Tendinitis

For more than two months now I’ve been struggling with tendinitis, and no, it’s not because I am a pianist / piano teacher.

As I explained to a colleague,

I am hesitant to tell people about it because they automatically assume “pianist” => “tendonitis” as if it were some kind of foregone conclusion.  As you know, playing the piano, even for a long time, doesn’t cause tendonitis (unless you don’t know what you’re doing).  In my case it was squeezing the insecticidal soap spray bottle for about an hour two months ago which wrecked my arm.  Repetitive motion at its finest …  Everything has been hurting, and getting worse, for two months now:  lifting the tea cup into the microwave, doorknobs, even just emptying the dishwasher, vacuuming!, anything that requires my hand to squeeze / hold on to something and then turn my arm.  Because I’ve been moving in a guarded manner, all kinds of compensation pain has now developed – left arm (to “save” the right arm), muscles I didn’t even know I had in my arm pits are screaming …  We tried a two-week course of OTC anti-inflammatory meds which helped with the pain but didn’t improve the inflammation.  It seems like the inflammation has settled comfortably in my tendons / muscles, so one of the goals of PT is to aggravate / re-injure the tissue to get a better response from the body.  Not much fun.  But I hope it works.  Fortunately, and amazingly, it hasn’t much impacted my piano playing – it’s a different set of tendons and muscles.

As mentioned above, we tried physical therapy.  After the third session, Monday evening I found a rather large and nasty bruise on my right forearm.  The entire area was very sore, extremely tender to the touch.  Even though it must have been largely my imagination, it felt like everything was hurting that night.

The next day I decided that 3 times-a-week PT alone – which focuses exclusively on the injured area – was not enough, it felt too limited.  I went to see my chiropractor who worked on my wrist, shoulder, neck, and upper back.  I don’t remember but I don’t think he even touched my forearm / elbow.  He explained that since my injury had been caused by repeatedly squeezing a spray bottle it could very well be that my wrist was involved as well – he called it “chicken and egg”:  who knows what came first, injury to the wrist which then moved back to the elbow, or injury to the elbow / tendon which then impacted the wrist.  Regardless, there were problems with my wrist and he addressed them.  As happens often after my (rather infrequent) chiropractor visits, there was a feeling of opening up, as if things (what things?) were moving more freely.  Somehow I was breathing easier, and my entire right arm felt less tight (I had not been aware that it felt tight before).  Very difficult to explain.  We scheduled a follow-up appointment three days later.

I called PT and explained that the injured area was extremely sore and that I wasn’t sure what my therapist would be able to accomplish the next day – except for stretching exercises all treatments are hands-on: ten or so minutes of ultrasound to get the topical anti-inflammatory deeper into the tissue; cross massage (NO WAY would I allow anyone to massage that area).  Electric stimulation I might have been able to handle.  The receptionist recommended to skip the appointment and pick it up on Friday again.

Thursday I saw a (different) chiropractor for acupuncture.  This was a first and while I had never experienced it before I was perfectly confident that it would be a valuable step toward healing.  The therapist explained afterwards that patients usually feel a difference within 24 – 48 hours which in my case would be Friday or Saturday (today).  When I made the appointment the day before, I had also asked about homeopathic remedies.  Dr Springer recommended arnica (both taken internally, and as an ointment), and ruta.  She warned to take the arnica for only two days:  that should be enough, and if one takes it without the body’s need for it, it may actually cause the symptoms to reappear.

Yesterday, Friday, I had another appointment with Dr Hamler (first chiropractor).  He was very pleased with my wrist but still found (to no one’s surprise) issues with other areas.  I told him that I haven’t been moving normally for over two months, so it would be a miracle if nothing else (other than right arm) was affected.  I like the idea of setting the body up for healing.  Dr Hamler suggested to allow enough time between different appointments, enough time for the body to respond to each treatment.  I will have one acupuncture next week, and one chiropractic treatment, nicely spread out over a couple of days.

Yesterday morning I met with the physical therapist.  She felt that my body – despite the very obvious response it showed Monday evening – was not responding to PT the way she felt it should in order to warrant continuing with PT.  (Originally we had scheduled 4 weeks of PT.)  I was surprised because when I had asked at the beginning how long it might be before things improve I was told “weeks, sometimes months”.  She wants me to go back to my primary doctor and re-visit other options, including a cortisone shot.  I was very disappointed.  Mark had injured his elbow several weeks ago and PT had been such a fantastic experience for him.

Anytime a doctor asks if my arm is improving – I don’t know what to say.  There are so many fluctuations during each day:  I wake up sore and stiff but things improve right away the moment I start moving.  Then I do something stupid, like carrying a pitcher of water across the room to water some house plants, and suddenly my arm screams.  There are so many things I shouldn’t do with my right arm:  there is practically no kind of housework that does not involve gripping and/or twisting:  vacuuming, ironing, moving laundry from washer to dryer, emptying the dishwasher, opening the fridge, opening a bottle or the milk carton, opening the mailbox, door handles, unlocking the car, brushing teeth, …  My left arm isn’t used to doing all of that, so it has been complaining now too … I have started to use two hands to do most of these things now.

Then things get better again.  I explain that I live with this arm 24 hours a day so it’s very difficult for me to see whether things are improving over the course of several days or a week or two.  I think I am also used to the constant nagging discomfort now, so if it feels better it may not actually be better, it’s just that I have learned to live with it.  ?

Having said that, I am secretly (so as not to jinx it) confident again that things are actually getting better.  Ever since yesterday afternoon-ish, my arm has felt better, lighter, less tense, hardly painful – God, how tempted I am to pick up that viola, and play, you know, just for 30 seconds or so.  Couldn’t hurt, could it?  I know it would … Playing the viola, and gardening are the two things (well, in addition to wanting to be able to take care of household by myself again, not needing Mark’s help left and right) that are so so very difficult to not be able to do.  Dr Hamler has a sign in his office:  “In spring, at the end of the day, one should smell like dirt.”

Yes please.