Guitar Techniques - - TALK BACK - ‘Hand Ther­apy For The Mu­si­cian: In­stru­ment Fo­cused Re­ha­bil­i­ta­tion’

More of your in­sights and opin­ions.


Re­cov­ery from se­vere in­juries like Mr Mod­ern has (GT238) is com­pli­cated and mul­ti­fac­eted. Th­ese rec­om­men­da­tions for re­cov­ery come from the ar­ti­cle ab­stract

by J Warrington. Re­ha­bil­i­ta­tion us­ing the in­stru­ment in­cludes early re­turn to mod­i­fied play­ing, in­stru­ment-spe­cific ex­er­cises, sen­sory reed­u­ca­tion and man­ual ther­apy, im­prov­ing mu­si­cal fit­ness, a mul­ti­dis­ci­plinary team ap­proach, and in­stru­ment mod­i­fi­ca­tions and splint­ing when nec­es­sary. Ed­u­ca­tion re­gard­ing good prac­tice habits is es­sen­tial to avoid sec­ondary prob­lems on re­turn to full play­ing. This treat­ment ap­proach is valu­able fol­low­ing trau­matic in­jury, for de­gen­er­a­tive con­di­tions, and for non­spe­cific wrist and hand pain.

A re­ha­bil­i­ta­tion pro­gram for this gen­tle­man is de­pen­dent upon whether there is: 1. Bone and ten­don dam­age 2. Mus­cle func­tion as a re­sult of the frac­tures, brac­ing, im­mo­bil­i­sa­tion of the ex­trem­ity, sta­bil­ity of frac­tures with in­ter­nal fix­a­tion of the or­thopaedic in­jury or not. 3. Specif­i­cally, pe­riph­eral nerve dam­age af­fect­ing mus­cle func­tion and re­cov­ery of the nerve in­jury which can take 6-8 months to re­cover. Nerve con­duc­tion tests of the ex­trem­ity and elec­tromyo­g­ra­phy of the mus­cle groups in­volved can be per­formed by a physi­a­trist or neu­rol­o­gist to de­ter­mine how quickly the nerves are re­cov­er­ing as well as as­sess­ment of mus­cle strength and tone by a phys­io­ther­a­pist. This is re­lated to a loss of mo­tor or sen­sory func­tion as well. Ro­bot­ics can be used to as­sist in re­cov­ery as well as elec­tri­cal stim­u­la­tion in some cases. 4. Time: what is re­quired for ac­tive and nat­u­ral re­cov­ery of the in­juries ir­re­spec­tive of the pro­gram used. Some re­ha­bil­i­ta­tion pro­grams may have vir­tual soft­ware to en­able an in­jured per­son to see sim­u­lated vis­ual move­ments cor­re­lat­ing with brain func­tion of in­jured arm or ex­trem­ity but still hav­ing dif­fi­culty mov­ing the ex­trem­ity. This is the most dif­fi­cult part of re­cov­ery psy­cho­log­i­cally for a pa­tient with in­juries and the im­mo­bil­i­sa­tion away from work and ac­tiv­i­ties of daily living, the de­pen­dence on other peo­ple for self care and as­sis­tance with per­sonal is­sues, the im­pa­tience of see­ing only slow re­cov­ery of th­ese in­juries day af­ter day last­ing into weeks and months. Be­ing cre­ative is an im­por­tant fo­cus on the things one can do de­spite the in­jury and lis­ten to more mu­sic and slowly the plink­ing noises on his gui­tar will be­come full notes and then riffs to fol­low in the months ahead. Above all, keep pos­i­tive and keep work­ing to­ward the goal of get­ting bet­ter. As we say, a lot of what we hu­mans do to com­mu­ni­cate and live is in ‘our heads’ and re­quires pa­tience in the face of pain and suf­fer­ing and ‘tinc­ture of time’. 5. Med­i­ca­tions can ef­fect cog­ni­tive func­tion as well mo­tor func­tion of an in­jured ex­trem­ity. 6. Pro­grams for mu­si­cian re­cov­ery in Europe and the US: the pro­gram at the Chicago Re­ha­bil­i­ta­tion In­sti­tute for in­jured mu­si­cians may be use­ful for Mr Mod­ern to con­tact as well as for ad­di­tional ref­er­ences for med­i­cal and phys­io­ther­apy pro­fes­sion­als in Eng­land and else­where. Henry Leven­son, MD. Med­i­cal Direc­tor of Re­hab, LAC+USC Med­i­cal Cen­ter, Los An­ge­les (PS: I love Gui­tar Tech­niques!) Thanks so much for that, Dr Leven­son. We weren’t go­ing to add any fur­ther com­ments to the de­bate, but com­ing from one so em­i­nent I thought yours would be well worth us tak­ing heed of, as you never know what’s round the cor­ner! And I’m glad you like the mag­a­zine enough to lend such sage ad­vice and in­for­ma­tion!


I’ve only just got a hold of your 20 Tips: Play Bet­ter So­los To­day is­sue (GT239) as I live in the back of be­yond. The rea­son I love Gui­tar Tech­niques is that it al­lows me to im­merse my­self in my play­ing, for­get the day’s toils and get lost in a fea­ture for hours. I’m no An­gus Young but I do my best. I’ve got a lit­tle bolt-hole with a com­puter set-up and a de­cent sound­card so I can record my ef­forts us­ing GarageBand. What I tend to do is spend a few days go­ing through a par­tic­u­lar fea­ture – in this case the 20 Tips – and then record my­self do­ing some­thing based on the ar­ti­cle in ques­tion. That way I can check if I’ve im­proved! Some­times I use your back­ing tracks but I have a few of my own that I en­joy play­ing over too. Jon Bishop’s ‘com­mand­ments’ gave me a lot of food for thought, and I re­ally think I came up with some of my best stuff this time. I’ve not gone through the whole mag yet, but I’ll be very in­ter­ested in try­ing the Soul Chords and Fool For Your Lov­ing when I get a mo. Thanks for all the great stuff. And all the best from Oz! Dan, Queens­land We have quite a few An­tipodean read­ers, Dan, and it’s great that GT can be a source of en­cour­age­ment and in­spi­ra­tion out there – and what a good way of us­ing the mag to full ef­fect! We love com­ing up with th­ese big fea­tures, too, as we truly be­lieve you can’t get bet­ter tu­ition any­where (un­less you fancy send­ing Jon Bishop a ticket for a few one-to-one lessons). Do any of you have sug­ges­tions for fea­tures on spe­cific tech­nique or the­ory top­ics that you’d like us to cover? Let me know and I’ll see what we can come up with.


Thanks for the Play­ing With Fin­gers fea­ture. I’ve never been a great picker – can’t seem to co­or­di­nate the two hands well enough to do it to the level I’d like – and so it had oc­curred to me that go­ing ‘fin­gers only’ might be my best way for­ward. I’d been tin­ker­ing about us­ing flesh only, but your les­son gave me the chance to sit down with a big chunk of work and go for it prop­erly. It was in­ter­est­ing to see the dif­fer­ent ap­proaches of the var­i­ous play­ers you chose for the ex­am­ples, and I think I’m com­ing down on the ‘thumb and first fin­ger’ side of things, as Jeff Beck does. I love Knopfler’s play­ing but his ap­proach is a lit­tle quirky and I’m a bit of a sim­ple soul. I might also have a go with a thumb pick, as there are some great play­ers I ad­mire that have used one. I also like the fact that fin­gers or thumb pick play­ing might put me put me in a smaller pond of play­ers, rather than find­ing my­self swim­ming in a vast sea of far su­pe­rior al­ter­nate pick­ers! Stu Laing Cer­tainly play­ing with fin­gers makes you a lit­tle more un­usual. Those that use flesh alone al­ways have great tone and seem to be able to ma­nip­u­late their sound due to the im­me­di­acy of con­tact. Not to say that pick play­ers can’t, of course. I love us­ing fin­gers and do it a lot, but I’m not sure I’d have the courage to com­pletely forego that lit­tle plas­tic se­cu­rity blan­ket. GT writer Steve Laney, who did our re­cent Coun­try Work­out, is a thumb pick con­vert who loves it and now wouldn’t have it any other way. He gave me one of his to try and, while I con­fess to find­ing it great fun, again I’m not sure I could make such a whole­hearted leap of faith. Glad you en­joyed the fea­ture and good luck with your fleshy for­ays!

Dr Leven­son pro­vides the last word on hand in­jury re­ha­bil­i­ta­tion

Flesh only play­ing would you take the big leap of faith?

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