A unique approach to treating musicians’ hands is achieving exceptional patient outcomes. Mr Mark Phillips, Consultant Hand & Wrist Surgeon explains how ….
Many of my patients are musicians. About half of them present with same conditions/problems as everyone else (e.g. ganglions, trigger finger). However, about half of them present with conditions that are instrument specific. What I’ve found is that there’s a need to treat these patients in a different way, using a holistic approach – similar to that adopted in elite sport.
For example, in elite sport, a team (or individual) will have a multidisciplinary team to treat them, consisting of a coach, physiotherapist, sports doctor and sometimes a psychologist. For too long, there’s been a massive gap in the music industry in providing a similar approach to treat musicians. This inspired me to set up the Musicians Hand Clinic and create a unique service to treat musicians’ hands.
I’ve achieved this by bringing together a virtual team of experts, who are specialist in their own field. This includes hand therapists; instrument musical educators and psychologists. Working together as a multidisciplinary team, we treat musicians using a similar holistic approach used to treat elite sportsmen/women.
One of these experts is Paul Anders Søgaard, guitarist, BAPAM registered Educator, who is Alexander Technique trained, who specialises in analysing guitar player technique. Over the last few months, we’ve been collaborating in treating patients who have presented in clinic with guitar-specific hand conditions.
The commonest conditions we see are:
- Musicians Focal Dystonia/Musician’s Cramp – a neurological disease that causes involuntary muscle contraction
- Carpal Tunnel Syndrome – tingling/pain/numbness in fingers caused by pressure on the median nerve
- Trigger Finger – flexor tendinitis, which causes sticking of the finger
- Digital Neuroma – damage to the ends of the nerves at the tip of the fingers
The way we work is quite simple. Paul joins me in my virtual clinic (video consultation), I describe the clinical problem that we want to work around, and we watch the patient playing their guitar. He quickly picks up specific playing techniques which may be implicated or can be adapted to try to reduce the clinical symptoms. He then recommends simple ergonomic adjustments and/or technique workarounds that can be used to address them.
The different degrees of wrist flexion, for example, can increase the symptoms of carpal tunnel syndrome, as shown on the front cover of this excellent textbook by Ian Winspur and Kit Wynn Parry.
Here are some examples of the ergonomic adjustments and/or work-around techniques that we’ve successfully recently used to specifically treat guitar players, as listed on Paul’s excellent website here.
I’ve been hugely impressed by Paul’s knowledge, expertise and strategies. Paul’s understanding of how the whole body should work together as a single unit whilst playing (i.e. back, shoulder, arm and wrist) means he can make adjustments to different body parts/posture and not just focus on where the pain is presenting (i.e. in the hand/wrist). Working collaboratively and using our collective expertise, we’ve achieved some exceptional results treating musicians in this unique way.
To my knowledge, I am the only Consultant Hand & Wrist Surgeon in the UK offering this service to musicians. The overlap of knowledge between me (the surgeon) and my virtual team of experts is growing all the time. I’m very proud to have set up this service and to see how this unique approach to treating musicians’ hands is achieving exceptional patient outcomes.
Mr Mark Phillips, Consultant Hand & Wrist Surgeon
For more information visit: www.musicianshandclinic.com
23 July 2020–