Tag Archives: Self-care for Musicians

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…

The Power of the Pause

Freedom is the capacity to pause in the face of stimuli from many directions at once and, in this pause, to throw one’s weight (put one’s intentions) toward ‘this’ response rather than ‘that’ one.

-Rollo May, existential psychologist, from his book ‘Freedom and Destiny’

One thing that virtually every musician has to do in order to improve is to change what they are currently doing. This might mean changing your practice regime, changing your understanding of your instrument and pedagogy, changing your perception of sound, changing your quality of attention, etc.

It might also mean that you have to change the postural and movement habits you bring to playing your instrument.

Habits of breathing, standing and/or sitting, how you use your arms and hands, how you balance (or not), how you use your other senses, etc. It’s entirely possible (and even highly likely) that you are sometimes misdirecting your efforts in these areas as you play.

The Alexander Technique is a practical method of helping you to change your postural and movement habits for the better. And one of the most essential tools of the Technique is known as “conscious inhibition” (most students and teachers of the Alexander Technique just refer to it as “inhibition”).

In the simplest sense, inhibition is your ability to consciously prevent yourself from reacting in an habitual, unwanted way. Unwanted tension in your neck. Unwanted rushing of the tempo. Unwanted stiffening in your shoulders, Unwanted gasping as you breathe, etc.

By keeping the unwanted things “in check”, you are free to pursue what you do  want in a way that is more in accordance to your human design. You increase your odds for success.

From a neurobiological point of view, all skilled motor activity requires a balance between “volition” (muscles going into the desired, or helpful action) and inhibition (muscles refraining from undesired, or unhelpful action). Most inhibition in skilled activities takes place naturally and unconsciously (as it should).

But sometimes you need to use inhibition in a more constructively conscious  way in order to improve things.

Unfortunately, there can sometimes be a misconception about using inhibition consciously. To many people, conscious inhibition means “trying” to stop something from happening. It is exactly this “trying” part that can too often create a whole other set of problems when setting out to change movement and postural habits.

“Trying” sometimes means that you are struggling to stop yourself from doing what you habitually do. As if you have little or no control over it. Here’s something F.M. Alexander (the founder of the Alexander Technique) said about it:

When you are asked not to do something, instead of making the decision not to do it, you try to prevent yourself from doing it. But this only means that you decide to do it, and then use muscle tension to prevent yourself from doing it.

But that’s not at all the way inhibition is used in the Alexander Technique. Rather than “trying to stop” something, you learn to simply decide not to do it.

I know, I know…more easily said than done, especially when you have a deeply ingrained habit attached to playing your instrument. But still absolutely doable. That’s the skill you develop by studying and applying the Technique.

The first step in learning to use inhibition in a constructive way, is to embrace the pause.

It is within this brief instant before taking action that you can choose to redirect your attention and clarify your intention and effort. In that moment you come face to face with your habitual reaction, and can give yourself a chance to say “no” to it.

You can decide  not to do what you habitually do. And that’s where the magic lies.

Because if you decide not to react habitually you leave yourself free to find other ways to react. You move from habit  into the realm of choice.

It is the discovery, exploration and embracing of the pause that has given me tremendously powerful tools in managing (which I do quite well!) the focal dystonia in my left hand.

Without using the pause as tool for change, I wouldn’t be able to play saxophone at all any more with any kind of reasonable skill and control. Nowadays, I’m playing better than I ever have, thanks to the power of pausing and redirecting my attention. That simple.

But I gained so much more from the using the pause than improving the functioning of my left hand. Using the pause has helped me to practice everything I practice in a much more constructive, efficient and clearly intentional way.

And as an improvising musician, learning that I can pause, that don’t have to fill every second of my solos with sound, is liberating, and (at the risk of sounding dramatic) has been life changing for me.

I listen at a much deeper level when I play with others than I ever have before. I play with greater empathy, confidence, authenticity, passion, creativity and satisfaction.

All thanks to becoming more and more skilled at pausing.

And to be clear, “pausing” is not the same as “hesitating”. Pausing invites calm, reassured choice, where hesitation invites conflict, misdirected effort and a lack of confidence and clarity.

I use the pause countless times every day that I practice, and I bring it with me to rehearsals and to the bandstand.

When I’m practicing, sometimes I pause between iterations of something challenging that I’m practicing. Just a split second to stop and redirect my efforts makes all the difference.

And even in the middle of a performance, the “imagination” of the pause is always there, reminding me that I have more choice than I might have perviously thought.

So I encourage you to explore the pause. Before jumping right in to “fix” what you didn’t like about what you just played in your practice session (by starting over with the same misdirected effort that led to your dissatisfaction), give yourself a chance to stop, find ease and balance in your body, clarify what it is you want and don’t want, and begin again.

As I’ve said in some of my other blog articles, you’ll never waste time when you give yourself a chance to stop and consciously redirect your efforts. Embrace the quiet power of choosing to pause. Respond rather than react, and reclaim your freedom.

Be Mindful of This Very Important Connection When Playing Your Instrument

Whether giving an Alexander Technique lesson to a musician, or simply observing myself when I practice, I’ve come to notice one particular postural/movement habit that we all seem to have in common when faced with a potentially “stressful” stimulus when playing our instruments.

This is also something I can see as I watch musicians (and other performing artists) during performance.

When I say “potentially stressful”, I mean to include a wide range of things, from mild to powerful.

For example, a mildly stressful stimulus might be to slightly increase the tempo of a particular etude you’re practicing. Whereas a more powerfully stressful stimulus might be anticipating playing the first note of an important audition for which you’ve prepared.

In either case, there is an almost universal tendency  with respect to your movement and posture when faced with these types of stimuli:

You begin to lose your connection to the ground.

It is your connection to the ground that is the basis of support that encourages the freely fluent, agile and powerful movements you need to perform at your fullest potential.

Nearly all of our movement/posture, with respect to our human design (and with respect to our relationship to gravity), is based upon support (the ground) and suspension (the elasticity of our musculoskeletal system).

When you lose support, you also begin losing the elasticity  necessary for optimal suspension, and ultimately, optimal coordination.

So what does “losing connection to the ground” look like?

Here are a few examples when you’re standing:

  • You stiffen your feet and ankles, losing the mobility necessary to respond effectively to changes in balance.
  • You roll to one side or the other of either/both feet (this too, involves stiff ankles).
  • You hyper-extend (“lock”) your knees.
  • You clench your buttocks and/or compress you hips, while at the same time “lifting” yourself off the ground slightly.

And even when you’re sitting you can lose this very important connection to the ground. Here’s a few ways how you might do so:

  • You stiffen your legs, thereby diminishing the necessary contact of your sitting bones to the support of the chair.
  • You begin to push (or pull) toward one side or the other of your pelvis (and thus, your sitting bones).
  • You begin to draw your knees up into your pelvis (as your feet come up slightly off the floor).
  • You lift yourself up from the support of the chair by narrowing your entire torso. (This is something you also might to when standing.)

I should also mention here (with respect to the principles of the Alexander Technique) that when you’re engaging in any of the above listed posture/movement reactions, that you are at the same time stiffening your neck, interfering with how your head needs to freely balance on top of your spine (in order to allow optimal coordination).

And these tendencies are not only potentially problematic to the “mechanics” of your coordination, but are also (perhaps even more important!) evidence  that your quality of your attention is less than ideal. It has gone from being flexible, integrating and expansive (inclusive), to inflexible, disintegrating and narrow (exclusive).

(There is always a reciprocal relationship between the quality of your attention and what you do in your body. It’s sort of like, “Which came first, the chicken or the egg?” In any case, one conditions the other.)

But here’s the good news:

You’re not stuck with any of these tendencies.

Because they are only that. Tendencies. Or “habits” as we would refer to them in Alexander Technique jargon.

And habits can be changed.

Start by paying attention. Notice both when,  and how,  you lose your connection to the ground.

Notice what types of stimuli (thoughts, circumstances, conditions, etc.) seem to invite you to lose your connection (the “when” part).

Notice what you do with your entire self (including your attention) when you lose your connection (the “how” part).

Once you notice, you can practice pausing to gently redirect your attention, allowing yourself to be easy in your body and regain your connection to the ground. (And allowing yourself to reconnect to your intentions, and with the music itself.)

Finally, there is a difference between being “planted” (stuck hard and fast into the ground) and being “grounded” (surely, but dynamically connected to the ground).

Aim for being grounded, letting your weight pass freely down through your legs, through your feet, and into the support of the ground (when standing), or through your sitting bones as you allow the chair to support you (when sitting).

Then think of yourself as going up lightly, freely and expansively from your supporting surface. Let the earth play its role in helping you make music. Notice the difference.

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?