String Players and Health
Playing a string instrument is a true joy, but is fraught with all sorts of potential health issues, from repetitive stress injuries to general aches and pains. Samantha George, Associate Concertmaster of the Milwaukee Symphony Orchestra, has had her share of violin-related health issues. She worked closely with Dr. Alice Brandfonbrener, the Music Medicine expert, to overcome her own problem and, in the course of healing herself, became quite conversant with many of the issues that confront string players.
In this introductory article, Samantha offers some basic, practical advice on how string players can avoid some common injuries, and what you should do if you find yourself in pain.
Playing a stringed instrument is a physically and mentally taxing endeavor. When we first learn to play our instrument, years are devoted to mastering proper alignment, hand position, and posture. The older we get, the more we realize that these are life-long projects, not challenges that are easily confronted and resolved. Because of the sheer hours required to learn a specific piece of music and polish technical passagework, we are extremely susceptible to Repetitive Stress Injuries (RSIs) and general aches and pains. The best way to maintain a well-rounded and fulfilling career is to avoid injury if at all possible. Therefore, prevention is key.
Staying Healthy and Preventing Injury
- Superb Health is Vital: A balanced diet, adequate amount of sleep, cardiovascular fitness, and physical strength. Professional orchestral players, freelancers, and music students often have such busy schedules that finding time to work out, prepare a decent meal, or get a full night of sleep seems almost impossible. We keep irregular hours and are constantly traveling to and from rehearsals and concerts. However, the stronger and healthier your body is, the better you will play, and the less likely you are to develop an injury. Creating time in your schedule to eat some vegetables, get some protein, take a nap, or go for a swim is worth the effort.
- Flexibility is Imperative. Stretching regularly helps to lengthen the connections between tendons and muscles. If you aren’t sure where to start or how to do stretches properly, check out Stretching by Bob Anderson (2000, ISBN 0-936070-22-6). Anderson describes how to stretch every muscle in the body and puts together short sequences of stretches to target your problem areas. The illustrations are helpful and he delineates stretches for beginners and for ultra-flexible people. Yoga classes also improve flexibility, strength, and concentration. If you enroll in a Yoga class, be sure to tell your instructor that you are a string player. The teacher can show you which asanas will be most beneficial for you and keep an eye on your hands, wrists, and arms in class to make sure you are using your muscles properly and not over-doing it.
- Smart Practicing and Warming Up. We are often told to take breaks while we are practicing; not only is this imperative, but it’s crucial. Most of us know that we should take a break of about 10-15 minutes per hour. However, taking mini-breaks during our longer chunks of straight playing is also essential. If we need to stop to mark something into our music or change the tempo on the metronome, we should put down our instrument to do so: stretch out the arms and (gently) shake out the hands. In orchestra, we can put down our instrument and release our arms during long rests or breaks between movements. Warming up our muscles before we practice is also important. However, doing the same warm-up every day or an overly elaborate warm-up can be problematic; we may get into a mental and physical rut with our warm up and use our muscles in the same way too many times in a row. Sometimes the best warm-up involves diving right into repertoire, but gently and quietly: striving to place the fingers down on the string as lightly as possible while still creating a pitch (no finger slapping) and noticing how little effort is needed to produce a sound with our bow. Sometimes our muscles respond best by taking a day off from the instrument altogether; our bodies can regenerate and we can think about something else for a while.
- Icing.Icing is a valuable resource that is rarely enforced or explained to students unless they are having arm problems. Icing before, after, and during practice sessions can help muscles calm down and relieve stress. A major-league pitcher ices down after each outing; we should learn from athletes and remember that we are athletes of small muscle groups. One word of caution: after icing, play lightly on your instrument for a few minutes to warm up again.
- Having a Life. Develop interests outside of your instrument. This makes you a more charismatic person and gives you a sense of perspective when you are technically or physically frustrated. Having outside hobbies and projects keeps you mentally alive and makes your musicianship more interesting and joyful. Taking a class, doing volunteer work, reading, collecting art, and traveling are worthy pursuits that help you step away from the detailed work that is necessary to become an accomplished musician.
- Vary Warm-Up Routine and Practice Routine. Change your patterns as often as possible. If you spent all day yesterday working on Bach, work on your concerto today instead (even if you have to perform the Bach tomorrow). If you focused primarily on your left-hand one day, make the next practice session a bow-arm work-out and practice a lot of open strings. If you have been using the same warm-up routine for a month (or years!), change the order in which you play things or switch the exercises you have been doing with equivalent exercises. Just as a shampoo loses its effectiveness over the course of time, so do our warm-up routines. Do not play your scales the same way every day: vary bowings and groupings or play the scales starting from the top instead of from the bottom. Changing your practice environment can also keep things fresh; try practicing in a different room in your house or apartment, or find a church or other performance venue in which to practice. The change in acoustic will be good for your playing; the change in scenery will be good for your brain.
What To Do If You Are In Pain
- If You Feel Pain While Playing, Stop If At All Possible. You need a break. Ice, stretch, step away from the instrument. Playing through pain is not glamorous, it is stupid. If you feel that you need to be practicing, work without the instrument; visualization and mental practice can be more beneficial for muscle memory than playing through a passage repeatedly when you are uncomfortable or in pain.
- Consult a Doctor. Many musicians are scared to talk to a doctor about their problems; we are often afraid that we will be diagnosed with a career-ending injury or we foolishly believe that we can diagnose ourselves or that the problem will go away by itself. Doctors who specialize in musician injuries will know much more about our problems than we do. To find out more about doctors who specialize in musician injuries, check out www.artsmed.org. This website was created by the Performing Arts Medicine Association (PAMA), a non-profit professional organization for physicians and other professionals who are involved in the treatment and/or research in the field of Performing Arts Medicine.
- Talk To and Play For a Teacher or Other Professional Whom You Trust. Often, someone else may see irregularities in your hand position or posture that you cannot spot by yourself while practicing in front of the mirror. Many Repetitive Stress Injuries are caused by playing too much, but some are caused by improper playing style.
- Eliminate Your Postural and Technical Bad Habits. Most professional string players start playing their instruments at a very young age. Our bodies change as we get older; likewise, our technique needs to adapt to our growing limbs. Often something that worked great when we were 16 needs to be re-evaluated in our 20s and 30s.
- Keep an Open Mind. There is always more than one way to play a passage or perform a technical element. Explore your options. For example, a violinist or violist does not have to play an octave passage with the first and fourth finger; the first and third fingers might work better and put less stress on the hand. A high note does not have to be held and vibrated on the pinky finger when it’s possible to use a third finger or second finger. Also there are multiple ways to finger a double-stop. Although violinists and violists are usually taught to finger thirds with the first and ring fingers or the second and pinky fingers, fingering them with consecutive fingers will often be more comfortable and keep the hand in a stronger, more balanced position. Cellists can experiment with different endpin heights and alternate chairs.
- Find Your Own Sound and Style and Make That Sound Your Trademark. Work with what you have. Trying to imitate another person’s sound or hand position can be detrimental. For example, if you have a small hand, emulating the vibrato or hand position of a larger person could put a lot of strain on your body. On the other hand, fingerings and bowings that work well for a small person may feel very uncomfortable for a larger person. Find your strengths and capitalize on them.
- Do Not Be Afraid To Cancel a Performance or Other Obligation If You Are Injured. Playing while injured can cause irreversible damage. Many injuries take time to heal. You want to perform throughout your life. So pace yourself.