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Norris Clement

Osteoarthritis Patient Plays the Piano Pain Free

By Abby Sinnott

Most weekends you can listen to Norris Clement playing jazz piano at Cafe Divino with his band, the Silver Fox Trio in Sausalito, Calif., and at other venues in Marin County and San Francisco. But in 2000, after 68-year-old Clement retired from his career as an international economist and returned to his true passion -- playing the piano -- he experienced severe pain in his hands.

"I retired and for the first time in forty years, finally had the time to do what I really loved, which is playing the piano," says Clement. "But then I realized I had these physical limitations that prevented me from doing so."

Following the recommendation of another jazz pianist, Clement went to the Health Program for Performing Artists at UCSF Medical Center for advice about his condition. Founded in 1985, the center is one of the first its kind dedicated to the study, diagnosis and treatment of ailments commonly encountered by performing artists. Although the center cares for all types of performing artists, they specialize in the evaluation and treatment of musicians.

"I was really blown away by the care and attention I received at the center. It's an amazing place and should be utilized more by the local artistic community, says Clement, who was treated by physical therapist Nancy Byl, who also serves as the administrative director of the Health Program for Performing Artists. "Logically it makes sense to have this sort of center in the Bay Area where there are a lot of performing artists, but 20 years ago, I don't think anyone would have considered it," she says.

At his first visit to the center, Clement says he didn't know what to expect. But when he arrived, rather than conducting an initial physical examination, Byl asked Clement to sit down and play the piano. "When I finished, Nancy said she understood why I was feeling pain in my hands it was the way in which I was using them as I played," says Clement, who was then diagnosed with osteoarthritis in his hands and spinal stenosis in his cervical spinal area, which was cutting off the circulation in his arms; and therefore limiting the strength and facility of his nerve responses.

In addition to feeling physically limited, Clement says he also experienced depression because of his situation. "Nancy talked to me about the psychological implications of my injury and that helped a lot," says Clement.

Byl says that certain imagery techniques can be very effective for addressing the mental aspects of pain. "I also asked Norris to use mental imagery to recapture the feeling of playing without pain and to engage in mental practice instead of physical practice until the inflammation quieted down in his hands," says Byl.

Byl also taught Clement a series of exercises to alleviate his pain and loosen his hands and cervical spinal area, which Clement does every morning before practicing. In addition, she referred him to Mark Steiner, a Richmond, Calif. teacher who specializes in the Taubman Method, an approach to piano playing built on the concept of coordinate motion defined as unified finger, hand and arm movements.

"It was like learning how to walk again after something like a stroke," says Clement. "I had to learn how to crawl on the piano and rethink the way I approached the mechanics of playing. It took me a year and a half before I became comfortable with playing again." But Clement says that now he is able to play relatively pain-free, thanks to the expertise and encouragement of Steiner and Byl.

"At 68-years-old, because I do have osteoarthritis, I realize I'll never reach the level of virtuosity I had when I was younger," says Clement. "But now I'm able to execute most of what I want to do musically and I'm having a great time."

Story written in July 2005.

Abby Sinnott is a freelance writer in San Francisco.

Related Information

UCSF Clinics & Centers

Hand & Upper Extremity Center
1500 Owens St.
San Francisco, CA 94158
Phone: (415) 353–2808

Spine Center
400 Parnassus Ave., Third Floor
San Francisco, CA 94143-0332
Phone: (866) 81-SPINE or
(866) 817-7463
Neuro-spine Fax: (415) 353-2176
Ortho-spine Fax: (415) 353-4047