Two years ago, Jill Gambaro received an email from Keith Emerson that now seems tragically prophetic. “Nobody wants to employ a session musician with any disability,” he wrote. “Some musicians have resorted to suicide.”

Last week Emerson himself, a keyboardist best known for his work with the prog-rock group Emerson, Lake and Palmer, committed suicide at his home in Santa Monica. So far there have been no reports that Emerson left a suicide note, so it's impossible to know what drove him to take his own life. But he had publicly admitted to struggling with nerve damage in his hands — a common result of repetitive strain injuries such as carpal tunnel syndrome — and his girlfriend, Mari Kawaguchi, confirmed after his death that “the pain and nerve issues in his right hand were getting worse.” He was suffering from depression and anxiety and, with a tour coming up, his injuries were no doubt adding to his mental anguish.

Is this what drove Keith Emerson to commit suicide? Gambaro believes the answer is yes.

Gambaro, an L.A.-based author and film producer, had reached out to Emerson in January 2014 regarding her book, The Truth About Carpal Tunnel Syndrome, a patient's perspective on a disease she says is still widely misunderstood by both the medical community and the general public. She was seeking endorsements and book-jacket quotes, and hoped that Emerson, who had gone public with his medical issues after canceling a tour in 2009, might be willing to lend his name to the project.

In his email exchange with Gambaro, Emerson avoided discussing his own injuries but lamented how widespread yet generally ignored repetitive strain injuries, or RSIs, are in the world of music. “Focal dystonia can really be a hindrance in a career forward,” he wrote, referring to another common RSI. “The sad thing is that nobody knows how to deal with it. To most people Focal Dystonia is a place in Europe.”

Although Gambaro herself has struggled with RSIs for more than 15 years, it wasn't until she began researching her book that she learned how widespread such injuries are among musicians. “It made sense that musicians would get these injuries,” says the author, whose own RSIs stemmed from typing and computer-related office work. “But I didn't realize the full scope of the problem.”

Part of the issue for musicians, she says, is what Emerson alluded to in his email. “Musicians can't talk about their injuries because then they won't get hired anymore,” she says. Many musicians also lack access to quality healthcare, or are afraid they won't be able to afford treatment. “So there's a lot of people basically suffering in silence.”

Based on her research, Gambaro estimates that as many half of professional musicians struggle with some form of RSI during their career. In fact, one of the few studies on the subject suggests that the number may be even higher; in a 2013 survey of 377 professional orchestral musicians in Australia by the journal Psychology of Music, 84 percent of respondents said they had “experienced pain severe enough to interfere with their performance.”

Keyboardists, Gambaro says, are especially susceptible to injury. “What we know about biomechanics has grown a lot,” she says. “But with keyboards, the technique hasn't changed since Beethoven.”

“Nobody thinks of carpal tunnel as being that big of a deal

But it's not just keyboardists. Buck Down, an L.A.-based musician who now produces and DJs with electro-swing duo The Gentlemen Callers of Los Angeles, underwent surgery to alleviate carpal tunnel syndrome brought about by decades of playing guitar. “As it start getting bad, I could barely play,” he remembers. “And that's not even doing any Yngwie Malmsteen–type shredder stuff. I'm talking about muscling through simple chord changes.”

At their worst, severe RSIs can be devastating. “Nobody thinks of carpal tunnel as being that big of a deal,” Gambaro says. “But you can't do anything without your hands. When I was in the worst throes of it, I couldn't wipe my ass or wash my hair.”

In the early stages of carpal tunnel syndrome, victims experience numbness in their hands and fingers — but eventually that turns to pain, and it can be constant and crippling. “Nerve pain is that burning pain. It felt like somebody had lit a match, and there was a campfire in my wrist,” Gambaro says of the five-year period during which her condition was at its worst.

Depression and other mental health issues are common side effects. “You lose your ability to think. Pain processes impair your cognitive functioning. I couldn't remember what I had for dinner last night. It's frightening.” 

Add issues of performance anxiety to this mix, and it's easy to see why for someone like Keith Emerson, a flashy performer who was often called “the Hendrix of the keyboard,” the damage to his right hand could have felt like a life-ending affliction.

Conventional treatment options, according to Gambaro, are limited. She describes Western medicine's approach to RSIs as “throwing spaghetti at the wall” — a combination of physical therapy, pain medications and surgery, though she notes, “Surgery largely does not help patients, especially when you have more than one of these repetitive strain syndromes.” Emerson felt the same way; although his girlfriend Kawaguchi told The Daily Mail that he had undergone “an operation a few years ago to take out a bad muscle,” the keyboardist wrote to Gambaro, “Surgery is not the answer.”

For Gambaro, a combination of acupuncture and Iyengar yoga, which focuses on proper physical alignment, has helped alleviate her condition in recent years. In general, she says, holistic practices, as opposed to so-called “allopathic” or Western medicine, seem to offer the best way forward for musicians and non-musicians alike.

Jill Gambaro, author of The Truth About Carpal Tunnel Syndrome; Credit: Courtesy of the author

Jill Gambaro, author of The Truth About Carpal Tunnel Syndrome; Credit: Courtesy of the author

“Musicians who are recovering from this are getting some kind of movement retraining,” she says, referring to a growing field that uses concepts of neuroplasticity to break patients of physical habits developed over years of repetitive motion. Unfortunately, she adds, there are “only a handful” of movement retraining experts in the world who specialize in music-related injuries.

Gambaro's next project is a one-hour documentary focusing on carpal tunnel syndrome and repetitive strain injuries among professional musicians. She's also giving talks about the issue at colleges and educational institutions like the Musicians Institute, where she hopes she can raise awareness among younger musicians about how to better take care of the fine motor skills that may one day provide their livelihood.

In the meantime, she says, repetitive strain injuries remain a subject most musicians don't like to discuss, and often know little about. And until more well-known musicians have the courage to speak out about their own struggles with RSIs, she fears it may remain that way.

“There's rumors about all kinds of people,” she says. “Some very, very big names. But I don't want to out anybody.”

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