Knee pain in 18 year old drummer.
16 year old drummer with concerns about injuries.
Stick size question.
Left hand on hi-hat playing.
Wrist pain in Australia.

Hand pain in Arizona.
Thigh Pain with Bass Drum Use.
Severe Calf Pain during Show
.
Wrist pain Practicing 2-3 hours a day.

 

The information presented here is not intended as a substitute for professional medical care, nor it is to be considered professional advice for a particular individual. Please seek professional care before under going any treatment. If you have a serious condition or a condition which has failed to improve in two to three weeks, you should seek professional health care.

 

Q. I am an 18 year old drummer and I have been experiencing knee pain while playing the kick drum. I have some tension on the bass pedal in order to develop leg strength.

A. Believe it or not, skeletal growth continues and matures until we reach our early 20's! Growth plates in the bones are still open while skeletal maturation occurs. Stress through growth plates (in the femur near the patella in particular) can increase the chances of irritation of the growth plate. Reducing stress is a good idea. Additionally, petellar stress can irritate the underside of the knee cap.

While there are many drumming techniques, (as many as there are drummers!) there are some fundamental things to consider which can help reduce bass drum leg stress:

1) Reduce pedal tension. The springs should NOT be in high tension. You do not need to build strength. You need to develop control. Back off tension. (although there are those who advocate higher tension, I recommend starting at a lower tension)

2) Make sure the bass is tuned well. A common error is over tensioning the head in a effort to increase rebound. Bass drum tension should be just to the point where the drum sounds "like a drum", +/- just a a bit. If the drum is over tensioned, it will transfer force into your body.

3) Make sure you are not seated too low. This is another common error. If you are seated too low your thigh is at a mechanical disadvantage and your muscles have to work much harder. Raise your throne so your thigh has a 5-15 degree down slope toward the drum.

4) Stretching of your thighs, hamstrings and lower legs should be part of your fitness routine.

Q. I'm a 16 year old drummer from Norway. I practice for about 3-4 hours a day, and I'm finishing school in a year, and that will probably result in 6-8 hours practicing a day (since I'm going to study jazz at a music conservatory). Lately I've been pretty scared of these drumming injuries, like carpal tunnel syndrome etc. How can I prevent these injuries from happening? I read an article about a drummer that got this so-called "tennis-elbow", that really destroyed his career. I've been playing the drums for quite some time now, and I have a very powerful discipline. Therefore I can push myself to... well, the extreme! It's especially an exercise that I do, that is practicing on a pillow with phonebooks under my arms for maximum intensity of muscle training for the wrists and forearms.

A. I compliment you on your desire and willingness to commit yourself to drumming. Before getting into any details, remember; drumming is an art and like other arts will benefit from life experience. In other words...make sure you find some balance in your life. Intellectual, athletic, cultural, social....these all can add balance and make you a more well rounded person. These activities give physical and mental balance to your life.  Don't limit yourself to drumming only or you will have little to say with your art!.

In no particular order, here are some ways to lessen that chances of drumming injury:

- Exercise and stretch daily.

- Cross train. Drumming should not be your only form of exercise or workout.

- Use good technique. If you haven't taken lessons from a good teacher, you should.

- Eat a well balanced diet.

- Pay attention to your technique while playing; it is easy to fall into poor habits.

- Check your equipment and replace damaged parts. Don't use cheap or damaged sticks.

- Don't over practice. If you are playing over 2-3 hours every day, consider cutting back.
You will learn better when your brain and body are rested. Injury can happen when you over-train,  just as in sporting activities.

- Playing on a pillow or other low rebound surface is a great form of practice. This can be used as PART of your practice. 10 minutes daily would be more than enough to help develop speed and strength. Like any form of physical exercise, be careful not to over-train. I would be not however advocate holding anything under your arms while playing, as this can easily overload your wrists, fingers and elbows. A balanced stroke which allows relaxed and natural rebound should be your goal.

Q. I want to use larger sticks to help increase the volume of my playing. My band mates say I am too quiet for the high energy music we play. Do you advice?

A. This question requires that we discuss several things.

First off, modern amplified music music creates interesting problems for drummers.  You should however never change your technique to increase your volume.  During rehearsals it is best that your band mates play to the level of your drums. This way you can play with the same techniques and intensities in both rehearsal and In live miked performances. Any volume problems in a miked performance can be adjusted by the sound personnel.

Secondly, I do not recommend using a larger stick to produce a "harder" hit. You should use a stick which fits your hand and suits your technique.  Of course you can use a slightly larger or smaller stick from time to time.  I would avoid dramatic changes in stick size however.  Good technique is all about control, relaxation, timing and endurance.  Good technique will enable you to play longer and better for years to come. 

Q. I have seen you play and I like your playing .............I especially like your playing time with your left hand on the hi-hat and right hand on the ride cymbal. How did you start doing this and are there any benefits to doing this?

A. Thank you for the compliment! Only other drummers notice technique things like this! I started playing time with my left hand on the hi-hat when I was young, after about 10 years of playing like this I learned to play either hand on the hi-hat. This has enabled me to build better independence and left handed control and power. This also allows me to spread the work load between my hands, decreasing the chance of right hand/wrist overuse injury. I would estimate that playing time on the hi-hat encompasses over 50% of the playing time in modern music. The remainder of the time is spent playing time with my right hand on a ride cymbal. I have found this to be a great way to save energy, share work load between the hands, and to offer subtle variation in tone and rhythm. Another side benefit is that with the left hand playing time on the hi-hat, my right hand is free to play across the kit or to show boat!

I highly recommend this exercise to other players! Many other great players use left handed ride hi-hat techniques including John Blackwell, Rayford Griffon and Carter Beauford.

Q. I'm in Sydney, Australia. About 5 years ago I started drumming in Germany. Unfortunately after 2 years of practicing (I had a professional teacher as well) my right wrist started hurting. Just simple playing on the HH caused severe pain. My left wrist was fine (probably because it didn't have the high repetitions like the "leading" right hand).

I consulted a couple of doctors and they diagnosed inflammation with possible permanent damage and recommended to quit drumming....my wrist usually doesn't hurt when I play snare drum or random combinations on the kit. As soon as I start playing grooves with 8th notes or 16th notes on the HH, ride the pain comes up. Actually, it usually doesn't hurt until after playing. I am a bit worried about causing permanent damage to my right wrist, because wrist movements now often come along with clicking in the wrist (even after 2 years without any drumming). There was never clicking before all these dramas and my left wrist still makes no noise at all. The pain itself is more dull and similar to a sprained wrist.  I don't have any other problems like tingling in my fingers or numbness....."Rest and put ice on it! Don't be such a sissy" are typical answers. Do you have any suggestions?
 

A. I am sorry to hear about your problem. These things can be tricky and there are a number of considerations to make.

1) If you get increased pain following playing on the harder surfaces, like cymbals, them there is a CHANCE that technique COULD be involved. Is your strike relaxed and are you allowing the stick to rebound from the surface? Often drummers try to "play through" the surface to increase volume and speed. Recheck your grip. If it is too tight, more force will be transmitted into your wrists. Check the angle of attack and positioning of your hands.

2)
Consider an evaluation by a chiropractor or osteopath who specializes in sports medicine. I know that health care these days can be expensive, and I know that insurance companies are "reluctant" to fulfill their promises to their policy holders. I would not recommend that you continue with severe pain which lasts longer than a few weeks. 

Proper diagnostic imaging can help identify IF severe damage has occurred and then it can put you on the right track.  It is possible that there has been some chronic damage to the cartilage or ligaments of your hand. You should follow a slow and progressive rehabilitation program, which includes slow increases in playing. If you flare up during this program, an MRI and possibly a CT bone scan would help determine injury to soft tissue or bone.

3) Consider learning to play left hand to hi hat and right hand to ride cymbal. This takes years to learn, but I recommend it not only for spreading the work load to each hand, but it also increases independence and enhances personal style. Start with this as an exercise and build up. I have done this for over 30 years. I was lucky to have begun this early in life, but any player can benefit from this exercise and learn to share the work load between two hands.

4) There IS a genetic / individual component to any physical activity. Some people are able to perform activities for years with little or no problem. For example; professional basketball/football/baseball players, who are ABLE to continue playing because their physical make up enables them to "withstand the physical the punishment", while other players are unable to withstand the decades of physical abuse and become injured...ending their careers. It is always best to learn habits which limit physical trauma or altered biomechanics. This can be the difference between playing for decades and only playing for years.

 

Q. I'm from Arizona. I don't know of any doctor here that specializes in drummers so I thought I would ask you if you could help me with my problem. When playing usually faster songs the web between my pointer finger and thumb extending down to my palm has a tendency to cramp up. It doesn't matter how much a stretch it or warm up it always does. Some days are worse then others though. It has been getting to the point when I am playing live ( three to four nights a week) that I can barely hold onto my stick. I find myself holding onto it more like a club then a drum stick. I am hoping that you have some incite on my problem and could give me a few tips on how to work this problem out.

A. After your doctor (MD, DC, DO) has ruled out a few medical conditions such as neuropathy, diabetes,  upper motor neuron problems and other systemic problems, we can look at several possible things which can account for the cramping.

Stick size
Grip
Technique
Positioning
Training
Injury

Either of these or any combination in subtle ways can lead to overloading of the intrinsic hand muscles. Over time such overuse can lead to injury of the tissues at the microscopic level or even as frank tears in the muscles.

Which hand does this occur in? Do you use a traditional grip or matched grip? What styles of music do you play? Which instrument surface tends to cause the most fatigue?

After seeing your doctor and ruling a few bad things, I suggest that you have a lesson or two with a good teacher. Even if you have been playing for decades, we can all fall into bad habits. Identifying the weak links and enforcing positive habits should eventually lead to a solution!

 

Q.  I am 43 years old. I have been drumming since age 8. Being mostly self-taught, I have admittedly had a number of bad habits in my playing. I have addressed a number of issues over the years including posture and neck stability/motion in particular. The one area I am concerned with right now is my right (kick pedal) leg. I have experienced in the past, upper thigh pain, which is in the very bottom area of the lower abdomen and very top of the leg/thigh. I had an issue with this problem years ago, when playing a gig where lots of kick drum work was required (i.e. disco, quarter note patterns, etc.). At the time, I actually reversed my drum kit, and played the kick drum with my left foot! Perhaps I will need to do this again? as my problem is back. I am playing (for about a year now) on a new gig, with similar kick drum demands. It seems that (to me) in order to get enough power to play the music, I have to lift my right leg a majority of the time on these tunes (play the pedal with my heel up). And this seems to be where I am encountering this problem again. Can you make any suggestions as to altering my technique, and possible treatment of the soreness, toning, etc. so that I can keep on this gig, and work in a more correct way so I don't continue to stress my leg. (I do some basic stretching before each night now). A.W.

A. Sorry to hear of the trouble. First off, I cannot offer specific advice or treatment recommendations without examining you fin person. I can make some general statements.

There are a few "nasty" things which should be ruled out. These include an abdominal hernia, lumbar intervertebral disc irritation and hip flexor muscle strain.

Playing heel up, (as I have done also for over 30 years) does place strain on the hip flexors and the abdominal region. You must make sure to stretch and strengthen these areas. I recommend a few visits to a sports rehab. Chiropractor or MD.

Regarding technique issues, I would make sure you are not seated too low as this will require greater hip flexion. Likewise, sitting too high can increase strain on hip flexors. Seek a height with limits hip flexor stress...you will feel that point were it is easiest to lift you thigh 5 or 6 times in a row.

Follow-up Reply from A.W.
I completely understand that you cannot make a specific diagnosis or recommend specific treatment without seeing me. I have contacted my primary care MD. So, I will get checked out later this week. Since my pain is mainly in the very top (inside) of my thigh, with very nominal pain in the lower abdomen, I am hopeful that it is not a hernia. The question of the lumbar disc issue is something I wasn't aware of. I will print this and show it to my MD. I also will seek out some physical therapy.

I hope you are well. I wanted to touch-base with you and wish you a very Happy New Year! My leg is stable now, and doing pretty well. I had completed 5 weeks of physical therapy  And I also chose to continue with a gym membership as well. I wanted to pass along my thanks to you for the helpful information and suggestions during that time that I was experiencing this leg injury again, and not sure if I could continue playing or not. Your help made all the difference.

 

Q.  Severe Calf Pain During Gig.
Great website! I stumbled across it looking for an explanation of how I wounded myself during a gig Saturday. Mid set I had a "charlie Horse" in my kick drum leg in the calf. Absolutely hurt like hell.... and scared me... this was in front of about 4,000 people. I managed to massage the kink out, but it's still pretty sore three days later now.  I have pretty good technique, but I hit very hard. I was thinking I was just lacking in the potassium dept? Any thoughts or advice?

I'm 25, I have been playing around 14 years. I'm a little worried though as I have a two week tour coming up in the middle of October. I'd hate to let it rest up just to kill it again. Would it be safe to give it 30 mins or so of practice daily? Or should I completely remove that motion from it for a few days? I realize you can't give much detail...but I appreciate any advice you might have.

A. This discussion is purely for background sake and is not a substitute for professional medical advise.

As you play "hard" it is possible that you strained a calf muscle (either the soleous or gastrocnemious). A strained muscle is a tear in the muscle. The difficulty with lower leg muscle strain is that 1) the calf muscles are a two joint muscle group, working to flex the ankle AND flex the knee. 2) the lower leg is a postural muscle group, it has to work all the time while you walk and stand. Because muscle heals with scar tissue which is more pain sensitive and less flexible, the healing tissue may over react and give pain signals for months beyond the injury. Slow and gentle early motion coupled with some rest is the key...slowly increasing the physical demands over time.

There are some stretches which can and should be done...I will try to get some photos of these placed on the web site.
Unless you have really been eating poorly, it is doubtful that a mineral deficiency is involved in of your trouble, however, given your youth and short period of time playing...it MAY be possible that you under hydrated or let your mineral balance come out of balance. Make sure to eat well and stay well hydrated, before during and after rehearsals and gigs. Beer and soda don't count...drink water or 50/50 water with sports drink.

As a hypothetical....I would rest well for a few days...doing gentle stretching AND non weight bearing range of motion. Elevate the ankle and do ankle circles and flex up and down against gravity only. After a couple days, then begin playing 5-10 minutes...any pain...you stop.

If you have any obvious pain or tender stops now, you should ice while resting over the next 2-3 days. Ice 7 minutes about 3x a day. Ice until numb but not longer. Eat well and stay hydrated. Avoid tobacco use especially while healing.

Q.  Pain while Playing 2-3 hours a day.
I am continually inspired by your website, it's just wonderful! I am in my senior year of college. Last year, I experienced a drawn out hand problem which turned out to be entrapped nerves, and was fixed by neuro-muscular massage. Finally Christmas break came and I was able to play on my real kit at home. I felt my chops were ready for some serious practice sessions and spent 2-3 hours a day on jazz, latin, and rock styles as well as coordination exercises. I would also continue pad work, a half hour to an hour doing fundamental stroke motions. About 2 weeks into my new regiment, I developed de Quervain's syndrome in both my hands. I am truly confused how I developed the condition, as I frequently stretch, massage, and wear splints when I sleep.  There was however a progressive "crunching" in my left wrist that I chalked up to just needing a good stretch. I am writing to ask for your opinion on this matter. I hear about players who can play for hours and hours and be fine, and am told by doctors that that will never be me. I refuse to give up though. Any advice on technique, prevention and practice habits will be infinitely appreciated. Thank you so much for your time and efforts in this matter.

A. This discussion is purely for background sake and is not a substitute for professional medical advise.

Sorry to hear of your problems. Thank you for your kind words!

In several places in your email, you mention practicing a great deal. In one instance you mention that you practice 2-3 hours per day. I have to tell you that playing at force for over an hour or so can generate enough stress and friction to inflame tendons and soft tissues. Think about it; the number of strokes in a minute times one hour. That is a great deal of force and friction. This will generate heat from friction!

You are still very young. Be patient and continue your studies. Stretching and taking care of your body will help, but you have to be judicious in your practice habits. You can't create a diamond in a single day, month or year. I don't advocate routinely practicing at force for over 1 1/2 hours a day. I suggest that you break your practice periods down into 3-4 sessions of 20 minutes. Work on theory for another 30 minutes.

Remember, drumming = friction = heat = inflammation. This equation will change very little from player to player.