Caution!... Injuries Ahead. How To Play Healthy!

 

Whether you’re an instrumentalist, a singer or a DJ, there are certain areas of your body that will undergo stress when you perform. Problem is, if you’re like many musicians, you fail to realize that playing music can actually be a punishing endeavor much like a sport. In fact, musicians and athletes suffer similar injuries, and they tend to react to pain and fatigue in the same way––“toughing it out” for the good of the performance. Such a mistake in judgment, however, could have long-lasting consequences. To help you avoid injuries that could derail your career, Music Connection investigates how to spot the danger signs, how to use proper techniques and when to make intelligent choices that will help prevent permanent damage.

By Bernard Baur

Flirting with Disaster 

Imagine never again being able to play music the way you want. It’s a horrible thought, but too many musicians carelessly flirt with disaster.
Janet Hovarth, author of Playing (Less) Hurt, notes, “Musicians often play hurt, and later think the pain will go away.” Dr. Yaniv Farbenbloom, a chiropractor with many high-profile clients, concurs, “That’s the biggest problem. All too often musicians wait until a problem is so severe they’re begging for help. By the time they seek medical attention, it’s a serious situation.” Our experts agree that a “wait and see” attitude can end your career.

Most injuries are caused by repetitive motion, poor technique or bad posture. Dr. Timothy Jameson, author of Repetitive Strain Injuries and The Musician’s Guide to Health, Wealth and Success, points out, “Playing an instrument can put an unnatural strain on the body. For example, holding a guitar low, so you look cool, creates a greater risk of injury.” In fact, Dr. Jameson maintains that “looking cool” and having a “long career” are two different things.

Practicing can also be harmful. Hovarth observes, “Musicians often get lost in practice and don’t realize how long they’re playing. That can cause problems due to repetitive motions.” She suggests using a timer to give yourself regular breaks. Brief rests, she says, can make a big difference in the long run.

Causes of Injury

• Poor posture: Holding your instrument improperly can cause unnatural strain.
• Playing the wrong sized instrument.
• Prolonged practice without breaks.

Symptoms
• Pain
• Itchiness
• Burning or tingling sensations
• Tenderness
• Cramping or spasms

Treatment
• Massage - Dr. Farbenbloom contends that massages are not a luxury, they’re a necessity.
• Electrotherapy
• Yoga / Pilates
• Surgery
• Medications are also available (for pain, etc.), but most of our experts advise trying natural, non-invasive, holistic treatments first.

“Musicians often get lost in practice and don’t realize how long they’re playing. That can cause problems due to
repetitive motions.”­­  —Dr. Timothy Jameson

Ailing Extremities 

Carpal Tunnel Syndrome • Tingling sensation or numbness of the thumb, index and middle finger.

Tendonitis • Inflammation or irritation of the tendons due to overuse or poor posture/position.

Bursitis • Inflammation or irritation of tendons, muscles or skin.

Quervain’s Tenosynovitis • Pain on the inside of the wrist and forearm.

Thoracic Outlet Syndrome • Pain, swelling or puffiness in the arms and hands, neck and shoulder, muscle weakness, difficulty gripping objects, muscle cramps and tingling or numbness in the neck and shoulders.
Cubital Tunnel Syndrome • Pain in the arm, elbow fingers and hand.

There are many more potential injuries related to playing an instrument, most caused by overuse and repetitive strain, as well as poor posture or positioning. If you feel you’re in danger of serious injury, consult a doctor.

Common Injuries

Musicians’ injuries vary depending on the instruments and how each individual performs. In fact, instrumental musicians are a special risk group for repetitive motion injuries. Many develop physical problems related to playing their instruments; and, if they are also computer users, the risks are compounded and complicated.
DJs: Dance music mavens have complained for years about the sore elbows, tweaked necks and bad backs—not to mention papercuts—that result from toiling over a deck of turntables.

String Instruments: String instrumentalists are prone to injuries of the back, shoulders and neck. Injuries will vary depending on the instrument being played, its height, weight and whether the musician is seated or standing while playing. String players often complain of muscle stiffness, pain, soreness, tension or numbness in the fingers, hand, wrist, neck, jaw, back and shoulders. Sometimes even abdominal muscles or respiration are affected.

Wind Instruments: Wind instrumentalists are prone to ear, nose, throat, mouth, lips, neck, shoulder and arm injuries. Some specific injuries are laryngoceles, which results from excess pressure to the larynx, and retinal hemorrhage, also due to too much air pressure.

Percussion Instruments: Percussionists often complain of back, shoulder, neck, hand, wrist, fingers and arm pain and tension. Some of the most common injuries are tendonitis and carpal tunnel syndrome, both of which can result in excruciating pain if left untreated.

Hearing Damage

Hearing loss is a common problem among musicians. It is an invisible handicap that sneaks up on you. And, it’s not just loud rock acts either. According to audiologist Dr. Marshall Chasin, “In the classical world, over 50 percent of all orchestral musicians suffer hearing loss.”

Beatles producer George Martin spoke to MC about how he retired from producing due to hearing loss (see Cover Story, MC No. 20, 1998). Martin blamed it on loud studio playbacks.

Some experts, however, insist that volume alone is not to blame. Dr. Chasin reports, “It’s actually the intensity of the music, which relates to the frequencies, not the loudness.” Studies have shown that sustained exposure to just 85dB (a telephone dial tone) can impair hearing. And if the sound pressure level is intense it can cause rapid deterioration. That’s why drummers, bassists (who stand close to the high-hat) and piccolo players are in a high-risk group.

Most interesting, Dr. Chasin has found anecdotal evidence that suggests an intriguing phenomenon. “If you like the music, it causes less harm.” He believes this is due to the chemistry of the inner ear.

Symptoms
• Tinnitus (ringing in the ears): If this condition persists, it could cause permanent damage. Steve Lukather, guitarist-songwriter for Toto, has stated, “I developed Tinnitus in the 1980s, and now wear earplugs ‘cause of it. My hearing is very damaged. I always have to say “WHAT???” Be careful guys, this could happen to you!”
• Pitch perception problems
• Conversations sound muted, as if people are mumbling.
• Often, the right ear is affected first since it picks up higher frequencies.

Treatment
• You should seek treatment as soon as you notice a hearing problem.
• If it’s temporary––like after a concert ––rest your ears.
• The FDA has approved several anti-oxidant drugs that have shown promise.
• Oxygen radicals, like blueberries, can help.

Prevention
• Simply dropping the intensity level 3dB can reduce damage.
• In-ear monitors allow for consistent volume, but are not safer.
• 80 percent of maximum volume for 90 minutes a day equals 50 percent of your “noise dose.” Anything greater than that can cause damage.
• ER-15 and ER-25 earplugs provide good protection.
• Drum Shakers (ButtKicker Sonic Shaker) can protect a drummer’s hearing, something Fleetwood Mac drummer wishes he’d taken seriously.
“I was a major glutton for volume: ‘Gotta feel it, gotta hear it.’ Now It’s horrible when you find yourself cupping your hand behind your ear. Sooner or later you’re gonna pay the reaper.”

Preventing Injuries

NEVER skip warm-up exercises 
Like any sport or exercise routine, a performer’s hands, throat, mouth, etc. need to be conditioned before playing an instrument.

ALWAYS observe proper posture
Make sure you are seated, standing or positioned correctly in relation to your instrument. Good posture doesn’t only prevent back and neck pains, it will also help you play your instrument with less strain.

RE-EVALUATE your instrument
Take a minute to determine whether the size, weight and shape of the instrument is right for you. Decide whether you need an accessory to make playing it more comfortable, such as a strap, cushioned stool, lighter strings, etc.

PAY attention to your technique
Music teachers would often stress that the best way to stop bad playing habits is not to acquire them. There are correct positioning and playing techniques you must learn and be aware of before you even pick up an instrument. Ask for advice, read books, do research and practice, right from the start, to avoid developing bad playing techniques.

LISTEN to your inner music
Our bodies let us know when something is wrong or if a certain body part isn’t functioning well. Listen to your body. When your arms are feeling tired and strained from playing, stop and rest. When your back and neck are starting to ache, take a break. When your throat is starting to get sore, take a breather. It’s true that practice makes perfect, but too much practice can be potentially dangerous. Take regular breaks and pace yourself.

EAT well and be healthy
Use common sense. Drugs, alcohol and smoking can adversely affect your playing ability and short-circuit your nervous system. And don’t overlook your emotional health––stress can lead to physical symptoms.

IF symptoms persist, consult a doctor
If you fear you’re in danger of injury or have injured yourself, don’t wait too long. Consult a doctor immediately. Most injuries are treated easily when caught early.

Vocal Injury

Every singer fears the word “nodes.” Mostly because they adversely affect range and can put vocalists out of commission. These growths usually occur due to poor technique, or as a result of repetitive and excessive use, like singing for hours in a studio or day after day on the road.

Your vocal chords come together and produce sound by vibrating. If the chords rub against each other too forcefully or improperly, it can create a nodule or polyp. A nodule resembles a callus and is either soft or hard, while polyps are like lesions. Both conditions can diminish a singer’s vocal range and cause their voice to become breathy, harsh, raspy and hoarse.

Vocal coach Jan Linder-Koda has worked with vocalists who have suffered from these maladies. She notes, “Sometimes you don’t know you hurt yourself until after you stop singing. The adrenaline rush of a performance can mask pain and discomfort. But, when you stop singing your throat feels sore.” And unfortunately, just like musicians, singers often discount or dismiss the symptoms.

Vocal Treatment

If your vocal chords are injured, Linder-Koda suggests vocal therapy. “If you catch it soon enough, when the nodes are soft, rest and gentle exercises (like lip flutters) could correct the problem. If you wait until it is unbearable and you can’t even talk, you should see a doctor.” Hardened nodes usually require surgery, which can alter a singer’s vocal range––sometimes permanently.

Recovering from nodules and polyps can take a while. “You have to approach the process slowly and gently,” Linder-Koda reports. “It’s very different from the typical exercises a singer may do. The goal is to stretch the vocal chords and get them back into the right position.” If you try to rush it, you could cause even greater damage.

If you must perform a do-or-die gig, you could try a cortisone spray. “But,” Linder-Koda cautions, “that’s only a temporary fix. If you rely on it too much, you could seriously hurt yourself.”

Prevention 

• Listen to your body, and always do warm-ups and warm-downs.
• Speak in a normal range and avoid screaming and loud talking.
• Use a humidifier when sleeping— especially in dry climates.
• Drink lots of water—you need to hydrate your body and vocal cords.
• Release neck tension by gently tipping your head forward and to each side while keeping your shoulders down.

Artists Speak Out

Artists may “tough it out,” but at times the pain overcomes bravado. Guitarist and vocalist (and MC writer) Oscar Jordan speaks from experience. “It’s easy to overlook aches and pains because most of the time you don’t notice them until later––sometimes a whole week later.” Jordan discovered that you can determine the cause if you track it down. For him, it was carpal tunnel syndrome due to using too much pressure on his fret board and way too much computer work.

Recently, Jordan noticed the onset of Tinnitus. “It’s like a white noise. Part of it is from playing too loud,” he admits. “But,” he adds, “it’s also from going to loud concerts. A lot of musicians are fans too, and you don’t think about earplugs when you’re in the audience.”

Mark Allee, a drummer, teacher and reality show producer, has had a slew of problems. “It started with a weird pain in my wrist,” he relates. “I tried different techniques and exercises, but it persisted.” Allee eventually got medical attention, but it’s been a long road.

“At first, nothing seemed to work and the pain moved to my forearm and then to my shoulders and neck,” he says. Carrying his drum kit didn’t help either. “I inflamed my injuries doing that.”

The biggest insight Allee got, however, was a realization. “I discovered that I wasn’t as bionic as I thought I was or wanted to be.” Today, he plays with much less pain. “I took it seriously and got professional treatment. I also stretch and do warm-ups before I play and use a stool with a back rest.” Allee also found that Pilates helped a lot. “It strengthens your core,” he says, “and helps with posture.”

Taking Care of Yourself

Neglect your body, neglect your career. If you’re like most musicians, you’d like to have a long lasting relationship with music. To accomplish that, however, you must remain aware of how playing, singing and performing actually affect you.

“Most importantly,” Dr. Farbenbloom advises, “do not ignore those first danger signs. If you do so, and wait too long, you could end your career prematurely.”

 

Contacts For This Article:

Dr. Marshall Chasin, AuD. 
Association of Adult Musicians with Hearing Loss
aamhl.org
Author: Musicians and the Prevention of Hearing Loss,
CIC Handbook, and Noise Control - a Primer

Yaniv Farbenbloom, D.C 
Farbenbloom Chiropractic
powerdoc.net

Janet Hovarth  
Founded the “Playing (Less) Hurt Injury Prevention Conference Series”
playinglesshurt.com
Author: Playing (Less) Hurt - An Injury Prevention Guide for Musicians

Dr. Timothy Jameson   
musicianshealth.com
Author: Reach For the Top!: The Musician’s Guide to Health, Wealth,
and Success and Repetitive Strain Injuries: The Complete Guide to Alternative Treatments and Prevention

Jan Linder-Koda, Vocal Coach, Vocal Therapy
angeldivamusic.com
Author: Directing Singers from an Actor’s Perspective

Mark Allee, Drummer (Starving for Gravity)
Associate Producer, Reality Show: Next Great Drummer: Is it You?
nextgreatdrummer.com / facebook.com/markalleemusic
reverbnation.com/starvingforgravity

Oscar Jordan, guitar, vocals
oscarjordan.com