Injury Prevention

“I’m a Math major and I want NUMBERS, not words, about performance injuries!”

One thing's for sure–many musicians (student, professional, and everywhere in between) experience performance-related injuries at some point in their careers.

A recently published study of incoming freshman instrumentalists at Northwestern University found that 79% of students reported “a history of playing-related pain.”

Approximately 85% of string, woodwind, brass, and keyboard students reported experience with performance injuries, as did 61% of voice students and 100% of percussion students.1

This phenomenon isn’t just a by-product of Conservatory culture.  It’s also an acknowledged aspect of professional life.

A 1987 survey of international orchestral professionals2 found that, at the time, 76% of orchestral musicians experienced at least one performance-related injury of a serious nature.

And it’s not just Conservatory students and orchestral professionals.  Even a study of amateur musicians rated overuse injuries at 72%. 3

The moral of the story: music is a rigorous field of study and a demanding line of work.  The vast majority of musicians experience pain at some point in their lives.  Therefore: educate yourself, develop healthy habits, and know that if you do start hurting, you are not alone!

1 Brandfonbrener, Alice G. "History of Playing-related Pain in 330 University Freshman Music Students." Medical Problems of Performing Artists. Vol. 24, No. 1, Mar. 2009: 30-36.
2 Fishbein, Martin and Susan E. Middlestadt, et al. "Medical problems among ICSOM musicians: overview of a national survey." Medical Problems of Performing Artists. Vol. 3, No. 1, Mar. 1988: 1-8.
3 Newmark, Jonathan and Richard J. Lederman. "Practice doesn't necessarily make perfect: Incidence of overuse syndromes in amateur instrumentalists." Medical Problems of Performing Artists. Vol. 2, No. 4, Dec. 1987: 142-144.

 

Janet Horvath's Do's and Don'ts for Injury Prefention (PDF)

   - See more about injury prevention from Janet Horvath

+ Personal Experiences from Students

The following are accounts from LU Conservatory students who have had personal experience dealing with playing-related injuries, and have found their own ways to address them.

Dan Schenk '09

     When I entered Lawrence as a freshman, practicing was something I prided myself on.  I could find time to practice six hours a day, sometimes more on the weekends! As my first two years went by I developed the idea that I could tell how well I had practiced any given day if I felt exhausted by the end of it. What I did not realize was that this idea was actually preventing me from seeing my exhaustion for what it really was: a daily build-up of fatigue that would eventually lead to tendonitis.
      The summer before my junior year I attended a music camp in the mountains, where I thought I could use a rest from the fast-paced conservatory year, practicing fewer hours than ever each day.  When I came back to school from that summer I jumped back into my high-gear practice schedule, and quickly found I was getting as exhausted after an hour practice as when I had been practicing six hours.  This led me to believe that I was out of shape, so I worked extra hard for a month, but each week my arms felt weaker and less under my control.  I had worked my arms into ruin, without realizing that injury was a consequence of practicing too much.  A trip to a specialist confirmed that I had developed tendonitis in both of my forearms and wrists, and without much choice was told that my only option was to rest my arms for as long as they needed to heal properly.
      For the rest of that year and all of the next I researched all the potential habits that could have led me to such a crippling injury.  What I found was that there were a large number of contributing factors to my injuries, most having to do with practicing. After that year and a half of not playing I was able to consciously change my approach to playing the piano.  I reworked everything having to do with posture and scheduling more frequent breaks, to how much repertoire I would allow myself to play and making sure I gave myself enough time to learn it with the most efficient technique.  I am happy to say that today my time was well spent, as my abilities are almost restored to what they once were three years ago, and I have no fear of ever overlooking the early signs of injury again.

Paris Brown '08

      It was the summer before my last year at Lawrence and I was in full swing with preparations for senior year recital, graduate school and opera auditions. In addition to weekly lessons, and daily practices, I was singing in a church choir and giving campus tours 1-2 times a day.  Coupled with my permanent struggle with year-round allergies and post-nasal drip, I created a situation where I was putting a significant amount of stress on my voice.  At first I didn’t notice any symptoms, but then I began to notice subtle signs of discomfort; prolonged hoarseness after a tour, loss of range and inability to practice as long as usual. Upon having a video stroboscopy, my otolaryngologist informed me that I had developed the beginning stages of vocal nodes (sometimes called nodules), or calluses, and if left untreated, it would be difficult to have a successful career in classical singing.
      The next five months were the most difficult of my life.  I had doctor’s orders to cease singing and giving tours (my current work study), attend weekly speech therapy sessions and speak as little as possible… for at least four months. I would essentially have to put everything related to singing on hold, including my recital and graduate school auditions.  I was angry, depressed and blamed myself for not listening to my body and my instrument, but I was grateful that my nodes were discovered early enough that healing could occur without more drastic measures like surgery.
      I learned many lessons during this time. Ironically enough, during the time that I couldn’t sing I was taking vocal pedagogy in which I learned how to teach others to sing with sound and healthy technique.  I developed techniques for optimal speaking and healthy vocal hygiene and learn that every musician has her/his limit. I previously had the terrible habit of comparing my limit with that of others.  If another singer could sing for three hours, cheer at a basketball game, and then sing a perfect aria the next day, then so could I, right?
      My voice teacher says it best: “some singers have vocal cords of Teflon and others have cords of porcelain.” We all have our own strengths, weakness and limitations and we become better musicians when we acknowledge and honor our own limitations as well as the limitations of others.  Injury can happen to any musician regardless of talent, ability, or musical background.  Fortunately, most injuries can be prevented by knowing your instrument and/or body and honoring what it can and cannot do when healthy.  I am a much better musician having gone through an injury and healing process, but I had to sacrifice time, energy, money and performance opportunities during my musical peak at Lawrence. In case you were wondering, I did have a happy ending; I was able to reverse my nodes and give my senior recital in the spring, but not without the help of my speech therapist, voice teacher and the countless support of my friends and professors.
      Lawrence is a wonderful place to discover your musical persona in a collaborative environment. Take the time to learn about wellness and if you feel that you might be heading in an unhealthy direction, STOP and talk to someone. Treatment is almost always more effective with early detection.  Singers, remember that you don’t stop using your instrument after a rehearsal or practice, but you have to use your voice throughout the day. Be mindful of entire daily voice use, as it is often the non-singing times that can be the unhealthiest for our instrument. To both vocalist and instrumentalist; every step you take towards health as a musician will not only prolong your career but will motivate and inspire others; a definite win-win situation.

Sarah Davies '09

     As a freshman music performance major, I arrived at Lawrence and began playing the flute more than I ever had before. Between practicing for 6 unit (one hour) lessons, technique class, ensemble and ensemble rehearsals, I quickly and dramatically increased my playing time to several hours a day. With this increase, I began to notice an incredible amount of tension in my neck and shoulders, and pain in my right arm, wrist, and hands. I also experienced numbness and tingling in my right hand. I acquired ice packs, ibuprofen, and Icy Hot to deal with the slow onset of pain, but I didn't change my practice habits or seek advice from a doctor until it was too late. I spent the end of my freshman year, my summer, and half of my sophomore year bouncing from specialist to specialist trying to diagnose the cause of my pain. After a visit to the Mayo Clinic in Rochester MN, I was finally diagnosed with a condition called Thoracic Outlet Syndrome, and was prescribed physical therapy as treatment. Though I wound up changing my major from performance to music education, my shoulder condition continued to affect my time at Lawrence.  I actually took two years off from playing the flute (sophomore and junior years) because of my injury.  I feel fortunate that I was able to join choir and take a few terms of voice lessons instead of playing in band and taking flute lessons.  During this time I tried to not get discouraged, and actually learned a lot about myself as a musician and about my body. 
      I am now graduating, and two weeks ago gave my senior recital—on flute. Though my condition has not entirely gone away, I've learned to listen to my body and have been able to manage the stress and pain through physical therapy and moderation of activities.  I need to be constantly aware of the effects of all my actions—not just practicing—on my body.  Things like typing long papers, sitting in class with poor posture, and carrying a heavy backpack all affect the amount of pain I feel and the way my body works.
      I strongly encourage all musicians to listen to their bodies at all times.  Remember, "Practicing is NOT a no pain, no gain situation!"  Don't ignore the signs of injury until it is too late, because these issues are manageable and not worth the pain, especially if they are dealt with right away.

+ Alexander Movement Technique

Alexander Movement Technique
from Kathy Privatt, Assoc. Prof. of Theatre Arts

Welcome to Lawrence!  You may have heard that both students and faculty at LU are interested in working across disciplines and are committed to life-long learning.  My current work with Alexander Movement Technique is a good example of that approach, and might be of interest to you too.  For the past two years, I have been attending teacher-training courses at Chesapeake Bay Alexander Studies (CBAS).  This year I will be completing the third year of training required to be certified as an Alexander Technique International (ATI) Teacher.  Once that certification is complete, I plan to offer for-credit classes in the Technique, with the possibility of a more advanced class if there is interest.  Why might that interest you?

Alexander Movement Technique teaches us to use ourselves with increased ease and efficiency in any activity.  By becoming aware of the communication between body and brain, we can make movement choices that avoid harmful habits, and increase our creative potential.  The Technique gives us freedom and flexibility in all our activities and work.  People who study and use the Technique include musicians, actors, physical therapists, athletes, and the Israeli Air Force. The Technique is taught at a number of colleges and universities, including Northwestern, Indiana, Cincinnati, Hart College of Music, the Juilliard School, New England Conservatory of Music, Aspen Music Center, Brevard Music Center, San Francisco Conservatory, Boston Conservatory, Manhattan School of Music, and the UCLA School of Theater, Film and Television.

Alexander Technique applies to performance-related injuries because of its focus on our use.  Performance, no matter what your instrument, is a physical activity, and your body is the tool you use to complete that activity.  The Technique teaches you to recognize and consciously choose the way your body completes that activity; whether you’re preventing an injury, healing from an injury, or just practicing and performing, you use yourself in sustainable, efficient ways.

+ Glossary of Injuries

Injury Prevention - Glossary of Injuries and Conditions

"A glossary of musicians' medical terms - brought to you by Lawrence Conservtory PAIN!"

Definitions in italics are from Conservatory students.

Acid Reflux

Heartburn is an irritation of the esophagus that is caused by stomach acid. With gravity's help, a muscular valve called the lower esophageal sphincter, or LES, keeps stomach acid in the stomach. The LES is located where the esophagus meets the stomach -- below the rib cage and slightly left of center. Normally it opens to allow food into the stomach or to permit belching; then it closes again. But if the LES opens too often or does not close tight enough, stomach acid can reflux, or seep, into the esophagus and cause a burning sensation. Acid reflux can damage vocal chords.

Arthritis

There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis and gout. The word "arthritis" means joint inflammation. Inflammation is one of the body's natural reactions to disease or injury, and includes swelling, pain and stiffness. Inflammation that lasts for a very long time or recurs, as in arthritis, can lead to tissue damage.

Bell's Palsy

Bell's palsy is a type of paralysis (or weakness) of the muscles in the face, thought to be due to inflammation of the seventh cranial nerve, also known as the facial nerve. Bell's palsy tends to come on very suddenly. Most people start to recover within a couple of weeks and are completely recovered within three months. Some people who develop Bell's palsy have a longer recovery period or have some permanent symptoms of the condition.

Bursitis

Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons and skin, that decreases rubbing, friction and irritation. This condition is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury.

Carpal Tunnel Syndrome

Carpal tunnel syndrome causes pain, tingling and numbness in your hand from pressure on the median nerve in your wrist. The tingling, numbness and pain of carpal tunnel syndrome usually develop gradually. Symptoms often get worse if you do not stop or change an activity that is helping to cause the condition. Most mild cases of carpal tunnel syndrome get better with treatment. Usually there is no permanent damage to the median nerve. Risk factors for carpal tunnel include activities that require repeated motions, especially in awkward positions.

Dental Hygiene

Dental hygiene is extremely important for everyone, but especially for wind and brass players. Wind and brass players should brush their teeth every time after eating before playing. Nobody wants cafeteria food in their instrument. Also, if your teeth fall out, it'll be pretty hard to play your instrument.

Emphysema

Emphysema is a long-term, progressive disease of the lung that primarily causes shortness of breath. In people with emphysema, the lung tissues necessary to support the physical shape and function of the lung are destroyed. Cigarette smoking is by far the most dangerous reason that people develop emphysema, and it is also the most preventable cause.

ENT

See Otolaryngologist

Focal Dystonia

Focal Dystonia is involuntary sustained muscle contractions which can lead to abnormal movements. Genetic as well as non-genetic factors contribute to all forms of dystonia. The most characteristic finding associated with dystonia is twisting, repetitive movements that affect the neck, torso, limbs, eyes, face, vocal chords and/or a combination of these muscle groups.

Herniated Disk

The bones (vertebrae) that form the spine in your back are cushioned by small, spongy disks. When these disks are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disk is damaged, it may bulge or break open. This is called a herniated disk. It may also be called a slipped or ruptured disk.

Instrument Adjustments

If you have a chronic condition that causes pain when you play, adjusting your instrument is not a bad way to go. For cellists, bent endpins (change the angle of the instrument to facilitate ease in thumb position) and posture pegs (pegs that don't have the knobs sticking out that poke you in the neck) are good choices. Bent endpins are also available for bassists. Violinists and violists can experiment with different heights and styles of chin and shoulder rests. Wind and brass players that play extremely large instruments, like bari sax and tuba, might want to consider a stand for the instrument so you aren't holding it yourself. Neck straps and harnesses are also helpful for wind and brass players who want to relieve the pressure the instrument exerts on the hands and wrists. Be sure to discuss all these options with your private lessons teacher before purchasing. These products are expensive and require thoughtful consideration before purchase.

Laryngitis

Laryngitis is an inflammation of the voice box, or larynx that causes your voice to become raspy or hoarse. Laryngitis can be caused by: colds or flu, the most common cause, acid reflux, also known as gastro esophageal reflux disease (GERD), overuse of your voice, such as cheering at a sports event, and irritation, such as from allergies or smoke.

Ménière's Disease

Ménière's (say "men-YEERS") disease is a disorder of the inner ear that affects hearing and balance. It causes sudden attacks of vertigo (a spinning sensation), tinnitus (a loud ringing in the ears), and a loss of hearing that may become permanent.

Musician's Chair

A musician's chair is a special chair specifically designed for musicians to facilitate good posture while playing. These chairs are very comfortable and reduce the amount of back pain after a 2-3 hour rehearsal. Lawrence has Wanger Musicians Chairs in the Chapel for large ensemble rehearsals and is planning on purchasing enough for the entire conservatory as soon as funds are available.

Numbness/Tingling

Numbness and tingling in your hand or arm is often a symptom of a more serious condition, like Carpal Tunnel Syndrome. It can feel like "pins-and-needles" or that the body part has fallen asleep. If you experience numbness or tingling often, especially during or after playing, you should consult a doctor immediately.

Otolaryngologist

Sometimes referred to otorhinolaryngologists or ear, nose and throat (ENT) doctors,medical doctors who specialize in the diagnosis and treatment of diseases or conditions of the ear, nose and throat. Otolaryngologists can prescribe medication and perform surgery for sinus problems, sleep apnea or to remove tonsils or cancerous growths, for example.

Repetitive Motion Injuries

Repetitive motion injuries are among the most common injuries in the United States. Simple everyday actions, such as throwing a ball, scrubbing a floor or jogging, can lead to this condition. The most common types of repetitive motion injuries are tendonitis and bursitis. These 2 disorders are difficult to differentiate and many times may coexist.

Rotator Cuff Disorders

The rotator cuff is a group of strong, ropelike fibers (tendons) and muscles in the shoulder. Rotator cuff disorders occur when tissues in the shoulder get irritated or damaged. Tendonitis and bursitis are rotator cuff disorders. Both normal wear and tear and overuse can lead to impingement, when a tendon rubs against bone. This damages and irritates the tendon, which causes bleeding and inflammation. Over time, scar tissue replaces healthy tissue, and the tendons become stiff, stringy, and more easily injured.

Scoliosis

Scoliosis is a lateral (toward the side) curvature in the normally straight vertical line of the spine. The normal spine curves gently backward in the upper back and gently inward in the lower back. When viewed from the side, the spine should show a mild roundness in the upper back and shows a degree of swayback (inward curvature) in the lower back. When a person with a normal spine is viewed from the front or back, the spine appears to be straight. When a person with scoliosis is viewed from the front or back, the spine appears to be curved.

Spasmodic Dysphonia

Spasmodic dysphonia is a voice disorder resulting from involuntary movements (or spasms) of the voice box muscles. These spasms interrupt normal voice (dysphonia) in "abrupt spurts" with a strained, strangled voice, with breathy, soundless voice or with a mixture of both. SD is a type of dystonia, a disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. It involves either the vocal folds coming together at the wrong time during speech (adductor SD), moving apart at the wrong time during speech (abductor SD), or both (mixed SD). There is no known cure, but treatment can and does improve symptoms.

Tendonitis

Tendonitis is an inflammation or irritation of the tendon, a thick cord that attaches bone to muscle. Tendonitis is most often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury. Incorrect posture at work or home or poor stretching or conditioning before exercise or playing sports increases a person's risk.

Tennis Elbow

Tennis elbow is a condition in which tendon damage causes pain or soreness around the outside part of the elbow known as the lateral epicondyle. Symptoms are especially noticeable when the palm is turned up. The muscles of the forearm, wrist, and hand attach at the elbow to the upper arm bone (humerus). Damage to the tendons around these muscles makes it painful to rotate the forearm and flex the wrist and fingers backwards. Tennis elbow is usually caused by overuse from repeated hand and wrist movements.

Tension

Like many things in life, tension can be both good and bad. Too much of it causes pain, but not enough of it and we wouldn't be able to walk or really do anything. When you experience pain during or after playing, notice if you are holding too much tension any  part of your body. These areas could be any where on the body, but good places to check are your shoulders, back, face, mouth, neck, feet or hands.

Thoracic Outlet Syndrome

TOS is an umbrella term that encompasses three related syndromes that cause pain in the arm, shoulder and neck: neurogenic TOS, vascular TOS and nonspecific or disputed TOS. Most doctors agree that TOS is caused by compression of the brachial plexus or subclavian vessels as they pass through narrow passageways leading from the base of the neck to the armpit and arm, but there is considerable disagreement about its diagnosis and treatment. Making the diagnosis of TOS even more difficult is that a number of disorders feature symptoms similar to those of TOS, including rotator cuff injuries, cervical disc disorders, fibromyalgia, multiple sclerosis, complex regional pain syndrome and tumors of the syrinx or spinal cord.  Symptoms of TOS vary depending on the type.

Tinnitis

Tinnitis, or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room.  In rare cases, the sound beats in sync with your heart.

TMJ

The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw.

Vocal Hemmorages

In the vocal fold, hemorrhage refers to bleeding into the superficial lamina propria, the layer that guarantees the pliability of the vocal fold for vibration. Because this layer is made up of a network of loosely-arranged of fibers, blood spreads throughout it quickly and affects it so that the vocal fold does not vibrate as well. It does not take a lot of blood to cause a vocal fold hemorrhage, so this kind of bleeding is in no way a risk to a person’s overall health or life. Hemorrhage is the result of phonotrauma, the physical stresses caused by voicing, upon the tiny blood vessels of the vocal fold. These may rupture and bleed after loud voicing, after sustained voicing, or when they are more fragile than normal, as when they are swollen during laryngitis.

Vocal Fold Granuloma

Vocal fold granulomas are non-cancerous growths on the two vocal folds comprised of cells and substances often found in sites of inflammation (inflammatory tissue) and reflect a response to irritation or injury. The granulomas are usually found near the back portion of the vocal folds over the vocal process of the arytenoid cartilages at the site of contact during vocal fold closure. The common causes of vocal fold granuloma include: irritation from a breathing tube (endotracheal intubation trauma), irritation from excessive vocal fold contact with improper or excessive voice use, backflow of acidic stomach fluids to the voice box (laryngopharyngeal reflux).

Vocal Fold Scars

Vocal fold scarring is abnormal scar tissue in the vibrating layer of the vocal fold. Vocal fold scarring causes a number of voice disorders that are problematic to patients and is very challenging to diagnose and treat. A vocal fold scar is disorganized tissue in the vibrating layer of the vocal fold that forms as a response to injury or stress (as would occur in the rest of the body). The scar tissue alters the pliability (viscoelasticity) of the vocal fold, thus decreasing its ability to vibrate during speaking or singing. The scar tissue can range from mild to severe and can occur in one spot or along the full length of the vocal fold, resulting in varying degrees of loss of ability to vibrate. Voice therapy and/or singing voice therapy can provide satisfactory voice improvement with better technique, as well as help prevent continued scar formation.

Resources Used:

http://www.voiceproblem.org/           
http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm
http://www.voicemedicine.com/hemorrhage.htm
www.webmd.com
http://www.biofreeze.com/
http://www.icyhot.com/morehowicyhot.html

 

+ Glossary of Treatments

Injury Prevention - Glossary of Treatments "A glossary of musicians' medical terms - brought to you by Lawrence Conservtory PAIN!"

Definitions in italics are from Conservatory students.

Acupuncture

In acupuncture, disposable, stainless steel needles are used to stimulate the body's 14 major meridians, or energy-carrying channels, to resist or overcome illnesses and conditions by correcting these imbalances. Acupuncture is also thought to decrease pain by increasing the release of chemicals that block pain, called endorphins. Many acu-points are near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins (morphine-like chemicals produced in our own bodies during times of pain or stress). Endorphins, along with other neurotransmitters (body chemicals that modify nerve impulses), block the message of pain from being delivered up to the brain.

Alexander Technique

Alexander Movement Technique teaches us to use ourselves with increased ease and efficiency in any activity. By becoming aware of the communication between body and brain, we can make movement choices that avoid harmful habits, and increase our creative potential.

Audiologist

Hearing specialists who are trained to identify, diagnose, measure and treat hearing disorders or balance problems.

Biofreeze/Icy Hot

Biofreeze is a pain relieving topical gel that offers temporary relief of minor aches and pains, and conditions like tendonitis, bursitis, and arthritis. Consult a doctor before use. Icy Hot is a topical pain reliever that gets ICY to dull the pain, then gets HOT to relax it away. It temporarily relieves minor pain associated with arthritis, tendonitis and muscle strains and sprains. The ingredients create cooling and warming sensations that divert attention from the actual pain and help block the pain signals being sent to the brain. This is not the same as ice and heat and you should not mix real ice/heat with these products.

Body Mapping

Body Mapping is a term coined by William Conable, a master teacher of the Alexander Technique and professor of cello at the Ohio State University School of Music. Mapping refers to one's own idea and experience of structure, movement, and size. Body maps can be conscious or unconscious, but they always govern how we move. Body maps often deviate from the reality of anatomic structure; even then, they govern how we move. When the brain has a concept of size, location or direction of movement, that concept is carried through the nervous system to act upon the body part in question. A faulty map can lead to inefficiency, distortion and injury. When the map is accurate, movement becomes efficient and clear. In mapping, the information is embodied and is reflected in movement and appearance.

Chiropractor

Chiropractors are health professionals who specialize in the diagnosis and treatment of problems that affect the alignment of the muscles and bones of the body. They use a variety of techniques to adjust the spinal column to prevent and treat muscle, joint, and ligament problems.

Common Sense

This is something that everyone has, but rarely uses when it comes to music related injuries. If you are playing or singing and something hurts, immediately stop what you are doing and take a nice long break. Come back in an hour or so and try again. If pain is persistent, talk to your studio teacher or ensemble director. Your teachers are here to help you. They won't be mad if you didn't practice for 3 hours one day because something hurt. The pain is your body telling you to stop and that something is wrong. Just use that good old common sense.

Ear Plugs

Ear plugs come in many varieties and certain ear plugs are more effective for different types of sound. There are ear plugs in the Conservatory office that you can purchase. Consider using them during loud ensemble rehearsals or in the practice room if you don't want to lose your hearing by the time you turn 40.

Feldenkrais Method

The Feldenkrais method is a gentle form of bodywork that increases flexibility and coordination. Feldenkrais exercises are intended to help increase a person's awareness of body movement and develop new patterns of movement. There are Feldenkrais teachers in the Appleton and Madison areas.

Hand Washing

This may seem like a no brainer, but washing your hands helps prevent disease, like colds and the flu, which spread pretty quickly in the small conservatory environment. Also if you plan on using a piano or the computer lab (which you will do frequently), hand washing before and after use will help keep you and others from getting sick.

Icing and Heating

Ice and cold packs can relieve pain, swelling and inflammation from injuries and other conditions, such as arthritis. Always keep a cloth between your skin and the ice pack, and press firmly against all the curves of the affected area. Do not apply ice for longer than 15 to 20 minutes at a time, and do not fall asleep with the ice on your skin. Heat dilates the blood vessels, stimulates blood circulation, and reduces muscle spasms. In addition, heat alters the sensation of pain. You can use either dry heat -- such as heating pads or heat lamps -- or moist heat -- such as warm baths or heated wash cloths. Heat therapy, is most often recommended for chronic, long-term ailments, including muscle tightness and tension.

Instrument Adjustments

If you have a chronic condition that causes pain when you play, adjusting your instrument is not a bad way to go. For cellists, bent endpins (change the angle of the instrument to facilitate ease in thumb position) and posture pegs (pegs that don't have the knobs sticking out that poke you in the neck) are good choices. Bent endpins are also available for bassists. Violinists and violists can experiment with different heights and styles of chin and shoulder rests. Wind and brass players that play extremely large instruments, like bari sax and tuba, might want to consider a stand for the instrument so you aren't holding it yourself. Neck straps and harnesses are also helpful for wind and brass players who want to relieve the pressure the instrument exerts on the hands and wrists. Be sure to discuss all these options with your private lessons teacher before purchasing. These products are expensive and require thoughtful consideration before purchase.

Magnetic Field Therapy

Magnetic field therapy uses magnets to maintain health and treat illness. Practitioners of magnetic field therapy believe that interactions between the body, the earth, and other electromagnetic fields cause physical and emotional changes in humans. People use magnet field therapy for a wide range of health problems including: joint problems such as arthritis, migraine headaches, pain, including mild to moderate pain after surgery as well as long-term (chronic) pain, depression, cancer, overstretched muscles or injuries to muscles, ligaments and tendons (strains and sprains).

Massage Therapy

Massage is rubbing the soft tissues of the body, such as the muscles. Massage may be helpful in reducing tension and pain, improving blood flow, and encouraging relaxation. Massage therapists usually apply pressure with their hands, but they can also use their forearms, elbows, or feet. There are at least 80 different types of massage. Some are gentle, and some are very active and intense. People use massage to promote relaxation and relieve pain. It can also relieve muscle tension and may improve blood flow, relieve pressure on nerves, and restore normal joint movement.

Musician's Chairs

A musicians chair is a special chair specifically designed for musicians to facilitate good posture while playing. These chairs are very comfortable and reduce the amount of back pain after a 2-3 hour rehearsal. Lawrence has Wanger Musicians Chairs in the Chapel for large ensemble rehearsals and is planning on purchasing enough for the entire conservatory as soon as funds are available.

Occupational Therapy

Occupational therapy is treatment to help people live as independently as possible. Occupational therapists work with people of all ages who, because of illness, injury, developmental delays, or psychological problems, need assistance in learning skills to help them lead independent, productive, and satisfying lives. Occupational therapists use work, self-care, and recreational activities to increase independent function.

Otolaryngologist

Sometimes referred to as otorhinolaryngologists or ear, nose, and throat (ENT) doctors, are medical doctors who specialize in the diagnosis and treatment of diseases or conditions of the ear, nose, and throat. Otolaryngologists can prescribe medication and perform surgery for sinus problems, sleep apnea, or to remove tonsils or cancerous growths, for example.

Optometrists/Ophthamologists

Optometrists are trained to diagnose and treat vision conditions like nearsightedness, farsightedness and astigmatism. They are trained in prescribing eyeglasses, contact lenses, eye exercises, low vision aids and vision therapy. They are also trained to identify cataracts, glaucoma and retinal disease, and to use some medications to treat eye disease. Ophthalmologists are physicians - doctors of medicine (MDs) or doctors of osteopathy (DOs). Ophthalmologists provide complete eye care services. These include: vision services, including eye exams, medical eye care, surgical eye care, diagnosis and treatment of eye conditions related to other diseases, like diabetes (diabetic retinopathy), arthritis (iritis) or brain conditions (multiple sclerosis/optic neuritis), eye disease and injury preventive services and plastic surgery.

Orthopedic Surgeons

Orthopedic surgeons are medical doctors who specialize in bone, muscle and joint surgery. This includes corrective procedures, such as removing torn cartilage or replacing a joint. Some orthopedic surgeons specialize in specific areas such as shoulder surgery, hand surgery or joint replacement.

Osteopathy

Doctors of osteopathy (DOs) are physicians who base diagnosis and treatment on the theory that the body's systems are interconnected, combining disease prevention and health maintenance with conventional medicine. DOs often use a treatment called manipulation or manual medicine, which is a hands-on approach that may include massage or pressure on an area of the body.

Pain Relievers

Ibuprofen (the active ingredient in products such as Advil and Nuprin) and naproxen sodium (in products such as Aleve) are other nonsteroidal anti-inflammatory drugs (NSAIDs). Like aspirin, these drugs relieve pain and reduce fever and inflammation. Also like aspirin, they can cause nausea, stomach irritation and heartburn. People who take blood thinners (anticoagulants) should use these drugs with caution. Acetaminophen (the active ingredient in products such as Tylenol) reduces fever and relieves pain. It does not have the anti-inflammatory effect of NSAIDS, such as aspirin and ibuprofen, but it also does not cause stomach upset and other side effects.

Physical Therapy

Physical therapy can help you recover from an injury and avoid future injury by reducing pain in the soft tissues (muscles, tendons, and ligaments), improving flexibility and function, and building muscle strength. Your physical therapist can also evaluate how you perform an activity and make suggestions for doing the activity in a way that is less likely to result in an injury.

Pilates

The system of strengthening and stretching exercises designed to develop the body's core, mobilize the spine and build flexibility.

Sound Shield

Lawrence has newly made sound shields to put on the backs of chairs so that musicians that sit directly in front of loud instruments (brass and percussion) during rehearsals, will have a reduced chance of hearing loss.

Speech-Language Pathologists (Speech Therapists)

Speech-language pathologists assess, diagnose, treat and help prevent speech, language, and communication disorders. Speech-language pathologists work with people who cannot make speech sounds or cannot make them clearly; have speech rhythm and fluency problems, such as stuttering; have voice quality problems, such as an inappropriate pitch or harsh voice; have problems understanding and producing language; have cognitive communication problems, such as attention, memory and problem-solving disorders; or have oral motor problems that cause eating and swallowing difficulties.

Warmups and Cooldowns

Warm-ups and cool-downs are very important to do before and after practicing, just like in sports, to prevent injuries. Stretching can be very effective, but talk to a physical therapist of personal trainer first to find ones that will be best for you. Your private lessons teacher will also be able to suggest some good warm-ups and cool-downs that are specific to your instrument.

Yoga

Yoga includes meditation and exercises to help you improve flexibility and breathing, decrease stress and maintain health. People have practiced yoga for thousands of years in India. Yoga is based on the idea that the mind and body are one. Practitioners believe that yoga improves health by improving how you see the world, which calms the spirit and decreases stress. Most people who try yoga for meditation find that it increases their flexibility and reduces stress. If you suffer from a long-term (chronic) medical condition, you can often combine yoga and conventional medical treatment. There are many different kinds of yoga that each have there own method of achieving "oneness."

Resources Used: http://www.voiceproblem.org/ http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm http://www.voicemedicine.com/hemorrhage.htm www.webmd.com http://www.biofreeze.com/ http://www.icyhot.com/morehowicyhot.html

 

More Student Advice about Injury Prevention

Sarah ’11, viola: “[Since I came to Lawrence,] I have learned how to warm-up correctly before I start playing. This includes before orchestra and practicing.”

Andy Olsen ’09, oboe: “I never play before I stretch; arms, hands, face, etc. I only practice 45 minutes at a time, with 15-minute breaks. I also stay hydrated all day, and especially while I practice.”

Georgi Petrov ’10, guitar: For injuries, if you feel pain, or something feels wrong, stop and ask somebody about it, because [it is probably worth addressing].”

Jake Crowe ’11, saxophone: “With injuries, if it starts hurting, don’t ignore it, talk to somebody because it’s not going to go away.”

Louis ’11, violin: “Warm-up before you play, take frequent breaks, take it easy in your ensembles; mentally be there, but physically take a break and be relaxed.”

Facebook Twitter Instagram YouTube