Bicep Tendinitis

[ttf_Bellend]

Just got from my osteopaths today (she's a an old friend)having being diagnosed with Bicep Tendinitis.

I took delivery of a a Bach 16M slide with a 12 bell section a couple of weeks before Christmas and had got really in to the horn playing may be a total of three hours a day split up in 45 minute sessions. The horn like many Bachs didn't  have a counterweight which I thought wasn'nt a problem but alas........I was wrong.

A couple of days before Christmas I started to get severe pain in my left forearm and wrist which I realised must be from holding up the Bach.I had had similar problems before from a very old Holton TR180 ,but never from a small tenor. Sarah my osteopath friend told me this was in the main a referred pain actually coming from the bicep Tendinitis. I halso have some inflamation in the forearm and an extremely stiff left wrist joint...... bummer!!!

I don't have a weight that fits the Bach so have taped an old H N
White one on as a temporary sort of fix but part of the problem is that trombones not only can be front heavy but they also want to fall to the left.After a bit of experimentation I found the weight worked best for me at the very bottom of the stay and that got me me wondering if anyone else had ever looked at a counterweight that might help with the falling left problem ?
I was thinking along the lines of the weights you see on competition bows in archery but obviously on a smaller scale.

Any thoughts?

BellEnd

[ttf_BGuttman]

If this is a temporarily aggravated condition you may need to use an Ergobone (or equivalvent) until it heals.  Maybe also some NSAIDs (Aspirin, Naproxin, Ibuprofen).

I assume when you say "bottom" of the brace you mean the part closest to the gooseneck.  Sometimes that can be a problem because of the ferrule.

I have seen people with counterweights "off center" and I never know if they are just inept at installing them or the position makes a difference.  In your case it's probably the latter.  You might want to see if you can locate one of the old Olds or B&H oval weights where the short axis of the oval goes across the brace.

One other thing you might try.  I have a Martin Imperial where the brace for the tuning slide is solid.  It doesn't need a counterweight.  Maybe replacing the tube in the tuning slide brace with a solid brass billet may solve your problem.

I find I use the finger on the mouthpiece to counter a torque from the weight of the bell tending to pull the instrument to the left.

[ttf_Ellrod]

Ergobone (KBiggs might sell you one) if you want to continue playing through the condition. Or rest, along with NSAIDS, physio (which will likely involve stretching and strengthening). I've found a diclophenac topical cream helpful.

I hurt my left wrist in late Nov and it is almost back to normal. Still, first post-holiday rehearsal last night and my wrist was a little sore afterwards.

[ttf_Bellend]

Hi ,

Thanks for that!

Unfortunately, I am allergic to NSAID's, Naproxin had me in accident and emergency at my local hospital so I can't go down that route although my osteopath is confident it will get better with further treatment and daily stretching exercises.

Funnily enough I have the very B&H oval weight you suggest coming in the post from a repair tech who is also an old friend. I too thought it might be a better option and after measuring it the good news is that fits the larger tubing at the ferrule end on my Bach  to within 0.5mm.
 
The Bow stabilizer idea just occurred as I was messing around with the counterweight and I thought
there are plenty of "acoustical engineers" on the forum, I wonder if there are any mechanical ones who might chime in?

Anyway, it's something I might pursue myself out of curiosity.

Thanks again,

BellEnd
 

[ttf_BillO]

Have you tried some bicep exercises?

You might just start out with no weight at all, and while you're watching you're favorite TV show do 30 repetitions in 3 sets from fully extended (from hands above your knees) to fully flexed (hands as close to your shoulders as possible).  Do this at lest 3 times a week.  Once the tendinitis subsides, add weight - about 1-2kG - for maybe 10 - 12 sessions, then add a kG or so per step (10-12 sessions) until you are at 6 - 10 kg.  You can go further if you wish, but in the 6 - 10 kG range you will have little trouble with holding any trombone.  If you follow these instructions it will take you about 6 to 10 months.  Once you get there, keep up the exercise (mandatory).  Add weight if you like, bu tif not keep[ it at 6 - 10 kG.  Never push yourself too hard unless you are 18 and your first name is Arnold.

[ttf_eightyeightH]

Although your osteopath has had the benefit of examining you and I haven't; it might be worth pointing out that bicipital tendinitis at the elbow is rare - if not very rare (cf at the shoulder). I've never seen it (in 20 years of doctoring). And when it does occur, it's usual symptom is pain in the elbow on flexing the joint. Any joint pain can refer to the joint above or below, but again, elbow pain tends not to. So I just wonder whether the diagnosis is correct.

Tennis and Golfer's elbow and wrist tenosynovitis are all common as xxx.

Probably makes no difference, as the early treatments are all pretty similar - rest, mobilising exercises, NSAIDs, analgesics.

(Dr) 88H.

[ttf_Bellend]

Quote from: eightyeightH on Jan 06, 2017, 08:12AMAlthough your osteopath has had the benefit of examining you and I haven't; it might be worth pointing out that bicipital tendinitis at the elbow is rare - if not very rare (cf at the shoulder). I've never seen it (in 20 years of doctoring). And when it does occur, it's usual symptom is pain in the elbow on flexing the joint. Any joint pain can refer to the joint above or below, but again, elbow pain tends not to. So I just wonder whether the diagnosis is correct.

Tennis and Golfer's elbow and wrist tenosynovitis are all common as xxx.

Probably makes no difference, as the early treatments are all pretty similar - rest, mobilising exercises, NSAIDs, analgesics.


(Dr) 88H.
Sorry if I've given the wrong impression at all but when I was diagnosed with the Bicep Tendonitis the area she was concerned with was at the top of the arm/front of the  shoulder.
As well as that there was also problems  in the forearm which she said was not tennis elbow.
My wrist was also very stiff but after quite a few alarming cracking noise during it being manipulated it feels better already.

Thanks for all the advice it is very much appreciated.

BellEnd

<Edit: Fixed Quote>

[ttf_Steve Foote]

Here is a sweet suggestion.

Dark chocolate supposedly has some inflammation fighting properties. Might not work but it could be fun to try.

I know your problem is related to your shoulder rather than your elbow but my experience may still generate some productive thoughts.

Don't just think about your trombone playing as being the cause of the problem. Long ago when I played tennis I developed tennis elbow. I quit playing for about a year but it didn't get any better. One day my brother-in-law challenged me so I just had to give it another try. Guess what. The tennis elbow got better! Could it be that tennis wasn't the cause? I started thinking about what else could be causing the irritation. Turns out I was sleeping on my right side with my right arm bent so my hand was up under to my ear. It took me forever to learn to sleep with my arm extended by my side but it absolutely cured the tennis elbow!

Check out other activities / habits and see if you catch yourself putting a strain on your shoulder, perhaps through repetitive motion or anything that keeps your arm bent beyond comfortable for an extended period of time. Are you frequently reaching / working overhead?

Hope you can get some relieve soon.

[ttf_Steve Foote]

Here is a sweet suggestion.

Dark chocolate supposedly has some inflammation fighting properties. Might not work but it could be fun to try.

I know your problem is related to your shoulder rather than your elbow but my experience may still generate some productive thoughts.

Don't just think about your trombone playing as being the cause of the problem. Long ago when I played tennis I developed tennis elbow. I quit playing for about a year but it didn't get any better. One day my brother-in-law challenged me so I just had to give it another try. Guess what. The tennis elbow got better! Could it be that tennis wasn't the cause? I started thinking about what else could be causing the irritation. Turns out I was sleeping on my right side with my right arm bent so my hand was up under to my ear. It took me forever to learn to sleep with my arm extended by my side but it absolutely cured the tennis elbow!

Check out other activities / habits and see if you catch yourself putting a strain on your shoulder, perhaps through repetitive motion or anything that keeps your arm bent beyond comfortable for an extended period of time. Are you frequently reaching / working overhead?

Hope you can get some relieve soon.