Tag Archives: Repetitive Strain Injuries for Musicians

You, Your Instrument, Space And Movement

There is a fundamental error that I see many musicians make when positioning their instruments in preparation to play. It usually begins seconds before the first note is produced. It might seem like a small thing, but it can have big consequences.

What is it?

It’s in how musicians bring their instruments to themselves to play.

Notice I said, “bring their instruments to themselves.” In a sense this is a misnomer. Because in truth, the real problem is that rather than bringing the instrument to themselves, many musicians bring themselves to the instrument. And they often do so in such a way as to compromise their balance, flexibility and coordination.

Allow me to clarify.

The other day I was giving a first Alexander Technique lesson to a violinist, who came to me because of unresolved chronic neck pain. We spent a good part of the lesson exploring and clarifying her natural balance as she sat, and as she stood.

(We do this in order to bring her most basic postural and movement habits to light. More specifically we’re looking at how her habits might be interfering with the way she moves, balances and maintains positions with respect to her bodily structure, and how that structure work best with gravity. How she might be unconsciously “fighting herself”.)

Once I was reasonably sure that my student was aware of (and at least somewhat able to prevent) the most obvious habitual interferences to her balance and coordinatin as she sat and stood, I then asked her to play her instrument.

What I saw was a habit that is common to many musicians: She was there, sitting in fairly good balance (based upon our brief work). But as she brought the violin up to her chin, she (simultaneously) began to pull herself downward (and somewhat sideward) into the chin rest.

So once the violin was in position to play, my student had lost the easy, elastic and flexible balance she had, and had replaced it with a rather stiff and inflexible “position”. (This is all driven, of course, by habit; and that’s where our real work begins.)

It took a significant amount of intention and conscious direction for her to stop this from happening. (This goes to show how powerful the habit of “position and posture” can be to a musician.) But she has made a step in the right direction. (She’s also going to re-consider the height of her shoulder rest, to see if it’s “inviting” her to pull downward.)

And I see such similar habits with so many instrumentalists: I see saxophonists (playing with the neckstrap adjusted too low) pull their heads down into the instrument (not good for your airstream or the freedom of your jaw and tongue); I see trombonists pulling their heads (like the violinists) down and sideways into the horn. I see guitarists hunched over an instrument that is too far (or sometimes, too close) to themselves. And so on.

It’s almost as if there is a fixed perception of where the instrument needs to be in space. And that perception demands that you distort yourself into position to meet the instrument.

So here’s a very simple bit of advice: Bring your instrument to you. Find balance first, as you sit, or stand.

In brief, this means letting your head balance on top of your spine freely as it is poised over your pelvis, with widening shoulders and unlocked knees, letting your weight travel evenly through your body to your sitting bones (if you’re sitting) or through your feet (if you’re standing).

Then practice bringing the instrument to you in such a way that you interfere with this natural balance as little as possible.

If you have to rotate (say, to play flute or violin), see if you can do so by “thinking upward” so you’re not pulling downward into tension and imbalance. Let your neck be free and your eyes be lively and engaged as you allow your breath to flow naturally and easily. Then allow your head and eyes to lead your body fluidly into rotation.

Practice this in front of a mirror (highly recommended!) if possible. Do it lots of times, until you feel reasonably confident that you can keep the awareness and intention up as you play.

Then work on bringing your instrument to yourself to play one note (just one!)

Again, do this with the aid of a mirror. Think of maintaining your internal space (so you’re not contracting and twisting) as you move the instrument toward yourself.

If you practice this enough, it will become part of who you are as you play your instrument. Not only will you find less tension and more balance and flexibility in your body as you play, but also, you’ll breathe better and will be more accessable emotionally and creatively to make your best music. Give it a go!

Three Misconceptions About Your Hands That Might Be Holding You Back

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Many musicians who come to me for Alexander Technique lessons do so because they have problems with their hands: chronic pain and/or coordination issues (these two can be very closely related).

Medical conditions like carpal tunnel syndrome and elbow tendonitis, as well as general discomfort and fatigue when playing can be, are often caused (or made worse), in part, by a misunderstanding of the structure/location and function (anatomy and physiology) of the hands, fingers and arms.

The same goes for coordination. I’ve lost count of the musicians I’ve encountered who are stuck at a certain level of technical proficiency (no matter how much they practice and how hard they try) because of the mechanical disadvantages they bring upon themselves through their habits (with their hands, arms, neck and back) as they play.

I won’t go into full detail here about how the hands relate to the arms, which relate to the back, which relates to the balance of the head on the spine. (Although this is of prime importance, and I’ve mentioned it before in several other articles).

Rather, I’m going to briefly talk about the three most common misconceptions (in my teaching experience) that most musicians have about the hands, wrists and lower arm. I’m also going to share some videos that will be highly useful in helping you to better visualize and understand how your hands, wrists and lower arms function.

So what are the three misconceptions I’m talking about here?

1. The location of your knuckles. Many musicians imagine their knuckle joints (metacarpophylangeal, or “MP” joints, as they are commonly called) as being in the location where their fingers connect to their palms (looking at the hand palm-side up). But in truth, these joints are lower than that. If you look at the topside of your hand and bend your fingers at the knuckle, while at the same time keeping them straight, you’ll see exactly where that joint is.

Now, bend your fingers the same way and look at the palm-side of your hand to see how much farther down those joints are from that fleshy place where your fingers meet your palms. If you play your instrument by trying to bend your fingers at this imaginary joint (where the fingers meet the fleshy part of the palm), you’ll create a signficant amount of excess tension and compression in your entire hand.

2. The joints of your thumb. Your thumb has three joints, not two. Many musicians think of the thumb has having one joint at the knuckle and the other joint at the fleshy location of where the thumb connects to the palm (an accurate, but incomplete understanding). But if you take the tip of your thumb (again, do this palm-side up) and touch the tip of your small finger with it, you’ll see how your thumb rotates from the bottom/middle part of your hand (from a third joint).

If you don’t allow for this movement when you play, you’re going to get a great deal of fatigue in you entire hand, and you’ll measurably interfere with the freedom and coordination of your other fingers. (I see this often in how woodwinds players use their right hands.)

Here’s a video excerpt from a DVD that I very highly recommend, called Move Well, Avoid Injury. This video not only illustrates my points about the knuckle joints and the thumb more completely, but also, offers a more constructive way of thinking about them:

3.How your wrist rotates. You have two bones in your lower arm (the ulna, which is on the small-finger side of the arm; and the radius, which is on the thumb-side of your arm). When you rotate your wrist at the elbow (let’s say, for example, what your left hand does as you play flute), the bones cross one another. (This movement is called pronatation and supination.) The most efficient way for this to happen is to allow the pivot point to be on the small-finger side (the ulna), so that the thumb can sweep radially into rotation (hence the name, radius).

If you try to rotate your wrists from the thumb-side, you’ll create a good deal of strain in your entire lower arm, as well as your hands and fingers. Your elbow joint, in particular, will be negatively impacted. This movement habit is what can lead to elbow tendonitis, among other things.

Here’s another video clip from Move Well, Avoid Injury to help illustrate this and suggest more helpful ways of thinking about it:

So whether you play, piano, guitar, saxophone, trumpet, drums (or any instrument where your hands are involved), by clarifying these three things you can play with greater freedom, less strain and more pleasure.

The Technique That Has Helped Me The Most

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I’ve been playing, composing and teaching music for nearly 40 years. In that time I’ve come across many different approaches to improving what I do. Nothing has come close to helping me as effectively and as completely as the Alexander Technique.

I came to study the Technique after struggling with some serious coordination problems that were threatening my career as a saxophonist. I was so impressed with how I’d been able to help myself with the work, that I decided to commit to the three-year training program necessary to become qualified to teach (completing my training in 2006). It was easily the best decision I’ve ever made in my musical life.

Everything I do in my musical practice is informed by the Alexander Technique. I would even say that I approach composition and improvisation with the Alexander principles very close at hand. And of course, the Technique is at the heart of what I teach when I’m teaching musicians.

So what is the Alexander Technique?

In the simplest (and most practical) sense, the Alexander Technique is a way to learn to recognize and prevent unnecessary (and potentially harmful) muscular tension in any activity. (This alone is quite helpful for musicians!)

But I would also say that it is a a way to more effectively connect thought with action. Clear intention combined with efficiently directed muscular energy leads to a highly satisfying musical experience in both practice and performance. This clarity between thought and action also makes me a more effective, and more authentic composer and improviser.

The Alexander Technique is the technique I apply to all other musical techniques, whether I’m working on tone, articulation, velocity, reading, or improvisation. Anything, really. My brother-in-law, Celio (who’s also an Alexander Technique teacher), calls it the “pre-technique” to any activity. I couldn’t agree more.

Here are eight ways the Alexander Technique helps me the most in my work:

1. It provides a lens through which to evaluate good coordination. In Alexander slang, we talk about the primary control, which is the working relationship of the head, neck and back. This head/neck/back relationship conditions the quality of everything we do in our movements: breathing; using the mouth, lips, tongue and jaw (as well as the other vocal mechanisms); using the arms, hands and fingers; sitting standing and walking; the eyes…as I said, everything.

The primary control is the lens through which I discern and evaluate all my (and my students) movement habits as they pertain to playing music. By learning to stop interfering with the natural coordination of this primary control, I (and my students) play with greater ease, efficiency and control.

2. It places the emphasis on the quality of the process. Rather than aiming only for specific results (with no consideration to how best to attain them), the Technique helps me grow my faith in working by principle, using reason and discernment, always aiming for a good use of primary control (see above). This not only helps me play better, but also, keeps me from harming myself as I play. As long as I take care of the quality of the “how” in what I do , the end takes care of itself.

3. It helps me to improve by doing less. This is perhaps the most important principle I’ve learned. I’m playing better than ever not because of what I’m doing, but rather, because of what I’m not doing (my old habits of excess tension) as I play. Addition by subtraction, as the cliche goes. I see far too many musicians making their playing more difficult by adding yet more things to “do” in a forced and unnatural way (breathing and embouchure are prime examples). No need for this added effort.

4. It teaches me when (and how!) to stop. To me, this is the most essential skill for a musician to have during a practice session. Learning to strategically stop and redirect my thinking has helped me improve more than anything. By doing so I prevent myself from reinforcing the habits that are interfering with my playing, and give myself the means and opportunity to truly change.

5. It provides tools for self-care. Constructive rest, breath work, taking care of how I use myself (in all my activities) have helped me significantly to practice music without pain or worry of injury.

6. It helps me maintain a better balance between the internal and the external. I’ve greatly improved my ability to stay connected to internal things as I play, like sensing time, imagining pitch and tone color, following my creative impulses, and what’s going on with my body; with external things like hearing my sound, hearing the other musicians, and my visual and spatial senses. This balance of attention (rather than the imbalance of over-focusing on certain things at the expense of ignoring others) has deeply enriched my musical experience. (It has also improved my pitch, sound, time and creativity.)

7. It helps me observe and improve my thinking. If I’m facing a particular challenge as I play, I immediately go to my thinking. When I ask myself, “Where are your thoughts going as you play this?”, I usually find that my thoughts are not supporting what I’m trying to do as I play. So I simply redirect my thinking. Improvement always follows. As an improvising musician, this has been especially helpful.

8. It clarifies my understanding of cause and effect. There is plethora of useless, even harmful, pedagogical information out there for instrumentalists and singers (much of it disseminated by highly respected musicians with limited knowledge of anatomy and physiology). By understanding how I work best in nature (again, see primary control, above), I can easily filter out the bad information, and stay with what truly works. I get a clearer idea of how “A” influences (or doesn’t influence!) “B”, so I can more accurately answer the question: Am I playing well because of what I do, or despite what I do?

Besides these eight, there are even more ways the Alexander Technique has helped me. I just wanted to list a few of the ones I personally consider most essential. By staying with the Alexander principles, I continue to develop a set of tools that I can use with confidence and consistency.

I’ve also enjoyed the privilege of teaching the Technique to a variety of musicians, from jazz artists, to Indian classical musicians, to musical theater performers, to principle players in symphony orchestras and more, with measurable benefits. It is remarkable work. I encourage you to find a good teacher and give it a try.

Are You Trying To Hear Your Sound By Creating Excess Tension?

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The other day, as I was working with a new Alexander Technique student, I encountered (again) a fairly common habit that many musicians have that usually leads to trouble. Allow me to share.

My student is a singer who came to see me because of problems she’s been having with vocal strain and intonation. As she told me: “I seem to start out okay (actually, she sounds very good), but after about 5 to 10 minutes of singing my voice becomes strident, kind of thin, and my intonation gets difficult to control.” She sang for me for a few minutes and confirmed her own assessment.

It wasn’t hard for me to see how she was creating these problems for herself. As she’d start singing I’d see her stiffening her neck as she thrusted her face upward and forward. This pattern of tension manifested itself through her entire body: shoulders pulled back, lower back arched, knees locked, unyielding ankles and feet.

So I began to work with her with my hands to help her find an easier state of balance as she was standing (without singing). She was very responsive to the directions I was giving, and was really beginning to release much of her habitual tension: freer neck, widening shoulders and back, neutral pelvis, softening knees, flexible ankles. She said she felt like “a whole new person”. All good stuff.

In Alexander slang, I’d say she went from doing too much, to a nice state of non-doing (leaving herself alone, to allow for a natural, virtually effortless balance).

I explained to her that this state of non-doing was a very good place from which to start singing. It was like starting with a blank canvas, and could help her see how much tension she was creating when she sang. So I asked her to sing.

She went immediately from a calm, pliable, free state, to one of immense tension (same pattern as before: head thrusted forward, narrow shoulders, etc.) I asked her if she could sense all that tension she created as she began to sing, and she replied (with a certain amount amazement) that she could:

“Wow! I had no idea I was doing so much in my entire body to try to sing. Working way too hard…”

So I asked her to sing again, but with the thought of not going into that tense pattern, of leaving herself alone. But as she sang again, there was little, if any difference. She’d go right into that tense pattern again.

(This isn’t uncommon when encountering performance habits. They can be quite stubborn. Yet if addressed effectively and consistently, they can be changed. That’s what the Alexander Technique is all about.)

As we proceeded to work more with her singing, my student suddenly came to a great realization: “You know, I think I’m making all this tension in myself as an attempt to hear my voice.”

And she is absolutely right.

You see, to her (and to so many musicians) the sound is more than what the ear takes in. It can involve other senses (feeling resonance, for example), beliefs (often also about what should be felt), and other expectations.

In the case of my student, she was trying to feel the sound a specific way. She said that’s how she was gauging her intonation. Yet by her own admission, her intonation was dubious as she created this tension.

So we worked on getting her to change her thinking. We shifted the goal from trying to sing well, to leaving herself alone as she sang: no face thrusting, no shoulder raising, no back arching, no knee locking. The aim was not to sing in tune, or even with a good sound. Rather, it was to begin to sing without going into her habitual tension. It would be a bit of an experiment.

In fact, I told her that if she sounded bad, even worse than she’d ever sounded, that she could consider herself successful in this experiment, because it shows she did something differently. She liked that idea.

Well, after a few takes, she finally had a moment when she started to sing without her habits. I had my hands on her, and could tell that she was leaving herself alone very nicely. She continued to sing for about 5 minutes. Her voice was clear, beautiful, consistent…and her intonation was spot on.

She was thrilled, to say the least. “That was hard. I don’t know if I could do that again”, she said. I assured her she could, perhaps not consistently at first, but eventually she’d be able to with considerable consistency.

I asked her, “How was your intonation? Did you notice it?” She replied, ” Oh yes, I could her my pitch so clearly and easily. But the strange thing was, I wasn’t trying to hear my pitch. I could just hear it, and knew it was fine.”

I explained to her that it was this “trying” to hear her pitch that was tempting her to create so much bodily tension, and that this excess tension was interfering with her ability to truly hear herself. That seemed to make sense to her. I’m excited to meet with her for her next lesson to see what else she’ll discover.

As I stated above, so many musicians I teach are struggling with the same habit: trying to feel their sound, both color and pitch, through excess bodily tension. Besides being counterproductive to the goal of a good sound and good intonation, it also carries with it the risk of strain, injury, poor technique and fatigue.

But there’s also something that comes with it that is equally negative. All that tension leads to a kind of physical and artistic prison when making music. You can become so dependent upon feeling your tension that you’re not free to experience the possibility of the unknown, the possibility of discovering something new in yourself as you make music.

So how are you when you play? How much tension do you create as you get ready to play your first note? Remember to allow your neck to stay free so that your head can balance easily on top of your spine. Let your shoulders widen. Don’t lift your chest and arch your back. Don’t lock your knees. Let the weight of your body travel easily into your feet as you let your ankles remain free and mobile.

Leave yourself alone as you play, and you’ll hear yourself so much better. To paraphrase F.M. Alexander, “If you stop doing the wrong thing, the right thing will do itself.” My experience as a musician and as a teacher (and student!) of the Alexander Technique affirms this every day.

The Nagging Truth About Chronic Pain And Injuries

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Recently I was reading a thread on a Facebook page (for saxophonists) about chronic pain. The thread started out asking about the value of chiropractic work for musicians, then quickly morphed into a discussion of the merits and/or shortcomings of various modalities to address pain and injury.

Lots of experiences, opinions and ideas were offered up. Several of the participants stated that chiropractic was not addressing the root cause of the problem. They thought that simply manipulating the bones neglected the deeper issue of muscles, fascia, etc. (I don’t necessarily agree with this, by the way).

Others talked about the the value of a good physical therapist to address muscle imbalances and flexibility issues. Deep tissue work was endorsed with great enthusiasm by others. Iyengar Yoga, Pilates, Myofascial Release, and other therapeutic work were also mentioned.

The thrust of the discussion was about getting to the root cause of chronic pain. Lots of debate about the hierarchy of importance of the structures of the body (bones, nerves, muscles, fascia, joints, discs, etc.) in preventing pain and injuries.

Yet nobody once mentioned the real root cause of most chronic pain and injury: Habit.

Your habits of thinking determine your habits of posture and movement. Period. You move and maintain posture in accordance to your conscious (and even unconscious) thoughts. And what predominately causes pain and injury for musicians (and others, as well) are dysfunctional postural and movement habits.

When you practice your instrument, you’re repeating movement patterns over and over, hundreds of times in a single session. If you’re doing this in an overly tense and unnatural way, you’re going to invite problems.

To be clear, I think there is a great value in the majority of the modalities that were discussed above. Without a doubt, manipulative work (massage, chiropractic, acupuncture, Myofascial Release, etc.) can be highly effective for ending the pain by bringing the structures of the body back into a healthy balance. It’s often a great place to start to get quick relief from pain.

Well prescribed exercise (Yoga, Pilates, etc.) can also help to change the structural organization of the body, which can help significantly in the long run.

But ultimately, unless you change how you maintain balance, posture, and how you move in general (with and without your instrument) throughout your daily activities (i.e., change your habits), chances are good that you’ll eventually return to having the exact same kinds of structural problems you had before treatment (or exercise program).

So what are your choices? You can continue to get the same treatment, viewing it as a kind of “maintenance” for your pain. You can try a new form of treatment or exercise and see if that makes a lasting difference.

Or you can learn to change the habits that are causing your pain. You can learn to replace tense, harmful movement with light, safe and easy movement.

Besides being a professional saxophonist, I’m also a certified teacher of the Alexander Technique, and I’ve found this Technique to be the most effective way I’ve yet to discover to make lasting changes in postural and movement habits. If it weren’t for this work, I would no longer be able to play saxophone. As it is, I’m playing better than ever. Completely pain and dysfunction free.

You see, the Alexander Technique goes right to the root of the problem: your habits and the thinking that shapes them. A qualified teacher can help you to become aware of the various harmful postural and movement habits you have, and give you the tools to prevent them, so you can make lasting changes for the better.

You’ll learn a new way to think about how you move, how you sit, stand, hold your instrument, use your breath, and more. You’ll clarify misconceptions about your body, and discover a way to move with far less effort and a minimum of strain. You’ll learn to move in accordance to the natural design of your body.

You’ll learn self-care strategies to rest your body and and restore your spine. You’ll even learn how to be calmer and more clear-thinking as you practice and perform music (or carry out any other activity, for that matter).

But most important, you’ll unlearn the habits that are causing the harm (the nagging truth about your chronic pain).

Sound too good to be true? It’s not. It does involve responsibility on your part, and a considerable amount of time and persistence (after all, you’ve spent a lifetime learning your habits). But it does work. Very well. One of my greatest satisfactions in life is seeing all the musicians I’ve been able to help by applying the Alexander principles.

Even the prestigious Juilliard School of Music knows the value of the Technique, and integrates it into its program to help serious musicians play pain-free and avoid injury.

So if you’re struggling with chronic pain, or suspect you have an injury, make sure you see a qualified physician first. It’s important that you rule out any kind of disease or other kinds of damage that must be addressed directly through medical means.

Ask your physician if any of your problems could be caused by dysfunctional movement and/or postural habits. If the answer is yes, then remember that you have a choice. Consider finding a certified Alexander Technique teacher in your area, and commit to taking some lessons. You can change. I have. So have my students. And for us, playing music is pure, pain free joy!