible for anyone here to say.


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Yes I have realized that I’ve been pulling my finger slightly sideways when practicing fast scales, this may have something to do with the pain! Bad technique, I need to learn how to play with a better hand position!

Last edited by Real Rob; 10/12/21 08:32 AM.
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Injured joints very commonly become arthritic over time. However, any reasonable size hospital should have one or more hand surgeons on staff. Find the busiest practice you can, especially in a large teaching hospital. The condition of your joint should be easy to diagnose with an x-ray or MRI. To echo what others have said, get a diagnosis from a specialist.


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