Below, you will find a listing of various prevention methods that can help prevent musculoskeletal performance-based injuries. Each section includes an active link to help you learn more and a brief description of the prevention method.
Alexander Technique: The Alexander Technique is a method of learning to carry your body in a natural way without tension while playing your instrument or singing. A lot of what Alexander Technique involves is unlearning bad habits you have developed throughout your pedagogy pertaining to posture, hand position, etc. as well as learning to free held tension in your body during your everyday life. For more information, visit https://www.alexandertechnique.com/at.htm
Body Mapping: Similar to Alexander Technique, Body Mapping is "the term given by William and Barbara Conable to the process of constructively applying an understanding of anatomy to improving how we move" (https://www.alexandertechnique.com/articles/bodymap/). It is a method to correct and refine your "body map" in efforts to produce efficient, graceful, and coordinated movement. Your body map constitutes your self-representation in your brain and your assumptions or conception of what your body is like, whether it is in whole or part. For more information, visit http://bodymap.org/main/
Body Tuning: Body tuning is a specific type of injury prevention and treatment method that incorporates a combination of physical therapy, manual medicine, and therapeutic modalities from both the Eastern and Western traditions. This treatment method is mainly specific to artists and musicians, and it is both spiritual and physical in nature. The therapist begins by first targeting and treating the area of injury, and then proceeds to prescribe suggestions for the patients general health and lifestyle once the area of injury has been treated properly. For more information, visit https://www.nyphysicaltherapist.com/blog/2007/08/alternative-treatments-can-benefit-musicians-body-tuning/.
Feldenkrais Method: The Feldenkrais Method is a method to become more aware of your habits and any tension held in your body while performing daily tasks in order to develop new, healthier ways of moving in your everyday life. Practicing the Feldenkrais Method regularly can not only benefit your instrumental playing but can also help to regulate your emotions, increase your range of bodily motion, heighten your overall thought-process, improve your flexibility, and most importantly prevent musculoskeletal injury. For more information, visit https://www.feldenkrais.com/
Yoga: Yoga is a physical, mental and spiritual practice that originated in ancient India and has since been popularized and adapted to many different cultures. In Western cultures, the practice of yoga is accessible to people of all religious and spiritual backgrounds. It is now considered to be a physical exercise with emphasis on spirituality and meditation, and it can also serve as physical therapy to "strengthen and balance all parts of the body". Many studies show that yoga can also improve one's mental health, reduce stress and treat injury. For more information, visit https://en.wikipedia.org/wiki/Yoga.
I have been an active practitioner of yoga for the past 8 years, and throughout my studies in college I have found some favorite "YouTube Yogis" that I highly recommend for those of you who do not have enough time or cannot afford to attend yoga classes. These channels present 20-30 minute yoga videos for quick sequences to relieve stress and tension, and longer 60-90 minute videos that go through full ashtanga and vinyasa practices.
Fightmaster Yoga: https://www.youtube.com/user/lesleyfightmaster
Yoga with Adriene: https://www.youtube.com/user/yogawithadriene
(this channel also has a 25-minute video specifically for relieving tension in musicians: https://www.youtube.com/watch?v=NXEoc1kN4yo - highly recommended!)
I have also recently discovered an amazing project specific to musicians created by Claire Howard, a Texas-based flutist and yoga instructor, titled “Practice Room Yoga”. Claire creates short yoga videos targeted towards musicians and exercises/poses you can do during your practice breaks. To check out her videos, visit https://www.practiceroomyoga.net/ and subscribe to her YouTube Channel, “Practice Room Yoga”!
If you are seeking a yoga center near you to attend classes, please visit the treatment centers page on this website and type in your zip code.
Massage Therapy: According to the Northwestern Health Sciences University, Massage Therapy is "manual manipulation of soft body tissues (muscle, connective tissue, tendons and ligaments) to enhance a person’s health and well-being." Getting a professional massage can help to reduce stress, tension, anxiety, and can also help to reduce pain and provide a form of rehabilitation for injury. If you are seeking rehabilitation, look for massage treatments titled "deep tissue", "medical", "therapeutic", or "clinical". It is very important to let your massage therapist know before the appointment where on your body you are experiencing pain, the type and severity of the pain, and whether or not you have been diagnosed with any injury. While massage therapy can become expensive, booking an appointment every 2-3 months can be very beneficial to injury treatment and prevention. For more information, visit: https://www.nwhealth.edu/school-of-massage-therapy/massage-therapy-definition/
To seek certified massage therapists in your area, visit the treatment centers page on this website and type in your zip code.
Physical Therapy: Physical Therapy is a rehabilitation process for a patient diagnosed with a musculoskeletal injury, disorder, disease or condition. Most insurance plans include Physical Therapy if the patient is officially diagnosed by a doctor and receives a prescription. Physical Therapists are qualified to examine the patient's injury, evaluate their needs for treatment, create a treatment plan for the patient, and assist the patient in regaining mobility of the affected area as well as providing prevention methods for future injury. I have been in physical therapy for one year, and it has benefitted me tremendously. After being diagnosed with tendonitis of the forearms and shoulders, I have been working with my physical therapist to build strength in areas where I was overcompensating for previously while playing my flute, and I have been working on building and maintaining a healthier posture while playing. For more information, visit: https://www.moveforwardpt.com/Default.aspx
To find a physical therapist in your area, please visit the treatment centers page on this website and type in your zip code.
Stretching and Taking Practice Breaks: Taking practice breaks is absolutely essential in preventing injury. Too often, we are guilty of "playing through the pain" in hopes to improve as much as possible in one practice session. While this may seem like the hard work you are expected to be putting in, you are actually harming yourself and possibly contributing to a serious injury in the future. Any sort of pain you experience is a warning sign of overexertion in your muscles, and it is important to respect to your body's requirements and rest when you need to. At first, this will seem unproductive (trust me - I am the queen of productivity and this was very hard for me at first), but as you become more comfortable with taking breaks you will find it may be easier to become more efficient in the time you are practicing. For example, assign 20-30 minutes to learning one page of your concerto very well, with great attention to detail, phrasing, the shaping of each note, etc. Once this time is up, move onto the next task on your practice to-do list and repeat. Practicing in shorter intervals with great concentration can help you keep on track and get a lot more work done.
Taking breaks is unrealistic sometimes in performances and rehearsals, but any time you are not playing try to hang your arms down by your sides to let them rest. According to Janet Horvath's book Playing (Less) Hurt (linked below), dangling your arms by your sides for just one minute can restore and rejuvinate your muscles up to 80%. Additionally, stretching before practicing, rehearsals and performances can greatly reduce your risk of injury, release a lot of tension, help to calm your nerves, and even open up your sound for us wind players. For examples of stretches you can do before you play, check out this article published by International Musician: https://internationalmusician.org/stretches-that-every-musician-should-do-before-playing/
Heating Pads/Massage Buddies: While heating pads are typically seen as products to help treat pain and injury, they can also be very beneficial in preventing injury if you use them just before a practice session. Placing a heating pad for 5-10 minutes on the area where you feel the most strain in your playing (ex. upper back, mid-back, shoulders) can help to warm up your muscles and slightly reduce your risk of injury. Self-massaging your affected area or using a "massage buddy" (https://www.amazon.com/Body-Back-Original-Trigger-Therapy/dp/B0006VJ6TO?th=1) can also help to loosen built-up tension in your muscles, which can contribute to injury prevention as well. Be sure to read the instructions before using this massage tool and stop immediately if you experience sharp or shooting pain.
When I know that I am about to go into a long rehearsal, I have placed heating patches or pads on my affected areas which provides a temporary relief and a degree of injury and pain prevention. You can find heating patches at local drug stores in a variety of different sizes and types. Be sure to read the directions before using these products also and do not leave them on longer for the recommended amount of time on the packaging.
What NOT to do: While painkillers provide a quick relief and can get the job done to relieve pain right before a major performance, audition, etc., it is very easy to become reliant on them to solve your pain problems long-term. Painkillers do NOT prevent or treat injuries, and taking them too frequently can put you at risk for addiction and also be very harmful to your kidneys and liver. While the occasional usage of them in moderate-to-severe situations is acceptable, try out some of these other methods of pain prevention first to see if you can relieve your pain in a more natural way. These methods can also help provide long-term injury prevention and can help you to learn how to carry and move your body in the healthiest way possible.
Check out these additional resources for more information about injury prevention:
Dr. Aviva Wolff, Hand Therapy for Musicians. A New York City-based occupational therapist who specializes in hand and upper extremity injury treatment in musicians and has a background in motor control and movement analysis. Visit her website and contact her for a consultation at https://www.musichandstherapy.com/
The Musician’s Essential Exercises by Angela McCuiston