RSI Musician’s Injuries: My Journey Overcoming Debilitating Pain and Nerve Damage

RSI Musician’s Injuries: My Journey Overcoming Debilitating Pain and Nerve Damage

Many might be surprised to learn that I once dealt with debilitating pain and nerve damage in my arms (RSI/Repetitive Strain Injuries). By my mid-twenties, I nearly lost the ability to practice shakuhachi.

As I type this out I’m 38 and it’s been over ten years since I’ve been pain and nerve-damage free.

Often, our bodies just need the right care and nutrition. However, with everyone after our money it can be very difficult to find actual help or answers.

(It’s common, though often unintentional, for well meaning individuals to subtly blame those suffering from “invisible illnesses” like RSI, by implying a lack of enlightenment, health, or effort. Those of us struggling with these conditions are, of course, not “inferior”.)

My Experience with Debilitating RSI and Recovery

“Musician’s injuries” are sadly all too common, running parallel to many occupational overuse injuries. In my case, I began crafting bamboo flutes full-time around age sixteen as my sole source of income. At nineteen, I moved to NYC to study shakuhachi where I would practice around six hours a day. Add all the other everyday tasks on top of this and RSI developed fairly quickly.

At first the pain popped up in my right forearm. Basically “repetitive motions” of the tendons were rubbing the nerves raw. These nerves travel from our fingertips all the way to the neck. In ’07, about a year into my studies in NYC, I actually switched from right-handed to left-handed shakuhachi playing to alleviate the pain (the bottom hand tends to bear more of the burden). My posture back then was also far from ideal and I spent years correcting it in my early twenties. (I didn’t return to right-handed playing until around 2020, as it simply feels more natural.)

I also started doing a lot of things left-handed, from flute work to brushing my teeth. Inevitably, my left forearm tendons and nerves began exhibiting the same issues. Over the years, I first explored alternative medicine and Yoga, but nothing truly helped my arms. Some practices even seemed to worsen them. Eventually, around age 25, I briefly gained access to U.S. health insurance and sought help from modern medicine… which proved to be quite a learning experience.

The Misleading Path of Conventional Diagnosis

I underwent scans of my arms and a nerve conduction study. Basically they shoot electrical currents through your nerves. This included shocking my ulnar “funny bone” nerve at the elbow.

However, like all tests, this one has significant holes. It often leads to misdiagnosis of carpal tunnel syndrome and ulnar nerve entrapment (cubital tunnel syndrome). In reality, it’s typically unnecessary for diagnosing these conditions because simple, more reliable physical tests can be done at home (a fact I learned only after electrocution).

After the shock tests and scans, I saw a surgeon. Predictably, they recommended surgery (the classic “when all you have is a hammer, everything looks like a nail” scenario). They proposed snipping the transverse carpal ligament in my wrists to “relieve carpal tunnel syndrome”. They also wanted to extract my ulnar nerve from its protective bony groove and relocate it just beneath the skin to address “ulnar nerve entrapment”.

The doctor joked that “After this surgery, if you slap the inside of your arm, it hurts like crazy!”

I told him I needed to consider my options, to which he replied, “Okay, we’ll just wait while your arms deteriorate”.

His pushy, macho demeanor triggered my alarm bells.

Clarity About My Body, But Also Getting Worse…

I went home and researched carpal tunnel syndrome and ulnar nerve entrapment. What immediately raised my red flags was that I had no wrist pain, which I’d told the doctor but he brushed it aside and assured me the nerve conduction tests “didn’t lie”.

With one search I found simple physical “flexion/extension” tests for carpal and ulnar. Best of all, no electrocution required. You simply hold specific positions and wait for pain. I held them and waited… no pain. Specifically, no wrist pain or ulnar/elbow pain.

While I was clearly injured, I clearly did not have the conditions I was misdiagnosed with so I didn’t need the drastic surgeries that surely would have left me worse for wear. Of course, I delved deeper into research and came across a book called “The Athletic Musician”.

I reached out to the author who confirmed that many surgeons often “farm out” those operations fully aware they may not be treating the root cause. The book and author offered me good advice and I began correcting my posture. My years of meditation helped me to be well aware of any excess bodily tension as well.

Now it was a case of healing my severely injured tendons. Despite my efforts the pain persisted and my function continued to decline over the years. I just couldn’t avoid the heavy work loads as a person who survives by crafting and teaching shakuhachi. By age 27 I was seriously researching disability benefits and facing the growing possibility of having to give up shakuhachi altogether.

By that point my daily life involved constant calculations of what I could manage. If I overextended myself I’d lose the ability to do simple things like hold utensils to eat, due to both pain and loss of motor function/sensation from nerve damage. I was performing contrast baths on my arms twice a day just to get by.

This involved filling a plastic tub with about eight trays of ice cubes and cold water and another identical tub with hot water, both in the bathtub. I’d squat down to submerge one arm in cold and the other in hot water up to above my elbows. I’d do three, three minute rounds). It’s a far more effective healing method than many.

(From the net: Contrast baths are a form of hydrotherapy involving alternating immersions in hot and cold water at specific rates, temperatures, and durations. This repeated temperature change is believed to cause blood vessels to constrict and dilate, creating a “pump effect”.)

The pumping action created by the contrast bathing is supposed to help the body remove waste cells and promote healing. The cold also significantly reduced my pain and inflammation. I had previously taken NSAIDs until I learned they could cause further health issues. So, ice water it was. I grew accustomed to it and actually looked forward to the relief. To maximize my “ice time” I’d work on memorizing Honkyoku by singing and visualizing the notation.

While icing helped, things continued to worsen. I was seriously looking into joining Buddhist temples by this point.

The Unexpected Breakthrough

One day I had a simple realization that I never once had any forearm pain after heavy lifting. Of course, “repetitive motions” are the cause for these injuries but it can make you cautious of heavy lifting too, at least in my case.

It felt like a long shot, but based on this small insight and considering my desperate circumstances, I decided to research weightlifting. I was already on the verge of losing my livelihood, my shakuhachi craft, and joining a Buddhist temple… so why not try?

Before jumping in, I researched physical training extensively. I committed to only the safest exercises executed with the most ergonomic form. The foundation was my prior years of correcting posture, body mechanics, and a heightened awareness of excess bodily tension. I always use(d) neutral wrists/grip, focusing on the safest exercises like ‘farmer’ and ‘suitcase carries’.

I also looked into nutrition to give my body what it would need to heal my tendons. Namely, all of the essential amino acids as well as avoiding common causes of inflammation, such as excess omega 6 and sugar. If I felt any worsening pain I would consider the experiment a failure, accept my fate, and proceed to the temple.

My first day in the gym resulted in no forearm pain. Second day was the same, and so on…

Within about six months I could do seemingly anything without forearm pain. I regained motor function and sensation that I had lost from nerve damage. It felt miraculous. I donated all those ice cube trays and the two tubs to the local thrift store!

I delved even deeper into understanding these mechanisms until I finally discovered “tendon remodeling”.

“Tendon remodeling involves both synthesis and degradation of collagen, with a net degradation beginning immediately after exercise, shifting to a net synthesis.“

In layman’s terms lifting weights caused my body to heal and modern science knew about it all along. Tendon remodeling should be fundamental knowledge, especially given how common tendon related RSI is. Yet, every professional I’d seen had either been ignorant of it, forgotten such a primary concept, or had reasons for not mentioning it. It felt like going to an ER with a deep laceration, and no one will stitch you up because they don’t know how, or have forgotten, or perhaps are trying to sell you something else.

Despite my results, some people have expressed to me, in various ways, that weightlifting isn’t “exotic” or “sophisticated” enough in their opinion. However, in my experience there’s no true substitute for the fundamental act of gripping with weight/resistance. Be it a weight or hanging from a bar or tree limb. In other words, for me there was no substitute for smart and safe exercise supported by good nutrition.

Your Path to Healing

I share this story for anyone suffering because they’re losing their ability to do what they love to RSI. If you’re struggling with RSI, I deeply and sincerely hope you find your path to healing. While each person’s RSI will differ, I hope that at least some of my experiences might be of use. No matter what, don’t give up on your body. Josen