Wednesday, March 16, 2016

Marimba Body: Wrists (part 2 - Skeletal Structure)

Injuries occur from overuse and misuse.  Overuse is a depressing notion for percussionists, as it implies that we will eventually "hit our quota" in terms of how many strokes we get to play in our lifetime.  But hear the good news, brothers and sisters! - injury happens most often from habitual misuse of a joint, not overuse.  Hallelujah! In the words of a dear friend, "Praise Jesus and pass the biscuits!"


Mismap = Misuse

circle vs ellipse
Misuse requires a mismapping of the body's structure.  It means repetitive motion of the body in a way that is incongruent with its design.  For example, if you think your wrist is a ball and socket joint (movable in 360 degrees) instead of a flexible hinge - technically, an ellipsoid joint - you will eventually injure yourself.  Why?  Because you'll be forcing the joint to overextend from an ellipse to a circle, resulting in tendonitis.  The anatomical difference is that a ball and socket, such as the hip, requires a spherical head, and there's no such thing in the wrist.  Therefore, a wrist is not meant to move in a perfect 360 degree circle.

Compare the pictures below.
femoral head = sphere

source
Mismapping is actually a huge deal.  It seems trivial at the outset: so what, the bone isn't spherical...wanna fight about it (read in a Brooklyn accent for full effect) - but mismapping is how we get hurt.  As people who depend on a healthy body condition for our livelihoods, constructing a correct body map is crucial to longevity, and to some degree, success.


radiocarpal joint

These drawings of the anterior view of the right hand (palm side) show that the wrist is articulated by several bones: the radius and carpals. Though the ulna parallels the radius in the forearm, it merely provides elliptical movement for the wrist, made possible by ligaments.

source

If both the radius and ulna ended closely to the carpals, our hands would basically move in one direction, like a door opening and closing.  The flexibility we need to play marimba, multi set-ups, drumset, and just about everything else is made possible by the space between the ulna and carpals.
Soft tissues fill that space in the form of ligaments, tendons, muscles, and blood vessels, and there will be more about them in a future post. :)

This leads us, as percussionists, to a very important concept, demonstrated in the video below. 

Video not working? Click here


movement

The two primary planes of movement, grouped as flexion and extension, and adduction and abduction, respectively, dictate how we can best approach playing in order to prevent injury.

Notice that the field of possible motion for flexion and extension is quite large compared to that for adduction and abduction.  This explains, to a great extent, why nearly every technique is based on some mix of flexion and extension: there are simply more possibilities, more opportunities for specificity, and, due to more muscle support, greater control.

Some techniques, like French grip on timpani, rely on adduction and abduction, but the sound desired from the grip correlates to having less power and less range of motion: lightness, bounce, percolating energy.

There is something to be said about the alignment of the fingers and health of the wrist, even in flexion and extension.

Check out the diagram below.  It shows a continuous arced line from the elbow, through the radius, to the tip of the middle finger.  The wrist's axis is most supported along this arc.  

You can imagine how the wrist contorts to force the other fingers into the center axis.
 - Centering the thumb would require constant adduction, and compression of the space between the ulna and carpals.
 - Centering the index finger would require slight adduction, causing tension in the upper forearm near the elbow.
 - Centering the fourth or fifth fingers would require extreme constant abduction, resulting in pain at the center of the wrist.


A Brief Testimonial

With hindsight has come clarity about one of my own alignment missteps about five years ago.

In summer 2011, once out of school but still pushing myself in practice sessions, I developed a strange torque in my left wrist.  In my efforts to align my outer mallet with my forearm I constantly abducted my wrist, thinking that my pinkie should be in a straight line with my forearm, not at an angle.

Eventually a dull pain developed at the top of my wrist, where a watch would be.  I wore a brace at night maybe once or twice a week, and other than that all was fine.  At least, until preparing for a performance at the Zeltsman Marimba Festival in Appleton, WI.  While playing a fast, awkward run, there was a loud *pop* from my left wrist and immediate immobility.

Terrified, I called my doctor (aka, my mom), and explained what happened - that it felt like my tendons just popped over one another and now wouldn't move.  She assured me that it would move again, probably in a few minutes, but that I was maybe dealing with the beginnings of Carpal Tunnel Syndrome.

People in my family have had surgery for it, and never recover full strength after, so her words were terrifying to hear.  I could NOT be 25 with Carpal Tunnel, not if I was going to keep playing.

Through research I learned that I was aligning the wrong finger, and should have focused on my middle finger, as shown in the diagram above.  Once I figured this out, it only took a few weeks of mindful practice to get rid of it. And, perhaps most excitingly, years later my chops are better, my tempos are faster, and my adventurous side has been able to experiment with adaptations that before would never have worked for me, like the Corrente from BWV 830.

I still mindfully practice, and still slowly investigate my own alignment.

It has become a joyful part of my practice.


Up Next

To further clarify these ideas of alignment, I will make a video showcasing ways to discover your own tendencies, get familiar with your wrists, and investigate your technique for potential injury-causing habits. 

I will release it before the end of the month, so stay tuned! 
- - - - - - - 
Bruce MacFarlane, MD.  "Notes on Anatomy and Physiology: The Elbow-Forearm Complex." written Oct 2010, accessed March 2016.  

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