Recovering…Again

Once again, I’ve found myself in an injury recovery protocol. This time, it is a fractured middle finger on my left hand due to a poorly executed attempt to catch a football. I was running and jumped to get it, the ball went off the tip of my finger, and I heard and felt a distinctive crunchy sound. Not good – I’ve heard that before, several times due to fractured fingers in middle and high school.

This time, however, I’m the lucky (?) beneficiary of experience with rehabilitation and recovery from a previous hand surgery and a spinal surgery. This one has been a walk in the park compared to the others, but there are some recurring themes here.

Get yourself to a hand specialist if you’re a flutist and you have an injury to your hand.

I went to an orthopedic urgent care on the weekend of the accident and was told that I had a small fracture. The recovery time was two weeks and I would need to have the finger immobilized in a splint. At that time, I insisted on seeing an orthopedic hand specialist and a hand therapist for a custom splint. With my past experience, I know that custom splints are so much more comfortable when built for my hand. The following Monday, I saw the hand specialist and was informed that the original information was not correct. I had an avulsion fracture of the volar plate, which means that a chunk of bone attached to the ligament pulled away from the rest of the bone. This sounds nasty, but it’s good news! The bone fractured before the ligament ruptured. Bones are so much easier to repair than ligaments. I did not need surgery and I did not need a splint, just a buddy wrap keeping middle and ring fingers together. In fact, had I worn the splint for 2 weeks, I would have been setting myself up for some permanent damage to the flexor tendon. Movement was required. Again, this sounds nasty—a fractured finger that is required to be moved, gently and frequently. Healing time was changed to 8 weeks.

Injury to a part affects the whole body

My whole left arm hurt. I was doing strange things with my whole body in order to try to type and prepare meals in the kitchen. I had final projects to grade for my college class and lots of things to do on the computer, as well as a family to feed.  I was sleeping in strange positions to protect my injured finger.  The rest of my body was compensating—taking up the slack for the injured part. This is by design…the team gets the task done.  I realized, yet again, that I needed to take more breaks and get extra sleep.

Massage therapy helps with healing

Self treatment using the skills I have as a massage therapist helped speed the healing. I used contrast water therapy, lymph massage, self massage of intrinsic muscles of the hand (those within the hand itself), and self massage of extrinsic muscles (those with one end in the hand and the other end somewhere on the forearm). I stimulated directly over top of the fracture site, gently, with intent to improve circulation to the area. I also started the hand therapy exercises for flexion that I was very familiar with from my previous rehab. I was very careful to not fully go into hyperextension. At my 4 week follow up, my range of motion and swelling were considered to be well above normal by the hand specialist.

Nobody likes not being able to do “the thing”

Frustration was plentiful. I was just getting ready to relaunch the manual therapy side of my business after a long shutdown due to the Covid pandemic. Two working hands are required, so that reopening has been pushed back again. I had several flute recording projects due. Two of them I was able to do with extensions to the original deadlines and the third was taken over by a colleague, FE’s own Keith Hanlon!  Thank you, Keith.

It could always be worse

Gratitude was plentiful. A broken bone is easy compared to what so many are suffering with other illnesses, financial difficulties, and death. This is just a temporary situation and change will come.

Returning to the flute in tiny practice sessions

I’ve done this before, too. I asked my doctor about flute playing at 4 weeks. He initially said no and I told him that middle finger isn’t weight bearing and pushing a key on my flute involves less effort than pushing a key on the computer keyboard he was using. He said I could try with the understanding that if there was any pain, I had to stop immediately. The first day, I played for 1 minute. I quickly found that my open hole C flute was more problematic than my closed hole alto. Covering the open hole with my middle finger wasn’t too hard, but my ring finger didn’t want to cooperate. How interesting that this finger, while uninjured, was not up to the job of covering its key! It’s not surprising when considering that the ring finger was also experiencing a lack of movement because of the buddy taping to the injured middle finger. Gradually, I was able to play for 2 minutes, then 3. Putting the instrument together was more of a challenge for my finger than actually playing. How curious!

Limited practice time requires more intentional planning

Knowing that I have an alto recording coming up, I decided to focus on alto flute until the recording is done. With severe limitations on practice time, I needed to be crystal clear in what my objectives were. What were the things that I absolutely had to get to as often as possible and what were the things that could wait? I decided that long tones, harmonic exercises, a traditional Irish folk tune played very slowly and one of Moyse’s 24 Little Melodic Studies would be my starting point. Then I added in extended techniques from the piece I’m recording, which is Flexion by Nicole Chamberlain. I commissioned this piece and am excited to have the recording appear on the virtual NFA Convention streaming this August. I isolated the techniques that needed work, for example, flutter tongue with crescendo on a low D and variation within pitch bends. The time spent making a practice plan is a great use of brain power and leads to good results without being overly demanding on injuries that are healing.

Mental study of the whole piece can be done without flute in hand

I’ve performed this piece several times already, but I still find that I can work for even more contrast in dynamics, in character, and in emotion. When the musical intention is very clear, it’s easy to find the movements that create that sound. This assumes one has a great understanding of how the body works in movement and what needs to happen physically to reliably and consistently create those specific sounds.

Trust in the process

My body wants to heal and will do so, given the time and all the things (sleep, hydration, healthy food, movement as tolerated) that are required. My flute playing skills will all come back once I can return to all the flutes without limitation. It just takes time and effort. My flute skills are not gone, they are patiently waiting for me to be ready to get to work. Each day, I’m a little bit stronger and a little bit farther ahead on this path of recovery.