One evening Michael called. He is a percussionist who had just started his freshman year in college. He is an avid heavy-metal, funk, and jazz drummer who will probably major in music with a view to going professional. He had started having wrist pain—which could severely disrupt his ability to drum—after he began practicing for four or more hours per day several days running, a significant increase in his practice time. The pain wasn’t improving. What should he do?

Diagnosis: Repetitive Motion Injury

• As the name implies, this is an injury that occurs because of repeated motion or exertion, especially in tendons, muscles, or joints used in awkward positions
• It usually causes tendonitis, muscles strain, or bursitis

Some Definitions

• Tendons connect muscles to bone
• Ligaments connect bone to bone
• Bursa are small fluid-filled sacs located where friction develops between bone and tendon

Overuse

• Overuse most often injures muscles and tendons,  and can cause nerve-entrapment syndromes such as carpal tunnel. I tend to see more instances of muscle and tendon damage.
• Michael’s wrist pain most likely developed because of his sudden increase of practice time from 1-2 hours a day to 4 hours a day.  That equivalent to switching from running 4-5 miles a day to running marathons for several days.

Keep in Mind!

• Training for any activity requires preparation.
• To keep your muscles, tendons, and joints in good working order, the smart thing to do is to undertake a gradual progression of activity.

Advice for Michael

• Since the increased biomechanical demand had strained his tendons, we discussed his resting his wrist, icing it, and taking NSAIDs like aspirin or Advil as needed.
• After the pain subsided, he could return to drumming for a short period, then gradually increase his playing time.
• I also recommended stretches.
• Under that regimen, his symptoms resolved, and he has kept his joints and tendons in good shape through attention to his training needs.

Biomechanics

• The muscles of the forearm control and give power to the wrist as well as hand/finger flexion and extension.
• The intrinsic muscles of the hand help to fine tune that movement.
• See pictures

Exercises

• Stretch palm up
• Elbow bent
• Elbow straight
• Goal – wrist to 90 degrees
• Pictures of each
• Also doing it on chair