My Hand Injuries

A few days ago one of my students wanted to delay his lesson as he had injured his hand, and this set me thinking about my own hands, and how often they have been injured. Pianists are supposed to treat their hands with great care, but I am sorry to say that I have been careless with mine, they have been injured many times, and I really have no right to be able to play piano at all, let alone to be improving rapidly at an age when most pianists have stopped improving, if they have not begun to decline. But if anyone is ever tempted to give up the piano because of a hand injury, my tale might persuade them to persevere, and if my tale is not enough, then the amazing achievements of one-armed pianists might do the job.

NEAR-SEVERED THUMB
My first act of carelessness almost ended my piano-playing career before it had begun. I was just 8 or 9 years old, and had just begun to learn some finger patterns from my grandmother. Whittling away at a piece of hardwood with a hunting knife (The H&S mafia was not so prevalent in the 1960’s !) I slipped and sliced the base of my left thumb. I was very lucky. There was a lot of blood, enough to make my mother come close to fainting, but somehow I had missed all the main blood vessels and nerves. At the local hospital it was pronounced that a dmaged tendon would, in time, be as good as new, so with a half dozen stitches the wound was closed and now only a faint scar reminds me of the misadventure.

SHREDDED FINGERS
A few years later I was making good progress and preparing for my Grade 5 practical. I had a morning paper round. One morning, a week before the exam as I was out delivering papers, I reached forward to stop a rattling sound from a front brake, lost my balance, flipped the bike, and found myself sliding down a gravel road with both hands being ripped to shreds .. one trapped beneath the handlebars, the other beneath the frame. When I looked all four fingers of each hand were missing a lot of skin and covered in gore.

In shock I staggered to the nearest house. I shall never forget the kindness of the lady that helped me. The first thing she did was to clean the wounded hands under running water. They looked bad. In some places the bones of the knuckles were exposed. Then she poured neat “Dettol” (a powerful antiseptic) over the wounds. The pain brought an involuntary scream and I almost hit the ceiling, but by killing any infection she almost certainly saved my fingers. She then put me in her car and took me to the local A&E department pausing briefly at the newsagents to leave the bag of undelivered papers and explain what had happened.

At the hospital the surgeon told me I had been very lucky. Once again there was no serious damage to joints, nerves or blood vessels, and he began to bandage my hands! I protested “You can’t do that, I have a piano exam in a week”. He replied with amusement, “You won’t be playing the piano for a long time lad.” . Nevertheless he agreed to bandage each finger separately, and to the amazement of the examiner I turned up for my exam at the appointed time. I passed comfortably (or should that be un-comfortably) although I don’t know if that was because my playing was so good, or because the examiner felt sorry for me.

FINGER TRAPPED IN CAR DOOR
I remained “accident prone” and was a regular in A&E but it was another fifteen years before my fingers were threatened again, when my wife, not seeing my hand on the roof, closed a car door on my fingers. Fortunately there are rubber seals on the door and in the door frame, so my index finger was squashed between 2 pieces of rubber.

Had it been metal on metal I would have lost the finger. Even so I screamed “Open the door!!!” , “Why?”, “JUST OPEN THE ******* DOOR … NOW!!!!”. So my right index finger is not quite straight. It healed with a permanent slight twist. Fortunately it makes little difference to playing the piano.

SECOND DEGREE BURNS
Roll on 10 years. I am on some scaffolding, stripping paint for the window frames. Something distracted me, and my attention was only drawn back to the job in hand by the smell of burning flesh. Looking back I saw (and felt) that I had inflicted about 10 square cm. of 2nd degree burn to my right hand. It took weeks to heal, and months to regain the lost flexibility between thumb and first finger but today the only reminder of the incident is a small patch that stays white when the surrounding skin is tanned.

SPRAINED WRISTS
Fast forward to 2007. I was working in a small tile company, looking after the computers, and had just re-started serious study of the piano. A customer had ignored the warning signs and was walking around in part of the warehouse. Worst of all she was wearing sandals, and not the regulation steel toe-cap boots. I moved towards her to ask her to wait outside, but as I reached there was a near-disaster, she dislodged a box of tiles from the rack. I had visions of severed toes and lawsuits, but luckily I managed to dive forward and divert the box so it landed harmlessly to the side of her foot.

Well not quite harmlessly. Deflecting a box of tiles that weighed well over 10kg takes some effort and it left me with a sprained wrist. A bad sprain. It was three months before I could play properly again. Looking back it is frightening how much worse it could have been. Broken tiles have been known top sever major arteries.

DISLOCATED FINGERS
You might think I had learned my lesson, but no. A year later I was living and working in Utrecht. Cycling home late on a drizzly night, a drunk walked backwards into the cycle lane, and into my path. I thought I could simply mount the kerb to the pavement to avoid him. Unfortunately the combination of speed, shallow kerb, and wet surface led to a crash.

When I regained consciousness I saw that the third and fourth fingers of my right hand were bent back at the big joints at an impossible angle. I heard a voice in my head telling me to keep my fingers still, get to the hospital, and all would be well. Fortunately I was wearing leather motorcycling gauntlets, otherwise I am sure I would have lost a finger or two.

Suffering an accident brings out the good side of people. A few folk from the nearby gambling arcade came to help. One secured my bike an put the keys in my pocket, another gathered my belongings, a third put me in a taxi and packed me off to hospital.

I was worried only about the fingers, but the doctor who saw me was far more worried by the fact that I had been unconscious. I tried to re-assure him that I had stuck my head many many times in cycling (and other!) accidents and it had done more damage to the road than to my head, but he still did all kinds of tests, and kept me in for several hours. It was a long time before anyone got around to straightening my fingers (reducing a dislocation they call it). When a nurse finally fixed my hands the “reduction” took a ftraction of a second – but never have I felt such pain!

This was by far the worst accident to befall my hands. I began to practice again as soon as I could press the keys without unbearable pain, but it was months before the RH regained fluency and over two years before it was anywhere near fully recovered. Even now I am still conscious that my RH 4th finger is sometimes a little slow to do what I want. So much for those medical web sites that quote about 6 weeks to recover from a dislocation. Yes I could use a knife and fork and tie my shoelaces after 6 weeks. Playing piano is slightly more demanding.

ARTHRITIS
Over the next few years I had a few more bike crashes as I explored the country on a racing bike, as part of the training for a Triathlon, but my hands suffered nothing worse than the odd bruise and mildly sprained wrists.

Which brings us to 2012, and my fear that I had developed arthritis in my left little finger. I thought a pain in the knuckle was due to a slight knock, but when it persisted for months it seemed that it might be arthritic. In denial and desperation I started to take chondroitin sulphate and glucosamine. There is no proof that it helps cartilage regenerate, but there is good evidence that it is harmless and some evidence that it might help. I also began to apply hot and cold compresses.

As the condition improved I continued to hope that it was tendinitis and not arthritis. Some experimentation proved that it was made worse (and probably caused, at least in part) by excessive practice of octaves and tremolos, especially if my finger was held straight. This had never bothered me when I was younger. I hoped it was that my tendons had lost some of their youthful resilience, but by 2015 I had to admit that I had an arthritic PIP joint. The real damage was probably done in that cycling accident as newspaper delivery boy.

I can still play as well (or badly) as ever. In fact I am still improving far more rapidly than society thinks possible for a 60 year old. But some kinds of music cause quite bad pain. I take pain killers before public recitals and experience, at worst, only mild pain for the next few hours. For daily practice I have figured out a way to tape the finger (with thin strips Dr. Scholes’s “moleskin”) in such a way that I still have good mobility yet can play the most physically demanding pieces without pain.

Incidentally,this has given me some insights into why the conventional “curved finger” position is so important. It is not about the musical effect or control of the keyboard. It is about directing the forces so as to avoid injury and minimise long-term wear and tear on the joints and tendons. I plan to research this and make it the subject of a future article.

LESSONS?
Is there a moral or lesson in this? Just this. If you want to do something badly enough, you can overcome most obstacles. Of course there are many people in the world who, to achieve their dreams, have overcome much bigger problems than a slightly painful little finger joint.

Nevertheless I think my story is worth hearing. If it persuades just one person to keep chasing their dream, when they might otherwise have given up, that will justify telling it.

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