It can happen to anyone!

I consider myself to be very lucky. Throughout most of my piano studies, I have had the good fortune to work with teachers who stressed an efficient and effortless technique. As a result, I have felt totally at ease at the piano and have avoided any playing-related injuries, in spite of a demanding performance schedule.

As many of you know, I have also been a long-time musician wellness advocate, lecturing on these topics as far back as the 1980s. In 1989, I instituted a pioneering course on wellness at Ohio University long before it was the "pc" thing to do. Information about healthy practicing and injury prevention strategies is a standard inclusion in my wellness course and my wellness lectures.

Given all my knowledge, how did I recently end up with a diagnosis of carpal tunnel syndrome? CTS is the most common peripheral nerve compression syndrome, caused by the impingement of the median nerve. Symptoms can include numbness, tingling or burning pain in the first three (and half of the fourth) fingers of the affected hand. In my case, I attribute my condition to computer overuse and misuse based on these likely precipitating factors:

Factor 1

If you've ever sent me e-mail, you know that you can expect a very quick response. To put it succinctly, I am addicted to e-mail, regularly checking e-mail from home, at school and on my laptop when I'm on the road.

Factor 2

Many years ago I used to sleep with my hand bent under my chin. I would awaken with a "numb" hand. I purchased a splint that kept my hand in a neutral position and, after a year or so, trained myself to no longer do this. Even though this happened years ago, I've been told that a predisposition for nerve impingement can be a lingering consequence.

Factor 3

In January 2007 I purchased a new desktop computer, accompanied by a mouse with a tiny scrolling ball in the center to enable you to move the cursor with the stroke of a finger. When I showed my physical therapist how I used the new computer mouse (the scrolling wheel is moved by the index finger), it was clear that this motion created incredible tension in the adjacent middle finger. I believe my current plight may be due to the use of this new tool that was ironically designed to make it more "ergonomically efficient."

Factor 4

As careful as I am at the piano keyboard, focused on proper seating, taking breaks in my practicing, warming up and utilizing a natural technical approach, I am not nearly so cautious at the "other" keyboard, where my time has recently grown exponentially.

[ILLUSTRATION OMITTED]

Factor 5

When the music building at Ohio University was constructed in 1970, the furniture purchased, including my desk, was not designed for computer use, although I am still using it today. My desk at home was also purchased pre-computer, and is not ergonomically appropriate for computer use.

When I noticed at the end of April that I was awakening in the morning with a numb right hand, I dug out my old splint and wore it to bed. However, this time, my hand continued to go numb even with the splint, and the numbness wasn't going away immediately upon awakening. After wearing the splint for a couple of weeks and taking an anti-inflammatory medication with no improvement, I decided to see my physician.

His "tentative" diagnosis was carpal tunnel syndrome. Although that thought had already crossed my mind, I was hoping to avoid hearing those words. He recommended that I try physical therapy and scheduled an electromyogram (EMG) and nerve conduction studies to provide a definitive diagnosis. Meanwhile, I managed to perform a major piano trio concert with my string colleagues in early June, even though the tip of my middle finger would periodically begin to go numb. Playing the piano when you can't feel the edge of the key is definitely disconcerting! (Luckily, this did not occur during the concert!)

I have chosen to share this personal saga with you to encourage you to: 1. Carefully evaluate your computer environment and your computing habits, and 2. Seek medical assistance early, should a problem arise. If this can happen to me, it can just as easily happen to anyone. Here are a few basic recommendations:

* Make sure that you are seated at the proper height and distance from the computer.

* Use an adjustable chair with a backrest to maintain the lumbar curve of your back.

* Place the computer and monitor directly in front of you to avoid twisting your neck or body.

* Position the monitor so your eyes are level within range of the top third of the screen.

* Experiment with a wrist pad to help reduce stress on the wrist.

* Take advantage of keyboard shortcuts to avoid excessive use of the mouse.

* Elevate your wrist to allow your fingers to move effortlessly.

* Take breaks every hour to rest your hands, body and eyes.

In spite of trying every available treatment--physical therapy, cortisone injections, acupuncture and massage-the escalating symptoms forced me to conclude that in my situation, the appropriate choice was a surgical solution. By the time you read this, I hope that I will be back to normal, and all of this will be a distant memory.

BONUS BYTE

You can read MTNA's newly adopted wellness policy by going to: www.mtna.org and choosing wellness from the resource tab.

Gail Berenson, NCTM 

MTNA president