OUCH, It Hurts When I Play (But Please Don't Tell Me To Stop!)
Taking A Look At Musicians Injuries
This article takes a look at
musicians' injuries. For an expert perspective,
I interviewed Dr. Sarah Mickeler, B.Mus., D.C.
Dr. Mickeler is a former professional musician
and a chiropractor who concentrates on
musicians' injuries in her practice. Her research can be found on her website at www.drsarah.ca.
[Linda Dessau] What led you to specialize in musicians' injuries?
Dr. Sarah Mickeler I have a very personal connection to musician's
injuries. I had trained as a classical clarinet
player and it was during my undergrad that I
started to have all sorts of problems from
playing too much and with poor posture.
Unfortunately I was told, as many others are,
that I should just play through the pain and
that maybe it would get better! Of course it
didn't, and it eventually led to the demise of
my career as a clarinetist because I was
totally unable to hold up my instrument. So I
decided to pick a new career that would help
others musicians - and hopefully before they got
to the point that I was at! Chiropractic
appealed to me because of the whole health care
paradigm that it embodies - as chiropractors, we
diagnose and fix the cause, rather than masking
[Linda Dessau] What is different about treating musicians
than treating the general population?
Dr. Sarah Mickeler Often what I tell people who don't understand
the specifics of musicians' injuries is that
"it takes one to know one." As a musician, it
can be very difficult to explain to a physician
or physiotherapist or even another chiropractor
what the mechanics look like when you are
playing your instrument. But when someone comes
into my office and says that they play a flute,
guitar, tuba or whatever, I know exactly
what the physical component of playing their
instrument involves. That is a very important
Secondly, not only do you have to be able to
have a good understanding of what playing that
instrument involves, but you have to be able to
see that person play. Even if someone tells me
they play violin (I automatically think: "ok,
so they will be leaning their head to the left
and have right shoulder problems, etc..."), I
am often shocked to see how over the years of
playing they have contorted themselves into a
little pretzel while they play! So, on the
first or second visit, all of my musicians bring
in their instruments and I do a thorough playing
analysis to see what it is that they're doing
right and wrong. It could be that their posture
is contributing to their injury. Or maybe
there's something about the instrument that we
could change; it might just need a minor
adjustment in the thumb rest or a key
positioning. For instance, I have very small
hands and found it difficult to reach some of
the alternate fingering keys on my clarinet - so
I had them sawed off and re-soldered on in a different direction so I could reach them.
Thirdly, it is important to recognize that there
are some really common reasons for performance
injuries. The most common ones are a change in
repertoire, a change in the instrument (such as
a new mouthpiece or something similar), a change
in practice time or an upcoming recital. If we
can pinpoint what it is that the performer has
been doing differently lately to contribute to
their injury, that helps immensely.
And lastly it is so important to realize,
especially for freelance artists, that you
can't just tell them to take a muscle relaxant
and take a few weeks off. If these people took
a few weeks off, they wouldn't have a roof over
their head or food on the table. While it's
occasionally absolutely imperative that a break
be taken, most of the time I take a holistic
approach to treating performers and change and
fix what we can, within the obvious limitations
of current gigs and upcoming events.
[Linda Dessau] What's the most common injury that you see in your office?
Dr. Sarah Mickeler In my office, there is a tie for the most common
injury. The first is upper back/shoulder/neck
pain - I lump these together because those terms
can mean the same thing to a lot of people -
often someone will come in and say that their
shoulder hurts and point to the pain, but to me
what they're pointing to is actually their
upper back or lower neck. This one is often a
function of poor posture or poor practice
ergonomics. If we can figure out how to improve
the overall posture and ergonomic situation then
this tends to resolve quickly.
And the second most common injury is hand and
arm pain. You would not believe how many people
walk into my office with numb and tingly hands
and fingers - which can be very scary if you're
the one to experience it - to find out that the
problem isn't actually their hands and fingers
at all, but it's a little further up the arm
and can be quite easily treated once properly
diagnosed. Or they come in with tennis elbow -
but they have never held a tennis racket in
their life! In my office, I call tennis and
golfer's elbow "musician's elbow" because it
is a repetitive strain injury. It is really,
really common and surprisingly easy to treat.
[Linda Dessau] What can musicians do to prevent injury?
Dr. Sarah Mickeler First of all, don't be a hero! There is just
no reason to practice for hours on end without a
break. Always remember to take a little break
for every 30 minutes that you are playing.
Secondly, don't play through pain. The pain
signal is there to tell you that you are doing
something wrong. Playing through it is not
going to get you anywhere - other than in more
pain and in worse shape down the road. Thirdly,
be aware of your ergonomics. If you sit to
play, does your chair fit you properly? In
rehearsal, do you have to strain at all to see
both the stand and the conductor? Are your arms
contorted oddly in order to be able to play
properly? This is not good. And lastly, seek
the help of a professional who can not only help
you with the injuries that you are currently
dealing with, but can help you avoid future
injury and optimize your overall performance.
You can find out more about Dr. Sarah Mickeler
and her Toronto-based chiropractic practice
concentrating on musicians' injuries at http://www.drsarah.ca
To echo Sarah's advice, please pay attention to
any pain signals your body is sending you!
Admitting you're having a physical problem
doesn't make you any less of a musician ñ it
means you're a very smart musician with years
of playing ahead of you!!
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