The Clarinet [Online]: Healthy Habits for Musicians

by Heather Mogielnicki, BFA, BS, OT/L, CHT

I am a musician, a flutist, to be exact. I attended a competitive conservatory and studied and performed with world-class musicians. And then I had to stop. What happened? If you are a musician you need to know. Let me tell you my story.

Back in 1994 (yes, the stone age), I was practicing 6-8 hours a day with performances and gigs thrown in, preparing to move my life across the country because I had a dream of doing studio work. On top of all my playing, I was also working a desk job to save extra money for this huge move! Desk job, yuck … not so fun, right? Especially since it put my body in yet another horrible position. You’ve heard of the perfect storm, right? Well, all that playing, and all that computer work provided the perfect storm for injuries and landed me with some serious pain in my right shoulder and wrist, numbness and tingling and a little finger that wouldn’t work. You could say I was freaking out ever so slightly. Every musician’s worst fear was coming to pass: not being able to play! I went from 6-8 hours a day to barely being able to hold my instrument. There are no words to describe the fear, devastation, anxiety and depression that occurred with all of this. But I was determined to fix it and get back on track! Little did I know that the health care system really has no idea how to treat musicians, approach them and treat them holistically. They advised rest, ice, maybe some therapy to treat the symptoms, meds or an injection. Telling a musician to rest is like ripping their soul out and stomping on it. There had to be a better way. Well, unfortunately back then I did not find it, even after going to the so-called “specialists” in NYC.

So why does my story matter? It matters because I gave up my dream and my passion because of my injuries, and I don’t want anyone to have to go through what I did. What should you do to prevent injury in the first place or treat a current injury? Empower yourself with knowledge from people that truly understand what it’s like being a musician and how the body works. I had none of these things back in the “stone age.”

Let’s face it, every single instrument requires some form of contortionism in order to play it and when you REALLY think about the demands you are placing on your muscles and joints to do all the very intricate movements we are required to do it absolutely blows your mind. I, of course, never thought about this when I was a musician. It wasn’t until I entered the field of occupational therapy and learned all about the human body that I had my “aha” moment. Holy smokes, it’s amazing we can do the things our instruments demand of us! With that said, why are instrumentalists not treated like athletes? An enormous amount of money goes into sports medicine and rehabilitation. There are countless studies on athletes and the effects of their sports on their bodies; not so with musicians. But why? Musicians are athletes. The requirements made in terms of our posture and small muscles are intense and the number of hours per day spent at our instrument wears them out. My next question is then, why don’t musicians take care of their bodies as athletes do? Professional athletes are all about self-care, body maintenance, nutrition, hydration, etc. Why not musicians? Because we are not taught to be! We are not taught about the effects of the stresses our bodies go through to play for hours a day and how that affects our bodies. In addition, money is just not dumped into this discipline to research it and promote it. We all know professional sports is where the money is and where the money goes! If this sounds cynical it is certainly not, it’s all about bringing awareness and changing the way things work and making sure musicians learn the importance of taking care of themselves, just as athletes do.

You may be wondering why I am qualified to even talk about this? Well, as I said, I was a musician and then a musician with an injury having to face the dreaded question of what I was going to do with my life now that I couldn’t play! I returned to school to study occupational therapy (OT) and then went on to get my advanced certificate as a certified hand therapist (CHT). As an OT/CHT, I have tons of education in the human body and how it works, ergonomics, body mechanics and activity analysis as well as all sorts of different treatment techniques up my sleeve. As a CHT, I have advanced education in the treatment of injuries in the upper body. The field of hand therapy, at least as it relates to musicianship, was comparatively undeveloped when I began and when I was navigating all of my own issues. I have witnessed over the years an advancement and more effective therapies and therapists coming into this field, but we need more. There needs to be more awareness as well for a more holistic approach to the care that is provided. When I combine my science with my music and my loss, it makes me more than qualified to talk about this. Frankly, though, it took me many years to get to the point where I was healed enough emotionally to go all-in with working with musicians. The wounds of not being able to play myself made it hard, but I have done my inner healing and now I refuse to be stopped because musicians need to know that there is help out there. There are things that you can do to recover from injuries and even more important are the things you can do to prevent them and that’s what I’m going to talk about today: Healthy Habits for Musicians. This article is not long enough to go into all the things I work on with my patients who are musicians, but I will touch on some of the most important things.

What are Healthy Habits for Musicians?

Tip #1: Breaks: Do not practice for hours on end and not take any breaks! I was SO guilty of this! I would sit/stand and practice for a solid two hours without stopping! This is one of the worst things you can do but also one of the hardest things to force yourself to do. Of course, you get totally into what you are working on and submerged into your playing. It is so important to take breaks and I recommend my patients (without injuries) take breaks every half an hour. It does not have to be a long break. You need to get up, get out of the deforming position that your instrument puts you in, move your muscles in the opposite direction of where you have been using them, take a quick walk, clear your head and then go back. It only has to be 3-5 minutes, but it has to happen. You need to take your body out of the stagnant position that your instrument puts you in.

Tip #2: Warmups: And no, I don’t mean long tones and scales and arpeggios! That’s all fine and dandy and needs to be done to warm up at your instrument. But you need to do a physical warm-up of the muscles you are going to use while you play and a dynamic warm-up is best. Dynamic stretching is when you actively use the muscles to stretch them but also bring blood flow to them. The old days of static stretching before exercise are long gone. Evidence has proven that dynamic stretching is far better before doing an activity than static stretching.

Tip #3: Hydrate: I know it sounds ridiculously obvious but we are made up of water and when our bodies don’t have enough, it creates issues. By the way, coffee does not count, I’m sorry to say and trust me I wish it did! Being dehydrated can cause muscle aches and pain, fatigue and dizziness. So, it’s important that you keep your water intake up in an attempt to ease off any extra or unwanted tension in your muscles. Take a water bottle with you everywhere and keep it next to you while you practice or are in rehearsals.

Tip #4: Make sure your body is fitted to your instrument: I CANNOT stress the importance of this enough! All too often we are playing with what we think is the right technique, and it may be the right technique for you, and it may not be. Our music teachers don’t go to school and learn about anatomy and muscles and how the joints work and the best positions for them. It’s just not what they do, they do music and what has worked for them. However, every person’s body is different, and those differences need to be taken into consideration with technique and positioning on the instrument as well as what the body is best suited to do. A therapist who is versed in the instruments and body mechanics/ergonomics can watch you play and take note of the ways you may be positioning yourself or playing that could be contributing to your issues or setting you up for injury in the future. Your neck may be bent too far, your elbow may be snapping with your bow changes, your wrist may be bent too far, or you may be death gripping your strings or keys. These are not things you are typically aware of. You are thinking about phrasing, dynamics, intonation, etc. But the way you approach your instrument can impact your body and its ability to perform. I have had countless patients that when I assess their technique, we find subtle things that once changed makes a huge difference and sets you up for keeping your joints and muscles healthy for the long haul. This is probably the most crucial tip!!!!

Tip #5: Static postures at your instrument: Did you know that when you place your body in the same position for long periods of time that your tissues will adapt and change? Perfect example: when I played, I would mostly play standing except for chamber music and orchestral stuff but I spent hours standing, leaning all my weight into my left hip. Wouldn’t you know, I created a leg length discrepancy because for hours a day I told my body to stay in this position so it adapted. The muscles around my hip region said, “OK, you don’t need us to be long, so we will adapt and shrink.” I chuckle at this now because this is a widely known principle in healthcare and in rehab we use it all the time to stretch out tissues by placing people in what’s called a static progressive splint to encourage tissue changes. So, be sure to change your position while you are playing. Don’t lock your knees if you are standing, don’t lean all your weight to one side, try to change your neck position slightly if you are playing violin/viola, guitarists don’t always look to the left. I could go on and on, but you get the picture.

Tip #6: Breath: Many wind players do not use their diaphragmatic breathing to its fullest. Our muscles and tissues need oxygen and when they don’t get it, they get tense. The tension can then lead to potential injury.

Tip #7: Stress management: A musician’s life is filled with stress. The goal of being perfect technically, the goal of playing from your heart and getting the emotional aspect of the piece across, the hours spent trying to perfect 2 measures, performance anxiety, audition anxiety; it’s a highly competitive field that comes with lots of stress. Stress usually leads to muscle tension which can lead to injury. What are you doing to de-stress? There are lots of options out there. Be sure to pick one that helps you! The more relaxed your muscles are, the healthier they will be and more able to undergo the stresses you put them under. Stress management is also about digging into our limiting beliefs that hold us back and can in themselves create tension in our bodies.

Tip #8: Exercise: I never exercised when I was at the conservatory. Actually, I did once. I went for a run with my roommate who was a liberal arts major. I couldn’t walk for days and ended up with bursitis in my hip! So, exercise but if you don’t currently exercise work up slowly. Who has time for exercise when you are playing 8 hours a day? Believe it or not, you need to think like an athlete. Every athlete prepares their body for their sport, you are no different. You need to prepare your body for your instrument and the hours you spend at it. Most important is some form of aerobic activity: walking, running, biking, etc. Find something you enjoy and get your heart rate up and your blood flowing! You don’t need to go to CrossFit or boot camp and do crazy weight training. Just move! Ideally, getting set up on an exercise program that works the opposite muscles than your instrument makes you work is the best for balancing your body as well. Pilates is a great exercise choice as well. It’s all about the core, breathing and shoulder stabilization, which are keys for musicians!

Tip #9: Posture: This is a tricky one because everyone’s posture is different. There is a “perfect posture” that our bodies should be in, however, no instrument allows us to be there. So, working on your posture away from your instrument will help you be in a better posture while at your instrument. The problem is it’s not as easy as saying “sit up straight.” Likely you won’t be able to sustain that because you have very specific muscles you likely need to stretch out and others that need to be strengthened. This is where it’s important to see a therapist who can set you up on a program to help with that. I don’t like cookie-cutter exercises for many reasons: 1) You may be doing the wrong one for your body, 2) You may not be doing it correctly for your body 3) You can actually make yourself worse if either of those is happening. It’s worth the money to go see a specialist to have your posture analyzed and get a program to keep you healthy for the long haul. That’s what this is all about: having a long fulfilling career doing what you love!

Tip #10: Be PROACTIVE and not REACTIVE: We all think, “I’m fine, I have no issues!” I thought that as well until things came to a screeching halt. The percentage of musicians that will end up with an injury is staggering: numbers range from 80-90%. Find someone that specializes in working with musicians, and I mean really specializes. There is a difference. I had providers that “specialized” in working with musicians, but they really didn’t get it, they were not a musician. How could they understand it all if they didn’t live it? Did they work with musicians here and there? Yes, but they did not have that true understanding of all that goes into being a musician; understanding things from a musician’s point of view. I wish I had that back then! I have many patients that come to me for prevention which is awesome. My goal is to get more and more musicians to realize the importance of that. I highly recommend that you get set up with some exercises, assess your technique and playing habits, look at your body mechanics while you play, address any postural issues, and look into what else you might be doing in life that could be affecting your playing. From there, find what works for you from a wellness perspective to take care of your athletic musician body!

These are just a few tips I address with my patients that I wanted to share, there is so much more but hopefully these get you started in thinking about how to stay healthy so you can keep doing what you love!

For more information, please visit the following links, or contact Heather through email at [email protected].

Website: https://healinghandstherapycenter.com/therapy-for-musicians/

Facebook Page: https://www.facebook.com/healinghandstherapycenterllc/

Private Musicians Facebook Group: https://www.facebook.com/groups/themasterfulmusician/?ref=bookmarks

The Clarinet [Online]: Healthy Habits for Musicians