Heeding the Signs of Injury

“I ignored all my body’s warning signals in the name of ‘dedication’ to what I was doing. I had absolutely no idea that this little problem
would in fact threaten my career.”

–Christine Harrison, violinist (The Musician’s Way, p. 238)

We may not like to admit it, but we all have physical limits. And given that music making is so physical, we musicians sometimes exceed our limits, much as dancers and athletes do.

Still, we can prevent minor hurts from escalating into dire injuries, if we’re able to recognize and respond to the body’s warning signs.

Consequences of Ignoring Symptoms
I’ve learned that many musicians don’t appreciate the symptoms of injury. They’ll notice persistent pain in the hand, ringing in the ears, cracking in the voice, or the like, and they’ll push through the problem rather than backing off and seeking aid.

Yet to disregard such warning signs is to invite serious trouble.

As an example, here’s a post that a young violinist wrote on allthingsstrings.com in 2009:

I’m a student violinist and play in my high school orchestra. I have had tendinitis in my right wrist for about a year now. I really can’t rest my wrist for any period of time right now. I have several concerts and at least two upcoming competitions. The pain comes and goes depending on how much I use my wrist, but it never goes away completely. What should I do? Heather

I hope that things turned out well for Heather. But I suspect that her formidable injury could have been averted if she had known what to do when she felt that first ache.

And what about her priorities? After a year of pain (a year!), she thought that her upcoming performances were more important than her health. It also appears that she didn’t know how to access local help.

We musicians need to be far more adept at caring for our wellbeing. All of us, students and veterans alike, should understand the causes and symptoms of injuries and be equipped to respond prudently when trouble knocks.

Plus, we must make wellness a priority because when we become unwell, our music making comes to a halt.

A 3-Step Response to Symptoms
Typical symptoms include pain, odd sensations such as tingling or numbness, fatigue, loss of control, hoarseness, and ringing or buzzing in the ears.

Such warning signs may turn up in varying levels of intensity, but when they persist, we should take three steps:

1) Stop.  2) Rest.  3) Get help.

That is, we should cease playing or singing, curtail hand, embouchure, or voice-intensive tasks, and seek help from teachers and medical experts.

Getting Help
Musical authorities can commonly be found at conservatories and university music departments. Medical help can be accessed at campus health centers, from physicians, and, in particular, from arts medicine specialists, who practice in many urban areas.

Of course, this simple-sounding recipe isn’t always easy to follow.

For instance, ensemble members might be counting on a hurting musician to perform at a high-paying show. In such a situation, a performer needing rest might see no option but to carry on.

Nevertheless, when symptoms loom, skilled helpers can aid performers to come up with various accommodations, many of which allow for degrees of practice and performance.

A violinist experiencing her first occurrence of wrist pain, let’s say, might be advised to begin treatment with a physical therapist, take lessons from an Alexander technique teacher to gain ease in her playing, and participate in portions of rehearsals and performances with a substitute covering some of her duties.

But that’s just one scenario – we don’t have room here to sort through dozens of others. What we need to remember is that symptoms call for actions, and we shouldn’t try to go it alone.

Prompt Action Brings Rapid Recovery
The good news is that when symptoms are caught early, most musicians can carry out ‘relative rest,’ make modifications to their habits, and gradually return to full-time performing without any detrimental effects.

Conversely, the longer symptoms are ignored, the more severe an injury tends to become and the more protracted the recovery period will be.

Occasionally, musicians who overlook warning signs for years learn that full recovery isn’t possible, as is the case with hearing loss, which is permanent.

*  *  *

In the past, performers and arts institutions often behaved as if musicians were indestructible. Groups would rehearse nonstop and at earsplitting sound levels; freelancers would gig incessantly and be struck down by strain and overuse.

I hope that present-day musicians will heed the lessons of the past and put health promotion front and center.

Chapters 12 & 13 of The Musician’s Way spell out comprehensive strategies whereby we can promote health, prevent injuries, and deal wisely with symptoms. 

© 2010 Gerald Klickstein

Share and Enjoy:
  • Print
  • StumbleUpon
  • del.icio.us
  • Facebook
  • Twitter
  • Google Bookmarks
  • email
  • LinkedIn
  • Live
  • Tumblr
  • Posterous
  • Reddit
  • Digg
  • Netvibes
  • Wikio
  • Yahoo! Buzz

10 Responses to “Heeding the Signs of Injury”

  1. Gretchen Saathoff said:

    Apr 04, 10 at 22:20

    This is such an important post. One additional way musicians ignore warning signals is due to their ability to focus!

    I can attest to forgetting that I’m hungry, not knowing what time it is, and not feeling a slight headache, for example, when I’m practicing.

    So it becomes even more important to notice what is really going on.

  2. Gerald Klickstein said:

    Apr 05, 10 at 07:45

    Excellent point, Gretchen – thanks. Self-awareness is indeed key.
    Plus, incessant practice wears down the body, even when a player executes without strain. So regular breaks are essential. Some musicians benefit from using timers to ensure that they take practice breaks every 20-30 mins.
    Speaking of breaks, readers may want to check out pages 75-82 of The Musician’s Way, which describe three types of breaks and provide images of restorative movements that invigorate our breathers and fuel our self-awareness.

  3. Dennis Aberle said:

    Apr 06, 10 at 09:34

    Thanks for the article.
    I’m recovering from ‘golfer’s elbow’, which is a tendonitis caused from too much vigorous rasgueado playing (guitar strumming). I am going for massage therapy, which seems to be helping. I still play, but I take more breaks, stretch and ice my elbow often. I also don’t practice everyday to give my arm a break. I could have chosen to have a cortisone shot, which would give me instant relief; however, I chose to heal myself in a more natural, comprehensive manner. And, it has worked for me in the past.

  4. Gerald Klickstein said:

    Apr 06, 10 at 09:58

    I appreciate the comment, Dennis. Sounds like you’re taking a smart route to full recovery.
    Here’s wishing you a swift return to unhindered playing.

  5. Alexandra Coursen said:

    Apr 07, 10 at 09:55

    With respect to tennis elbow, I researched online, and found a NY Times article about a rubber bar and a simple, exercise. I had a searing pain in my arms even when they were straight and still. The exercise and the $11 bar have solved the problem.It takes a minute or two, a day. Probably developed the tennis elbow from years of piano practice and then harp practice.
    Appreciate all the advice, and the book is excellent.Thanks

  6. Alan Brown said:

    Apr 07, 10 at 11:31

    As a 30 year professional pianist I was always terrifed of tendonitis however I was completely unaware of Cubital Tunnel which I now suffer with. To explain Cubital tunnel syndrome is a condition that affects the ulnar nerve where it crosses the inside edge of the elbow. The symptoms are very similar to the pain that comes from hitting your funny bone. When you hit your funny bone, you are actually hitting the ulnar nerve on the inside of the elbow. There, the nerve runs through a passage called the cubital tunnel. When this area becomes irritated from injury or pressure, it can lead to cubital tunnel syndrome.

    The ulnar nerve passes through the cubital tunnel and winds its way down the forearm and into the hand. It supplies feeling to the little finger and half the ring finger and controls the small muscles of the hand.

    This means I lose feeling in my little finger of my left hand sometimes for days at a time. When at its worst I also suffer with my left ring finger as well. As you can guess this affects my playing greatly.

    It is not to be confused with Carpel Tunnel which affects usually th thumb and index finger.

    I think this is a very useful and important thread and I intend to reserach this subject more for an article in the near future

  7. Gerald Klickstein said:

    Apr 07, 10 at 12:37

    Alexandra and Alan: thanks for the helpful comments and supportive words. Researchers find that both tennis elbow and cubital tunnel syndrome are relatively common among musicians. These conditions often arise from a combination of behavior and anatomical propensity. For ex., some of us have narrower cubital tunnels than others, allowing less room for the ulnar nerve and increasing the likelihood of nerve compression due to inflammation or typical playing motions. Hence, as this post describes, it’s essential that musicians get expert help when injury symptoms arise so that they can pinpoint the causes of problems (whether due to music making, computer use, sport, or whatever) and discover customized ways of living, playing, or singing that encourage injury-preventive music making.

  8. David said:

    Apr 13, 10 at 14:09

    Thanks for this. I’m one that tends to ignore aches and pains as well, often times only to find out if I would have taken a break for a couple of days things would have healed naturally. I’ve been having some soreness in my left fretting hand and I think it’s time I let it rest to avoid any long-term or more permanent damage.

  9. Gerald Klickstein said:

    Apr 13, 10 at 19:11

    Thanks for commenting, David. In addition to rest, you may want to consider taking more frequent breaks in practice and minimizing left hand pressure (maybe play with a mute sometimes, and barely touch the strings with your left hand). Also examine your playing posture and, especially, your wrist alignment – a misaligned wrist is a frequent contributor to playing-related pain and injury among all instrumentalists (see p. 250-269 of The Musician’s Way).

  10. Geraldine said:

    Jun 03, 10 at 19:11

    Great article! I also suffered from tendinitis for years and wrote about my experience on my blog at http://geraldineinabottle.blogspot.com/2010/05/are-you-healthy-musician.html
    I do hope that our generation is heeding the lessons of the past, but there is still so much stigma put on musicians that have injuries, with people implying that they are not playing their instrument properly, that I think that we still have ways to go before health is put front and center.