What causes pain in my left wrist after extended violin sessions?

Question

Yesterday I had a real blast as I had the opportunity to practice my violin for at least four hours off and on including my lesson. While I enjoyed the nothin' but violin, I noticed that at least fifteen minutes after the last session of the day, my the inside of my left wrist hurt dully. If I hold it absolutely straight, I can alleviate all of the pain and even have a certain range of motion, but I can't bend my wrist back, or rotate it, and God forbid I try to pull my violin out and do vibrato.

I vaguely recall having this problem a while ago. I think that it went away after a day or two, but that feels like FOREVER. It feels almost like the tendons in my wrist are swollen, but there's no visible swelling from the outside or even redness.

I almost expect carpal tunnel syndrome, except that I'm kinda young (hardly even a teen) and I wouldn't expect to get something like that yet. Also, it doesn't really match the symptoms of carpal tunnel syndrome because if I let my hands hang like suggested for checking yourself, it doesn't cause numbness in my fingers.

What is physically causing this weird pain, and how can I alleviate it? Is there a way I can avoid it in the future? Is a factor of my playing technique causing it (maybe I'm clenching?)?

Quick edit: I had previously described the pain as "dull," but on second thought I'd call it semi-sharp. It's not like a knife, but it's certainly not muscular pain.

Answer 1

You don't have to over-dramatise this. You practiced for an unusually long time, your hand hurts a bit. It would almost be unusual if it didn't! There are probably some tensions that can be sorted out, check with your teacher. And maybe just don't practice for so long.

Answer 2

Standard generic advice first: It's probably a factor of your playing technique: poor ergonomics, too much muscle tension, or (most likely) both. No one can tell you exactly what's causing the pain over the internet: for that, you'll need a doctor. If it's an option, a doctor would probably be a good idea anyway. If you want to make it better without seeing a doctor, things that are more likely to help than hurt in the short term are rest, over the counter painkillers, ice, and a brace to hold it steady until it heals a bit.

I'd suggest e-mailing or calling your teacher as well: they may be aware of something in your technique that could cause these symptoms, but they might not have addressed it yet if you weren't having problems and they have other things to focus on.

Since this has happened more than once, you might want to look into physical therapy to strength whatever is getting injured before it happens again. Your doctor can help with this too. A therapist who works routinely with musicians is best, but second best is one who works with athletes: they'll at least understand the mentality of wanting to get back into the activity that caused the injury.

Answer 3

Although this is an old post, there are a few points that should be added to this discussion:

1. Pain is serious. It's your body's way of warning you, and should not be ignored or dismissed. I'm not sure I could even find a professional musician who hasn't encountered serious pain, and those who continue to play changed their behaviors in response to it. It's not at all hard to find those who "pushed through," or made the wrong changes, and wound up unable to play at all.
2. No, your posture and technique can't be diagnosed over the internet, but you should get them diagnosed by someone. Preferably, seek the advice of someone with an emphasis on sustainably healthy practices. Some teachers might actually teach unsustainable practices, or fail to recognize them. There are a number of physical therapists who specialize in these instrumental performance concerns, and you could seek out a teacher who has dealt with pain or injury themselves and come through the other side with healthy technique.
3. I would not dismiss significant pain as "Oh, you just played longer than you're used to" (the pain the OP describes suggests that its "set up" by habitual practices over days/weeks/years) ... but it is true that you should increase your endurance gradually. Any runner who suddenly runs four times longer than they have before will be in pain (and perhaps also at risk of injury). Four hours is not an unreasonable practice session (after all, many orchestra rehearsals are nearly as long), but you should build up to it.
4. Even with the ultimate, most ergonomic technique, there are limits. No one needs to be playing, say, for 24 hours. And no 4-hour rehearsal runs without breaks (not if unions or human decency are involved). A 4-hour practice session is enough of your day that its worth planning strategically. Your brain as well as your body will benefit from regular breaks; perhaps a Pomodoro-style 5-minute break in each half-hour.
5. What you're doing in those 4 hours matters. Which does more damage to your body, 4 hours of folding laundry or 10 minutes of moving pianos? Stay conscious of your body. Reading between the lines, the OP described the practice session as "a real blast"; perhaps they were enthusiastically and energetically tackling technically difficult material. I enjoy such practice sessions myself; you might find me trash-talking a musical passage like Muhammad Ali, and showing heightened physicality while practicing—pacing the room, scribbling notes and throwing the pencil down. While exhilarating, this is exactly the time that physical tension and effort are likely to enter my technique. Is my right arm relaxed? Are my shoulders balanced? If these kinds of questions are important for a smooth-as-glass bow tone in "Spiegel im Spiegel," they're also important for the left hand in the "Devil's Trill" or the third movement of the Barber concerto. (And, surprise, relaxation actually makes difficult passages easier.) And since we live in these organic, physiological bodies, our mental state is closely tied to our physical state, and a "manic," muscular practice session can be a bad idea. If I instead try to channel my mental energy into a Zen calm and practice even Sturm und Drang angst or blistering passagework with an emotive detachment that can "wear" the face-melting drama like an actor wearing a mask, then I have a better chance at using only the necessary muscles, contracting them no more than necessary, and keeping them limber when not in use.
6. As mentioned above, a multi-hour practice session should have a plan. It's too long a time to spend on one piece. And even 10 minutes is too long to spend, without a moment's pause, on one motion. If you're practicing a particular shift or scale, you will probably reach a point of diminishing returns after only a handful of repetitions. Plan your practice session to make the repetitive and physically demanding work (scales, arpeggios, speed exercises) take up less time than the work that is more mental and less physical (getting to know a new piece, working on interpretation). We learn little from rote drudgery. If you, say, try a shift to a note and land out of tune, don't simply re-try it 20 times until you happen to get it right. Engage your brain as well as your body: is there a pattern to your mistakes? Do you usually land low or high? Can you explain that (maybe by the musical context of what came just before? maybe by a physical aspect of your technique)? Now change what you're doing, armed with knowledge. The notion that you then have to repeat it numerous times to "lock in" the learning, that "practice makes perfect," is more sound when talking about learning across many days and many practice sessions than when talking about successive repetitions seconds apart.

Answer 4

You are correct in that you are clenching too hard. I'm an experienced violinist and pianist and I have had multiple wrist injuries from playing the violin. I suggest that you warm-up before practicing with stretches and 'tossing' your hands out and just warming up those muscles. Stretch the shoulders, elbows, wrists, and fingers before practicing, always (On BOTH Sides). If you're going to be practicing long, take a break every hour or so. Make sure to walk around and take a stretch.