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.’

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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.

 

Post-Exercise Muscular Soreness

Feeling like you’ve gone 10 rounds with Mike Tyson for a day or two after you’ve done a serious workout?

We all know the feeling- stairs? Not a chance.

But why do our muscles hurt so much when we’ve been working so hard?

Post-Exercise Soreness explained.

The DOMS

Delayed Onset Muscle Soreness: refers to the potential reaction our bodies have when we take up a new exercise plan, adapt an existing exercise plan or alter the intensity or duration of regular physical exertion. This may happen regardless of our fitness levels and although often unwelcomed, it can be the sign of a Physiologically Positive Reaction.

DOMS usually develops between 12-24 hours after the activity itself. We’ve all heard the phrase ‘that’ll hurt tomorrow’ but the truth is the greatest discomfort is often experienced between 24-72 hours post-exercise. Although DOMS can be associated with a positive reaction, is often a sign that you need to take a rest, this is useful feedback from your body.  If you are experiencing symptoms associated with DOMS, to include muscles soreness ‘tender to touch’ and reduced joint mobility, this may lead to instability if not well rested. Instability and weakness combined with muscle soreness and fatigue can lead to injury.

What’s happening?

There is some controversy surrounding the cause of DOMS, however most believe that DOMS is the repair process that develops as a response to the microscopic damage of our muscle fibres likely stemming from novel stresses that were experienced during the exercise.

A common misconception is that DOMS is due to lactic acid build up however it is generally believed that lactic acid is not involved in the DOMS process.

Activities which are thought to result in DOMS are ones which cause muscles to lengthen whilst a force is being applied, also known as an eccentric muscle action. There are three main actions; Concentric, Isometric and Eccentric- The notion of a concentric chest press evokes a much more stressful loading onto the muscles than let’s say a handstand where an Isometric action is seen. However eccentric movements such as the lowering phase in a bicep curl are considered structurally, to cause a higher stress level on muscle fibres than the aforementioned. Try and work your way gradually into a new exercise program to help reduce the severity of DOMS!

 There is a fine line between positive, and injury provoking muscular ‘pain’.

Every body is different and you must remember to listen to yours.

As performing artists we should not be working towards ‘pain’. We should only push our bodies to a certain level, and DOMS is a welcomed indication that we have pushed our bodies a little beyond their normal comfort zone. If you do experience pain during an exercise this could be an underlying factor of over intensified exercise or incorrect form, you should consult a medical practitioner if pain persists and exceeds regular DOMS symptoms.

It is important to remember eccentric movements are to be treated as one ingredient within a well-tailored exercise plan, combining concentric and isometric movement will make for a well-rounded workout. Mastering technique, control and stability within movements will lower the risk of injury and in turn DOMS.

Does Massage Help?

Massage is an extensive physiological tool that eases muscle and joint stiffness. The hands on approach of massage works towards reducing tension within the body, combined with passive movements that not only stretch the connective tissues around our joints, but lengthens muscles and tendons too.  Sports Massage may help prevent the onset of injury, work as a tool to rehabilitate and in turn may improve performance. With classes, rehearsals, shows and tours on the horizon pushing bodies to outside of their regular comfort zone, Dancers, Musicians and Musical Theatre performers may consider seeking treatment in order to gain immediate relief for muscle soreness. It can also be applied post-event to remove waste products/toxins, speed up recovery time and de-stress after a performance.

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Don’t forget TL Health offers Sports Massage where TL Students receive a brilliant discount!

http://www.trinitylaban.ac.uk/trinity-laban-health/health-treatments/sports-massage

Jess Coleman: Graduate Intern, Health.

The Musicians’ Care

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Musicians’ hands are vital to their musical performance. Rapid, complex and coordinated movements are required. Musicians frequently have to play in less than ideal postures and environments, usually without the support of a medical team and with poor facilities. Touring increases the hours of playing with reduced sleep. Noise, alcohol levels and pressure can be very high. In summary, musicians as well as other performing artists often have to perform to the limit of their abilities physically and emotionally. Thus, there is an increased risk of acquiring injuries that can lead to difficulties or an inability to play an instrument.

The vast majority of problems that musicians have are non-traumatic and highly related to posture. Some examples of clear-cut pathologies, in which a specific diagnosis can be made, are old injuries, tenosynovitis, joint hypermobility and focal hand dystonia; although in most cases few physical signs can be found and symptoms are seen as very general and due to poor posture or performance-related issues such as; incorrect practice or technique when playing an instrument.

Many performers are unaware of the stresses that poor posture puts on the body. Carrying the head forward will lead to increased tension in the neck muscles and upper back. Holding the shoulder and shoulder blades forward will overwork the muscles in the arms, which can eventually cause arm and wrist discomfort and pain. The muscles in the forearm are largely responsible for controlling movements in the hand, here, the importance of warming up, cooling down, and stretching these muscles, is crucial to increase the ease in performance and reduce pain levels.

Specialist assessment and rehabilitation techniques are required when dealing with musicians and any type of performing artist. An understanding of the instrument and the type of music played is imperative. Education is vital in the treatment of overuse syndromes and postural correction needs to be an essential part of the rehabilitation plan for Musicians.

Performing Arts Medicine (PAM) has been established for over 20 years now and it is a field devoted to the care and support of all performing artists. In the UK, there are two main organisations acting as advocates for this: The British Association for Performing Arts Medicine (BAPAM) for musicians and singers and Dance UK for dancers. At Trinity Laban Health we are proud to say that our physiotherapists are registered within this field so we can offer the best quality and a specialised service.

Isabel Artigues Cano

Physiotherapist at Trinity Laban Health