Hand & Arm Strain, and Flute Headjoint Alignment
Dear Bloggy flute readers,
Over the past few weeks on Galway's Flute Chat group, we've been discussing the whole topic of hand and arm comfort.
James Galway was suffering right hand problems; I've long had a problem with the left arm (witness my wooden key extensions on my videos) and the topic of The Thumbport came up and was much discussed.
To clarify several of the points made, I created a quick video in answer to a question of what happens when the flute is unstable in the hands.
Here's the headjoint alignment video.
There are also some photos in in a short photo essay in pdf of the flute keys tilting backwards, and how to spot it, for flute teachers.
Read below some of the other interesting emails and responses.
=========================
Continued coversations about arm pain below:
========================
If you're interested, I'll also include below the answer I sent to Sir James Galway about treatments and ideas for right arm problems:
Over the past few weeks on Galway's Flute Chat group, we've been discussing the whole topic of hand and arm comfort.
James Galway was suffering right hand problems; I've long had a problem with the left arm (witness my wooden key extensions on my videos) and the topic of The Thumbport came up and was much discussed.
To clarify several of the points made, I created a quick video in answer to a question of what happens when the flute is unstable in the hands.
Here's the headjoint alignment video.
There are also some photos in in a short photo essay in pdf of the flute keys tilting backwards, and how to spot it, for flute teachers.
Read below some of the other interesting emails and responses.
Dear Jen,
Thank you for the video. I was the one who posted this query several days ago, and the response has been nothing short of amazing. Since I did not play the flute while growing up (started at 52), I went through all the stages of learning that younger students do, including lining up the flute the tone-hole-center-to-keys-center way. And, my first teacher would always tell me that I was choking off my tone because as I played I had a tendency to roll in my flute. Not until recently, when I saw your website, did I realize that as I played the flute tended, over time, to roll inward. To compensate, I would constantly readjust when my tone wasn't as good as when I started. The other way to compensate is to clutch the flute so it won't roll, which I would think would slow down finger technique. Then, I saw your website, and I thought, of course, it's the weight of the flute. Also, I should mention that about three years ago, I developed an injury in my left
thumb--called "trigger finger." It's when the tender sheath collapses around the tendon and the joint hurts and makes a clicking noise when you bend it. I can assume, but can't say for certain, that I was putting too much pressure on the thumb, as I needed to slide it back and forth from b to b-flat. Hand surgery took care of it.
Also, I like the idea that not everyone needs to change their flute setup. But it never hurts to make adjustments to see how they work.
Regards, Ron
Thank you for the video. I was the one who posted this query several days ago, and the response has been nothing short of amazing. Since I did not play the flute while growing up (started at 52), I went through all the stages of learning that younger students do, including lining up the flute the tone-hole-center-to-keys-center way. And, my first teacher would always tell me that I was choking off my tone because as I played I had a tendency to roll in my flute. Not until recently, when I saw your website, did I realize that as I played the flute tended, over time, to roll inward. To compensate, I would constantly readjust when my tone wasn't as good as when I started. The other way to compensate is to clutch the flute so it won't roll, which I would think would slow down finger technique. Then, I saw your website, and I thought, of course, it's the weight of the flute. Also, I should mention that about three years ago, I developed an injury in my left
thumb--called "trigger finger." It's when the tender sheath collapses around the tendon and the joint hurts and makes a clicking noise when you bend it. I can assume, but can't say for certain, that I was putting too much pressure on the thumb, as I needed to slide it back and forth from b to b-flat. Hand surgery took care of it.
Also, I like the idea that not everyone needs to change their flute setup. But it never hurts to make adjustments to see how they work.
Regards, Ron
=========================
Continued coversations about arm pain below:
========================
If you're interested, I'll also include below the answer I sent to Sir James Galway about treatments and ideas for right arm problems:
It is my right arm which nags me the most. What are your thoughts on that?
Sir James,
----------------------------
Dear Sir James,
Personally, I have only ever suffered from left arm problems, but I am willing to list some suggestions that might help out in the short run. Try out some of these ideas.....
---------------------------------------
1. Deep Tissue Massage or Myo-Fascial Release Massage - Have the massage practicioner focus on your legs, back, shoulders and neck over several appointments. It's possible that there is reduced blood flow to your right arm because of a misalignment or tight muscles elsewhere in the body (shoulder impingement or neck mis-alignment from long years of angling the head.)
If the forearm is currently painful to the touch, you might want massage only on adjacent areas to start with. Twice weekly may help. Eventually the massage person can focus on the bicep, shoulder, fore-arm and hand, once it has begun to be pain-free, and loosen any longterm muscle tightness that is present.
-------------------------------
2. Heated clay wraps - you can find heat-able clay wraps for the forearm if you ask around at the alternative/herb health shops for the best clay powder to use. Clay wraps are used for athletes who have strained or pulled muscles. The dehydrated clay powder is heated by mixing with boiling water, applied to the forearm, and wrapped with a cloth and a then a protective plastic cover (to save your carpet and furniture if you're messy with this stuff.) Alternately you can simply use the clay and an old towel while soaking in a bath. The clay is left on for 20-60 minutes to pull built-up toxins in the arms through the skin. You can wear a deep-heating clay wrap on the forearm while resting or watching a movie etc. See: http://www.eytonsearth.org/carpal.html or http://www.earthtobody.ca/products/clayneem.cfm for information about which types of clay and how to wrap. Doing this at home for $14 and the use of some old towels is far cheaper than getting the $200 spa treatment of same.
---------------------------------
3. Yoga/Stretching - If you start an easy yoga course. Richard Hittleman's 28 day Yoga plan is a good little paper back book for beginners. you may find that the stress levels go down considerably in a few days from the yoga breathing and stretches. Protect the injured arm at first, and don't try to stretch it too much or too rigorously, but use the gentle easy yoga and slow stretching to relax the rest of the body. The arm will benefit from increased blood flow which will help remove the built up chemicals in the tissues.
------------------------------
4. Flute Thumbport - For $20 you can test out a right thumb flute "Thumbport". I recommend them highly. They reduce the need to clasp the flute with the right hand, and the fingers, hand and forearm can remain completely relaxed while playing very very VERY fast technique. I find the technical speed and lightness of play using this device to be extra-ordinary. It easily slides on or off for your choice of when to use it.
Note: Your thumb tip will still touch the body of the flute; only the shank of the thumb supports the Thumbport (You don't need to hook your thumb tip underneathe the little shelf, just let the shelf brace against the shank of the thumb. See pictures at the above link.)
If you have ever cocked the right wrist at an angle, instead of using a straight wrist, this thumbport device allows you to completely straighten the wrist so that the tendons in the forearm can expand and contract freely, without becoming shortened in the wrist area.
------------------------------
5. Rotate the flute's set up a few milimeters; let the key tops be parallel to the ceiling or even a tiny fraction of an amount tilting forward. This stops the flute from rolling inward, and releases the right hand from needing to use pressure to keep the flute from rolling inward. (I'm sure you know all this already; but others might be interested.)
See: www.jennifercluff.com/lineup.htm
The straightening of the right wrist and the ease of using the thumbport will facilitate the sliding of the forearm tendons to reduce muscular tension in the right arm.
----------------------------
6. Body Mapping for Flutists, by Lea Pearson and any good book on Alexander Technique would both have a great deal to offer in terms of long-term flute posture awareness. I particularly recommend a book called: "Indirect Procedures" for musicians with muscle strain.
----------------------------
7. Tai-Chi;
A particular kind of Taoist Tai-chi is highly recommended for musicians with body tensions. It's the same remarkable slow-motion "dance" style of martial art that you see practised in China, but with more attention to not damaging the knees of the student. Tai Chi guides healing and quickly soothes nerves and muscles, allowing nerve pathways to regenerate after years of tightness or strain, through the gentle re-alignment of the nerve and blood pathways or ley-lines in the body. I highly recommend this for anyone who stands still to practise for several hours a day.
---------------------------------
8. Reduce any strain of the forearms, wrists and hands hand in computer use. This is very important for computer uses. If you are leaning the arm in a rigid way when operating the computer, change your computer's ergonomic setup. Move it to a higher or lower table, change hands when using the mouse, change chairs, change keyboard types. Computer use can really be a problem if it adds to a flute injury while you're searching for flute injury cures. :>)
--------------------------
I hope that one or more of these suggestions is helpful. There are countless more suggestions at the link below.
All my best, and of course, hoping for a speedy and happy recovery for you. :>)
Jennifer Cluff
Articles on flute hand and arm pain topics at: http://www.jennifercluff.com/deathgrip.htm
================
Dear Jen,
Thank you all for your good advice. I will get to work on it and see where it all leads. Best wishes, Sir James,
-----------------------
Dear Sir James,
There's a good flutist's diagram from "Body Mapping for Flutists" by Lea Pearson that really helped me figure out the pains I had in my left arm. It shows how the blood and nerve supply to the arm can become pinched by tight muscles in the shoulder area. Those tight muscles can pinch the blood and nerve flow to the arm up in area where the collar bone and top ribs meet. Here's a close up medical text book picture. After years of repeated left arm/hand injury I finally discovered that the real reason for the pain in my left arm was this shoulder/thoracic pinching. I had been choking off the blood supply to the left arm quite high up, in the "thoracic" area by consistently tightening my shoulder muscle groups over long hours of practise.
This pinching of the thoracic area happens slowly, over time, and the muscles very gradually get less and less blood. With no blood to clear away chemicals and built up crystals in the muscles, the result is pain in the muscles. They need to be flushed out and can't because their blood supply is being squeezed off at the source.
Unknowingly, by holding my shoulder every so slightly "UP and IN" plus tilting my head while practising I had been contracting several groups of muscles in the shoulder area (thoracic area) that hardened into place, and then gradually cut off the blood and nerve supply to the arm, resulting in forearm and hand pain. When the massage person worked deeply on the shoulder area, pulling apart the tight faschia-tension that had built up , the pain disappeared in 45 minutes!!
As you can see in the pictures in "Body Mapping for Flutists" by Lea Pearson, the upper arm bone, you may be surprised to see, has to actually HANG by itself from the shoulder area. The boney knob at the top of the upper arm is not actually connected to the collar bone or the scapula or any other bone by anything other than compressable tissues (muscle/tendons etc.)
When I play the flute and feel any pain in the arm, I re-picture this shoulder/thoracic anatomy, and try and gently release my upper arm to allow the arm bone to hang freely in its socket, without shoulder tightness or contraction. I also release any pinching of the muscles around the under-arm, shoulder and collar bone area.
You can clearly see when the anatomical pictures emphasize the blood and nerve supply to the arm following a tiny, narrow space between the upper ribs and collar bones, just how the pinching from too tight muscles could pinch shut the blood flow to the arm.
To free up the blood flow and nerve pathways to the fore-arm or hand, the muscles around the shoulder area have to be loosened considerably by massage and heat. I would ask your massage person to work on the thoracic area and to release any habitual contraction.
Here's a picture and a very thorough article about Thoracic problems.
I believe that flutists get a very mild form of this "syndrome" because they also bend the neck to the side for many hours a day which brings on the symptoms of pinching quite rapidly (and keeping the neck straight is close to impossible over several hours a day of playing a long, side-held instrument.)
A very good massage therapist should be able to feel the contraction, and release it gently for you.
Rolfing and/or myo-fascial release practicioners are also very skilled at this.
Hope this helps,
Best, Jennifer Cluff
Sir James,
----------------------------
Dear Sir James,
Personally, I have only ever suffered from left arm problems, but I am willing to list some suggestions that might help out in the short run. Try out some of these ideas.....
---------------------------------------
1. Deep Tissue Massage or Myo-Fascial Release Massage - Have the massage practicioner focus on your legs, back, shoulders and neck over several appointments. It's possible that there is reduced blood flow to your right arm because of a misalignment or tight muscles elsewhere in the body (shoulder impingement or neck mis-alignment from long years of angling the head.)
If the forearm is currently painful to the touch, you might want massage only on adjacent areas to start with. Twice weekly may help. Eventually the massage person can focus on the bicep, shoulder, fore-arm and hand, once it has begun to be pain-free, and loosen any longterm muscle tightness that is present.
-------------------------------
2. Heated clay wraps - you can find heat-able clay wraps for the forearm if you ask around at the alternative/herb health shops for the best clay powder to use. Clay wraps are used for athletes who have strained or pulled muscles. The dehydrated clay powder is heated by mixing with boiling water, applied to the forearm, and wrapped with a cloth and a then a protective plastic cover (to save your carpet and furniture if you're messy with this stuff.) Alternately you can simply use the clay and an old towel while soaking in a bath. The clay is left on for 20-60 minutes to pull built-up toxins in the arms through the skin. You can wear a deep-heating clay wrap on the forearm while resting or watching a movie etc. See: http://www.eytonsearth.org/carpal.html or http://www.earthtobody.ca/products/clayneem.cfm for information about which types of clay and how to wrap. Doing this at home for $14 and the use of some old towels is far cheaper than getting the $200 spa treatment of same.
---------------------------------
3. Yoga/Stretching - If you start an easy yoga course. Richard Hittleman's 28 day Yoga plan is a good little paper back book for beginners. you may find that the stress levels go down considerably in a few days from the yoga breathing and stretches. Protect the injured arm at first, and don't try to stretch it too much or too rigorously, but use the gentle easy yoga and slow stretching to relax the rest of the body. The arm will benefit from increased blood flow which will help remove the built up chemicals in the tissues.
------------------------------
4. Flute Thumbport - For $20 you can test out a right thumb flute "Thumbport". I recommend them highly. They reduce the need to clasp the flute with the right hand, and the fingers, hand and forearm can remain completely relaxed while playing very very VERY fast technique. I find the technical speed and lightness of play using this device to be extra-ordinary. It easily slides on or off for your choice of when to use it.
Note: Your thumb tip will still touch the body of the flute; only the shank of the thumb supports the Thumbport (You don't need to hook your thumb tip underneathe the little shelf, just let the shelf brace against the shank of the thumb. See pictures at the above link.)
If you have ever cocked the right wrist at an angle, instead of using a straight wrist, this thumbport device allows you to completely straighten the wrist so that the tendons in the forearm can expand and contract freely, without becoming shortened in the wrist area.
------------------------------
5. Rotate the flute's set up a few milimeters; let the key tops be parallel to the ceiling or even a tiny fraction of an amount tilting forward. This stops the flute from rolling inward, and releases the right hand from needing to use pressure to keep the flute from rolling inward. (I'm sure you know all this already; but others might be interested.)
See: www.jennifercluff.com/lineup.htm
The straightening of the right wrist and the ease of using the thumbport will facilitate the sliding of the forearm tendons to reduce muscular tension in the right arm.
----------------------------
6. Body Mapping for Flutists, by Lea Pearson and any good book on Alexander Technique would both have a great deal to offer in terms of long-term flute posture awareness. I particularly recommend a book called: "Indirect Procedures" for musicians with muscle strain.
----------------------------
7. Tai-Chi;
A particular kind of Taoist Tai-chi is highly recommended for musicians with body tensions. It's the same remarkable slow-motion "dance" style of martial art that you see practised in China, but with more attention to not damaging the knees of the student. Tai Chi guides healing and quickly soothes nerves and muscles, allowing nerve pathways to regenerate after years of tightness or strain, through the gentle re-alignment of the nerve and blood pathways or ley-lines in the body. I highly recommend this for anyone who stands still to practise for several hours a day.
---------------------------------
8. Reduce any strain of the forearms, wrists and hands hand in computer use. This is very important for computer uses. If you are leaning the arm in a rigid way when operating the computer, change your computer's ergonomic setup. Move it to a higher or lower table, change hands when using the mouse, change chairs, change keyboard types. Computer use can really be a problem if it adds to a flute injury while you're searching for flute injury cures. :>)
--------------------------
I hope that one or more of these suggestions is helpful. There are countless more suggestions at the link below.
All my best, and of course, hoping for a speedy and happy recovery for you. :>)
Jennifer Cluff
Articles on flute hand and arm pain topics at: http://www.jennifercluff.com/deathgrip.htm
================
Dear Jen,
Thank you all for your good advice. I will get to work on it and see where it all leads. Best wishes, Sir James,
-----------------------
Dear Sir James,
There's a good flutist's diagram from "Body Mapping for Flutists" by Lea Pearson that really helped me figure out the pains I had in my left arm. It shows how the blood and nerve supply to the arm can become pinched by tight muscles in the shoulder area. Those tight muscles can pinch the blood and nerve flow to the arm up in area where the collar bone and top ribs meet. Here's a close up medical text book picture. After years of repeated left arm/hand injury I finally discovered that the real reason for the pain in my left arm was this shoulder/thoracic pinching. I had been choking off the blood supply to the left arm quite high up, in the "thoracic" area by consistently tightening my shoulder muscle groups over long hours of practise.
This pinching of the thoracic area happens slowly, over time, and the muscles very gradually get less and less blood. With no blood to clear away chemicals and built up crystals in the muscles, the result is pain in the muscles. They need to be flushed out and can't because their blood supply is being squeezed off at the source.
Unknowingly, by holding my shoulder every so slightly "UP and IN" plus tilting my head while practising I had been contracting several groups of muscles in the shoulder area (thoracic area) that hardened into place, and then gradually cut off the blood and nerve supply to the arm, resulting in forearm and hand pain. When the massage person worked deeply on the shoulder area, pulling apart the tight faschia-tension that had built up , the pain disappeared in 45 minutes!!
As you can see in the pictures in "Body Mapping for Flutists" by Lea Pearson, the upper arm bone, you may be surprised to see, has to actually HANG by itself from the shoulder area. The boney knob at the top of the upper arm is not actually connected to the collar bone or the scapula or any other bone by anything other than compressable tissues (muscle/tendons etc.)
When I play the flute and feel any pain in the arm, I re-picture this shoulder/thoracic anatomy, and try and gently release my upper arm to allow the arm bone to hang freely in its socket, without shoulder tightness or contraction. I also release any pinching of the muscles around the under-arm, shoulder and collar bone area.
You can clearly see when the anatomical pictures emphasize the blood and nerve supply to the arm following a tiny, narrow space between the upper ribs and collar bones, just how the pinching from too tight muscles could pinch shut the blood flow to the arm.
To free up the blood flow and nerve pathways to the fore-arm or hand, the muscles around the shoulder area have to be loosened considerably by massage and heat. I would ask your massage person to work on the thoracic area and to release any habitual contraction.
Here's a picture and a very thorough article about Thoracic problems.
I believe that flutists get a very mild form of this "syndrome" because they also bend the neck to the side for many hours a day which brings on the symptoms of pinching quite rapidly (and keeping the neck straight is close to impossible over several hours a day of playing a long, side-held instrument.)
A very good massage therapist should be able to feel the contraction, and release it gently for you.
Rolfing and/or myo-fascial release practicioners are also very skilled at this.
Hope this helps,
Best, Jennifer Cluff
posted by jen at 6:07 PM
permalink
Comments (14)
Great that you put this all in one place! Thanks!
Lessons from a wonderful Alexander Technique teacher made a huge difference my arm and shoulder strain issues. Their website is very helpful: http://alexandertechnique.com
This comment has been removed by a blog administrator.
Dear Josh,
Haven't been able to locate the clay-wraps. You may have to tell ME if you find them.
If your arms are so sore that you're considering deep-heating clay wraps then:
a)have your flute checked for pad leaks
b) take a few days off and get a serious deep-tissue massage on neck, shoulders, back and arms (but don't massage any area that's seriously inflamed, wait til it calms down) and
c) don't practise in a way that hurts your arms and hands. Play technique and tone alternating, and like Julius Baker teaches; go slowly; do not race or play repeditively at high speeds. Racing plus repetition of fast technique inevitably hurts muscles. Don't do it.
I know from experience. See: http://www.jennifercluff.com/deathgrip.htm to read what happened to me; and now I have permanent nerve damage in the left arm. PLEASE protect yourself from this level of damage.
Jen
Jen, I just recently discovered your wonderful website and already I am seeing a huge difference in my playing experience. This website is so rich in material that it will take me a long time to get through it all. In the meantime, I feel like I am getting incredible professional help with my flute playing. My greatest weakness is sight reading, and I see that you have even addressed that issue!
Thank you so much for this amazing resource!
Wow, great news!
So glad you commented with such positive results.
GREAT! Jen
Dear Ms. Cluff,
Thank you for this video...I have been playing the flute since high school (now in my 30's) and have been playing in a local university's community/college groups the past few years. I found your post on the flute alignment helpful in two ways:
1) Made me realize that it's best to set up the flute in a way that produces the best tone & the least bodily stress FOR ME, and that my set-up may not be the same as someone else's. Under the direction of Alexis Del Palazzo, I've become familiar with the "Body Mapping for Flutists" book, and your video dovetailed nicely!
2) My husband (in his 40's) is just starting out with the flute, and for basic stuff, at the moment, I'm his teacher. I have been CONSTANTLY telling him to roll out, as the way he sets up his flute (when centered) has his keys pointing at the ceiling! I can't wait to show him this video, as it explains much more succinctly & eloquently what I've been trying to get across.
Thankyou Laurie,
Wonderful feedback!
Jen
Dear Jen,
I had been suffering from chronic left shoulder pain and upper arm pain, which was aggrevated during flute playing. It turned out I had calcific tendonitis as a result of continued straining or injury which preventing proper healing. I have been healing with the aid of physical therapy, but I also researched information regarding the posture during flute playing, since I always feel very uncomfortable when playing the flute. I found some information in your site. I realized that I was pulling my left shoulder too forcibly towards my body, which probably is the main reason for the strain. Then also realised that I had difficulty holding the flute stable. I have just completed 2 years in flute playing and I know it is not much, but I was feeling stuck at a point in tone development, beyond which I couldn't move forward. I tried your recommendation on the alignment of the headjoint with the far end of the hole. Suddenly everything got much easier, holding the flute, the finger movements and even making a clean unblocked sound was easier. I practiced with this alignment for 2 months suring summer. My private lessons begun again this week. My teacher told me that this alignment is not apropriate and it may create tone problems in the future. But still we will try it for a while because its more comfortable for me. The thing I want to ask is, my flute is not inline, that is, the flute key which is the closest to the hole is not aligned the same to the other keys. Then which key should be my reference? I have aligned according to the center of the second key, maybe that has turned the headjoint too much inward. The second thing is, is this alternative alignment well known in Europe? I have been hearing that European style and US style can be different.
Thanks in advance
Nalan
Dear Nalan,
I've done a lot of research on aligning the headjoint for comfort. The position is slightly different for every player (finger length, chin shape, lip shape are variables.) but it definitely does not cause tone problems in the future. Many of my students, and myself, have no problem playing like this for years with excellent tone development. Once you find the comfortable alignment, mark it with a sticker on barrel and head-joint, or with a shiny-surfaces marker; make a tick mark.
I line up the far side of the blow hole with the center of the keys.
This alignment is also recommended by Quantz (1752), Devienne (1795), Berbiguier (1820), Drouet (1827), Dressler ((1828), Tulous (1835) and all sorts of fundamental flutists from the past and present. Let your teacher know. They are all listed in the new reprint of Drouet's Method in the XIII page of the introduction.
So yes, align your headjoint to suit your own ergonomics. Experiment, and then mark it. You can always move the marks.
See: www.jennifercluff.com/lineup.htm for more info.
Best, Jen
Thanks a lot Jen,
I'll experiment to find the best position.
Regards,
Nalan
Oh my goodness, this helped me so much. About the 7th time I've picked up the flute and I've been getting discouraged with the way it was rolling; this made all the difference and I played for a very long time without the pain I'd had!
Dear Joe,
So glad it helped!
Best, Jen
This comment has been removed by a blog administrator.