Topic: Pinky "Lock-up"

This question has emerged on the Teaching Topic - keen to have replies from medical experts.

"My pinky also locks on my right hand making it extremely difficult and painful to play fast passages using Ab and low F. Has anybody had this and fixed it?"   -  Mike

#when you say "locks up" does it a seem to be a form of stiffness reducing speedy movement or is it (as I am recently experiencing) a physical "locking" of the joint when it is curled into the palm?
I ask this because to date my playing hasn't been affected as I don't curl my pinky under far enough to cause the painful "lock-up". If its the latter you experience you may possibly be curling the finger too much - perhaps the hand is too far over the keys? Good playing posture has the hand totally relaxed without contraction of the fingers into tight curves. Keep finger contact as flat as is consistent with maintaining relaxed natural finger curvature.
I would be interested in comments from Bill Dawson Moderator of the Health & Wellness Topic of this Forum.

Neville

Neville Forsythe
Christchurch New Zealand
Bassoonist / Teacher / Conductor

Re: Pinky "Lock-up"

Neville and others,

Mike needs to be more specific regarding the exact difficulty he is experiencing -- stiffness vesus true 'locking' of a finger in flexion. It is with some chagrin that I report that, as a bassoonist and hand surgeon, I also have been afflicted with a true locking of my right long digit for nearly a year.  There is a thickening of one of the two flexor tendons to that finger that has, after more than a decade, progressed to 'catching' or 'locking' in flexion, producing an often painful 'click'ing sensation as I extend it from a position of full flexion int the palm.

Normal bassoon playing should not cause the finger to catch or lock, since the abnormal process involves full flexion only of the outer two joints.  We do most of our movement during playing with the innermost (to the palm) joint of the fingers, not the outer two. Indeed, with a trigger digit giving me daily symptoms if I do not watch how I use it, I performed the Weber Concerto last Wednesday without physical problems (let's not discuss the artistic aspects!).

if your student is truly having problems with a trigger finger ('stenosing tenosynovitis/tenovaginitis' as the medical term), he should seek care from a hand surgeon, and should let the surgeon know that he plays a musical instrument (and bring it with him to the first appointment). Treatment, whether by steroid injection or surgical release of the tendon tunnel, is not a major undertaking and can offer great benefit.

Dr. Bill Dawson, bassoonist and teacher
IDRS medical consultant
Past President, Performing Arts Medicine Assoc.
Author of "Fit as a Fiddle: The Musician's Guide to Playing Healthy"

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Re: Pinky "Lock-up"

Thanks for the comments - in my own case the "lock-up" happens only when the pinky is curved into the palm of the hand - almost to the degree of clenching - not at "flat" extension although if I extend my pinky and waggle it there is some pain. What does the surgery involve?

Neville

Neville Forsythe
Christchurch New Zealand
Bassoonist / Teacher / Conductor

Re: Pinky "Lock-up"

Based on anatomy of the 'tunnels' through which the flexor tendons glide, the tendon can lock only when the digit is almost fully flexed -- when this occurs, the thickening on the tendon slides out of the tunnel into the looser tissues of the palm. The 'catch' occurs when the thickening tries to get back inside the tight tunnel entry during finger extension.

Surgery is as Christopher describes. I've always done this procedure under local anesthaesia -- it only takes 5-10 minutes, including the 3 sutures to close the 1.5 cm incision. When the tunnel entry is cut longitudinally, it expands to accommodate the extra tendon diameter -- then heals in the new enlarged dimension. This means, of course, that the tendon musi continue to move back and forth during the healing process -- something that is aided by everyday activities, including playing music.

Dr. Bill Dawson, bassoonist and teacher
IDRS medical consultant
Past President, Performing Arts Medicine Assoc.
Author of "Fit as a Fiddle: The Musician's Guide to Playing Healthy"

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Re: Pinky "Lock-up"

Normal bassoon playing should not cause the finger to catch or lock, since the abnormal process involves full flexion only of the outer two joints.  We do most of our movement during playing with the innermost (to the palm) joint of the fingers, not the outer two. Indeed, with a trigger digit giving me daily symptoms if I do not watch how I use it, I performed the Weber Concerto last Wednesday without physical problems (let's not discuss the artistic aspects!).

Triactol

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Re: Pinky "Lock-up"

I agree with the last comments regarding bassoon playing -- but refer the author to my previous post regarding the locking needing flexion of all three finger joints. The digit won't lock with the outer two joints fully flexed but the big knuckle (nearest the wrist) in full extension

Dr. Bill Dawson, bassoonist and teacher
IDRS medical consultant
Past President, Performing Arts Medicine Assoc.
Author of "Fit as a Fiddle: The Musician's Guide to Playing Healthy"

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Re: Pinky "Lock-up"

I know this thread is a bit old now but I just came across it as I have been experiencing the same issue (a locking of the right hand pinky finger at the large/first proximal interphalangeal joint). I have played with a hand rest (or crutch) since I first started playing and am wondering if the length of the hand rest could prohibit the proper hand position/laying of my pinky finger on the Ab/G# key?

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