Living and Playing with an Injury
By Rena Urso
In early October I suffered a significant sprain to my right wrist. It was a beautiful autumn evening as I headed out for a walk with our enthusiastic and loveable 70 lb. puppy Po. As soon as I opened the door, Po shot out of it like a rocket, slamming my hand that was holding his leash into the door jamb. After a series of X-rays and an MRI, the orthopedic hand specialist delivered the news: “Good news, nothing is broken, it’s a bad sprain. Bad news, nothing is broken, it’s a bad sprain.” He went on to explain that soft tissue injuries like this take much longer to heal than broken bones and it would be at least three months until I’m 100%. As I continue to navigate through the recovery process of this injury, I am sharing my journey with hopes that it might be helpful or comforting for anyone who is working through something similar.
The past three months have been a learning experience; humbling, painful, and challenging. I’m still in the care of occupational therapists (OT) and a small group of specialized doctors including an orthopedic hand specialist. With long-awaited orchestral work returning this past fall, I was excited about getting back on stage. Unfortunately, that was not in the cards, and one by one, I let go of all my performances through the first of the year - a difficult but necessary decision. There were times I broke out in tears at the OT, worried that even when I was fully recovered by their standards, it would never be quite the same by mine. The good news is that I am making progress. With the combined efforts of this excellent care team, I can honestly say that though I’m not yet at 100%, I’m slowly getting there.
One injured wrist would have been plenty, but because of using my left (dominant) hand for pretty much everything, it didn’t take long until I began to experience problems with my “good” hand; carpal tunnel symptoms, a cyst at one of my finger joints, and mysterious nerve pain, all from overuse. Up until recently, even the most basic activities and household tasks have been arduous and often painful. Typing this column, for example, falls into that category.
Injuries are a scary thing for musicians. It’s not something we are comfortable talking about until safely on the other side of it all. It was surreal sitting in the ER watching the doctor build a cast on my hand/forearm to completely immobilize it. I have been injured many times over the course of my career, most of which were caused by repetitive motion and overuse, and not something caused by an accident. Being told that you must stop using your hand is a tough pill to swallow; the immobilization, and literally doing nothing is what has to be done so that all the injured tendons and ligaments can have a chance to properly heal.
Once my immobilizing cast was removed, I did what any of us would do – I tried to play. It was awful for all the reasons you can imagine. At first, I tried to stay in shape by playing long tones but even that was impossible; holding either instrument for more than a minute or two was problematic. I wasn’t even strong enough to do at home exercises prescribed by my OT - they were simply too much.
Flute playing continues to be challenging; the weight and pressure on my right thumb; navigating the foot joint, and finding the balance of the instrument between my left and right hands. For a while, all I could play were left-handed notes – I struggled with notes in the right hand. I almost dropped my instruments a few times due to my lack of coordination and strength. Stamina has been another hurdle; both with the use of air and the physicality of holding my flute. Playing for even 3 minutes at a time before feeling intense fatigue in my hand was a big deal, so I learned to stop short of this, knowing that pain follows close behind fatigue. My hand and stamina have been steadily improving over the past few weeks, and although I won’t be playing a full concert on flute in the immediate future; I’ll get there.
Piccolo has had its own separate set of obstacles. Between its small-bore size, closer spacing of keys, and not having quite enough fine motor skills and coordination, holding the piccolo was awkward in a different way than the flute. Piccolo has become much easier – the finer motor skills are improving, and I am now able to play moving notes at a slightly faster pace than a week ago. Even the smallest steps forward are progress. Healing from an injury is not always linear and there will inevitably be steps back.
Over the past couple of months, I brought my flute and piccolo with me to a few OT appointments. This has been especially useful for my care team to better understand how and what I do as a flutist/piccoloist: the position of my hands and their movements, and how they differ from flute to piccolo. If you are working through an injury that is preventing you from being able to play, I highly recommend sharing this with your care team, because it will help them to truly understand what it is you need, and also know where to go next with your treatment plan.
The process of finding the ideal support splint/brace is worth mentioning because it has been almost comical; including the first soft-ish cast I was fitted for in the ER, and several experiments with physio tape, I have had a total of 9! The moral of the story here is that each one represented a steppingstone and provided me with support, stability, and protection at that moment to help me along the course of my treatment. Many times, I have asked my care team what I can/can’t do. Each time their responses are the same; “…if it hurts don’t do it, rest, do nothing as much as possible.” On some level, I knew this but still sought out their guidance, hoping to get a different answer each time.
How am I rebuilding?
- Maintaining a positive attitude and focusing on what I can do instead of what I cannot. It’s easy to feel discouraged in times like this, and when this happens, I draw upon my strength and resilience and build on what I can do.
- Accepting that time and patience are essential for the body to heal itself. We can’t rush the healing process – it’s going to take however long it’s going to take. It wasn’t easy hearing my doctor say “…. three months until you will be back to 100%...” but here I am, past the three-month mark, and though dozens of balloons didn’t fall from the sky to commemorate that milestone, I am definitely beginning to see and feel my progress. The takeaway: accept where you are in the moment and know that everything is temporary. Also, be generous with days off, they are essential to the healing process.
- Warming up my body before playing. Long, slow inhalations and exhalations while draped over a physioball and gentle stretches are excellent ways to invite in greater awareness. Constructive rest is also an ideal way to spend all the micro-breaks; reconnecting with my breath, resetting, and noticing. We know our bodies and selves better than anyone else – as I have written before in other columns; get quiet, deepen your awareness, and listen to your inner voice so you can take what you need.
- Creating daily exercises which directly address my specific limitations, tailored to where I am that day. This speaks to the importance of being aware of your body and the space you are in, staying curious and focused on the process, understanding there is always another way (Thank you, Clem Barone!), and of course, all the above in a kind and non-judgmental way.
- Slow, thoughtful practice in front of a mirror. This approach to practice is essential; the mirror offers us greater awareness to see what is happening at the moment so we can address it immediately.
- Keeping the rest of my house in order; tone, vibrato, dynamics, embouchure flexibility, and articulation. Playing technical studies at even a moderate speed has not been remotely possible during this time. It has given me the opportunity to focus on other areas of my playing.
- Exploring other activities that will aid in the recovery process and ultimately make me stronger. Meditation and yoga are a part of my day, every day. I implement the focus on what you can do versus what you cannot mindset to my yoga practice and teaching as well. Throughout this process, I haven’t been able to do any weight-bearing poses with my hands/arms. Core work and balance shapes as well as most Yin Yoga poses, on the other hand, have all been available to me.
- Body Mapping is an invaluable part of the healing process. Even though my wrist injury isn’t a result of an incorrect body map, taking a deeper dive into the anatomy of the hand and arm from the perspective of an injured musician has been enlightening. There is always something new to learn or in this case, relearn. As Shakespeare wrote, “…. sweet are the uses of adversity…”
When we look at the habitual things we do every day through a different lens, we invite the possibility of uncovering a new or better way to do what we do. Often, these are things we do without much thought because they are ingrained or automatic. I enjoy practicing my various technical exercises and etudes in slo-mo. We don’t have to be injured to practice in this way, and so much can be gained from it. Try deconstructing your technical studies and etudes with this attention to detail approach, always with the most beautiful sound and musical expression you would otherwise implement at tempo, and see what you discover.
Here’s to brighter days ahead for us all.
Be well.
Rena Urso is a member of the faculties at California State University Long Beach and California State University Stanislaus, and a Course Coordinator for California State University Summer Arts – home to her popular biennial summer flute course, The Complete 21st Century Flutist at CSU Summer Arts. As a Licensed Body Mapping Educator, she presents Body Mapping workshops and masterclasses all over the world. Rena is also a teaching artist at the International Piccolo Flute Academy. An active freelance musician in the San Francisco Bay Area, she is a member of the Oakland Symphony, the Oregon Coast Music Festival Orchestra, and Alcyone Ensemble. Additionally, she is a certified yoga and meditation instructor and member of the NFA Performance Health Committee. Rena lives in the Chicago area with her husband John and their three dogs: Lillie, Po, and Girl. She is available for personal or group Zoom Body Mapping sessions. For more information about Rena and Body Mapping tips, please visit www.renaurso.com.