Every month we put readers' questions to some of the string

world's top names. Here, teachers and health specialists

give their advice on helping double-jointed students

I have a new student, quite advanced, who has a double-jointed

left thumb, and plays with it in a locked 'L' position (pictured).
I am afraid that this may affect shifting, intonation and vibrato,
and I feel she should relearn her left-hand position with
a relaxed curved thumb. Would you agree? If so, what would be
the best way to encourage her to practise in a different way?
One curious thing is that in moving to third position, she will
actually go to fourth position, and play with the hand leaning
back to get the third-position notes,
BARB MCDOUGALL, VICTORIA, CANADA

MIMI ZWEIG JANET amazing pyrotechnics. But most of

The double-jointed
thumb is always a
difficult nut to crack.
On the positive
side, double-jointed
students have the advantage of flexible
knuckles that facilitate a warm vibrato.
If the thumb can remain loose and slide
gently along the fingerboard during
shifts, the double joint should not be
a hindrance. Also, the student can try
various amounts of pressure in placing
fingers down. Too much pressure on
the fingerboard will force the thumb
into an awkward position, and make it
more difficult to play in tune. Less finger
pressure is better. I have found that in
the course of a lesson, if I gently place
the thumb in its more natural position,
strength in the thumb tendon will
develop over many months (if not years).
HORVATH
Studies have
shown that
double-jointedness
(hyperlaxity) is quite
common, especially in string players,
and these players maybe at increased
risk of injury. As teachers, we find them
loose' and able to do things more easily
initially. Hyperlaxity may affect all
instrumentalists, some not only in their
hands but also in their torsos, necks and
other joints in the body. Due to ligament
laxity, these players cannot prevent their
joints from buckling, hence they must
use added pressure to maintain curved
fingers. In the long run, this added force
can cause injury and dysfunction in the
joints, including arthritis.
It is said that Paganini was also very
hyperlax and that is why he could do
us are not Paganini! I wonder if this
student also has difficulty with the
bow hold, as her right thumb must
coUapse as well, which will cause pain
in the thumb and prevent smooth bow
changes and string-crossings.
LINDA ROSE
I have had many
students with this
problem, and double
joints in other fingers.
I never accept that
the problem can't be overcome, although
it takes a great deal of determination for
students to change the way they play.
Each person's hand is different, so
there is no universal solution. With
younger students, a parent can gently
hold the thumb in the proper position
during parts of the practice. I have also

34 THE STRAD MARCH 2014 www.thestrad.com


placed an object, such as a small spool
of thread, in between the thumb and
firstfingerfor a few minutes, to keep an
uncramped position. And one can never
underestimate the importance of looking
at the position of the hand during practice
- a mirror is helpful.
The relationship of the thumb to the
hand and fingers is very important.
Whether you hold the thumb opposite
the first finger or the second, it must be
relaxed andflexible,and move together
with the hand and fingers.
For strengthening, I have the student
hold the left hand up and move the thumb
inwards without bending the joint, then
outwards, bending a little. The thumb
must feel relaxed at all times. The pressure
when holding the violin should be equal
between the neck, shoulder and hand.
Violin tutor Dorothy DeLay had an
exercise where students would play a
whole-bow scale (starting on open G)
and move the thumb forward and back
twice, then under the neck and out twice.
The photos of the left-hand position
in Ivan Galamian's book Principles of
Violin Playing are helpful visual guides,
KATHERINE
BUTLER
It sounds
as though this
student might
be hypermobile in
the metacarpophalangeal joint (MCPJ)
- the one where the thumb meets the
hand - and possibly in other joints as
well. The extent of the hypermobility
could only be determined with clinical
assessment on and off the violin. There
is evidence that a higher incidence of
§2
hypermobility exists in musicians than
52 in the population at large, and there has
been debate for years as to whether this
is an advantage or not. The issue is not
so much learning to play with a relaxed,
curved thumb, as the affected thumb is
unable to maintain the desired position.
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owing to the MCPJ being too mobile.
The lack of ability to position the
thumb can lead to muscles within
the hand and forearm having to work
harder to sustain positions and make
the desired sounds on the instrument.
This can lead to generalised arm pain.
The collapsing of the left MCPJ could be
affecting the ease and quality of playing,
and in time may lead to other medical
conditions such as osteoarthritis in the
carpometacarpal joint (the thumb's
lowest, which goes down to the wrist).
Symptom management is paramount
when treating the hypermobile patient,
and splinting is particularly important
when resting joints. If there is no pain,
or once pain has settled, then treatment
must focus on increasing joint stability,
'I never accept that
the problem can't
be overcome'
LINDA ROSE
Strengthening the muscles surrounding
the affected joint(s), improving awareness
of the position (proprioception) of the
affected joint(s), and education about
healthy joint use and how to prevent
injuries from occurring.
Strengthening muscles can be done
using therapeutic putty, or isometric
exercises on and off the instrument,
Compressive tapes or splints can increase
the awareness of the position and
decrease the ability of the joint slipping
into an undesirable position. Patients
must also be careful not to place the
joints under undue stress (pressing too
hard on the fingerboard or holding the
neck of the violin toofirmly),A specific
splint has been designed for the purpose
of maintaining the thumb's MCPJ in a
curved position while enabling the other
joints to move and play with ease.
ROLAND
VAMOS
I start out with what
I call the standard
hand position, and
then I consider
the variations in physique and certain
limitations. No matter how many things
we think are verboten, there is always one
great violinist who breaks that rule and
still plays well.
The thumbs have always been a
source of woe. For the teacher, it means
bending down and looking upwards to
check the right-hand thumb, which we
usually agree should be bent outwards
near the lower half of the bow, or we
have to run around to the student's left
side to check on the left thumb.
Probably the best ways to attempt to
remedy this problem are: practising in
front of a mirror and monitoring the
thumb; playing without the using the
thumb at all; and stopping frequently
to correct the thumb, I always stress
relaxation, I make adjustments for each
student as I watch how the position
affects their playing. This is why
teaching is always a challenge.
My wife's teacher, Mischa Mischakoff,
would sometimes say in his gruff Russian
accent: 'The thumb - it would be better if
we cut it off,' His hand was agile and his
intonation perfect - he must have suffered
greatly watching unruly thumbs, •
Mimi Zweig is professor of violin at the Jacobs School
of Musk and director of the Indiana University String
Academy in Bloomington, US
Katherine Butler is a clinical specialist in hand
therapy based at London Hand Therapy, UK
Linda Rose teaches at the Cole Conservatory of
Music, California State University Long Beach, US
Janet Horvath is associate principal cello at the
Minnesota Orchestra, based in Minneapolis, US
Roland Vamos is a violin professor at Northwestern
University and at the Music Institute of Chicago, US
MARCH 2014 THE STRAD
35
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