Physical Therapy & Rehabilitation, PC
609-884-9800 ProPTRehab@live.com 650 Townbank Rd., Suite 203; N Cape May, NJ 08204
The Musician Athlete
The Musician Athlete?
Yes, that’s me and with the guys of one of my old bands 'Mythology Bulfinch!' Notice that my posture isn't so bad, except when we start bouncing off each other on the stage!
Ah Oh, ..what's this? ...Tisk, tisk, tisk, I spoke to soon, just look at that cervical flexion (neck/head bent forward)! Well, I suppose I did alright because I did not maintain that position for prolonged periods.
However, if I were to sustain that posture the entire time I played, well, this could have very well lead to some significant problems! Hey, I ain't ask'n ya to be a robot, however, anytime you hold a joint(s) in one position for a long time, the stress builds up.
With regard to the neck and back, prolonged spinal stress, or end-range loads, can have a negative impact upon spinal discs and other spinal structures and tissues. I've been fortunate in my endeavors to stay pain-free during my many years of gigging and playing music.
Considering that I am not only a Physical Therapist, but so too am I a Musician; it would be remiss of me not to write an article correlating the two. Considering the apparently typical postures we see musicians maintain while playing (the image is probably in your mind as well as mine), it becomes rather easy to see where some pain problems may arise from.
Well, consider the number of hours some bands play at one time and the precarious positions musicians often find themselves. Ever notice the all too common posture of the guitar players? Rounded shoulders, neck flexed downward along with a rather heavy guitar around their neck, all adding to the stress and strain of gravity.
How about those repetitive finger movements. Actually of concern is the maintenance of the fingers and in a contracted state; even to some degree although the musician may be fairly good at keeping his wrists and hands fairly loose.
There exists many horror stories relative to the ending, or threatened ending, of music careers due to a variety of conditions. Spinal pain, tendonitis, carpal-tunnel syndrome, the list goes on. Many of these injuries can be prevented with some due diligence. While pain is the body’s warning sing (this was a Freudian slip; I mean to say ...body's warning sign) of impending problems, don’t wait until pain ensues before you do something to prevent painto begin with.
Common reports by musicians involve neck and back pain, upper extremity pain, including the hand(s), wrist(s), finger(s). Aside from the obvious postural problems, maintaining the hands and arm muscles in a steady state of contraction (even more so than repetition) can be an awful byproduct of being a musician. To utilize fine motor skills, especially if one tends to allow tension to build in the hands, wrists and/or fingers, can cause inflammation and micro-trauma to the tendons; the blood flow can be decreased which may allow for a build up of metabolic wastes.
The muscles in the upper extremity, especially the wrist, hand and fingers can become fatigued and strained with the continuous demands placed upon the musculoskeletal structures.
Physical Therapists are in the business of maximizing individuals ability to improve, practice and maintain proper posture and body mechanics. Far too often medical and/or health care providers will provide a quick 1,2,3 treatment and somehow expects their patients to do wonderfully on their own. Well, if enough time goes by, it is possible for the natural resolution process to take place and then the practitioner can take the credit. However, pain from musculoskeletal problems most often recur, sometimes with great severity. The sooner one begins to 'practice' proper postural and body mechanic habits, the sooner one can learn to take steps to becoming self reliant and have a better chance of successfully treating themselves.
Physical Therapists help their patients with self pain management techniques geared to allowing for undisrupted healing of the affected areas. Use a mirror while playing your instrument (you use to as a kid when you dreamed of becoming a Rock Star). Many bands video tape their practices as well as their live performances; use those videos to cue you in to your posture, even if you have to look a little less ‘cool’ to do so.
That musician on the stage can actually play that song without even thinking that much about it. He/she could have several other things on his/her mind. How can this be done? The way we learn is through repetition. The more we do it, the more our movements become automatic. Our posture, body mechanics and even skills we have comes through repetition; so much so that we don’t often appreciate what we are really capable of until we realize others can’t do what we do as well in our respective areas of interest.
The body learns! Some behaviors become automatic. Therefore, practicing proper posture and body mechanics, as is typically done via a Physical Therapist, whether by simulating activities of daily living (i.e., vacuuming, cleaning, donning/doffing clothing), simulating work activities or playing an instrument, the body needs to practice proper posture and body mechanics in order to make this a near automatic response. That booklet instructing you with proper posture and body mechanics alone 'may not' be enough. It can be quite helpful to review the information and actually practice the techniques with the instruction of a licensed physical therapist.
Here awesome warning signs to look out for:
- Ensuing Pain anywhere to any degree, as soon as it’s noticed needs to be heeded.
- Stiffness in neck and/or back; decreased mobility / range of movement in the spine and/or in the extremities.
- Neck pain begins to travel into the shoulder and/or arm; low back pain begins to travel into the buttock, and/or hip and/or thigh and/or leg.
- Increasing intensity of pain.
- Ensuing paresthesias: Tingling, numbing or burning in the spine and/or extremities.
- Cold sensations and/or discoloration in fingers and/or hands while playing and/or grasping/lifting light to moderately heavy objects.
- Difficulty and/or pain elevating your arm and/or grasping objects. Weakness of any area ofther upper extremities.
- Swelling in the wrists and/or hands / fingers.
Pain during or after playing or practicing. However, keep in mind, many peopleassume the pain came from an activity when it just might have occurred due tothe assuming of poor posture after an energetic show. In other words, while playing for a couple of hours or so, the lights are beaming on you, you are giving an energetic show and afterward you collapse onto a couch, a bench or a chair; perhaps onto the ground.
Your joints and muscles are warmed and therefore, more susceptible to postural stress / loads. Usually, if pain is caused by an activity, there will be some tell-tale sign; however, that is not to say that the activity, if performed with poor posture and/or body mechanics did not contribute to your susceptibility to experience pain.
Continuously sore upper extremity muscles, arm, forearm, wrist, hand, finger muscles.
Pain upon movement of an extremity whether fingers, hand, wrist, elbow or shoulder. Pain upon carrying instruments to and from sessions.
So what do I do now?
If you really want to take advantages of ‘Prevention’ it wouldn’t be a bad ideato visit a physical therapist before you have pain so you can 'learn and practice' proper postural and body mechanic techniques with the goal of making those newly learned 'good' habits your new norm.
The martial arts are a good example of neuromuscular retraining. In Ving Tsun Kung Fu, Muay Thai & other martial arts, the students learn to react to one another's movements and/or attacks in a far different way than what our own natural reactions would have us react. It takes time and hard training to allow your body to learn how to maneuver without letting your brain consciously get in the way or without allowing your 'usual' reflex response get you into trouble. Your actual physical reactions become retrained to the point that your body reacts properly when attacked, basically without really having to think about it. Our normal response to being 'grabbed' for example may be to 'resist' and 'guard' and 'pull away' from the attack. However, in VIng Tsun,for example, you learn to utilize the attackers force to your advantage and this all happens automatically after 'much' neuromuscular retraining.
There would appear to be no reason why anyone cannot learn how to pastorally re-train their body with enough practice. Anecdotally we see how martial artists demonstrate right before our very eyes the power of practice; so to is true with any of the physical and/or mental arts. Practice seems to improve our abilities, even if at times they do not become perfect. Therefore, there should be no reason why any of us cannot retrain, with enough effort, proper use of posture and body mechanics.
Even with this apparently sound logic, however, studies have shown a severe problem with many who simply don’t follow through with the learning process. This is probably why many endeavors for so many are short lived; many simply give up! They don't want to be bothered until their body leaves them little choice but to change the way they do things. However, you would think that learning proper posture and body mechanics would not be as difficult to learn; however, for some, it just might be a bit too tedious. When one starts feeling better, he/she often becomes over confident and does something wrong to cause a relapse.
My advice, stick with the practice! If you learned how to play that instrument as well as you do, why can’t you learn how to protect your own body via postural awareness and practice? Even though it might take, what might appear to be, one minor mistake to set-off your pain; it’s always a good idea to try to minimize the likelihood of exacerbating and/or producing pastorally related pain.
The problem is that most people don’t do anything to get such training on their own; in-fact, I don’t know if any insurance company would pay for such preventative training unless someone falsely claims to have pain and by no means, no one would suggest such a thing. Many simply have to learn the hard way, when the pain gets ‘too bad’ to tolerate, than we usually see them after the damage has occurred. Well, as long as you made it, now the learning begins.
Here are some other tips in the meanwhile:
- Take intermittent breaks during your practice sessions. Contracting limbs need periodic breaks to allow the contrition of muscles, tendons and vessels to subside. Metabolic wastes need time to clear out. Rest and stretching encourages blood flow which can potentially help rid the metabolites and irritating chemical substrates.
- In between songs, stretch your limbs especially any that appear to become fatigued or achy. Take a 10 minute break after about 35 minutes or so to further rest the area and stretch. Preferably you will have visited your Physical Therapist who can show you various methods for stretching. Mind you, this kind of stretching is not so much for elongating tissues as it is to help with blood flow to the area and rid any metabolites that may have developed from prolonged musculotendonis contractions.
- Drink a lot of water as many theorize that water may help rid the body of irritating metabolites. If you have to increase your ‘practice time’, ensure you take more breaks and hopefully a few longer ones than usual.
- Be careful when using 'higher' tension stringed instruments, especially if you are not use to using them on a regular basis. Higher tensioned strings on a guitar, for example, can increase the work load for your fingers.
- Colder temperatures may enhance muscular tension and/or guarding which can potentially feed into the problem. The cold weather 'may' decrease blood flow to the extremities.
- Before band practice, ride a stationary bike to warm your whole body up; however, if you don’t have access to any aerobic equipment, you can jog. Sounds a bit strange to warm up in such a way when you are about to play an instrument, however, such activities can really get your warmed up to play. That Marshall, Fender or Huges & Ketner, Mesaboogie Amplifier Head of yours needs to warm up to get really get cook'n and hit those sweet harmonic tones; take a lesson from them! At the very least, stretch, not so hard as to strain un-warmed muscles and/or tendons, but just enough to encourage blood flow. The Musician Athlete needs to be prepared as any other athlete needs to be.
As a musician, or even as a musically lay person, don't you prefer seeing musicians groove a bit to the music? Doesn't it make more sense to move with the rhythm, rather than to remain static? One of the primary reasons people who exercise have less pain apparently has less to do with the exercise itself and more to do with simply keeping the body moving, thus keeping the joints of the body, especially the spine, off of sustained end-range loads.
Certainly exercise strengthens tendons, muscles and even bone, however, typically some amount of force is applied to one's spine when spinal pain ensues.
What do concert artists, amateur musicians, music students, studio players, chamber musicians and orchestral players as well as truck drivers have in common?
They all experience higher rates of back pain than most of the population. The rate of back pain among cellists is higher than for any other group of musicians, followed by harpists, pianists and bass players, in that order. Over time, those who suffer with these problems tend to accept pain as normal and inevitable. (ref: http://home.earthlink.net/~vsazer/seating.html)
All of these musicians, along with the Truck Driver, remain seated for prolonged periods of time. The spine is stressed for prolonged periods and what do you think that can do to the tissues of the spine; especially the discs?
Your spinal discs are similar in some respects to a 'jelly donut.' If you compress one side of that donut, where do you think the jelly will likely go?
Studies have actually demonstrated intradiscal fluid (nucleus pulpous) milking toward the opposite direction from which they are compressed via flexion and extension movements (bending the spine forward and backward). As Truck Drivers 'sit a lot' (which tends to compress the front of the discs as most apparently slouch for extended periods in this position), the spinal discs often suffer continual compression 'potentially' milking fluid through possibly already damaged discs toward the back of the disc, causing increased pressure and build up of (nuclear) fluid there and producing and/or increasing spinal pain.
With regard to postural and body mechanic advice, be careful to ensure you are not just handed sheets and told to simply read them and put them into practice on your own. Depending upon your respective pain problem, some seemingly harmless postures may actually be detrimental for your particular condition.
As always, if you have pain, seek out medical attention. As Physical Therapist's job descriptions avail them 'Time' to work with you directly and typically spend time reviewing proper posture and body mechanics, it would behoove you to see a physical therapist as soon as possible.
Once you understand the potential influences 'gravity' and 'excessive loads' can have on the body and you are trained in proper posture and body mechanics, from then on it’s practice, practice, practice. Your Physical Therapist can also instruct you with various therapeutic exercises & stretches specific to your problem. It is rather common sense to realize that a ‘5’minute visit to a doctors office isn’t going to alter your behaviors and postural / body mechanic habits. The Medical Team should work together withy our best interests in mind!
Now, I suppose it would be remiss of me not to advise one to ensure eating a healthy diet; however, what a healthy diet consists of often constitutes the opening of a whole other bucket of worms of controversy. At the very least, drink plenty of water, eat your fruits and vegetables, limit fats and bad carbs and do all those nice things we all pretty much agree on at the very least. At least until science tells us we should have been eating bacon all along (just kidding, I think, lol).
In addition to the above suggestions, as you realize, there are a number of Great High Quality Products available right here on this web site to make things a bit easier for you.
There area number of problems that can arise physically as a Musician; to list everything in this article would be tantamount to writing a book. The purpose to expose the Musician to some common symptomatic problems and to heed any and all warning signs. The label of your problem can always be ascribed as seen appropriate by the appropriate treating medical professional.
As always, if I can be of any further help; please feel free to contact me at. . .
- Song - "Age Of Rock" - By my band "Remote Control" - Jam Sessions In Durham, Maine - Taylor Studios
Added 01/02/09
