Musician Injuries: OUCH, It Hurts When I Play (But Please Don’t Tell Me To Stop!)

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This article takes a look at musician injuries. For an expert perspective, I interviewed Dr. Sarah Mickeler, B.Mus., DC Dr. Mickeler is a former professional musician and chiropractor who focuses on injuries to musicians in her practice.

1) What led you to specialize in musician injuries?

I have a very personal connection to musician injuries. I had trained as a classical clarinetist and it was during my undergraduate degree that I started having all kinds of problems with playing too much and having bad posture. Unfortunately, I was told, like many others, that I should play with the bread and maybe it would get better. Of course, it was not to be, and it eventually led to the demise of my career as a clarinet player, because I was totally unable to hold my instrument. So, I decided to choose a new career that would help other musicians, and hopefully before they got to the point I was at! Chiropractic appealed to me because of the whole health care paradigm it represents: as chiropractors, we diagnose and repair the cause, rather than mask the symptoms.

2) What is different about treating musicians than treating the general population?

Often what I tell people who don’t understand the details of musician injuries is that “it takes one to know one.” As a musician, it can be very difficult to explain to a doctor or physical therapist or even another chiropractor what the mechanics look like when you play your instrument. But when someone walks into my office and says they play the flute, or the guitar, or the tuba, or whatever, I know exactly what the physical component of playing their instrument is. That is a very important first step.

Second, not only do you have to be able to have a good understanding of what is involved in playing that instrument, but you have to be able to see that person play. Even if someone tells me that he plays the violin (I automatically think: “okay, so he’ll tilt his head to the left and have right shoulder problems, etc…”), I’m often surprised to see how over the years from playing they have contorted into a little pretzel while playing!

So, on the first or second visit, all my musicians bring their instruments and I do a thorough analysis of the performance to see what they are doing right and wrong. It could be that your posture is contributing to your injury. Or maybe there is something in the instrument that we could change; you may only need a minor adjustment to the thumb rest or key position.

For example, I have very small hands and I had a hard time reaching some of the alternate fingering keys on my clarinet, so I cut them off and re-soldered them in a different direction so I could reach them.

Third, it’s important to recognize that there are some very common reasons for performance injuries. The most common are a change in repertoire, a change in the instrument (like a new mouthpiece or something similar), a change in practice time, or an upcoming recital. If we can identify what the artist has been doing differently lately to contribute to his injury, that’s a big help.

And finally, it’s very important to realize, especially for independent artists, that you can’t just tell them to take a muscle relaxer and take a few weeks off. If these people took a few weeks off, they wouldn’t have a roof over their heads and no food on the table. While occasionally taking a break is absolutely imperative, most of the time I take a holistic approach to treating artists and changing and fixing what we can, within the obvious constraints of current concerts and upcoming events.

3) What is the most common injury you see in your office?

In my office, there is a tie for the most common injury. The first is upper back/shoulder/neck pain. I group them together because those terms can mean the same thing to many people. Often someone will come in and say their shoulder hurts and point to the pain, but to me, what they’re pointing to is actually my upper back or lower neck. This is often a function of poor posture or poor ergonomics practice. If we can figure out how to improve the overall posture and ergonomic situation, this tends to be resolved quickly.

And the second most common injury is hand and arm pain. You wouldn’t believe how many people walk into my office with numb and tingling hands and fingers, which can be very scary if you’re the one experiencing it, to find out that the problem isn’t actually your hands and fingers. , but it’s a bit higher up the arm and can be treated quite easily once it’s properly diagnosed. Or they come with tennis elbow, but have never held a tennis racket in their life! In my office, I call tennis and golfer’s elbow “musician’s elbow” because it is a repetitive strain injury. It is very, very common and surprisingly easy to treat.

4) What can musicians do to prevent injuries?

First of all, don’t be a hero! There is simply no reason to practice for hours on end without a break. Always remember to take a short break for every 30 minutes you are playing. Second, don’t play in pain. The pain signal is there to tell you that you are doing something wrong. Playing through it will get you nowhere except more pain and worse shape in the future. Third, be aware of your ergonomics. If you sit down to play, does your chair fit you? In rehearsal, do you have to strain a little to see both the music stand and the conductor? Are your arms twisted in a strange way to be able to play correctly? This is not OK. And lastly, seek the help of a professional who can not only help you with the injuries you are currently dealing with, but can also help you avoid future injuries and optimize your overall performance.

You can learn more about Dr. Sarah Mickeler and her Toronto-based chiropractic practice that focuses on musicians’ injuries at http://www.drsarah.ca.

To echo Sarah’s advice, pay attention to any pain signals your body is sending you! Admitting that you have a physical problem does not make you any less of a musician, it means that you are a very intelligent musician with years of playing ahead of you!

This article originally appeared on the Muses Muse Songwriter’s Resource website (February 2005) http://www.musesmuse.com.

(c) Copyright Linda Dessau, 2005.

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