Questions from Readers: #2

Q:

Dear Janet,
I play the violin as an amateur and am having trouble with arthritis.
I am 68, so perhaps I shouldn't be surprised. But is there anything that you have found I can do?

A:

Regarding your inquiry, I assume your arthritis is osteoarthritis and you are being treated by a rheumatologist I hope? As there are several medications that can at least alleviate some of the pain.

It is very important to work with a physical or occupational therapist who can advise and design tools that will take stress off painful joints and offer specially designed tools that prevent grabbing and gripping. It's a good idea to build up handles even her violin case handle with Coban or Ace bandages as the bigger the surface area the less we tend to grip.

That said, it is essential on the violin as well. It is very important that you do not "grip" the bow nor the fingerboard. The right hand thumb should not squeeze. You should concentrate on arm weight and gravity to make the sound rather than pressure. I often use the image of spreading peanut butter or a paint brush for the pulling on the downbow and pushing on the upbow. It is important to have a very flexible wrist which is not physically possible with a squeezing R thumb. It would help too if you can get a very light bow and a light, small, responsive instrument. Every little bit helps!

You should use the least pressure in the left hand fingers to "pull" the strings down rather than press. In fact, one should focus on lifting quickly and never holding down more than the playing finger. In my book you will see a number of finger splints for the left hand. These help protect the joints that are already compromised by arthritis. The advantage is that one can play with them. These are prescribed medical devices and need to be fitted by a qualified hand therapist and if it is someone experienced with the performing arts all the better! The splints are available in skin tone plastic as well as silver. These well help prevent further injury of the joints.

You should also choose times of the day that she is more comfortable - that is typically later in the day, and she could begin first by immersing her hands in warm ( not hot) water and then go through some gentle hand, arm, neck and shoulder stretches - but never to the point of pain. Those recommended by your or PT doctor are best. Then warming up on the violin is also essential. Begin not too fast, not too slow, not too high not too low....in other words avoid extremes of positions, tempo and dynamics initially. I would also advise you to avoid stretches, double stops and very high positions as these are a real strain for any violinist. Taking breaks often is also a good idea, to let go of the instrument, move and wiggle around and lower arms.

I would also suggest that you look at the Mayo Clinic's Wellness Solutions for Arthritis DVD (through GIAIM) www.gaiam.com/product/id/1022716 which recommends safe movement/exercise which is important so that she can keep joints moving and lubricated. They also have Do's and Don'ts for arthritis sufferers which might be helpful. I hope this is of benefit to you. Keep me posted.

Questions from Readers: #1

Q:

Dear Janet,
I am a percussion student and I have been out on a break now for months due to tendon inflammation in both arms. I read your book and I really enjoyed reading it. On page 168 there is a picture of modified timpani sticks, and I was wondering if you could tell me what is surrounding the bottom of the timpani sticks. I understand that they are modified, but I can not tell how they are modified. I would greatly appreciate it if you could tell me.
Thank you for your time.
Sincerely,
Amy

A1:

Hi Amy
I am sorry for your problems and do hope you have a good performing arts medicine doctor or at least someone experienced with repetitive strain injuries. These sticks firstly are longer so a smaller individual doesn't have to reach or stretch into awkward postures to reach the instrument. They were custom made. I have emailed the person who did the wrap on the sticks and hope to have the particulars soon. There also are polymer drumsticks available which transfer less vibration up ones arm. Iin the meantime I hope you are taking time off. Then wrap the sticks with anything. Coban is a good bet as it sticks to itself- available in most health care supply places, or even ace bandages. The thicker the surface the less one tends to grab. Try to reduce all gripping especially squeezing with your thumb when you hold your sticks as this will cause the muscle on the top if your forearm to rebel and get tight. Squeezing with the thumb also prevents playing with a loose wrist. Reduce repetition. Take lots of breaks and also reduce time spent at the computer. These can exacerbate the condition. Do everything to play with ease and weight rather than force. If you have my book look up Drummer's injuries by Darrin Workman. I'll get back to you soon.
Janet

A2:

(From Peter Kogan principal timpani of the MN Orch)
Amy, These are spongy latex rubber hoses cut to size and with appropriate diameter are slid onto the timpani stick handle. (you have to buy 50 foot lengths and cut them). I know of snare drum players using them as well. Also experiments with sticks are going on. It was found that there is too much vibration up the arm from aluminum sticks whereas bamboo sticks are lighter and have less vibration. These so far have not been universally adopted because of the difference in "feel" of these sticks.

Sight Reading (Daily Tips #6)

An email from a reader:

Dear Janet
I read your article in the May 2010 edition of The Musician. I am sixty four and an active jazz trumpet-flugel performer and a conductor. I agree with all of your preventative measures except one. You make a statement about avoiding sight-reading as you age. I disagree. I read about keeping your mind active and exercising mentally as you age. As a jazz musician, i sight-read a lot and improvise a lot. I find both of these activities to be enjoyable, refreshing, and, yes tiring at times. I personally would encourage musicians to sight-read something daily, as a part of practice. By the way, my sight-reading skills and improv skills are two of the biggest assets that i bring to a band. Thank you for the article. I will investigate the book.
best
Jim Jones trumpet-flugelhorn, retired band director, Conductor, Princeton Community Band.


Janet's Reply:

Hi and thanks very much for your comment.
You make a very astute point about keeping your mind active. We know that playing music in general does contribute to doing just that. As we age this is very important. Yes, I agree that sight reading as part of daily practice is a good idea , very good - once we are all warmed up and we are used to it being a part of our daily practice regimen. No stress there. Just you and the music.
One does gets better at sight reading if one practices it! We get better at recognizing patterns and learn fingerings and keys. In the long run when we feel that our sight reading skills are improving we can stay loose. We stop unraveling at the thought of sight reading.
In my article I was referring to those of us in the orchestral setting for whom sight reading is this very scary thing. Preparation, especially of huge long and difficult orchestral works is important. Sometimes, musicians will show up to a rehearsal at the last minute and must sight read difficult ( and sometimes unreadable) new music or very difficult older music and then in the ensuing panic to get it right, we become tense and stiff, with jerky motions, which is hard on the body.
I must admit I haven't advocated practicing sight reading per se : a very good idea. Reserve 5 minutes during a practice session and choose a section of a work unknown to you. Try to get through it without stopping and then go back and try to recognize scale passages or repeated patterns. Get more comfortable nailing time and key signatures especially the unusual ones. This will train your ears, fingers and mind. Also, learning to transpose a section on sight is a good exercise.
I appreciate the fact that you jazzers are much better at this than we are and if only we did experiment more with improvisation, I think then we too would enjoy our music making more.

Hope you like the book
Janet

Jim's Reply:

Thank you for the reply. I know what you mean about difficult and unreadable music. Manuscript (at least in big bands, concert band, and combo's) is sometimes very poorly written and then on top of that, you get an old photo copy that really adds to the stress you are talking about. Point well taken. On the topic of improvisation....I know that efforts are made, from time to time to put out an orchestral work that incorporates improv. But it seems this fundamental part of jazz is not going to make it big in the orchestral repetoire. This is too bad for orchestral players, conductors, and the audience. On the other hand we have Stefan Grapelli and Mark O'connor to listen to.
Jim Jones

Postures (Daily Tips #5)

Risky or Poor Postures. What are they?

Some of these may be proscribed by our instrument but many are avoidable. The body is happiest in a natural or neutral position. Here are a few risky postures:
- in necks – tilting or rotating heads
- in torsos – bending or twisting
- in wrists – flexing or deviating
- in hands – pressing thumbs and squeezing fingers
- in shoulders allowing shoulders to droop or hunch collapsing chests raising, lifting, or bringing shoulders forward and holding arms away from the body at or above shoulder level for prolonged periods of time.
Hunched postures compress internal organs and the spine, and they prevent proper breathing.
Reaching or leaning or bending backwards can compromise your body negatively. Do we try as musicians to perpetuate a “look”. Does the so-called JAZZ “LOOK” prove intensity or passion? Or should we try to make it look easy, fluid and natural?

Let’s talk about Hands.

AWKWARD HAND POSITIONS ARE RISKY. Extreme positions of the wrist, pinching, or deviations side to side, and prolonged grasping can increase injury risk by 90% At the keyboard (piano or computer for that matter) maintain neutral! Your hands should descend from your elbows. Your wrists should not be dropped nor raised. Do not turn your hand and wrist sideways (deviate) to reach pinky keys. Quick finger action for any instrumentalist, involves a quick release and a light touch. Always release non-playing fingers and focus on an up action while still keeping your fingers close to the keys or string. Avoid slamming your fingers down! Do not squeeze your instrument when you hold it. Use the least force necessary. Watch for excessive calluses. Imagine cupping an orange in your palm so that fingers are curved but with some length. Avoid too much practice of chords, octaves, stretches and taxing or fast passage work. Release as quickly as possible and work on something else before returning to it. Students and teachers, listen for clacking keys or snapping strings. This may indicate that you are pressing your fingers too hard.

It is very important to be aware of what you are doing physically. Use a mirror or video camera to keep tabs on how your body looks. If it looks tight it probably is.

Danger Signals (Daily Tips #4)

Listen to your body when it is trying to tell you something. The sooner the symptoms are recognized and treated, the sooner and more completely recovery can occur. Overuse injuries can be categorized on a scale from one to five, five being the most severe.

1) Pain at one site and only while playing. The pain ceases after playing.
2) Pain at multiple sites when playing but there is no pain outside of music-making.
3) Pain persists when you are away from the instrument. Player underperforms.
4) All of the above where most aspects of hand function cause pain, even at rest and at night. Player is only able to continue with stoicism.
5) All of the above but all daily activities that engages the affected body part cause pain and there is very little capacity for playing.

But there may be more subtle indicators than pain! There may be burning or a "hot" sensation, fatigue or heaviness, weakness, impaired dexterity, numbness or tingling, clumsiness or stiffness, involuntary movement and loss of coordination without pain. Keep a daily practice diary and note if something was sluggish or more difficult than before - something you could "nail" no problem a few weeks ago and today your fingers just won't do it. Try to look back and to analyze what you may have been doing differently: more practicing? a new instrument? a new technique? a more demanding conductor or teacher? Perhaps you played in a cold environment with poor chairs and inadequate lighting? Did you help a friend move and/or paint their apartment? Did you spend hours on the computer typing a paper (or texting) and practice a lot?

These more subtle signs indicate that this is a time to back off and stop playing for a few days. Notice difficulty with normal daily activities and get help immediately if you feel numbness for more than one day. Playing (Less) Hurt has an extensive resource list of qualified health care professionals who understand musicians' issues. Don't wait until problems become severe. Complete recovery is possible and the lessons learned about your body's limitations are invaluable.

Injury Susceptibility (Daily Tips #3)

Repetitive stress injuries are usually due to a combination of factors. You may be susceptible without even knowing it. Overuse can creep up on you. Keep tabs on the following:

1. The force and tension with which you play- Is your playing style intense, emotional and macho? Do you squeeze your instrument or grip your bow? Do you clench your teeth? Do you hold your breath? Do you prefer difficult, pyrotechnical, loud, challenging repertoire? Do you jam keys down even when you play softly?

2. The amount of repetitive movements you perform. These can be cumulative over days, weeks or a whole career, Do you schedule back- to- back gigs, rehearsals and performances? Do you play the same passages over and over?

3. Your body size and build. Are you slender with narrower tunnels, a longer neck, droopy shoulders? Or are you overweight or de-conditioned? Are you a stressed, tense person?

4. The instrument you play. Do you play a very heavy, large, or resistant instrument? Do you play with a heavy bow, keep your strings too high, or do you use an ill-fitting chin rest? Does your instrument leak or do you strain to reach keys? Are you just down- right awkward and uncomfortable?

5. Your genetic make-up. Do you have small hands? Are you very petite or very tall? Do you have joint laxity
(i.e. are you "double jointed") which causes you to use more force in your fingers to keep them from buckling?

6. Your posture. Do you slouch when you play? Do you turn or twist your torso? Do you raise your shoulders or cock your head when you play? Do your legs dangle or conversely do you feel like your knees are "in your face"? Then the chair you are using is not right for you.

7. How much and how long you play. Do you take breaks? Do you take a day off a week? Do you play marathon sessions? Do you lose track of time when you are practicing? Do you have difficulty saying "no"?

8. Pay attention to your body. Do you play despite fatigue or pain? Do you need caffeinated beverages, alcohol drugs, or beta blockers to get through your day?

If your answer to these questions is mostly "yes" then you may be putting yourself at risk for an injury. Consult Playing (Less) Hurt for suggestions regarding how to avoid injuries and how to feel and play better.

Be Consistent (Daily Tips #2)

Are you a busy student with an erratic schedule? Do you practice maybe an hour or so every other day and then do a marathon? Or are you an overworked professional with many responsibilities including young children and old parents, and your practicing is sketchy but you show up to play a double rehearsal on a Mahler symphony racing in at the last minute? Scenarios such as these can be a recipe for disaster. It is better to practice a consistent hour a day (with a day off a week) rather than cramming. It is very important to increase your practice load gradually before a major performance, before a festival you are planning to attend with longer hours than you are accustomed to, or before a jury, an audition or a competition. But back off a few days before the performance or audition so you give your muscles a break.

It is essential to return to playing gradually after a vacation or when you are coming back after an injury. I will often start with only 10 minutes. Increase the number of short periods of time that you play before you increase the length of time. Avoid getting "stuck" on one difficult passage. Vary your repertoire. Different works or passages with different techniques and challenges will use different muscle groups. This prevents overusing a specific muscle group. Playing (Less) Hurt has several practice plans. It pays to practice smarter not harder.

Keep Moving (Daily Tips #1)

Keep tension at bay by moving. We are taught to sit like statues and after years of playing in postures that are sometimes required by our instruments, asymmetrical body development may occur. Muscles become tight and weak on one side and strong on the other. Static postures are the enemy. Muscles are not replenished with oxygen and tire quickly. Even onstage one can move unobtrusively. Here are just a few suggestions.

Take every opportunity to allow your arms to uncurl and hang down for a moment. Shrug or roll your shoulders. Release thumbs and fingers as often as possible. Don't hold stretches, chords or awkward positions any longer than necessary. Avoid grabbing or squeezing your instruments. Do circles with your wrists and thumbs. Press your shoulder blades together stretching your pectoral muscles. Reach one or the other arm behind you and if you can, place your hand flat on the chair behind you. Tuck in your chin and gently look left, then right. Tuck your chin again and move your right ear gently to your right shoulder, then left ear to left shoulder. Take a deep breath and as you exhale pull in your abs. Adjust your seating and move your feet. When you stand to take a bow reach one arm behind you bending your elbow as if you need to reach an itchy spot near your shoulder giving your pectorals and your shoulder a stretch. Try standing on your toes, squeezing your buttocks and rotating your hips.

There are many more stretches and moves described in Playing (Less) Hurt for both onstage, backstage and at home. All of these small movements are tension busters and your muscles and tendons will appreciate these mini-breaks.

Coming Next Week: Daily Injury Prevention Tips

Stay tuned on The Playing (less) Hurt Blog and on Twitter for Daily Injury Prevention Tips every day next week. More to come.

Standing versus Sitting

I have often been asked if there is an advantage to standing rather than sitting to play if you have that option.

I advocate alternating between one and the other when possible. It is true that when standing, musicians are more free to move around and change position, hence they are able to be more fluid. This is good. Static postures are the enemy. Any posture has a static component except when we are lying down and the static portion ( like holding up an instrument or a head that is leaning forward..) is the most important to evaluate in determining position, as it is the most taxing physically. Standing is not better necessarily, although chances are that our training was in a standing position and we are more accustomed to that and possibly more comfortable, and comfort and ease is the goal.

Of course there are musicians who, when playing in a standing position, might tend to lock their knees, perch on their toes, tense their calves or hamstrings, arch there back, or hunch shoulders and lean forward. ( ie I term it the "jazz look" a look that some people equate with really being "into" the music or looking very taken by their playing). These are similar problems that one encounters sitting.

It is essential whether playing seated or standing, that one maintains as neutral a position as possible. This means that one's body weight is on one's feet, shoulders are down and relaxed, head is erect ( not cocked, or leaning to the left or right, or dropped forward, and the chin does not jut out or forward); no turning or twisting of torsos, and there should be a normal lumbar curve in the lower back which we see if we stand normally.

When sitting to play, the most advantageous position, to ensure that the spine does not curve into a C curve, is to sit so that the knees descend downward from the pelvis. In other words the knees should be below the buttocks. ( this can be achieved by a variety of different ergonomic chairs which are now available and/or wedge shaped cushions and a myriad of lumbar cushions).

Feet should be flat on the floor although one leg can be more forward than the other, the torso should be erect ( not twisted or turned) and balanced, so there is a lumbar curve in the lower back. The shoulders should be square, relaxed and down. This erect ( but not arched) posture not only prevents spine damage, but also prevents the compression of internal organs and allows one to breathe normally. This of course is essential.

One needs to nourish the muscles and tendons, the brain and the organs with oxygen and blood flow that is constricted when there is tension. It is essential though, as with standing, that one is not "locked" into one position. We are trained to sit ( or stand) like statues and that builds up the static loading scenario. In my seminars, I demonstrate several Onstage Tricks (tm) which are small movements to ensure that tension does not build up. We must be conscious about releasing and letting go even for seconds. To MOVE is what is the most important- to uncurl arms, circle or roll shoulders, release hands and thumbs, to wiggle and adjust sitting, to let instruments and arms down for a few seconds.....etc

Lastly, whether a musician stands or sits, it is important to be aware that one does not to clench one's teeth, raise or lower wrists exaggeratedly, slam down fingers ,or squeeze thumbs. Instruments must fit the player. Adjustments should be done to make sure shoulder pads and chin rests are fitted appropriately, instruments are not too large, strings are not too high, instruments are in good repair and not "resistant" and bows are not too heavy.

Hearing is Everyone's Business

Click here to go to the "Senza Sordino" Download Page. The latest edition should be posted shortly.

Some genius decided that everything should beep - ATM's, grocery store scanners, gas pumps, seatbelt warnings, backing up trucks, microwaves, TV's, cordless phones, etc and they are all at high pitches- the most damaging frequency.
Add to that power tools, drills, leaf blowers, lawnmowers, snow blowers, iPods cranked up,
( iPods are capped at 100 decibels in Europe. Over that level one can only listen for one hour a day without risk to hearing) and amplified music everywhere you go and we have a scary scenario. Our hearing is at risk!

If hearing is your business ( and livelihood) it is our responsibility to protect our hearing and to advocate for turning volumes down. As more and more people become hard of hearing, decibel levels will rise. It is certainly my vision of hell, living in what is already a toxically loud environment that hurts not only our ears but also increases blood pressure and anxiety levels.

Noise induced hearing injuries are rising rapidly. The injuries including constant ringing or roaring in your head called Tinnitus or off the charts sensitivity where all sounds are as if they have been turned up on high and normal sounds seem intolerably loud. There are two injuries where this can occur called hyperacussis and recruitment. These may or may not be accompanied by hearing loss but in fact are more life changing. For a very in depth study please see asoundear.playinglesshurt.com which is downloadable on my website.

We have been so proactive in the greening of our country, of lobbying against all types of pollution. What about noise pollution? We have to do it!

Gold award in the Health category Independent Publisher Book Awards 2009

Just attended the BookExpo America Convention in NYC where my 2009 new book was awarded a gold medal in the Health category from the Independent Book Awards. It was beyond fabulous. A once in a lifetime event. There were 2 days of education everything from a "pitch blast" - a little like speed dating (we had 3 minutes to pitch a new book to agents of impressive stature), to how to use today's electronic and networking options. The many seminars focused on the fact that what we as book writers really want is to deliver the content in whatever format people prefer to read it in!

Please let me know if you think providing an ebook format or a download by subscription is something you think I should start providing. I could also offer the option of an ebook while the beautiful new paper book is going snail mail so you could get started reading it.
I rubbed shoulders with some best selling authors like James Patterson and John Irving and Greg Morgenson and also many Independent book sellers, writers and all the outstanding publishers both large and small out there.

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Playing (less) Hurt 2009 Edition

The newly revised edition of Playing (less) Hurt has been released!

Please visit our online store to order!

The new edition of Playing (less) Hurt has many more pages of helpful resources. Visit our website for more details on the new additions.

Playing (less) Hurt Website

Fall has arrived and we are in the process of publishing our new 2009 edition of Playing (less) Hurt. The 2009 edition has a fully revised hearing chapter, new information for musicians, teachers, students, more then 20 pages of new resources, and much more.

Our second large project is the revision of PlayingLessHurt.com. We have completely revised it and it is looking better then ever. It will include a new theme, colors, easier to read text, faster loading, easier navigation, and much more. Stay tuned for the launch of the new site and we would love to hear your feedback!

- Janet & The PLH Team

New!: Playing (less) Hurt 2009 Edition

COMING SOON!

New in the 2009 edition:

~ Expanded chapter on hearing

~ Information for classroom music teachers

~ Training and education resource listings

~ Information for jazz and rock musicians

~ Photos of woodwinds, ergonomic products, and other instrument modifications

~ Latest research and resources fully updated

Stay Tuned for Release Information!

Upcoming Events...

Stay tuned to the PLH Blog and the Upcoming Events page on our website for Janet's Lectures during this coming summer! She will be traveling in Colorado, Vermont, and Minnesota giving lectures. Click on the link above! Updates Coming Soon!

TIP OF THE MONTH: JANUARY

WHEN TO USE ICE AND WHEN TO USE HEAT

When you feel you have overplayed, you have some pain, or for those hot, tired muscles after a heavy performance even when injury is absent, drop everything and ice the area. Icing accelerates recovery and promotes healing. Ice minimizes swelling and therefore allows blood flow to continue unrestricted, and is a good pain killer. Since your pain is minimized, it allows you to keep moving, which can prevent scar tissue from forming.

 Keep ice packs handy and apply to the sore area over a thin towel 40 to 60 seconds several times a day just long enough to make the area numb, combined with gentle massaging by “painting” the ice over the painful areas when an injury first occurs.

Ice is not advised for anyone with circulatory problems. Avoid ice if you have RSD, Raynaud’s rheumatoid arthritis or diabetes.

Make sure that you stop playing and other hand intensive activity after icing. Do not stretch and do not play right after icing. You can injure yourself further, as your muscles are less flexible after icing.

Use heat to relieve pain when an injury is chronic or long term. Here is a rule of thumb:

Cold reduces pain and inflammation; heat assists in stretching.

                        

Use HEAT BEFORE playing and ICE AFTER playing.  

Heat can relax and soothe sore muscles. It can help you prepare to warm up prior to  practicing or performing by gently warming up your hands if they are cold and by assisting with range of motion stretches. Never use hot water – stick to warm water. Heat should not be used when inflammation is present and when the injury is acute.

From Janet Horvath’s

Playing (less) Hurt- An Injury Prevention Guide for Musicians

Available for $29.95 at  www.playinglesshurt.com

© 2008 Janet Horvath All Rights Reserved