Tag Archives: musicians’ health

Musicians and Injury – don’t become a statistic

The first of two guest posts by Jennifer Mackerras exploring the benefits of Alexander Technique for musicians

Injury to musicians: everyone knows it happens, but very few like to talk about it. For professional musicians, this is entirely understandable: nobody wants to endanger their career by being open about the pain they might be experiencing. And with amateur musicians, very often discomfort while playing becomes such a problem that they stop playing entirely – they vanish from their ensembles or music groups, and no one really questions why.

What distresses me, as a musician and an Alexander Technique teacher, is that so often the problems that cause musicians such distress are entirely preventable and treatable. It just takes a little time to find the cause, and find the right person to help you overcome it.

The clinician’s view

Christopher B. Wynn Parry’s 2004 article on ‘Managing the Physical Demands of Musical Performance’ makes for fascinating reading. He includes details of an analysis of musicians who attended clinics run by the British Association of Performing Arts Medicine (BAPAM) to that date. 48% had a clear-cut diagnosis of conditions like focal dystonia or tenosynovitis. But the other 52% had no specific diagnosis. Just over half of the musicians had non-structural performance-related problems.

That’s a shockingly large percentage!

We are talking about musicians who were struggling with symptoms that had no obvious clinical cause. They were problems caused by a coming together of over-practice, stress, muscle tension, poor posture, and insufficient technique. All of these problems are solvable. All of them.

There are lots of disciplines out there that can help you: your teachers, performance coaches, fitness instructors… Each has its own benefit. But I’m an Alexander Technique teacher, and I want to give you an overview of how Alexander Technique could help you avoid injury.

What Alexander Technique can do

Alexander Technique is taught in music schools and conservatoires precisely to combat and prevent the ‘non-specific’ symptoms that cause musicians to call for professional help. It isn’t about feeling nice – although that often happens. It won’t force you into ‘perfect posture’ – though other people will notice that you seem to sit and play more easily.

As an AT teacher and performance coach, I help people change their manner of using themselves in activity, so that they can truly fulfil their technical ability and achieve their artistic aims. My job is about helping you free yourself from a manner of using yourself (physically and mentally) that is getting in your way.

I see some common themes in the musicians I teach: too much tension while playing; effort put in the wrong places; and unhelpful ideas about practice and performing. I’ll explain what these are, and give you a hint about how to change things if you think you have this problem.

Too much tension

Do you bang your fingers down on the keyboard? Can you hear your fingers slapping the fingerboard on your cello, or on the wood of your recorder? Do your arms and shoulders feel tight and sore after playing? If so, you’re probably using too much muscular tension. In these cases, I give students the 50% less game: can you play with 50% less effort? This is best first attempted on easy pieces or scales. You may be astonished at how little effort you actually need to use to make a sound!

Effort in the wrong places

This can show up in attitude – 2, 3 or even 4 hour practice sessions with no breaks – or more physically. For example, have you ever thought about what joints you actually need to use to get your fingers to your keyboard? What muscles and joints raise the violin to your chin? It would astonish you how often I work with players who create a tremendous amount of unhelpful physical tension simply because they have never really thought about how to approach their instrument.

Before your next practice session, spend a couple of minutes thinking about the minimum number of joints you could use to achieve a playing position. If you don’t know where the joints are, there are really fantastic phone and tablet anatomy apps that can help you.

Unhelpful ideas

All of us, whether amateur or professional musicians, can sometimes have unhelpful ideas about practising and performing that can suck the joy from our music-making. Do you know anyone who has these ideas:

  • Needing to be perfect
  • Looking on the audience as an adversary
  • Focussing only on the mistakes in the performance, not the good things
  • Being afraid of ‘messing up’, to the point where you don’t want to perform
  • Fearing the audience ‘judging’ you
  • Believing that the only relevant practice time is on the instrument

Because we are a mind-body unity, the ideas that we have can have physical manifestations. If we believe in perfection, for example, we can begin to create a physical tightness as we try not to make mistakes. The physical tension then contributes to us making mistakes, the thing we most wanted to avoid! Try sitting down before your next performance or exam, and note down the ideas and feelings that you have about it. Can you find any twisty thinking going on?

Making music can be one of the most joyous and fulfilling of human activities. I know I’m biased, but I think that Alexander Technique is a great tool for helping musicians to rid themselves of the unhelpful ideas and physical traits that get in the way of musical expression. I hope that you give my ideas and games a try, and please do let me know how you get on. I wish you success!


Reference:

Christopher B. Wynn Parry, ‘Managing the Physical Demands of Musical Performance’ in Williamon, A., ed. (2004) Musical Excellence: Strategies and Techniques to Enhance Performance. Oxford: OUP. 41-60.

 

jen_working6Jennifer McKerras is a performance coach, musician and fully qualified and registered Alexander Technique teacher

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The Cross-Eyed Pianist Supports BAPAM

Frances Wilson (AKA The Cross-Eyed Pianist) is fundraising for the British Association for Performing Arts Medicine (BAPAM), a  unique charity set up to help musicians and other performers to stay healthy.

DONATE NOW

BAPAM holds free clinics where musicians (including music teachers) can obtain a free consultation with a clinician who has an expertise in problems affecting performers. These might include, among other conditions, playing-related injuries and pain, tension, hypermobility, voice problems, performance anxiety and stress.

BAPAM’s clinicians are from a wide range of backgrounds. They include general practitioners, physiotherapists, osteopaths, psychologists, rheumatologists and orthopaedists. These practitioners have a special interest in musicians’ health and well-being and many are musicians themselves with a deep understanding of the physical and emotional demands of the musician’s life.

Frances and other musician friends and colleagues have benefitted from consultations with BAPAM’s specialist practitioners, including physiotherapists and hand specialists, in addition to attending workshops and study days on musicians’ health and well-being.

Please make a donation to enable BAPAM to continue its important work.

Thank you in advance for your support

Musician, heal thyself…..

Injury, like performance anxiety, is something musicians tend not to discuss. Admitting to an injury (or anxiety) can be perceived as a sign of weakness, and as most musicians are self-employed, peripatetic and freelance, without the cushion of statutory sick pay or health insurance, injury can mean loss of work, which means loss of income.

Musicians, like sportspeople, put their bodies under a great deal of stress, but unlike with sportspeople, it’s rare to see a musician stretchered off the stage. Musicians go to great lengths to make their playing appear effortless and free, which can put additional strain on one’s body. However, until fairly recently the idea that one should care for one’s body in the manner of an athlete was not discussed nor seriously considered. I think this has a lot to do with a now rather outdated view that musicians are “artists” and don’t need to concern themselves with such prosaic issues as keeping fit. After all, it’s all about the music, isn’t it?

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(photo: lastminutemusicians.com)

But if you’re not fit, you can’t play and make music or make a living from making music. Musicians are prone to a range of injuries from simple aches and pains to more significant problems such as tendonitis, RSI, tenosynovitis, carpal tunnel syndrome, and focal dystonia. Many of these injuries are related to posture. In fact, pianists come off relatively lightly – other musicians contort their bodies (violinists, flautists) or carry heavy instruments (French horn, tuba) which can put tremendous strain on ligaments and muscles. Injury can also be caused by bad technique (in part related to posture), insufficient warm up, too much repetition in practising, playing too loudly, suddenly increasing practise time (perhaps to prepare for a recital or audition), poor choice of repertoire. The website Musical Toronto quotes some alarming statistics: “The lifetime prevalence of injury for musicians is 84 percent, and the chance of a musician playing while injured is 50/50, which is much higher than for athletes.” Musicians are playing complex, virtuosic/technically demanding repertoire much younger (mid-teens), which also affects their health.

One’s emotional health can also impact on physical health: psychological stress caused by practising, performing, traveling, financial insecurity, competition can lead to physical problems (last year, for example, I had stress-related tendonitis, which was cured surprisingly easily by making some simple changes to my working life as a musician).

Conservatoires and music colleges are now offering courses in yoga, Pilates, Alexander technique, mindfulness and general well-being for musicians in recognition of the importance of caring for one’s body, and many musicians I know do daily yoga and other keep fit regimes which help both body and mind.

We can, of course, put in place habits which can protect our bodies from injury. I like the term “Pre-hab“, which was coined by Sir Chris Hoy, cyclist, multiple Olympic gold medal winner and a commentator on the track cycling at the Rio Olympics. For the musician, Pre-Hab should include:

  • Adopt the correct posture when playing
  • Do a proper warm up: this can include exercises at the piano or exercises done away from the piano (which I personally prefer)
  • Don’t start your practising session with your most difficult music – work up to it
  • Take regular breaks between practising (c45 mins then a 10 minute break is sensible)
  • Do light stretches between practise sessions to loosen arms, shoulders and neck
  • Take extra care when lifting
  • Practise away from the instrument – this can include memory work, and listening and reading about the music you are working on
  • Take time away from the instrument to unwind and don’t feel guilty about it – allow yourself a social life!
  • Listen to your body and take seriously any pain, tension or tenderness in any part of the body
  • Never play through pain and seek specialist help as soon as possible if you are in pain
  • If recovering from an injury return to playing gradually and don’t practise excessively

 

Musicians’ Health Resources

BAPAM (British Association of Performing Arts Medicine) offers advice and help for musicians and performing artists including physiotherapy, counselling and referrals to specialist medical practitioners

The Healthy Pianist – fact sheet especially for pianists written by Penelope Roskell and Dr Hara Trouli (PDF file)

Other BAPAM fact sheets

Playing Less Hurt

Back to School for Elite Musicians – Musical Toronto article

Recovering from Injury – article by Alicja Fiderkiewicz

 

 

 

 

 

Reblogged: Q&A Neck pain and the piano

Here’s a helpful post from Gretchen Saathoff’s blog Gretchen’s Pianos for those of us who are feel certain parts of our anatomy need some care & attention.

Any type of pain associated with playing an instrument needs to be addressed.

Let’s talk about neck pain in this post, though, to keep things manageable for readers.

Onset

When and how did your neck pain start? What were you doing at the time?

What do you do when not playing the piano? For example, do you drive long distances? Work at a desk? Use a computer for long periods of time?

Possible causes

Your work setup, car seat, steering wheel angle, different mattress, different pillow, bicycle handlebars, even not wearing sunglasses outdoors can all be factors.

Look at your practice setup.

  • Bench too high or too low?
  • Enough light?
  • Music at a comfortable height?
  • Have you had your eyes checked recently?
  • Body alignment
  • Drafty room
  • Cold room
  • A glare on the music
  • Recent changes in technique
  • Practicing too long without a break
  • Learning a lot of notes all at the same time
  • Sight-reading for hours

A look at some other factors

  • Not getting enough sleep.
  • Not eating regular meals.
  • Being under the weather.
  • Anaemia
  • Virus
  • Having a cold
  • Coming down with something
  • Dental issues

Possible solutions

  • Ask a friend to watch you play
  • Videotape yourself playing
  • Make small changes as indicated above
  • Stretch before and after practice
  • See a doctor who treats musicians
  • Get a massage
  • See a chiropractor
  • Work with a physical therapist or sports trainer to strengthen back and shoulder muscles

Letting pain continue while proceeding as usual is not a solution, but will exacerbate the problem. Even if you are busy, have several performances coming up, or can think of a list of reasons not to address the pain, you must. Your longevity as a musician depends on it.

Related posts:

Warming up & keeping fit

Piano Pilates

Piano Yoga