INJURY TREATMENT FOR VIOLINISTS

By Bayla Keyes

 

As violinists and musicians, it is easy to get so caught up in our intense love for music and our need to practice endless hours that we forget that we are physical creatures with wonderful bodies which can do so much for us. We are athletes, and just like athletes, we must get to know our own bodies with all their strengths and limitations. Unlike athletes, however, we will want to practice our art for decades, and in caring for our physical self we will need to develop both incredible sensitivity and power.

 

Injuries are likely to occur because we are out of balance, weak in some area, working muscles without releasing them, or not able to listen to the signals our bodies give us when we use them incorrectly. When you are injured, whether due to an accident, sudden overuse, poor playing habits, long hours at the computer, or some combination exacerbated by worry and stress, it is easy to panic. This will not particularly help! Remember that nearly all musicians, particularly string players, will deal with injuries at some point in their careers. There are many ways of treating injuries and getting the help you need. In the process, you will become a better player AND you will live more happily in your body.  I love the Chinese character for crisis; it is actually a combination of two characters – one for danger and the other for opportunity.

 

Ways to Heal

I. Self Treatment

• If you have tendonitis, your goal should be to reduce the cycle of inflammation and pain.  Icing and taking aspirin or Ibuprofen (not acetaminophen) are best for this. Ice the insertions of the tendon at the elbow and/or wrist for 3-5 minutes, once an hour, to reduce the inflammation. Take aspirin or ibuprofen regularly.

• Arnica (in cream or drops) is scarily helpful for relieving pain when you must keep playing through an injury. Be careful when you are playing the violin, though – you can easily make your injury worse!

• I have many exercises for specific parts of the hands, arms, neck, and shoulders, including a very good set for preventing carpal tunnel syndrome.

II. Strengthening - Violin playing is extremely asymmetric; the resulting imbalance in our muscles can invite injury.

• Personal trainers can give you targeted exercises and stretches to balance your muscles, strengthening arms, shoulders and back. Find someone who has worked with violinists and musicians. Kelly Bellinsky at Performing Arts Occupational Therapy, 1330 Beacon, is great. kelly@performingartsot.com

• I have a handout called Gym Babies, a description of exercises for violinists to be done in a gym with equipment. 

III.   Alignment - Sometimes injuries are the result of poor alignment in the spine and neck.

• Dr. Stuart Grey (617-738-7428) is a wonderful chiropractor who has an office near Boston University and has helped many musicians. http://stuartgreydc.com/

• The Egoscue Method is a fabulous postural therapy training program. https://www.egoscue.com/

IV. Stretching and body awareness

• Systems such as yoga and tai chi are invaluable for helping you get more in touch with your body and release excess tension. Tai chi and yoga are offered at BU. I attend Brookline Tai Chi Academy, at https://brooklinetaichi.org/. I love tai chi because it is a form of moving meditation; it centers me, teaches me to feel inside my body with ever more awareness, opens my joints, stretches my muscles, and is great for balance (both mental and physical). 

• The Alexander Technique is a well-established body awareness path. Betsy Pollatin, an excellent teacher, offers a class at Boston University for musicians.

• The Feldenkrais Method is a type of exercise therapy devised by Moshe Feldenkrais. It reorganizes connections between the brain and the body so that you can perform actions without strain.  Olivia Cheever is a terrific practitioner. She gives classes and individual lessons. oliviacheever.com

V. Massage and bodywork

• Deep tissue massage therapy can be helpful. For pain relief, massage is often the first and best line of defense. My violist friend in the National Symphony gets a weekly massage – it is tax deductible!

• Tui Na is Chinese acupressure and is fabulous: I go to Carolanne Oller at Ancient River Healing Arts, 1141 Beacon Street in Brookline, 617-566-3603.

• Some people find acupuncture to be life-saving.

VI. Medical intervention 

• Dr. Michael Charness at Mass General specializes in musicians’ hand injuries. He may recommend splinting the hand for a period of a few weeks and then send you to a physical therapist for treatment and exercises.  Immobilization of an area can make it weaker, and the risk of injury may be even greater when you return. However in the rare case where you have damaged a nerve, stopping playing may be the only answer.

• Cortisone shots temporarily relieve pain (usually for 2-6 months) but do not help your body learn to heal itself. After the pain-relieving aspect wears off, the remaining cortisone may lessen your ability to feel into the injured area. I would consider this only after trying soft tissue work and exercise.

• I also usually caution against operations, because cutting and the resultant scar tissue are permanent. Go this route only after trying everything else!

VII. Changes in playing

• Work with your violin teacher to identify areas of tension when you play, particular in your hands, arms, shoulders, neck, lower back, hips, legs, and feet. 

• Release before and after every action.

• Always warm up with loosening exercises for your legs and hips.

• Do not play with full force at the beginning of a practice session.

• Whenever you practice or play, notice what your body is doing. Try to sense any tightness or extra effort. The “freeze technique” is useful: periodically stop in your tracks in the middle of a passage and hold perfectly still. Breathe out and release any areas that have contracted; for example, if your shoulders are up, let them relax down; if your toes are curled, let them straighten; if your teeth are clenched, consciously let your jaw soften.

• If you notice any pain whatsoever, try to analyze what is causing it. Can you perform the action more gently? Does playing more softly with either or both hands reduce the pain? Are you squeezing or clutching in any part of your hand, arm, or side of your body?

• Take many breaks, particularly when you are learning new skills and positions! 10 minutes rest out of every hour is a good general rule.

 

Most often healing will mean a combination of first calming inflammation with icing and anti-inflammatories and then getting massage or stretching to loosen up, retraining muscles, strengthening imbalanced and weak muscles, coming into alignment so that nerves can communicate properly with muscles, and increasing body awareness.

 

Except for certain cases of prolonged or chronic injury, I always recommend the slower route of healing, stretching, strengthening, and reconnecting to your own awareness of your body—intense people are often so focused on thoughts and musical expression that they miss their own kinesthetic sensations.

 

You may have to try several things before you find just the right combination.  For me it was retraining on the violin, seeing a chiropractor, getting some exercises, finding a great Feldenkrais teacher, and then doing Tai Chi.  I still do many of these things and am stronger and more flexible than I ever was as a youngster. Be patient; this is important work which will affect your whole life, not just your playing -- you will be better off for having undertaken it, and you may come to realize that your injury has been a doorway to a whole new life. 

 

CAROL RODLAND’S TOP TEN:

1. Feldenkrais Awareness Through Movement
2. Pilates physical training system for strengthening; Yoga exercises to stay limber
3. Alexander Technique (although she does not think that Alexander
Technique is as complete as Feldenkrais)
4. Use of free body-energy flow (not holding on to tension in the body)
5. The importance of good posture.
6. Balancing and centering the instrument, not gripping the instrument.
7. Inner awareness.
8. Use of core, larger muscles to guide smaller muscles. 
9. Karen Tuttle's coordination exercises.
10. Bringing the instrument to an already supportive stance; not contorting self.