Updated: Dec 24, 2020
Violinist Adelle Fregoe opens up about her life-altering injury
that first-handedly fought against her through college.
It was October 2013 when I was diagnosed with Kienbock's disease.
I was a junior in music school, a violin performance major. I had just turned twenty. What a way to kick off a decade.
Perhaps this was a symbol foreshadowing all of the hardships that I would face through my years. I sat in the examination room with my mom. When the doctor came back in with the MRI results, he stated the name of the disease, then proceeded with, "The lunate bone in your wrist is dying."
A spark of electricity shot up through my spine. So many emotions flooded my body. I kept my cool until he left the room. I looked at my mom, nervously laughing, and told her that I was going to cry. She assured me that everything would be okay. Upon the discovery of this life-altering disease, I did more research and was horrified with what I found.
Kienbock's disease, also called Avascular Necrosis, progresses through four different stages. Essentially, it is the lack of blood supply to a bone of the body. I experienced this lack of blood supply to the right wrist lunate and capitate bones. I have heard of other people experiencing this in their foot or elbow.
The cause is still unknown but some people, myself included, believe that a certain type of trauma can trigger the disease. In my case, I believe the cause was when I had fallen down the stairs of the music building during my sophomore year. The only thing I landed on was the palm of my hand, so I am certain that the shock from the fall - plus the odd angle that my wrist was slammed into - was the cause of my Kienbock's prognosis.
Stage 1 is found in an MRI and the symptoms are usually similar to a sprained wrist. It can be hard to turn your hand upward as well as grab and squeeze objects; this of course includes general wrist pain.
Stage 2 can be seen in an x-ray by small white marks on the bone. This is the hardening of the bone due to lack of blood supply. This is a sign that the bone is, in fact, dying.
Stage 3 is when the bone starts to break apart. One will experience an increased amount of pain along with decrease of range of motion.
In stage 4, the bones around the lunate begin to deteriorate. This can lead to arthritis. Sugery options in the later stages include bone grafting, radial shortening, or total wrist fusion.
I started noticing pain that summer of 2013 and ended up going to physical therapy. Looking back, this may have been a mistake. I did not know that I was dealing with Kienbock's disease at the time. After the last day of physical therapy, my wrist had hurt the worst it ever had. The therapist I was working with revealed to me that day that she didn't know much about hands and wrists.
You could imagine how beyond pissed I was when she said this. The medical "professionals" in the area of my hometown are a complete joke. I'm surprised that my wrist didn't proceed all the way to stage 4. After this information came to light, I was sent to the occupational therapists where my symptoms improved. By the time the fall semester began, I thought everything was going to be okay.
It was my third semester as a performance major. I was enrolled in a course titled "The Art of Practicing." I began practicing three hours a day and continued my exercises from occupational therapy. Towards the end of September, however, I noticed that the pain returned. I knew something was wrong. This was when I decided to see an orthopedist and thus, received my diagnosis.
Since I was supposed to keep a journal for my Art of Practicing class, I had to inform my teacher, as well as my studio professor, of my diagnosis. We decided that I should only be practicing an hour per day; that is, if I felt as though my wrist could handle it.
Eventually, I went to see a different orthopedist in Albany, New York. He was about to put me in a cast, on the spot. Still having to finish out the semester and play in concerts and play for the final of my Art of Practicing course, I could not immediately be put in a cast. I opted for a wrist brace instead and decreased the amount of practice and playing time, per day. I ended up playing only when absolutely necessary. There were some orchestra rehearsals where I could not physically play because my wrist was in so much pain.
The combination of the disease, my lack of practice, and having been involved in a couple of unhealthy relationships destroyed my love for classical music. I could not stand orchestra rehearsals anymore. I grew scared of playing in a large ensemble setting.
Flip to March 2014, the orthopedist in Albany said my Kienbock's disease had cleared, but I just couldn't truly believe it. I still had occasional wrist pain. I continued to practice only occasionally. This really took a toll on my bow hand and my stamina. Even things in everyday life are a little bit more difficult. I have lost a tremendous amount of grip strength in my right hand. While it no longer hurts, I can't squeeze things with my right hand very hard anymore.
(Performing in Korea)
(Performing in Korea)
My playing hasn't quite been the same since then. It has changed in ways both good and bad. Since my bow grip changed a bit, it is hard for me to do more advanced techniques like spicatto and up bow staccato. It has become tiring to play fast sixteenth note passages, as well. I cannot practice every day like I used to, in fact, there are times where I go a month without touching my instrument. But when I return to it, I find that I can play more difficult pieces.
It is a bit strange. I am finally able to play things that I listened to in high school and only dreamed of being able to play!
Since I was unable to practice at the time, I was also unable to perform. This absence of performing has left me with crippling performance anxiety. The only time I am partially comfortable playing for an audience is when I play chamber music.
But things are looking up: I recently landed a job at a music school here in Korea! I am beginning to gain confidence in my playing again.
Perhaps it was luck or a guardian angel that kept my encounter with Kienbock's disease short. Whatever it was, I am thankful every day that I still have the ability to play the violin. While I may not ever reach my dream of performing professionally as a soloist, I believe that I will be able to play for a long time. I cannot even imagine where I would be today without being able to play the violin.
Even though I couldn't play at the time, music somehow got me through everything I was dealing with. One of the most comforting things I have discovered is that music will always be there for you, whether or not you are able to play. Dealing with Kienbock's disease also made me come to terms with the fact that everyone moves at a different pace.
I am finally happy with the musician that I am today and will happily continue the journey to be the best musician that I can be.