“I continued to play with a sore arm with the rationalization that I could play through the pain and that the discomfort would just miraculously go away as I got into better shape as a cellist. But the pain didn’t go away. It got worse.”
–Janet Horvath, cellist
The Musician’s Way, p. 231
High-level music making brings immeasurable rewards, and it also comes with significant risks of injury.
But if we understand the risks, we can minimize them and position ourselves to keep performing for life.
This post spotlights the 5 main causes of musicians’ injuries, aside from those that affect hearing, along with ways in which we can sidestep common mishaps.
See Chapters 12 & 13 of The Musician’s Way for more comprehensive occupational health guidelines.
Five Causes of Musicians’ Injuries
Muscles, tendons, vocal folds, and other tissues have limits. If we persist playing or singing despite our limits, overuse injuries can ensue.
Some performers believe that tissue damage isn’t possible as long as we employ strain-free techniques, but medical experts say otherwise.
Take tendons, for instance. In Repetitive Strain Injury, physician Emil Pascarelli explains that when tendons slide through sheaths as they do in the wrist, a lubricating fluid ensures that friction doesn’t occur. Nonetheless, this fluid is used up during movement and restored when we rest (p. 3-4).
Even if we instrumentalists play efficiently, therefore, if we do so relentlessly, we risk depleting that fluid and causing injurious friction to arise between tendon and sheath. The result? Pain and swelling which, if ignored, can become chronic.
The answer? For starters, whether we play instruments or sing, we should take regular breaks, limit repetition, and avoid sudden dramatic increases in our music-making time – overall, health professionals counsel us to restrict increases to no more than 10-20% per week.
If we employ movement or vocal habits that run contrary to the body’s nature, we can bring on strain. And if we strain repeatedly, we can incur the injuries named in the title of Pascarelli’s book.
Chapter 13 of The Musician’s Way illustrates ways in which we can sit, stand, sing, and move with ease – dozens of high-resolution photos are included. Key takeaways: use wrists in their midranges of motion; align and lengthen the spine; release and widen the shoulders; minimize tension.
To help us acquire easeful habits, many of us enlist teachers of the Alexander technique or Feldenkrais method.
Aside from avoiding accidents in daily life, we need to take care to avert mishaps when we’re hauling gear or dealing with stressful performance situations.
Precautions include allowing ample time to set up at concerts so that we don’t rush, using wheeled carts for heavy equipment, and adopting sensible movement practices when we lift and carry.
4. Anatomical Differences
We all differ somewhat in our proportions, so, to help evade misuse, instrumentalists should make certain that their instruments match their physiques.
For example, short-fingered wind players can gain comfort by applying extensions on selected keys; petite guitar and bass players might opt for shorter-scale instruments; small-handed pianists can benefit from practicing on instruments with narrower keys.
Similarly, singers need to choose repertoire that fits their range and then employ healthy vocal habits such as those detailed on pages 268-277 of The Musician’s Way.
5. Individual Sensitivities
Allergies figure prominently in the roster of sensitivities that impact musicians. If we ignore allergy symptoms and attempt to sing or play despite inflammation, we risk serious problems.
In Keep Your Voice Healthy, Friedrich Brodnitz writes, “Treatment of an allergy is part of vocal hygiene” (p. 77). Such treatment is also part of the health-maintenance plans of sensible instrumentalists.
Other sensitivities can arise due to the aging process and from genetic variations, which make some of us prone to conditions such as arthritis.
* * *
In sum, injury prevention is a complex topic, and this article merely touches on basic issues. Still, by being mindful of these 5 causes we can avert many problems.
Even so, if we notice pain or an odd twinge when playing or singing, we should stop, rest, and get help, and never push through persistent pain.
Part III of The Musician’s Way contains in-depth guidelines for preventing injury and unleashing creative potential.
The 12 Habits of Healthy Musicians
Balanced Shoulders, Open Heart
Hear Today. Hear Tomorrow.
Heeding the Signs of Injury
The Total Warm-Up
© 2012 Gerald Klickstein
Photo © Paul Hakimata, licensed from Shutterstock.com
Great article! I completely concur with everything you bring up here, and am especially glad that you also mention equipment issues. As an Alexander Technique teacher, I often encounter musicians who are getting into trouble from poor choices with their gear.
Besides what you’ve mentioned, I also see saxophonists and clarinetists playing on mouthpiece/reed combinations that are far too resistant; drummers sitting on thrones that are too low for them; guitarists using straps that are too small for them; flutists with small hands who really do need an offset “G” key, etc. Not to mention the legions of musicians who sit for long periods of practice on poorly designed chairs (in poor lighting, too). What all this does, of course, is invite misuse. Combine that with overuse and lack of proper rest and you have a recipe for strain and injury. Thanks for this concise and very helpful advice.
Thanks for contributing Bill – terrific examples! I also appreciate the fine articles on your site.
The issues you mention regarding mismatches between musicians and gear are disappointingly common. Given that information is becoming more and more available online, though, let’s hope that students and teachers can make better decisions going forward.