Tag Archives: Repetitive Strain Injuries 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…

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!

Breathing: Avoid This Misconception About “Moving the Air”

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Whereas most of my blog posts are written with all instrumentalists in mind, this particular post is aimed exclusively towards wind instrumentalists and singers. It addresses a common misconception about how you manage the movement of the air on the exhalation  as you play or sing.

The idea has to do with the concept of the “velocity” of the airstream.

As you know, you must use your respiratory mechanism in an extraordinary way when singing or playing a wind instrument. You are not simply breathing in a completely passive way. You are using your breath with an energetic purpose that serves both function (physiological and mechanical) and self-expression.

And of course, the “working part” of the breath cycle is the exhalation. In large part, this kind of management of the exhalation involves changing the velocity  of the airstream.

Yet, what you do with yourself  to manage those necessary changes in air speed can significantly impact not only your breathing, not only your sound, but also the coordination of your entire body and ultimately, your skill.

One of the ways that air is “sped up” is by “compressing” the airstream. (In short, everything else being equal, a narrower airstream means “faster air”.)

And there’s where the problems sometimes begin.

I once watched a video of a highly skilled, fairly well-known trumpet player talking about the importance of “compression” when using the airstream.

In fact, it was something that he encouraged his viewers to do consciously each time they began to play a note or a phrase.

Now, he was talking about doing something with the airstream, but it was interesting for me to see what he was doing with his whole self  as he carried out the instructions he advocated.

His entire body went into a state of “compression”.

Specifically, his head was pulled down onto his spine, his ribs were pulled downward with great force toward his abdomen (which was actively involved in distorting his pelvis), and his shoulders became rigid and narrow. I couldn’t see his lower half, but I imagine that was affected as well.

In essence, as this very fine trumpet player compressed his airstream, he simultaneously compressed and shrunk himself. (For the record, I’m not here to criticize this musician, only to call into question some of his ideas. I’d say he plays very well, despite  what he’s doing with himself.)

But here’s the truth:

For you to compress your airstream you don’t need to compress yourself.

Really. You don’t.

You certainly need to use a considerable amount of muscular energy to move the air, especially at high velocities.

But this muscular energy doesn’t need to involve shortening your three-dimensional stature.

Here’s why.

First, because of the way your ribs attach to and move with your spine, the natural, structural tendency of your spine is to lengthen  on the exhalation.

It will do so, even with tremendous muscular energy, if you let it.

Second, by forcefully pulling your ribs downward into your abdomen, you are interfering with two things: The full excursion of the diaphragm and the full excursion of the ribs.

The movement of the ribs in concert with the diaphragm is essential to optimal breathing.

Third, by compressing your respiratory mechanism in this manner as you exhale, you signficantly impact the coordination of the following inhalation, again limiting the excursion of the ribs and diaphragm.

It is these reciprocal excursion patterns between the ribs and the diaphragm (and other parts of you, as well) that are essential to all breathing, both natural and task-specific.

So what to do instead?

Mostly, subtract a few things.

First, subtract a noisy, forced inhalation (which often carries with it a tense jaw). Instead, aim for a free, energetic and expansive reflexive  inhalation.

Second, don’t pull your head down into your spine. If you need more muscular energy, direct it upwards, as you ride the wave of your naturally lengthening spine. Allow your neck and jaw to be supple and responsive.

Third, avoid pulling your ribs down forcefully on the exhalation. Imagine your ribs (including the muscles between them) as being in an active, but gentle state of opposition to your upward moving spine. As your ribs slowly descend, your spine gently lengthens, as you move the air into your instrument at the most optimal velocity.

Fourth, allow your abdominal muscles to respond  to the needs of moving the airstream, as opposed to a preconceived set amount of tension. If you work with this idea a while, you’ll learn to trust that your intention with your sound (range, color, pitch, etc.) will inform your neuromuscular system to do the right thing with your abs (and all the other muscles involved in supporting your airstream and sound). This “response” I’m talking about will take place instantly, optimally and organically. Naturally, if you will.

In sum, aim towards separating the concept of air  compression from bodily compression. To be clear, I’m not talking about using less  muscular effort, so much as avoiding misdirected  muscular effort.

Allow yourself to move freely and energetically (always aiming upward), with a three-dimensionally expanding  organism. You might be surprised at how much easier and more efficiently you can “move your air” to create the sound you wish for. And as a bonus, you’ll avoid some of the patterns of misuse that often lead to fatigue and injury. Win/win.

Skill and Coordination (They’re Not Necessarily the Same Thing)

One of the aims of the Alexander Technique is to improve coordination.

And I would say more specifically for musicians, the aim of the Technique is to improve the quality of  overall  coordination that you use to implement your music making skills.

A misapprehension that many musicians have is that skill and coordination are one and the same thing.

Though they are certainly closely related, they’re not exactly  one and the same.

How so?

Allow me to clarify by offering my  working definitions of the two terms.

Your skill is your ability to carry out your desired task (for our purposes, playing music). It is manifested in tangible, sonic results: pitch, time, articulation, tone color, technical control, expression, etc.

Your coordination is what you do with your entire self  to carry out your skill. It is manifested in muscular effort, or more specifically, the quality of movement you apply to the task. (This includes balance, posture, breathing….everything you do!)

So it is possible to be a highly skilled musician (and yes, this does mean having highly cultivated  fine  motor coordination skills), yet have less than optimal overall, gross  motor coordination.

You can witness this in many instances, if you take time to notice.

Some musicians make it look easy, don’t they?

Truth be told, for most of these musicians, it is  easy. They typically appear effortless because their efforts are so singularly integrated into the skill of their performance. Virtually nothing they do interferes with their artistic intentions, with their desire of self-expression, nor with the acoustic and physiologic components involved in playing.

(I look upon classical pianist Artur Rubinstein as a glowing example: free neck, strong and flexible back and arms, moving easily, fluidly and naturally with the music. It is this beautiful, efficient coordination that is at the service of his skills.)

And I think we’ve all seen/heard virtuosic musicians who look like they’re fighting an imaginary foe as they play music: head compressed into the neck, raised (stiff) shoulders, rigid ribs and back, hard narrowed gaze, noisy breathing.

Yet they still deliver the goods. They still play devastatingly beautiful music. (No, I won’t point my finger at any one musician here, as a gesture of respect. But I so easily could!)

So should these musicians even bother with improving their overall coordination? Should you?

Yes. And for three main reasons:

1. Your overall coordination impacts your skill. When you are working in a less than optimally coordinated way, you are interfering with your brain/body’s ability to carry out your skill in the most efficient manner. In essence, you’re working against your human design, and not in accordance with it.  You might be able to do so. But you do so despite of, not because  of, your coordination. Improving your overall coordination invites greater skill. Or, as F.M. Alexander (the founder of the Alexander Technque) said, your improved coordination creates “the ideal conditions” for your skill to manifest itself through your bodily mechanism.

2. By improving your overall coordination, you reduce your risk of injury (and fatigue). This is why many musicians seek my help as an Alexander teacher in the first place. I have volumes of stories of very highly skilled musicians I’ve encountered who have career-threatening health issues that are related to the poor coordination they apply to their skill. As their coordination improves, so does their health, comfort, endurance and satisfaction.

3. By improving your overall coordination, you open yourself up to other expressive possibilities. This is the hidden gem of all this. As you improve your overall coordination, you also discover different ways to experience the music you play. You become less stereotyped (less “stuck”) in your interpretive choices, which, believe it or not, are highly conditioned by your bodily reactions. (This is especially true for improvising musicians!)

Our tendency as musicians is to sometimes become overly concerned with the parts that seem most pertinent to playing our instruments at the expense of neglecting the rest of ourselves. (For example, a flutist thinking perhaps too  much about the formation of the embouchure at the expense of not noticing neck and shoulder strain.)

If this sounds even remotely familiar to you, consider including  the quality of how you “use” your entire self (your overall coordination) into the consciousness of  playing your instrument.

Let your head be poised freely atop your spine (and of course, let your jaw be free). Let your shoulders release and widen. Soften your gaze. Let you knees unlock. If you’re standing, let your ankles be free and mobile (feet, too!) as you permit the ground to support you. Let your breathing be elastic, easy, reflexive and expansive.

Think balance, mobility and expansion, instead of position or  posture. A nice, lively, upward organization of your whole organism is the wish. Notice how these things impact your skill.

And of course, if you need any help in this area, consider finding a skilled Alexander Technique teacher. Allow your coordination to support your skill, and your expression.

Two Main Reasons Inefficient Practice Advice Gets Perpetuated

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One of the things I usually discover early on when teaching the Alexander Technique to musicians, is that part of the problem that led them to seek my help has to do with counterproductive pedagogy.

With a wind instrumentalist, for example, I might observe what appears to be a forced, tense, noisy, unnatural-looking inhalation before playing a note or phrase.

When I ask about this breathing habit, as often as not, I learn that it’s something that has been deliberately  cultivated. In other words, it is something that they do consciously as they play.

When I ask, “So why do you do it that way?”, the answer is usually something like, “Because that’s the way ‘so and so’ (insert name of highly respected musician here) says it should be done.”

Then I ask a second question: “Why do you think he/she does it that way?”

The answer that follows usually falls into one of two categories:

Either:

They don’t know why this great musician does it that why, but it obviously works best for them.

Or:

They “know” why this great musician does it that way, but the explanation they provide isn’t in accordance with the acoustical principles of the instrument and/or with the design of the human mechanism.

And so yet more misinformation by well-meaning experts gets perpetuated. Some of it benignly inefficient, some of it downright harmful (and everything in between).

So why/how do these “myths” get perpetuated?

Two reasons:

  1. Trusting without testing.
  2. It works (to a certain degree).

Let’s look at this first one, trusting without testing:

No matter what we might think about how our bodies work, or about how our instruments work, there are certain solid, measurable, scientific realities about how they really  work.

As a serious musician, it is your responsibility to continually improve and broaden your understanding of these things.

The more clearly you understand the real “hows and whys” of your organism (including how your thinking impacts this organism!), the better your sense of cause and effect becomes when being introduced to any new pedagogic principle and/or procedure.

If you comprehend the science behind playing your instrument, you’ll see that “some musicians do well (in part), not because  of what they do, but despite  what they do.” (All of my students, and some of my readers, will recognize this as one of the recurring themes in my teaching.)

It is not enough to trust and expert. You must also build a solid faith in the efficacy of a particular pedagogic element because it stands the test of actual, measurable fact. Cause and effect.

The second reason these inefficient practice ideas get perpetuated sounds contradictory to the point I’m trying to make here:

They work (to a certain degree).

It’s the “certain degree” part that opens the door to trouble. The reason for this is actually fairly simple.

Let’s go back to my earlier example about inhaling when playing a wind instrument. If you believe that you need to noisily suck in air as you try to force the air down into your abdominal region, in order for you to get a sufficient breath, you are simply working against nature.

You can’t put air “down into your gut”, because you have no lungs there. (And don’t talk about pushing the diaphragm outward to “make space for the air”; it doesn’t work like that, either.)

Yet the noisy, gasping, overly energetic breathing often accomplishes one thing: It creates a more “active” inhalation that engages more muscles (not necessarily in the most efficient way, mind you!), and that does seem to draw in more air than when you inhale in a more passive, unintentional  way.

But there is some unwanted baggage attached to this way of breathing.

To begin with, all this effort creates undue strain in your jaw, glottis and facial muscles. Not to mention the strain it puts on the rest of your body. I’ve had musicians come to me for help with chronic neck and back pain that is clearly related to these poor breathing habits.

Equally important, you lose touch with what it is like to have a free, naturally reflexive  inhalation.

It’s the free movement of the ribs, the diaphragm, the pelvic floor, and other muscles in the body that creates the kind of necessary expansion to draw in a deep breath. Combine this with the intention of the musical phrase and expression, and you’re good to go.

Yet, as long as you need to “feel” this forced inhalation as a “complete and full breath”, you will continue to work in this inefficient way.

And unfortunately, you’ll likely pass this advice onto your students. In Alexander Technique slang, we sometimes say that this is a case of “specifically focusing on a part, while neglecting the whole”.

So stay clear about these two things as you practice, explore and expose yourself to new ideas about playing your instrument. You’ll be better off (and so will your students!)

I’ll leave you with a quote from F.M Alexander, the founder and developer of the Alexander Technique:

If I went to a man to take singing lessons, it wouldn’t matter what he taught me, he couldn’t injure me.