Wednesday, April 20, 2016

Marimba Body: Superfriends (aka Wrists part 3)

Tendons are like a muscle's alter ego: a superhero that manages to somehow make sure every scenario ends up ok, regardless of villainous plots.  They have undeniable strength, can hold on to just about anything, and save just about anyone.

Like Superman and Clark Kent, tendons aren't separate from muscles. They are simply two kinds of soft tissue, gently converging to form one shape.  In a way, one without the other is functionless. Both are needed to form a cohesive whole.

Any time a muscle attaches to a bone, a tendon forms the literal connection. Take a look at the diagram below. There's a tendon - drawn here in white - at each end of the bicep and tricep.

Though it might be oversimplified to the MD's and DO's out there, each muscle in the body has a tendon at each end to anchor it to the skeleton.

What is exceptional about the wrist is the number of highly active tendons running through such a small space.  Not only are there tendons for the wrist, but the fingers as well: tendons that help move the wrist inevitably help move the hand and fingers.

Tendons at Work

Recall the four ways the wrist moves: flexion, extension, adduction, and abduction.
Speaking from a minimal perspective, there's a tendon running through the wrist, across the palm, to the end of each finger in order to facilitate the movement of flexion.  There's a tendon running the same path on the other side to facilitate extension.


InnerBODY is a website featuring 3D models of the wrist that highlight and explain the function of whatever tendon you choose.  Here's a screen shot of one of the diagrams.

You can see [just a few] tendons (here, off-white) extending across the wrist to the tips of the fingers.  Can you see the translucent band of tissue that encircles the wrist, like a watch?  That's the Extensor Retinaculum of the Hand, and it's made of heavy connective tissue that forms little tunnels for tendons to pass through over the carpals, among other things.  Without it, imagine the tangles all those tendons would create.  Hot mess.  Hot. Mess.

Finger - Forearm Connection

How often do we move our wrists when we aren't also engaging the fingers?

Like the wrist, fingers are moved by forearm muscles.  There are muscles in the hand that contribute, but that's a post for another day.

You can feel the finger-forearm connection if you put your palm on a table and try to move each finger individually - you can feel it all the way up your forearm, probably see it, too.

We can't move our fingers without affecting our arms.  It's an obvious but pertinent observation we must make.


In studying the animations on InnerBODY, I find it fascinating to look at the size of the muscle attached to each tendon, as this clues me in on which muscles should be used more.  You'll notice the muscles involved in flexion and extension are much larger than those meant for adduction and abduction, and upon reflection, will probably note that most wrist movement each day lies in the flexion/extension plane.

Where we place our focus during movement informs what muscles are working.  Any personal trainer will tell you to think about the muscles you should use during burpees or squats, and once you do, the movement narrows to those particular muscle groups, rather than getting dispersed to other muscles that should be supplemental only.  Playing can be the same way.

Let me share a personal story.

When I first started working full time as an accompanist, I was immensely frustrated by tendonitis creeping into my left hand. I had done so much movement work with marimba playing -- how was this possible?! I knew how to move; I had fixed bad, old habits. Yet there I was, dealing with a sore wrist and a thumb that liked to go numb.

In hindsight, the pain came from two things: playing piano for hours on end when I hadn't done that in years, and; thinking that my wrist had muscle in it.  Though my upper arms and elbows were loose, I thought piano playing happened in my hands and lower halves of my forearms.  Erroneous. Erroneous perception on all counts.

Movement occurs when muscle tissue contracts, not tendon tissue. Tendons are connective, not controlling.  My area of focus  forced tendons to control the muscles I wanted, instead of the other way around. It's like I was curling my bicep while thinking about the inch of space above my elbow - no bueno. Also...ouchies.

In the years since then, I've retaught myself how to play piano, and rarely deal with strange sensations in my hands. If I do, I explore to find the acute cause, and work slowly from there.  Something I found in my initial search years ago was that my thumbs liked to be slightly taut and extended away from the palm. Such tension can mimic the same symptoms as Carpal Tunnel: numbness, soreness, slight loss of control.

So, if any of you are wondering if you have Carpal Tunnel...maybe check out your thumbs.  Perhaps they've been working a little too hard.

If you've had a similar experience, please share it with me in the comments. :)

Thanks for reading!

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