The Musician’s Hand
One of my keen areas of interest in plastic surgery and hand surgery is the musician’s hand and the hand injuries musicians get. Their hand functions are so delicate and in that sense they resemble fine microsurgeons. As a microsurgeon I feel that affinity and passion to understand and help with their particular type of injuries.
Musician hand injuries are due to how far and how much they push the limits and extremes of hand, writs and upper extremity motion. To give you an idea of the huge demands on the musician hand, consider that a violinist who plays a Bach’s sonata for solo violin may perform over 100 plus movements per minute!
Musicians practice for many hours every day. The hand injuries musicians get therefore are overuse type of injuries. Violinists, guitarists and piano players are the most vulnerable groups.
The more common entities that affect the musicians’ hands involve nerve compression, nerve entrapment, tendon fatigue, tendinitis, tendon tears, and ligament injuries.
The most common compression neuropathies include: carpal tunnel syndrome, ulnar tunnel syndrome, radial tunnel syndrome and pronator syndrome.
Tendon injuries include trigger finger and trigger thumb (tendinitis of the digits), tendinitis of the elbow and forearm and cramps.
Other conditions include ganglion cysts or the wrist and extensor tendons.
Therapy is tailored individually for each musician. The goal in treating musician hand and wrist injuries is improve symptoms and function while they can still practice. Early diagnosis and treatment therefore are imperative to help avoid surgery.
Rest and immobilization can splinting can lead to healing of inflamed tissues. However prolonged immobilization can lead to joint stiffness, which ultimately prolongs full recovery. Therefore treatment of the musician’s hand requires frequent evaluation and re-assessment of the progress and therapeutic management.
As a plastic surgeon, hand and microsurgeon I understand and relate to the sensitivity of treating the musician’s hand.