The purpose of this article is to demonstrate to musicians with special needs that there may be custom key solutions that would allow you to continue in music performance. In addition, solutions used to modify instruments for damaged hands may provide ideas for other repair technicians when serving their clients. I intend this article to be an ongoing project where new examples will appear as they become available.

The majority of hand problems that musicians have appear to involve repetitive motion syndrome including carpal tunnel. Because of the nature of my work, I find that I continually have incipient repetitive motion syndrome. I cannot directly remove the cause of my syndrome, but I can perform stretching exercises that stretch muscles and nerve sheaths from fingertip to fingertip across forearms, arms, shoulders, chest, and neck. It takes one or two sessions of stretching to get rid of "tennis elbow", but it takes several stretching sessions to noticeably increase my "finger speed." Without stretching, my hands would eventually turn into clubs. Ultimately, my own personal experience shows me that deep tissue massage therapy, acupressure, and carefully designed stretching exercises can greatly improve these conditions. This is especially true if one removes the cause of, for example, carpal tunnel.

I had a young client whose parents bought her a premium oboe for high school. The parents assumed that a new instrument did not need any repair, thus the daughter played the instrument "as received". After several months of playing, the young lady developed a substantial case of carpel tunnel in her right wrist. She went to a hand surgeon who, unfortunately, showed her a completely unnatural way of holding her oboe. This led to further problems with her wrist. After bringing the instrument to me to check over, I found that the cork pad in the right hand stack E key had changed its shape and leaked badly. She had been squeezing to get the key to close and this squeezing had caused carpel tunnel to develop. I replaced pads as necessary and set her oboe up for very light finger pressure. The thumb rest was moved to optimally fit her right hand. It took several months, but her carpal tunnel eventually went away.

There are several devices on the market that can help relieve stress on the right hand by supporting some of the weight of the instrument, but ultimately, the instrument needs to be adjusted such that it can be played with a very light touch.


Missing Fingers

	Jeff approached me several weeks ago to see if I could solve his problems while trying to play saxophone. He had a fight with a shaper and it cut off part of two fingers on his left hand. His index finger was cut between the knuckle and second joint and his second finger was cut off between the first and second joints. He had purchased a new Keilwerth alto saxophone that has adjustable palm key spatulas. This proved a great aid while adjusting the custom keys to allow him a "natural" hand position and to further allow him to play up to a high F. An additional challenge was his request that I mount the custom key extensions in such a way that, if he chose to sell the sax in the future, they could easily be removed without damaging the instrument's finish. The solution was to build a clamp on the end of each key extension that mounted on the key arm behind each key cup. Using a clamp mount proved beneficial because it also made it easy to remove a key extension to further modify it. You will note from the picture that each finger is in a natural position for playing its respective key(s). To correctly locate the hand, it was necessary that the little finger was located just above the G# key and that the third finger was just above the G key. From this point, the correct location of the second and first fingers was accomplished by modifying the angles of the key extensions. The last step involved adjusting the palm key spatula heights and positions such that they could be depressed by the appropriate part of the palm and index finger knuckle. I am pleased to say that Jeff has returned to playing jam sessions and is enjoying sharing musical experiences with other musicians.
(click on images for larger view)

To be continued -