Musicians and Injuries

Maybe it's a nagging ache in your thumbs, every time you practice at the piano.  Perhaps there have been long rehearsals for that crucial recital, and now you notice stabbing pains in your forearms.  Or you find yourself struggling with hands that have become increasingly clumsy, or numb. It may be that you are even waking up at night with pain in your arms, or your back, or your neck.  Well, it's just a part of being a serious musician, right?  And after all, you can't stop practicing - there's too much at stake, and music is your very life!  Does this sound familiar?

Computer overuse, Carpel Tunnel Syndrome, Tendonitis, Bursitis, Tenosynovitis, Tendonosis, DeQuervain's Syndrome, Thoracic Outlet Syndrom, Myofascial Pain Syndrome or Trigger Finger / Thumb.

These are also particularly common among keyboardists, fretboardists, flute and string players.  But the particular demands of different instruments produce other problems as well, including hearing loss or TemporoMandibular Joint Disorders.

Incorrect posture, non-ergonomic technique, excessive force, overuse, stress and insufficient rest also contribute to chronic injuries that can cause great pain, disability and the end of careers.  But while these problems are unfortunately common, it's NOT an unavoidable part of being a musician. If we're willing to listen to what's being learned in the field of arts medicine, we may be able to escape the bullet of occupational injury and recover our ability to play.

What Can You Do?

• INFORM YOURSELF. Take time to read up on causes and prevention of common injuries.
• EVALUATE YOUR TECHNIQUE.  In general musicians often need to reduce force, find postures that keep joints in the middle of their range of motion, use larger muscle groups when possible, and reduce body usage that involves fixed, tensed positions.
• ALWAYS WARM UP.  Athletes do not abruptly start vigorous physical activity without warming up and stretching because they know it is an invitation to injury.  Musicians are putting athletic demands on fine motor musculature and should similarly be religious about warming up before practice or performance.

Constant tension and repetitive motion does not allow the body to flush away metabolic waste products and this is traumatic to tissues over time.  Even in the middle of playing a piece, you may have a moment to relax a hand or arm to restore circulation.  The marathon rehearsals that musicians pride themselves on also have great potential to hurt them.  Try two or more short rehearsals in a day rather than one long, intense session.

• PACE YOURSELF. It is very common for musicians to notice injury when they are...
• preparing for recitals or concerts
• attending music camps
• heavily involved in multiple musical groups

...not surprising, because all of these can radically increase our playing time and exceed the limits of our body. (Yes, even for young people, who feel invincible. I have seen more than one gifted high school string player in my city seriously injured in this way.) Learning to pace ourselves and learning to say "No" to some playing is critical.

• EVALUATE OTHER ACTIVITIES.  Your problems may be caused or aggravated by other things you do frequently.  Computer use is a notorious example, but sports, carrying children, hobbies, and excess effort/tension in other daily things may have enormous impact too. 
• PAY ATTENTION TO YOUR BODY.  Pain is your body yelling that it's in big trouble, but learning what is comfortable or awkward for your body before you're in pain may prevent injury. "Physical re-education" through stretching, yoga, pilates classes maybe be helpful

CHECK OUT YOUR INSTRUMENT.  Are you using an instrument that is too large or awkward for you?  Is it set up optimally for you?  Could you use lighter strings or reeds?  Is there a strap or stand that could make playing less stressful?  If it's big and heavy (like a string bass), can you get a cart to help transport it?  And remember, if it is a new instrument, especially a larger one, you need to take time to adjust to it before you plunge into intense use of it.

On the other hand, if you are not yet injured, or are undergoing rehabilitative therapy, properly conditioning muscles may help prevent injury or re-injury.  Be patient in building strength, and talk to a qualified doctor of chiropractic who will address all issues of your musculoskeletal condition.  Chiropractic care will focus on the specific muscles and joints involved and help restore and strengthen the areas that are causing you pain.