Tag Archives: Musician’s Health

The First Three Steps You Can Take For Resolving Chronic Pain And Injury

close up photo of a man having a neck pain
Photo by Kindel Media on Pexels.com

After recently reading some rather disheartening discussions on various social media platforms, where professional musicians were discussing the “inevitability” of chronic pain and injuries, I thought I’d offer some (hopefully) helpful thoughts.

As a certified Alexander Technique teacher and musical practice coach, I have a good amount of experience helping musicians effectively address such issues. I’d like to offer up what I think are the three most important steps you can take if you’re struggling with chronic pain associated with playing your instrument.

Step One: Believe that you can improve.

This is one of the most commonly counterproductive assumptions many musicians I encounter have about discomfort, chronic pain and chronic injuries associate with making music.

Chronic pain conditions associated with a repetitive activity like playing a musical instrument are typically caused because of the interplay between two things:

Overuse, and misuse.

You can dramatically improve upon both of these variables. It’s a matter of choice. And that choice starts with belief. If you believe you can’t improve upon these things, then you’re right. But only because your disbelief stops you from taking action.

So start by believing things can get better. (Because they most certainly can!)

Step Two: Do some research.

If you’re at any stage of chronic pain or discomfort, take some time to research and understand the science behind your struggle. Try to find simple, but relevant information on the physiological framework that defines your condition.

This starts with getting a medical diagnosis from your primary care physician. Your condition might not be one that can be effectively addressed from a medical point of view, but it is always a good place to start. Even if you can’t get a definitive diagnosis for your condition, you should at least make sure that it’s not because of a measurably pathological element (e.g. neurological, metabolic, etc.) that truly needs immediate medical attention.

From there, you can do some extra research on your own.

For example, if it appears you might have the beginning of Carpal Tunnel Syndrome, first understand (from an anatomical and physiological perspective) what the carpal tunnel actually is, and what you might be doing in your movements to cause the inflammation that leads to the Syndrome.

The better you understand the “mechanical principle” of what is causing the dysfunction, the better equipped you are to choice the best course of action to improve.

And part of that course of action involves finding the appropriate professional help, if needed. So take time to understand the “scope of practice” that various practitioners adhere to, and decide which practitioner(s) might be able to help.

There are many professional resources these days to effectively address even the most stubborn chronic pain issues. Skilled movement experts (like Alexander Technique, and other somatic education teachers, physical therapists, etc.) and skilled manual therapists (like neuromuscular massage therapists, chiropractors, etc.) are plentiful.

Then it’s time to do some research to find the specific individual(s) best suited to help you. Look for recommendations from others. Read reviews. Ask questions.

Also, take some time to research the potential “environmental” factors (e.g., equipment, lighting, chairs, stands, props/supports, etc.) that can impact your condition.

Three: Take action

Once you’ve done your research, it’s time to go into action. Get an initial consultation with the appropriate professional(s). Make the specific environmental changes you’ve researched that seem to be most likely to impact you in a positive way.

After you’ve taken some action, make a conscious decision to reassess your choices. Give things a reasonable time to make an impact (sometimes changing these things takes a fair amount of time and patience), but be willing to recognize when something clearly isn’t working.

And if it isn’t working, do some more research. Ask more questions. Find another way.

Pain can be a slippery slope, in that the experience of pain is impacted by many variables. And there certainly are specific chronic conditions that seem to be impervious to any kind of help.

But most chronic pain and injury is most definitely improvable. Often significantly so.

Just remember the most important step in this process (step one). Believe that things can get better…

For This “Career Ending Condition”, There Is Hope

Around 25 years ago, I started noticing a deeply troubling change in my saxophone playing experience. Simply put, I would have days where I just couldn’t seem to get the fingers of my left hand to do what they could so easily and naturally always do before in order to express myself musically.

At first this was a phenomenon that seemed to come and go, but after about 5 years of this “come and go”, I fell rather immediately into a period of complete loss of control of the fingers of my left hand.

The strange thing was that my left hand worked just fine in any other activity…writing, using hand tools, cooking…activities that require a good amount of fine motor skill.

Yet the moment I even touched the keys on any of my saxophones, my fingers would curl up uncontrollably.

I got to the point where I couldn’t even hold the fingers of my left hand down onto the keys of the saxophone, much less play anything resembling music. I had to stop accepting any kind of work playing saxophone, as well as even just enjoying a rehearsal or jam session. I could no longer play. Simple as that.

To say that I fell into a deep despair would be an understatement.

It was after seeing a physician (a very good internal medicine doctor, whose specialty was in diagnosis), that I learned that I most likely had a form of focal dystonia. I went on to get a diagnosis from a neurologist to confirm this.

The term “focal dystonia” was something I’d never heard before. But the symptoms, this type of unexplained loss of skill specific to the act of playing music, was not unfamiliar to me.

I had encountered several other musicians over the years prior to the emergence of my condition who had similar experiences. In fact, one of my closest friends and musical colleagues, a highly skilled and highly accomplished trombonist, was experiencing this same phenomenon with his facial muscles and tongue.

So what is focal dystonia?

I think this definition by the Dystonia Research Foundation sums it up best:

“Dystonia is a neurological disorder that causes excessive, involuntary muscle contractions. These muscle contractions result in abnormal muscle movements and body postures, making it difficult for individuals to control their movements. The movements and postures may be painful. Dystonic movements are typically patterned and repetitive.”

Within the realm of focal dystonia, there are several sub-categories. For those whose dystonic symptoms only appear while engaging in a learned, skilled activity, the condition is referred to as task specific focal dystonia.

This includes things as common as “writer’s cramp” (though I suspect that lots of forms of writer’s cramp are not focal dystonia, but simply overuse, or misuse), to surgeons losing their “hand skills” only while performing surgery, to a condition in the sport of golf known as the “yips”, where the golfer shakes uncontrollably before a shot that is normally “easy” to make.

And within the of category of task specific focal dystonia, there is task specific musician’s dystonia, more commonly known as musician’s dystonia, or simply by its acronym, MD.

And to subdivide even further, there are generally two types of musician’s dystonia: hand dystonia and embouchure dystonia (“embouchure dystonia” includes the facial muscles, tongue, jaw, soft palate, sometimes neck muscles, and even respiratory structures).

The first thing you are told if you are diagnosed as having musician’s dystonia, is that there is no cure. There are a few medical modalities that can be applied (medications, botox injections, etc.), that might lessen the symptoms. But I’ve yet to encounter a musician who became permanently “symptom free” from these interventions.

This is in part, because the “mechanism” of the condition is still largely a mystery to medical science, and hence any kind of “cure” is not to be found.

For most musicians who get medically diagnosed as having musician’s dystonia, the advice is often the same: Switch careers.

Well that’s just something that’s not easily accepted by many musicians. It certainly wasn’t easy for me. In fact, I refused accept it.

For “serious”, life-dedicated musicians (whether professional or amateur), the idea of not being able to express ourselves freely, authentically and skillfully through music is tantamount to losing an essential part of what defines us, and what gives deep meaning to our lives.

So I was faced with my only option: work at making my condition better so that I could restore this essential part of my life.

My path was (and continues to be) long, and the learning (and more important, the “unlearning”) process was not a straight line. At first I tried to improve my symptoms by practicing more. Much more.

But the more I practiced, the worst my condition became.

Then I went in the other direction, deciding to take a break from playing saxophone completely in order to see if I would “forget” the old dystonic patterns.

After not touching the instrument for many months (and being at the point where I just couldn’t stand being away from it any longer), I painfully discovered that nothing had changed. If anything I felt even more “dystonic” and disconnected to the saxophone than ever before.

I tried massage, stretching, exercise, change of diet…just about anything I could to try, to alleviate my condition. Nothing seemed to work even in the slightest.

It wasn’t until I discovered the Alexander Technique that things begin to change. It was in my Alexander Technique lessons that I learned three very important things:

First, musician’s dystonia (like any focal dystonia) is a “whole body/whole person” reaction. It is something that affects the coordination of my entire physical (or more precisely, “psycho-physical) organism. As my general “use” began to improve (my quality of movement, balance, posture, attention, etc.), my dystonia symptoms became noticeably fewer and less intense.

Second, a big part of learning to improve my overall “use” was in developing the skill of conscious inhibition, i.e., the ability to keep an unwanted reaction in check. I learned that by simply “giving myself permission to stop” whenever I felt the rise of a dystonic reaction while playing my instrument made an immediate and remarkable improvement in my symptoms.

Third, I learned the importance of accepting my symptoms just as they were in the moment. In short, I developed the ability to stop “reacting to how I was reacting”. I discovered that I could observe myself more discerningly, more objectively and dispassionately. This was an empowering realization, and became emblematic of my emerging skills with conscious inhibition.

(I was so impressed with the efficacy of the Alexander Technique, that I went on to train to become a certified Teacher, and have been teaching since 2006.)

As I applied this work, I also started doing lots of studying, from neuroscience, to kinesiology, to anatomy/physiology, and more. I formulated lots of exercises, explorations and activities based upon my studies, and spent a good deal of time working things out.

My progress often seemed “two steps forward, one step back”, but that was okay. I’ll accept that ratio. My daily practice sessions transformed from frustration, despair and discouragement, to curiosity, exploration, discovery and delight. The process of improvement itself became deeply satisfactory.

Since then I’ve continued to improve my condition to the point where I can play saxophone now with the skill, confidence, connection and authenticity that gives me joy and satisfaction.

I’ve also had the opportunity to help some other musicians with dystonia to improve their condition, and it is for this reason that I’ve created a page on my blog dedicated to offering this help.

So if you have musician’s dystonia (or suspect that you do), please get in touch with me. I always proceed from a place of love, understanding and safety in addressing this condition.

And if you know a musicians that is struggling with musician’s dystonia (whether with the embouchure or hands), please direct them my way.

There is hope…

Five Checkpoints For Healthy And Efficient Practice

As I write this post, I can easily say we are living in “historic times”. Because of the current health crisis, people from all over the world are staying inside (thankfully!) much more than usual.

And based upon the significant increase in inquiries about my remote services and my e-books, I can also safely assume that musicians worldwide are practicing their instruments considerably more than usual, as well.

And that’s a good thing, perhaps a small silver lining to this cloud.

So I thought I’d share some very basic principles based upon the Alexander Technique, as well as my experience coaching musicians of all kinds (as well as my own experiences practicing saxophone and improvisation).

These are things to pay attention to that can better enable you to optimize your practice efforts, as well as help you avoid injury or strain from increasing your daily practice time.

I’ve narrowed the topic down to what I consider to be five of the most essential things you can take into account (i.e., five “checkpoints”) in the practice room.

These checkpoints serve as a quick, simple and comprehensive way to take care of yourself as you practice. Here they are:

1. Your head/neck relationship

In Alexander Technique jargon, the dynamic relationship of your head to your spine is called the “primary control”. F.M. Alexander discovered that this relationship is key to governing your overall coordination (hence, the word “primary”).

So as you practice, take a bit of time to notice what’s going on between your head and neck. Is your head balancing freely as you start to play, or are you stiffening your neck, perhaps pulling your head downwards into your spine?

If you allow your head to release upward into free and easy balance on your spine, you might also notice that your shoulders and arms become freer.

If you allow for it, this freedom will tend to spread throughout your body all the way down to your feet, gently encouraging you to release in your back, and unlock your knees and your ankles.

Think of your entire self as expanding into length and width as you play. This expansion is not rigid “posture”, but rather, is dynamic elasticity.

2. Your connection to the ground

Your connection to the ground both supports your head/neck relationship, as well as is influenced (for better or worse) by it.

Allow the ground (or if you’re sitting, the chair) to accept your weight, but don’t collapse downward to do so. Think of your body has having a light, easy and upward suspension that interacts dynamically and efficiently with the ground to counter the downward pull of gravity.

3. Your breathing

Whether you use air to make sound on your instrument, or not, breathing is essential to you coordination, poise, consciousness and power.

For the most part your breathing will “do itself” just fine if you let it. In other words, your brain knows just what to do to breathe optimally if your habits don’t interfere.

In short, think of your entire torso (especially your ribs!) as being free to move in all three dimensions (side to side, front to back, top to bottom) in order to produce the movements necessary for inhalation and exhalation. Don’t aim for anything that feels labored or unnatural.

4. Your external environment

No matter where you practice, always use your senses/attention to include the room you’re in.

This is a matter of allowing your senses to open up and reach outward. So listen for your sound out into the room (as well as hearing or “feeling” it close to you or even “inside” of you).

And let your eyes be free to see the room as well. Not in any kind of distracting way, but rather, as a way for you to get better oriented into your practice space.

If you tend to always close your eyes when you practice a particular thing, experiment with what it’s like to not do that, to actually let your attention be flexible enough to go inwards (towards you) and outwards (where your sound ultimately comes to life) at the same time. Think of your attention as being “inclusive and flexible”.

5. Your use of time

When I talk of “use of time” here, I’m really talking about time as a broad, multi-faceted subject.

There is “time” as it relates to how you play rhythms, meter and inflections. What you do with your metronome, or backing track or drum groove, etc. Because all of your coordination ultimately depends upon your perception of time (“pulse”), I encourage you to make time the most essential musical element whenever you practice, no matter what you’re practicing (even when working on your sound).

And then there is how you use your time to pause and redirect your attention/efforts while practicing a particular thing. It is never a waste of time to stop, notice and redirect. This is an essential tool of the Alexander Technique, and something that takes a good deal of discipline to implement (but it is so well worth it!)

As you learn to pause and redirect, you open yourself up to the possibility of discovery, change and growth.

And finally there is how you use your time to take care of yourself during your practice session.

Make sure your taking lots of breaks (lasting even just a few seconds between iterations of whatever it is you’re practicing, to 5 to 15 minute breaks during your practice session). Doing this will not only keep you healthier (avoiding strain and injury), but will also keep your attentional capacity fresher and more effective.

So enjoy your extra practice time. Use these five checkpoints from time to time during your practice session. Be safe, and stay flexible, curious and productive.

Why “Feeling Relaxed” Isn’t Always a Good Thing To Aim For When Playing Music

The word ‘relax’ can be a very dangerous word for some musicians.

Karl Snider, singer, voice teacher, Alexander Technique teacher

One of the fundamental benefits of studying  the Alexander Technique and applying it to musical performance is in reducing or eliminating misdirected effort.

It is this misdirected effort (manifested through muscular tension) that leads to unnecessary fatigue, compromised coordination and skill (including problems with time/rhythm), and even injury.

My Alexander Technique students learn to play their instruments with far greater ease, efficiency, confidence, consistency and satisfaction than they did before studying the work.

Yet if you asked virtually any of these students (musicians from a large variety of genres) if they are more “relaxed” when they play now, compared to before they started taking Alexander Technique lessons, you might be surprised by their answers:

“I wouldn’t say I’m more ‘relaxed’ when I play now, just that I’m freer to move and respond in a way that is more conducive to playing my instrument the way I want to play it.”

The above is a quote from one of my students, an excellent guitarist here in Los Angeles, who’s been studying and applying the Alexander Technique for a number of years now.

(His response pretty much sums up and concurs with typical responses to this question from just about any of my students.)

If you asked this guitarist if he aims to be “relaxed” when he plays, he’ll answer with a resounding “no.”

Why is that? (you might wonder)

“Because (going again to what my student said) saying I want to be ‘relaxed’ is misleading.”

“First of all, it takes a certain amount of energy and tension to play guitar. Muscles are constantly working when I play. They have to. So it’s impossible to be completely ‘relaxed’ in the way most people think of being relaxed, and certainly in the way that I used to define that state of being.”

“Second, aiming for relaxation can often lead to other problems, like under-energized practice and performance. And before, when I didn’t ‘feel relaxed’ in the way I thought I should, I immediately became anxious, thinking I was doing everything wrong. That would lead me to playing with even less freedom and with more strain.”

As my student discovered, it’s this “feeling wrong” if you don’t think you aren’t as “relaxed as you should be” that often leads to even more misdirected effort.

If we go back to what my student does  want in his playing (what he has gained from studying and applying the Alexander Technique), it is more freedom.

Freedom to move lightly but powerfully. Freedom to respond in a constructive way to musical impulse. Freedom to use time more effectively.

Ultimately, freedom to choose.

If you were to ask this student what qualities he now seeks and enjoys when playing guitar, some of the words would be: balance, mobility, ease (not the same as relaxation), flexibility, efficiency, precision, satisfaction.

Freedom  instead of relaxation.

And this doesn’t even take into account the psycho-physical state of readiness necessary for actual live performance. So many musicians confuse the heightened state of arousal before and during a performance as “fear”, as something to be avoided at all costs.

While there are certainly some musicians who feel “fearful” about performance, the feeling of “excitation” necessary for optimal performance is too often confused with “fear” by many performers.

That’s unfortunate.

Because great performance is  exhilarating. It is  magical. It is  dynamic. It is  alive with energy (and even tension!) It is indeed  special.

But it is a far cry from anything anybody would call “relaxed”. In fact, I’d go so far as to say that it is impossible to be relaxed during an authentically expressive musical performance.

So instead of aiming for “feeling relaxed” during a performance, perhaps you can wish for this instead:

To be free, mobile, supported by the ground, appropriately energized, connected (to the music, to the other performers, to the audience), inspired, curious, generous and loving.

And, perhaps…

You can wish for a light, easy upward and outward dynamic expansion throughout your entire body as you play.

You can wish for freely moving breath.

You can wish for an integrated attention, balancing what you think/feel internally, with what you experience externally.

You can wish for allowing yourself to use time to your advantage, never rushing ahead, instead letting the music unfold into its natural, easy rhythm.

You can wish for buoyant, freely flowing energy throughout your entire self.

You can wish to be graciously receptive of the creative impulses moving through you.

You can wish to be graciously receptive of the presence and energy of the audience and the other performers.

You can wish for economy of effort  instead of relaxation.

You can wish for clarity and freedom in thought and expression…

What else would you  wish for in practice and performance, if you could have anything you want?

Don’t Overlook This Important Element For a Satisfying Musical Life

Perseverance, discipline, passion, courage and faithfulness are qualities that every serious musician needs in order to achieve any kind of success (both/either commercial and/or artistic).

In this rapidly changing world, where the perceived value of artistic efforts in general is in a constant state of flux, I find it remarkable that there are so many marvelously talented, inspired, skilled and driven musicians.

With the advent of the internet and digital recording technology, along with the ever-changing cultures at music schools and in professional ensembles, the skill standards in musical performance seem dauntingly high.

No question in my mind that musicians are working as hard as ever pursuing excellence in their art and craft. In many genres of music, the precision  with which many musicians play these days is at its peak.

And there are loads of great, highly useful resources (teachers/mentors, articles, DVDs, books, online subscriptions, etc.) available these days to help the serious musician improve and grow in order to meet the demands of today’s professional musical standards.

But there is one essential element that is rarely mentioned for succeeding in this fast-paced musical world we live in:

Sustainability.

Put simply, sustainability is having the capacity to continue doing what you love (playing music!), in a healthful and ultimately satisfying way.

Many of the musicians who seek my help as an Alexander Technique teacher do so, in large part, because of a particular issue of sustainability. Specifically, playing music for them has become uncomfortable, painful and in some cases, even injurious.

They might already be playing quite well (several of my clients are top-shelf performers in either classical, commercial or jazz music), but realize that they need to change something in themselves if they are to sustain the careers they so love.

Helping them to discover how to play with less strain, with less misdirected effort, with greater ease, balance and flexibility, is one of my deepest satisfactions.

But it is not uncommon for my clients, during the course of their work with me, to confront other aspects of sustainability.

For example, I have worked with professional symphonic musicians who’ve become so stressed out by the demands for “absolute precision” in their performances, that, even if they can deliver such “precision” (and many can!), they begin to lose the joy of what brought them to play music in the first place.

Their work experience is one of considerable worry, and even fear. This not only negatively impacts their musical performance experiences, but also deeply affects the quality of their lives in general.

Some time back, I gave Alexander Technique lessons to a highly accomplished brass player (principal player in a world-class orchestra) who related to me how stressful the entire day  would be of whichever concert that he was playing.

He would sometimes have to “disconnect” from his family, isolating himself the entire day so that he could “focus” completely on the task at hand. (And keep in mind that he was playing hundreds of concerts per year!)

His “performance day” stories made me feel deeply sad. Though I envied his skill and accomplishments, I certainly did not envy the lifestyle of his “success”.

He also told me that his case was not at all unusual, and had loads of stories of his colleague’s “rituals” and “phobias” before concerts. He mentioned how their entire lives were in constant subjugation of their careers.

In essence, that kind of lifestyle was becoming more and more unsatisfactory, and ultimately, unsustainable for him and many of his colleagues. Lots of burn out, injuries, divorces, career changes and worse, for some of these folks, unfortunately.

And there are other issues of sustainability that musicians of varying levels of skill and success face.

Many serious amateur musicians, for example, are in a constant state of dissatisfaction with their practice efforts.

Either they’re frustrated because a lack of sufficient practice time keeps them too far from realizing their desires and potential, or that even when they do get enough practice, they keep running into the same, seemingly impossible hurdles in improving their skills.

A good amount musicians that have sought my help have done so because no matter how “hard” they practice, they can’t seem to improve. This becomes an unsustainable situation. Unless these musicians can learn to change what they do, to redirect their strategy and effort in a more constructive way, they will eventually stop playing.

As human beings, we are built to deal with adversity and disappointment, as long as there is meaning in this adversity and disappointment. But when we try, try, try, and get no discernible improvement, we begin to lose meaning.

And when we lose meaning, we eventually stop trying.

So it’s not enough just to practice that much “harder” (or longer), or even to find the best and latest exercises and techniques to keep you improving and meeting the demands of your profession and/or avocation. To stay in it for the long haul, your efforts, your passion…must be sustainable.

Here are some of the qualities of a sustainable musical life:

  • Physical efficiency and ease. Yes ease. If every day that you practice feels like running a marathon, you’re likely to encounter chronic pain and possibly even injury. Learn to cultivate “effortless effort” (a good Alexander Technique teacher can really help a lot with this!) Staying healthy (physically and emotionally) is of prime importance!
  • Artistic satisfaction. Yes, it’s okay to always want more, but learn to enjoy what is already there, what you already have. It’s okay to be happy with your efforts. Plus, you should be playing the kind of music that brings you  satisfaction. It doesn’t have to be your dream gig, but you have to find pleasure in doing it, if you’re to continue.
  • A balanced family/social life. Remember that you are a human being first. It is deeply wired into your brain and body to connect with those you love. Don’t let your musical life threaten your life as a human being. If you’re spending all  your time practicing…well, you know that’s less than ideal, to say the least.
  • A reasonably comfortable lifestyle. None of us are in it for the money. But if your professional life as a musician is keeping you in oppressive poverty, you might want to rethink a few things. You don’t have to be rich, but having a comfortable and safe home, with access to good food and health care, is essential for sustaining your efforts.
  • Self-esteem. Knowing that you are being kind to yourself, that you are working on your music from a place of love (instead of fear), that you can accept the ups and downs of  your artistic, professional and personal lives, and that you truly do love yourself, is probably the quality that will help you find the other for items mentioned above.

So continue to work hard, continue to strive, but always find meaning in what you do. Keep cultivating hope. Keep on keepin’ on!