Category Archives: Alexander Technique and Music

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

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close up photo of a man having a neck pain
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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

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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…

Something You’re Always Doing When You Practice (Even When You Think You’re Not)

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I often ask the following “trick” question to my students on the first day of class at the college where I teach the Alexander Technique:

“If one of my students is staring out the window with her eyes glazed over as I’m speaking to the rest of my class (who all seem to be engaged in the topic of conversation), would it be truthful to say that that particular student is paying attention?

Of course most of the students answer with a resounding “No”.

But I always seem to have that one deep-thinking student that disagrees. It’s always something like this:

“Oh she’s paying attention to something. She’s just not paying attention to what you’re saying.”

And that is entirely true.

Or as I often phrase it (if you’ll forgive my use of a “double negative”), “Whenever we are awake, we are never not paying attention.”

You see, as far as the functioning of you brain is concerned, as long as you’re awake, you’re paying attention to something. Always.

So during your practice session:

When you “daydream”, you’re paying attention.

When you’re wondering what you’re going to have for lunch, you’re paying attention.

When you remember something funny that happened yesterday, you’re paying attention.

When you get “distracted” by something (or “blank out” and forget that next phrase you should be able to play by memory), you’re paying attention…

So when you’re practicing your instrument, the question isn’t “Am I paying attention?”

The question is “What am I paying attention to right now?”

And perhaps a more important and constructive question would be, “How can I direct my attention right now to optimize my practice efforts?”

This might be a “where” question, as in “Where am I ‘placing’ my attention?”

Or it could be a “quality” question, as in “How would I describe the quality of my attention?” (Is it “narrow”, “diffused”, “focused”, “scattered”, “calm”, “agitated”, “disengaged”, “playful”, “curious”, to name a few…)

If your attention seems “focused”, you could further inquire, “Is my attention ‘exclusive’ and narrow, or ‘inclusive’ and expansive?”

In other words, is your attention broad enough and flexible enough to easily include noticing what you’re doing with yourself as you practice?(your balance, mobility, ease, breathing etc; what we refer to as your “use” in Alexander Technique jargon)

Or does your tendency to “focus” exclude your sense of what you’re doing with yourself?

Because if you can’t notice how you’re “using” yourself, you run the risk of developing habits of inefficient and even harmful movement patterns you’ll bring into your music making.

On the other hand, does your “focused” attention have you placing too much of your consciousness on the parts of your body that you think are most relevant to playing your instrument? (e.g., wind instrumentalists focusing almost exclusively on the embouchure)

If that’s the case, you might be interfering with the movement and postural mechanisms that work best with a little less direct conscious attention (not to mention making yourself less available to your expressive impulses with the music).

It’s all a matter of balance, isn’t it?

Too much, too little, too broad, too, narrow, too specific, not specific enough…

The key thing to remember is that the way you pay attention impacts how you react. How you react impacts how you learn, experience and express the music. (When I refer to “reaction”, I’m talking about posture, movement, balance, sensory perception, use of time and more.)

And most important of all, you have a choice in how you direct your attention.

So give a bit of your attention to “how you pay attention” as you practice, and discover and develop the attentional qualities that work best for you.

An Important Thing To Notice The Instant You Prepare To Play

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One of the most fundamental things to pay attention to regarding your musical practice and performance habits is how you prepare.

This “preparation” can be put into two categories:

  1. What you do the months, weeks, hours and/or moments before you begin to play (as in preparing for a specific performance).
  2. What you do the very brief instant before actually producing a sound on your instrument (both in the practice room and in performance).

Though both of these can have a profound impact upon the quality of your musical experience, today I’m going to address the second of these categories: What you do the instant you prepare to play.

As far as the functioning of your brain is concerned, nearly all motor movement (and all skilled and/or learned motor movement in particular) can not happen without some kind of preparation.

The vast majority of this preparation takes place unconsciously (e.g., postural tone, pre-learned basic motor programs, spatial positioning adjustments, etc.), while a much lesser part of it is conscious (e.g., voicing, “setting” the embouchure, conscious hand placement adjustments, etc.)

Though to function well, it is indeed necessary that most of the things you do to “prepare” the instant before playing are done without any conscious effort, there can sometimes be some negative consequences attached to this lack of attention to the details of what you do:

I’m talking in particular about any habits of reaction you have (movement, posture/positioning, attentional quality/direction, breathing, etc.) that might be keeping you from accessing your optimal coordination.

I use the word “habit” here deliberately, meaning that habit is something that you acquire through repetition. It is something learned and constantly cultivated (for better and for worse). Habits manifest themselves unconsciously, and are never “neutral” (i.e., you are either strengthening or weakening them, depending upon experience).

Again, these unconscious habits are useful and highly desirable if they are truly helping you get what you want.

But what about when they’re not helpful?

One of my main jobs as a teacher of the Alexander Technique is helping my clients understand and discover the “unhelpful” (counterproductive) unconscious habits they might bring to their playing experience.

When my clients learn how to recognize and subtract these habits, their playing opens up in lovely ways. In essence, they find more ease, power, control and satisfaction.

One of the first things I look for when I see a client for the first time is the quality of their preparation. “What does ‘getting ready to play’ look like for them?”

In asking myself this question, I look for several things, various clues as to how they are “using themselves”, both in preparation and in performance: what they’re doing with their bodies, how they are using their eyes, the sound/quality of their breathing, and more.

But the main thing I’m looking at is simply how they are managing the relationship between their head and their spine.

In Alexander Technique jargon, this “head/spine” relationship is known as the “primary control”. F.M. Alexander (the founder of the Alexander Technique) called it that because he found that this relationship had a primary impact upon the functioning of the limbs, quality of balance, breathing, as well as other senses and attentional quality.

A lot of what I look for with a first-time client is what they are “doing” with their neck in preparation to play. (Here by “doing”, I mean the typically unconscious and unnecessary muscular effort they’re applying to the act of playing their instrument.)

In reality, the best thing they can “do” with their neck is… nothing.

Yes, nothing.

You see, it’s this interference with the dynamic relationship (think “balance”, “mobility”, “stability”) of the head to neck relationship that is both a manifestation of, and evidence of, other aspects of misdirected effort.

When this misdirected effort is subtracted (or lessened) the ability to access your natural and healthy coordination is restored. You access the optimal conditions within yourself to more effectively “cooperate” with your glorious human design.

So what do you do with your neck that instant before you prepare to play?

What is the quality of your neck? Is it supple, dynamic and tending toward lengthening?

Or is it perhaps held, rigid and tending toward shortening?

If you notice that you tend to prepare by stiffening, holding onto and/or shortening your neck, maybe you can notice some of the other things you do in relation to that.

In particular, notice your jaw (free or held?), your shoulders, your back, your arms/hands, your knees, your connection to the ground, your breathing…your eyes.

Notice whether any of these other components of your “use” are organized and impacted by what you’re doing with your neck.

See what it’s like when you give yourself a wish to simply leave your neck alone, so that your head can balance freely atop your naturally lengthening spine.

Remind yourself that you don’t need to do anything with your neck to prepare to play those first notes. The unconscious movement/postural mechanisms in your brain already know what to do.

When you’re able to leave your neck alone, see if you can notice how the rest of you changes for the better.

Use a gentle, curious and kind awareness of yourself and your habits, and enjoy discovering more ease and satisfaction in your playing.

Awareness In Playing Music: “Looking For” In Contrast To “Noticing”

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To improve what you do as a musician, you must pay attention to things in sometimes extraordinary ways.

This is especially true if you aim to change any habits you might have of misdirected effort and energy. To find more ease and efficiency in your body as you play your instrument, you sometimes have to call things into question.

But consciously increasing the awareness of your postural and movement habits as you play your instrument can be a double-edged sword.

On the one hand, if you never become aware of these habits, you’re never going to be free of them (thereby limiting your growth as a musician).

On the other hand, focusing too much on these habits while you’re playing can actually make things worse rather than better.

So to improve what you do, you need to balance these two (sometimes opposing) forces.

When musicians come to me for Alexander Technique lessons, there is always some imbalance between “lack of awareness” and “hyper-awareness”. My job is to help my client explore, discover and cultivate the kind of dynamic (“dynamic”, as in always able to change) attention that will yield the best results.

Here’s a little experiment I sometimes use with the musicians I coach to get them aware, not only of themselves and their postural and movement habits, but of the quality of their own self awareness:

Experiment One-Scanning for Misdirected Effort/Tension/Energy

As you play your instrument, pay attention to a particular part of your body. Do this several times, each time changing the anatomical location of where you’re looking. While drawing your attention to each part, observe and ask yourself these three questions:

1 “What do I notice?”

2 “Am I free and available for movement here, or am I holding on more than I need to?”

3 “What could I let go of to play more easily?”

Don’t worry about being “right or wrong” as you ask these questions. Just observe. You can organize your observations toward the following areas of your body, starting and stopping each time you change the awareness of where it is you’re looking:

  • Head/jaw/neck
  • Shoulders/chest/upper back area
  • Arms/hands/fingers
  • Lower back/abdominal area
  • Buttocks and hips (front and rear of your pelvic area)
  • Knees/upper legs
  • Lower legs/ankles/feet

What do you notice when you do this experiment?

You might have noticed some unnecessary effort (i.e., “stiffness”, “tightness”, etc.) in one or more areas of your body. And that awareness can be a very good thing, enabling the possibility of change and improvement.

It’s also quite possible that in “looking for” this misdirected effort that you actually increased it.

(Take a moment to think about that.)

Too often when you look for “trouble”, you not only find it, but typically amplify it. (There are myriad reasons why that is with respect to how your neuromuscular systems function.)

So “looking” for it helps you become aware of what needs to change, but it doesn’t necessarily improve your coordination in that moment.

Okay, lets look at another experiment:

Experiment Two-Noticing Ease

This time as you play your instrument, pay attention to yourself in a more “global” (whole body) way, instead of the “segmented” way you did in the first experiment.

But this time, don’t “look for” anything in particular. Instead, as you bring your body gently and flexibly into your attention, simply take note of places in your body where things are already easy and free. Notice where you are already mobile, already in good balance, already dynamic, already poised…

In essence, notice the ease that is already there inside you.

That ease might be anywhere…your shoulders, hands, legs, back….in your breathing….

No matter how “tense” you might think you are when you’re playing, there is always some ease going on somewhere. It’s just a matter of being available in your attention to notice it.

To be clear, you’re not searching for something that is not there, nor are you trying to “create” ease. (Trying to do so would most likely invite unwanted/misdirected effort.)

Instead, you’re just opening your awareness to what is already happening unconsciously on its own.

And what do you do with this acknowledgment of ease?

Nothing at all. Don’t form any agenda with what you take note of.

Just let it be.

So what happens when you notice what is already “right” (easy, mobile, freely available, light) inside your body as you play your instrument?

How does this contrast to the quality in your body when you are “looking for” misdirected effort/tension/energy?

(Take some time to seriously ponder these questions.)

You just might find (as I do) that when you “notice ease” in your body, that this ease migrates and expands to other parts of your body. It’s kind of like a “virtuous circle”, perpetuating itself to inform you of the possibility of ease in the rest of your entire organism.

When I’m performing on saxophone, I never “look for trouble” in my body. Because if I do, things become worse rather than better.

But the instant something moves toward “wrong” with myself (in my body) as I’m playing, it comes easily into my attention, and I’m able to gently say “no” to it. (In Alexander Technique parlance, that’s known as “conscious inhibition”.) This is a skill that I cherish, and is one that helps me play with greater ease, efficiency, consistency and satisfaction.

It is a skill that has been (and continues to be) cultivated by “scanning” myself while practicing (Experiment One).

But I had to learn early on as a student of the Alexander Technique to balance the “looking for trouble” part with “noticing ease” as it applies to playing my instrument.

And as I’ve said above, the “looking for it” part can be a useful tool in the practice room when used wisely. (The “looking for it part” is a good place to visit from time to time, but not a great place to live all the time.)

Nowadays, for sure, I notice ease more readily and naturally. And that ability to notice what is already there, what is already helping me, continues to enhance my coordination and skill as a musician.

And I hope it can enhance yours, too! So give this two-part experiment a go. See what you discover. Be kind with yourself, (and curious, persistent and patient, too). And please always feel free to contact me if you need help. Helping musicians do what they do better is my passion!