Endurance, precision, and incredible focus. Weeks and months of conditioning and hours of practice every day to prepare for a season of bringing a crowd to a standing ovation.

Are you picturing a day in the life of a football or basketball player? Think again. This is also a day in the life of a professional musician. Just like sporting athletes, musicians endure grueling physical and psychological stress in mastering and perfecting their performance, which can result in disabling injuries that prevent playing an instrument.

If you are a musician experiencing a performance-related musculoskeletal disorder (PMARD) you are far from being alone. As many as 93% of musicians will experience a playing-related injury in their career. The most common affected body regions include (but are not limited to) the neck, thoracic and lumbar spine, and the shoulder, especially in string instrumentalists. Some of these injuries have cause musicians to end their performing careers, but often this outcome does not have to be the case. Here are some things to consider:

-How are you playing?

When you look at your playing technique, what do you see?  How are you holding your instrument? What happens when you play that first note? How do you look when playing a difficult piece versus warm-up scales?

For instance, violinists who are trained in bow grips such as a Russian bow grip may be more vulnerable to wrist pain or carpal tunnel injury than a musician trained in the Bavarian bow grip. Also, your violin neck rest should be adjusted to a height that allows  you to play without excessively tilting your head to the side. With playing any instument, one helpful tip can be to make sure that the joints of your body are in more neutral, non-stressed positions and that regular breaks are taken during long playing sessions. A 5-minute break for every 20-25 minutes of playing is recommended.

-Where are you playing?

Factors such as lighting, room temperature, position of a music stand or position in an orchestral rehearsal can influence muscle tension and sustained postures. Adjusting your equipment, the method used for carrying your instrument, as well as playing in well-lit areas that are not at low temperatures can helpto avoid excessive tension and help your muscles to move more optimally.

-What are you playing?

Playing multiple instruments, multiple genres of music, or making recent modifications to your instrument can also be potential factors in muscle imbalances, decreased endurance, or sustained postures that can become uncomfortable. For instance, many guitar players may experience a change in their symptoms with playing an acoustic guitar versus an electric guitar due to changes in width of the instrument or string tension.

-Are you exercising the bigger muscles?

Research demonstrates resistive endurance training has shown favorable results in helping to alleviate pain and improve playing in musicians. Your physical therapist can custom-build a home exercise program to strengthen and improve muscle quality in the neck, back, and shoulders. We can also incorporate soft-tissue techniques, joint mobilizations, and dry needling to your treatment plan.

Telling Drew Brees to completely give up his career as a quarterback may not be the most effective first line of intervention. The answer for many musicians experiencing pain might not be to “just stop playing.” Advances in the field of performing arts medicine continues and will continue to take the spotlight in physical therapy research. Call us today for an evaluation to see how we can calm your pain, and enhance your technique so you can continue making the beautiful music that enriches our city, and our human experience.

*Special thanks to musician Henry Weber for his contribution to the image used in this blog post.