Musicians, don’t cramp your style!

In the last 20 years musicians’ medicine has become increasingly popular. But are musicians aware of the prevalence of injury and how best to treat them?

An article published under The British Association for Performing Arts Medicine (BAPAM) couldn’t have said it better…

‘Musicians should think of themselves as athletes.’

musicians

The physical and psychological demands that come hand in hand with being a musician, are no different to that of a dancer or perhaps even a rugby player?! It is essential that Musicians are attentive to their physical needs, limitations, and work, to condition their bodies accordingly.

The repetitive nature of a musicians’ repertoire, lengthy rehearsals and performances, tests posture and muscle strength, so it probably comes as no surprise that the vast majority of injuries sustained include repetitive strain, lower back pain and Tendonitis, to name but a few. However a study of 1046 musicians conducted by BAPAM in 2004, suggested 52% of injuries recorded were due to performance-related issues, such as overwork and incorrect practice or technique when playing their instruments.

Having said this an injury or trauma can be sustained by simply completing a harmless day to day activity, therefore it is essential that the treatment process is managed with the musician’s instrument and the demands of the lifestyle at the focal point. When assessing and treating a musician, a holistic ‘whole body’ approach is paramount- regardless of the type of treatment, the plan should be tailored to the individual artist!

All musicians face limitations, the physical dimensions of an instrument requires the musician to make adjustments to the body, muscles and tendons can be put under strain or ‘unusual’ positions during this modification. To maintain a high performance level, musicians may need to take preventive action or seek treatment that can help strengthen essential core muscles or correct muscle imbalances, thus keeping those dreaded repetitive strain injuries at bay!

Reduce the risk of time away from your passion…

PHYSIOTHERAPHY works towards improving your physical performance and reducing the risk of further injury by developing a biomechanical understanding of how you play. Forms of treatment can range from exercise referral, postural analysis (taking your instrument into consideration), manual mobilisations, dry needling and taping where necessary. These techniques collaborate to address the factors mentioned above, focusing on building strength to support and stabilise muscle imbalances and weaknesses.

ACUPUNCTURE is the balance of energetics of the mind and body. Chinese medicine techniques boost the uptake of oxygen and dissemination to our muscles, thus minimising those pesky cramps. Working to relieve tension, throughout the body it is a saving grace for shoulder and back pain. Did I mention its holistic approach to the body, treating headaches, anxiety and insomnia?

PILATES is a great tool for musicians. A typical Pilates class includes exercises to build or ‘restore’ endurance, flexibility, trunk and pelvic stability, muscle balance, strength, and efficient breathing patterns. Every one of these can help a musician to play a longer repertoire with less fatigue.

SPORTS MASSAGE works to relieve muscle tension as well as improve circulation, flexibility and posture. Whether it be through soft tissue release, trigger point, muscle energy or general massage techniques, this form of treatment can help bring more awareness to the body and decrease pain. Sound good? It can also tackle anxiety and restlessness pre or post performance, reduce stress and improve our overall wellbeing.

Prevention is better than cure!

It is handy to know what treatments are appropriate for musicians and their specific needs but as always remember the aforementioned!! The key to any injury is prevention – intense practice (although sometimes unavoidable) should be limited and performed in moderation.

Try taking regular breaks and work towards conditioning and maintaining a strong body by introducing warm ups and cool downs to your practice. If possible gradually increase the intensity and duration of your practice and restrict yourself to reasonable playing times- we know this may be a tricky one!

For any other information regarding the best treatment for YOU and what we offer at TL Health please contact us on  health@trinitylaban.ac.uk or 0208 3059479/0208 3059482.

Remember a clear and open communication between health care professionals, teachers and most importantly Performers will aid in effective Injury Treatment and in the long haul- PREVENTION!

 

Jessica Coleman

Graduate Intern for Health & Dance Science.

BA (Hons) Dance and Professional Practice, MSc Dance Science.

 

Core Stability for Performing Artists

We often hear the terms ‘engage your core’ or ‘use those core muscles’ in the performing arts world but just what is ‘the core’ and how do we use it?

The core

The core refers to the trunk of the body and the muscular system which aids in providing support and stability for the spine and pelvis. When we think about the core we often think first of the external musculature, the muscle which gives the ‘six pack’ appearance, a.k.a the Rectus Abdominis, but there is much more to the core than this muscle alone.

Let’s break the core up into two groups: anterior muscles and posterior muscles

Anterior muscles of the core

These are the muscles located at the front of the trunk and they include: the Rectus Abdominis which is important for moving the rib cage in relation to the pelvis, Internal and External Obliques which together control rotation and side bends, and the Transversus Abdominis which is often referred to as the ‘corset muscle’, it helps to compress the ribs, not unlike a corset, to aid in spine and pelvic stability.

anterior core

Image: http://leanmuscleproject.com/abdominal-muscles/

 

Posterior muscles of the core

This group of muscles are located at the back of the trunk and they are: The Erector Spinae which is a bundle of muscles and tendons that lie in the groove at the side of the spine and help the spine rotate, the Deep Multifidus which is an important stabiliser of the lower back before the limbs move, and the Quadratus Lumborum, connecting the pelvis to the spine, assisting the diaphragm in inhalation, and in flexion of the trunk. Two other muscles which help to stabilise the trunk and are often not considered are the Lower Trapezius and the Latissimus Dorsi which help to depress the shoulder and aid in side bending movements.

posterior core 2

Image: http://www.humankinetics.com/excerpts/excerpts/build-your-core

Other important muscles of the core

In addition to the anterior and posterior muscles of the core there are three other important muscles which include the diaphragm, the pelvic floor and the Iliopsoas. Learning to engage these muscles correctly can facilitate core stability and help to further support the link between the upper and lower parts of the body.

side vie

Image: http://stoneathleticmedicine.com/2014/01/low-back-pain-in-runners-in-a-battle-of-muscle-supremacy-evil-prevails/

 

So just what is core stability and why do performing artists need it?

There is often more of a focus on strengthening the core with a large focus on planking and abdominal exercises e.g. sit ups and crunches, however working on the external core muscles alone can lead to key weaknesses in supporting the whole body in movement.

Core control involves more than just strengthening the abdominals it involves coordination of muscles to support the spine, it is all about creating a stable base from which the limbs work.

Until there is a level of stability in the core, it will be more difficult to safely achieve a level of strength in the core throughout dynamic movement.

Core stability and injury

Another reason why performing artists require core stability is to aid in the reduction of injury risk. If we lack core stability it has been suggested that we are more prone to lower limb injuries, back injuries and it has also been suggested that a weak core could contribute to shoulder injuries, all of which are common across performing artists. Consider a dancer lacking adequate core stability, placing unusual demands on the body which could apply additional loading to the spine and pelvis area, or a musician simply carrying and holding their instrument in a position which is not natural for the spine. Core stability can aid in these types of movement and help to protect the back and pelvis and ultimately the limbs.

 

Effective and safe ways to train core stability

So we want to train and enhance our core stability but how do we go about it in a safe and effective way? Firstly understanding the anatomy of the core and each muscles job can go a long way to understanding how to train them to do the role they are meant to do. It is then important to train all of these muscles collectively, to avoid excess strain on the more superficial muscles (e.g. Rectus Abdominis and External Obliques) the deep muscles must be working too (e.g. Transversus Abdominis). Finding a training programme which involves a combination of strength, endurance, power and proprioceptive work will help to train the muscle’s patterning, exercises which involve balance work and resistance work which challenges stability is thought to be very effective. Pilates classes/exercises are an excellent way to learn to engage and utilise the core muscle group to enhance its stability. Exercises which incorporate the use of an uneven surface, such as air discs or BOSU balance trainers, will aid in the training of balance and proprioceptive awareness and will challenge the core further.

If you are a performing artist and you are considering enhancing your core stability make sure you train safely, targeting those deep muscles too, both at the front and back of the trunk, it’s not always about crunches and sit ups!

Felicity Beach

Graduate Intern, Health and Dance Science