Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

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Hand Hypermobility Helpers- Part 2

To get started, take a look at this gallery of images related to setup, bowhold, and simple solutions for teachers and students.

So here's the deal- when students have hypermobility, it means their joints are unstable because they don't have a normal end range.  When you then ask unstable joints to support weight or articulate, you are putting undue stress and strain on the joint and just continuing to ask the ligaments to do the work, rather than strengthening the muscles to support the joint.  What we want to do is strengthen the muscles as much as possible, and then add load.  The easiest way to do this is take the instrument away and isolate specific joint issues.  Many PT's use theraputty as a great way to get specific finger strength (it's basically a denser version of silly putty with different resistance levels).  This would be great to have on hand in studio (no pun intended) and add to your weekly lessons, especially with growing kids.  The most important moves to focus on would be the finger pinch, keeping the fingers curved.  For string teachers working with wayward pinkies, I like this video about using a clothespin for resistance- also a great idea.  (Also, take a look at how to teacher kids to hold pencils- great if you're a parent!)

 

I'm also a huge fan of bow hold buddies, especially for young children.  This creates a pinky nest to help curve the pink, as well as provide a nook for the right thumb, especially if it locks out usually.  They also make something called the "cello-phant" which looks interesting. 

For flute, clarinet, etc., I've also seen finger slings/rings/ etc, that can help to train the joints to stay bent and start to strengthen the muscles.  Also ask the student to look at how they type, text, hold a pencil, etc.  If you can cultivate even a smidge of awareness in daily life, there can be huge transfers in a musical setting.

The bottom line, is that continually locking out the joint puts strain on the joint, can lead to osteoarthritis, pain, and other issues, and that the surrounding muscles are usually weak and can't support the movement being asked.  Some people live a full pain free life with hypermobile joints, others deal with osteoarthritis early in life, or are diagnosed with Hypermobility syndrome.  Helping students (or yourself) can improve your performance and prevent future pain.

Hypermobility- What is it? Part 1

Picture courtesy of  CoreWalking - can you see how the left leg moves beyond perpendicular?  The ligaments aren't telling the body when to stop moving backwards.

Picture courtesy of CoreWalking- can you see how the left leg moves beyond perpendicular?  The ligaments aren't telling the body when to stop moving backwards.

Whether you know it or not, you probably have students, colleagues, and friends who are hypermobile, whether in larger joints or smaller joints.  Hypermobility, or as we called it as kids, "double jointedness," is a joint (or joints) that move beyond normal end range.  The ligaments (which duct tape bone to bone) are loose and don't offer feedback to the body to say "hey, stop moving here!" It means that the body doesn't observe normal end range for joints because it's not receiving feedback from ligaments. Hypermobile folks end up in all sorts of movement spaces, from yoga and pilates to crossfit and olympic weight lifting, and helping (and identifying) hypermobility can help your music students greatly.

Notice how the standing leg (the right one) is SUPER hyperextended and the elbows are as well.  This yoga pose manifests in many different styles, and in many permutations, but I imagine that in this case, the practitioner is hyperextended to make the pose "prettier" rather than respecting her end range and coming out of the pose a bit.

Notice how the standing leg (the right one) is SUPER hyperextended and the elbows are as well.  This yoga pose manifests in many different styles, and in many permutations, but I imagine that in this case, the practitioner is hyperextended to make the pose "prettier" rather than respecting her end range and coming out of the pose a bit.

Here's an image from  80gladstone  demonstrating hypermobile elbows.  When a student hyperextends the joint (left), they are no longer using muscular energy to support themselves.  This is a problem in music, because we need muscles to support weight and help articulate keys.

Here's an image from 80gladstone demonstrating hypermobile elbows.  When a student hyperextends the joint (left), they are no longer using muscular energy to support themselves.  This is a problem in music, because we need muscles to support weight and help articulate keys.

The most obvious example of hypermobility is in the knees.  Jonathan FitzGordon recently did a post on hypermobile knees, and how they manifest in yoga classes, so let's take a look.   This simple drawing above shows a knee that has locked and gone beyond normal vertical joint end range.  Many people can hyperextend their knees-it's not uncommon.  The risk is when you spend all of your time in this position (standing, yoga-ing, walking, weight-lifting) the body doesn't stop at the end range of the joint, your ligaments are overstretching (if they aren't already), and ligaments are not an overly elastic tissue.  Many people with looser ligaments have always been that way- I remember little kids who could do full splits, lateral splits, etc, without a warmup, because they were just built that way.   Now let's look at how that affects us in the Music and teaching space.

Ouch!  I definitely wouldn't want to load this joint in this position!  Yes, the right thumb is in the right "position" to hold the clarinet in terms of the thumb ledge, but it's not in a great position to hold any weight!

Ouch!  I definitely wouldn't want to load this joint in this position!  Yes, the right thumb is in the right "position" to hold the clarinet in terms of the thumb ledge, but it's not in a great position to hold any weight!

We will all meet students and colleagues who are hypermobile in their hands, which often means that supporting an instrument, pressing keys, and holding a bow will be challenging in different ways.  String players will be familiar with students who can't bend their thumb and hold the bow (their muscles are weak!) or who can't bend their pink on the upper side of the bow.  Wind players may be familiar with the double-jointed thumb, which can cause problems with supporting the weight of the instrument.  Whether it's a flutist's stray pinky or a violinist's dubious bow hold, students of all ages and levels can have issues with hypermobility.  My next post will give some suggestions for what to do with hypermobile students, or how to help yourself!

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