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

This article reviews injuries to musicians. From an expert perspective, I interviewed Dr. Sarah Mickeler, University Lecturer, DC. Dr. Mickeler is a former professional musician and chiropractor who focuses his practice on musician injuries.

1) What made you want to specialize in musician injuries?

I have a very personal connection with the musician’s injuries. I trained as a clarinet player and during my university years I started having all sorts of problems from playing too much and bad posture. Unfortunately, I was told, like many others, to just play through the pain and maybe it will get better! Of course not, and it eventually led to the downfall of my clarinet career because I was completely unable to hold my instrument. So I’ve decided to pursue a new career that will help other musicians – and hopefully before they get to the point I’m at! I was drawn to chiropractic because of the whole healthcare paradigm it embodies – as chiropractors we diagnose and correct the cause rather than masking the symptoms.

2) How is the treatment of musicians different from the treatment of the general population?

I often say to people who don’t understand the specifics of musician injuries that “man knows man.” As a musician, it is very difficult to explain to a doctor, physiotherapist or even another chiropractor what the mechanics look like when you play your instrument. But when someone comes 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 an instrument involves. This is a very important first step.

Second, you not only need to know how to understand well what is involved in playing an instrument, but you also need to see how it is played. Even if someone says they play the violin (I automatically think “ok, so their head tilts to the left and they have right shoulder problems, etc…”), I’m often shocked to see how they’ve turned themselves into a little pretzel over the years while playing !

So on the first or second visit, each of my fellow musicians brings in their instruments and I do a thorough performance analysis to see what they are doing right and what they are doing wrong. Their posture may be contributing to their injury. Or maybe there is something about the instrument that we could change; it might just need a little adjustment on the thumb rest or key placement.

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

Third, it is important to recognize that performance injuries do have common causes. The most common ones are a change of repertoire, a change of instrument (such as a new mouthpiece or something similar), a change of practice time or an upcoming performance. Being able to determine what the performer has been doing differently recently to contribute to their injury is a huge help.

And finally, it’s really important to realize, especially for freelance artists, that you shouldn’t just tell them to take a muscle relaxant and take a few weeks off. If these people took a few weeks off, there would be no roof over their heads and no food on the table. While a break from time to time is absolutely necessary, most of the time I take a holistic approach to artist management, changing and improving what we know within the obvious constraints of current acts and upcoming events.

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

My office has a tie for the most common injury. The first is upper back/shoulder/neck pain – I put these together because these terms can mean the same thing to many people – often someone comes in saying they have shoulder pain and points to the pain, but to me what they actually point to is the upper back or the lower part of the neck. This is often a function of poor posture or poor ergonomics. Figuring out how to improve overall posture and ergonomics can quickly fix this.

The second most common injury is hand and arm pain. You wouldn’t believe how many people come into my office with numb and tingling hands and fingers – which can be very scary if you’ve experienced it – only to find out that the problem isn’t their hands and fingers at all. , but that’s a bit higher up the sleeve and fairly easy to treat once properly diagnosed. Or they come in 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’s very, very common and surprisingly easy to treat.

4) What can musicians do to avoid injuries?

First of all, don’t be a hero! There is simply no reason to practice for hours on end. Always take a break every 30 minutes you play. Second, don’t play through the pain. The pain signal is a warning that you are doing something wrong. Playing through it won’t get you anywhere – unless you end up in more pain or worse down the road. Third, be aware of your ergonomics. When you sit down to play, is your chair comfortable? Do you have to make an effort at the rehearsal to see both the stand and the conductor? Are your arms twisted in a weird way to play properly? This is not good. Finally, seek help from a professional who can not only help you manage your current injuries, but also help you avoid future injuries and optimize your overall performance.

Learn more about Dr. Sarah Mickeler and her Toronto chiropractic practice focused on musicians’ injuries at http://www.drsarah.ca.

To echo Sarah’s advice, please listen to your body’s pain signals! Admitting you have a physical problem doesn’t make you any less of a musician – it just means you’re a very smart musician and have many years of playing ahead of you!!

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

(c) Copyright Linda Dessau, 2005.

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