The article examines musicians’ injuries. To get an expert view, I spoke with Dr. Sarah Mickeler (B.Mus. D.C.). Dr. Mickeler was a former professional musician who is now a chiropractor that focuses on injuries to musicians in her clinic.
1) Why did you choose to become a specialist in injuries of musicians?
My personal experience with musician’s injuries is very strong. As a classical clarinet player, I was trained and had all kinds of issues due to my poor posture. As many other people, my doctor told me to just go with the flow and hope it will get better. It didn’t. I ended up losing my clarinet career because it was impossible for me to lift my instrument. It was then that I realized I wanted to find a job that could help musicians, and to hopefully get them to where I am. Chiropractic appealed me due to the holistic health care model it represents – chiropractors diagnose and correct the problem, instead of masking them.
2) Is there anything different when treating musicians than the general public?
People who aren’t familiar with the details of musician’s injuries often forget that I’m a professional. “it takes one to know one”. It can be difficult for musicians to describe to doctors, physiotherapists or other chiropractors the mechanical aspects of playing their instrument. If someone says they have a flute, guitar, tuba or any other type of instrument to play, then I will know what it is. This is an important step.
You must also have an understanding of the instrument and be able watch someone play it. I automatically assume that someone who tells me they are a violin player is: “ok, so they will be leaning their head to the left and have right shoulder problems, etc…”() I’m often amazed at how they can make themselves look like a pretzel during play.
On the second or third visit to my office, I ask all musicians to bring their instruments. Then, I conduct a detailed playing analysis of each musician, in order for me see what they are doing well and where there is potential. You could find that they are causing their injury by their posture. Maybe there is something we can do to improve the instrument; perhaps the thumb rest could be adjusted or the key position.
One example: I am very short and struggled to reach the alternative fingering keys of my clarinet. I sawed them off and had them re-soldered in another direction.
It is also important to realize that performance injuries can be caused by a variety of reasons. Changes in repertoire or instrument, as well as changes in practice or recital time are all common reasons for performance injuries. We can help tremendously if we are able to identify what the performer did differently in recent months to cause their injury.
It is important that freelance artists realize, particularly, that it’s not enough to tell them to stop taking muscle relaxants and to just take some weeks off. These people wouldn’t be able to have food or a roof over their heads if they took weeks off. It’s sometimes essential to take a break, but I tend to adopt a holistic approach when treating performers. We change what is possible, given the limitations of our current gigs.
3. What is the most frequent injury you are seeing in your office?
My office has a tie for most commonly injured. First, the upper back/shoulder/neck/pain – these terms are often interchangeable. Sometimes people will say their shoulder hurts but I see that they actually mean their lower back and neck. It is usually due to poor posture, poor ergonomics or bad practice. This can be quickly resolved if we are able to fix the ergonomic and posture issues.
Hand and arm pain is the most common injury. It’s amazing how many people come in with tingling fingers and hands. Once properly diagnosed, it can usually be treated. They may also have tennis elbow, but never had a tennis bat in their lives. My office calls tennis elbow and golfer’s elbow. “musician’s elbow”It is called a repetitive strain injuries. This is a common condition that’s surprisingly simple to treat.
4) How can musicians prevent injuries?
Don’t try to be the hero. You don’t need to be a hero if you can take a short break every 30 minutes. For every thirty minutes you play, take a short break. Second, do not play through pain. You are being misunderstood by the pain signals. Do not try to ignore the pain signal. It will only lead you into more pain down the line. Third, take care of ergonomics. Do you feel comfortable in your seat when you are playing? Do you strain to see the conductor and the stand in rehearsal? Is it possible to move your arms in a strange way to enable you to play the music properly? It is not a good sign. Finally, get the assistance of professionals who will not only treat the current injuries but also help prevent future injuries and improve your 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.
Sarah advises that you pay close attention to the pain signals from your body. Recognizing that you have a medical problem does not make you a less talented musician. It means that you are a highly skilled musician who has many years ahead!!
This article was originally published on the Muses Muse Songwriter’s Resource website (February 2005) http://www.musesmuse.com.
(c) Copyright Linda Dessau, 2005.