[Dixielandjazz] Fw: Musician Injuries

Dave Gravatt dave at creolejazz.com
Sat Mar 29 14:35:14 PST 2003

Bob, yes, it is an interesting post and I'll throw in my own experience for
the record.

Without going into too much detail, I had played trombone for 25 years and
was in my fourth year at a show in Branson, Missouri when I experienced a
gradual but severe loss of chops. Over an eight-month period, I experienced
less and less flexibility and endurance. Eventually, the stiffness in my
embouchure was so that I could not play any more. I saw five doctors who
couldn't figure out what was happening. Then, I drove to the Rehabilitation
Institute in Chicago and saw a doctor who deals only with musicians and
their medical problems. She told me it was "focal dystonia" and there is no

That was seven years ago.  I was making $900 a week in Branson when this
occurred. Workmen's Comp paid me what was equal to 11 weeks pay and that was
it. No more music career. I dusted off my banjo and made the best of a bad
situation. I miss playing trombone a lot but, hey, otherwise I am healthy --
and for that I am most thankful.

And before anyone writes with a, "hey, my buddy had that and he fixed it
by..." story, no, he didn't have this.

The Creole Dixieland Jazz Band
"It's a treat to beat your feet"
Springfield, Missouri

----- Original Message -----
From: "Bob Romans" <cellblk7 at attbi.com>
To: "DJML" <dixielandjazz at ml.islandnet.com>
Sent: Saturday, March 29, 2003 9:28 AM
Subject: [Dixielandjazz] Fw: Musician Injuries

> Any of you jazz musicians injure yourselves while playing? Or from playing
> too much?
> Long but interesting post.
> Bob Romans
> >From the Washington Post --
> washingtonpost.com
> Tuba Lips, Guitar Nipples and Other Musical Maladies
> By Stephanie Mencimer
> Special to The Washington Post
> Tuesday, March 25, 2003; Page HE01
> Daria White, a 19-year-old sophomore at the College for Visual and
> Performing Arts at George Mason University (GMU), has been playing the
> clarinet since she was 9. Since coming to college, her playing time has
> increased dramatically -- and so has the pain in her wrist, up into her
> and shoulder.
> "My thumb lost feeling for several hours," she says. For a while, White
> couldn't play more than 15 minutes at a time. "That really kills your
> performance," she says.
> She suspects the clarinet itself is to blame. The instrument weighs about
> two pounds -- not a whole lot, you might think, until you hold it up for
> sustained playing with only the thumb and mouth for balance. "Everyone who
> does it has wrist pain," says White. She has seen a number of doctors
> the condition, including a neurologist. She's had a battery of tests, from
> an MRI to painful electromyography, but the doctors can't find any
> explanation for her pain. The medical advice she has gotten so far: Lay
> the clarinet. "That sent me into orbit," she says, noting that the doctors
> don't understand that music is her major and future career, not just
> something she noodles around with in her spare time.
> White's problems are far from unusual. For years studies have shown that
> musicians are at high risk for injury, especially repetitive strain
> that affect the small muscles in the hands. A decade ago, a doctor at the
> National Rehabilitation Hospital in the District surveyed students at
> Catholic University's Benjamin T. Rome School of Music and found that 76
> percent of them had suffered music-related injuries severe enough to keep
> them from playing for more than two weeks. Those numbers mirrored the
> landmark survey by the International Conference of Symphony and Opera
> Musicians in 1986, which found a high incidence of musculoskeletal
> among instrumentalists.
> Some researchers believe those numbers have only gone up because of the
> competitive nature of today's music world, and that injuries are affecting
> younger and younger musicians. Washington area doctors say they see a rash
> of serious injuries in kids as young as 12 and 14 after summer music
> where their playing time jumps to as much as eight hours a day. Hours of
> practice combined with the muscle-stiffening pressures of stage fright
> take their toll on musicians' bodies, says David Sternbach, director of
> GMU's Center for Arts and Wellness, who is trying to integrate injury
> prevention into the university's music curriculum.
> "The practice room is hazardous to your health," he says.
> Don't Ask, Don't Tell
> While movies often cast the geeky kid with the cello as the high school
> anti-jock, playing music can tax small muscles in much the way competitive
> sports strain the larger ones. Jennifer Gamboa, past president of the
> performing arts special interest group of the American Physical Therapy
> Association, likes to refer to musicians as "upper-extremity athletes."
> Gamboa, "A lot of times this is a new concept for musicians as well."
> Musicians' injuries are as numerous as their instruments: fiddler's neck,
> tuba lips, violinist's jaw, horn player's palsy -- even guitar nipples and
> harpist's cramp. The poor bagpiper is threatened by fungus that often
> inside the instrument. And the flutist? "The flute is a biomechanically
> impossible instrument to play," says Scott Brown, chief of the department
> physical medicine and rehabilitation at Sinai Hospital in Baltimore and a
> musician himself.
> Like athletes, musicians tend toward the "no pain, no gain" philosophy of
> practice, craning chin to violin and maintaining other unnatural positions
> for hours on end. Reflecting on the hand injury that derailed his
> concert piano career nearly 20 years earlier, Leon Fleisher told an
> interviewer in 1985, "There was something macho about practicing through
> pain barrier. Even when my hand was exhausted, I kept going. Although I
> thought I was building up muscle, I was, in fact, unraveling it."
> Musicians admit they don't like to talk about injuries and are often
> reluctant to seek medical help. Concert pianist Gary Graffman, whose
> was ended by a hand injury, wrote in 1986, "Nobody wants a wounded
> There is an oversupply of healthy ones. Admitting difficulties is like
> jumping, bleeding, into piranha-filled waters."
> After 25 years with the National Symphony Orchestra (NSO), Milt Stevens,
> is now the orchestra's principal trombone player, has seen many of his
> colleagues felled by injuries, some permanently. Yet he says that
> keep their ailments under wraps for fear of losing their jobs. Right now,
> for instance, with rumors flying that NSO conductor Leonard Slatkin is
> clearing out deadwood, Stevens says, injured orchestra members are "not
> going to go running to [Slatkin] to show him what's wrong. One reason I
> talk about it is, I'm not injured."
> One more reason musicians try to ignore their pain as long as possible:
> They're some of the most under-insured professionals in the country. Once
> they do go for help, though, musicians like White find that their
> frustrations continue in the face of a medical profession that doesn't
> necessarily speak their language.
> Unacceptable 'Remedy'
> Musicians' injuries can be difficult to diagnose and rarely show up on
> X-rays or MRIs, says Brown, who is also past president of the Performing
> Arts Medical Association, a national group of doctors and other medical
> professionals committed to improving performers' health care. Most tend to
> be lumped into the vague "overuse" category that includes other
> disorders like carpal tunnel syndrome. They can still be disabling.
> Tendinitis in the shoulder very nearly ended the career of Max Weinberg,
> drummer for Bruce Springsteen's E Street Band.
> Pianist Fleisher spent 30 years playing only left-handed concerts after
> excessive practice caused the fourth and fifth fingers of his right hand
> curl under and stop functioning when he was 37. Psychiatry, lidocaine
> injections, traction, hypnosis, L-dopa, acupuncture, EST -- you name it,
> tried it. Later, Gary Graffman joined him in making the rounds, seeing
> than 40 doctors.
> In the early '80s, Fleisher and Graffman went public with their stories,
> bringing musicians' health care needs into the open for the first time.
> Until then, many doctors believed such injuries were psychosomatic -- a
> byproduct of the same artistic temperament that some have linked to
> musicians' high rates of substance abuse.
> "The traditional medical community has not been very sympathetic to
> musicians' problems," says Brown. "The usual recommendation is 'stop
> playing,' " which for most musicians is simply not an option." Despite
> recent progress, he says, "Arts medicine is still 20 years behind sports
> medicine."
> Part of the problem is that what may seem like a nuisance injury to most
> people -- such as a strained pinky -- can be a career-ending disability
> a musician. Jan Dommerholt is a physical therapist who played the clarinet
> and saxophone in the Netherlands' military band and now treats musicians
> his Bethesda pain clinic. He says, "Small changes can make an enormous
> difference in a musician. Most health care workers don't appreciate the
> complexity of what musicians do to play their instruments."
> Finding a medical professional who understands musicians' special needs
> be a challenge, particularly in Washington. Daria White's clarinet
> professor, Brian Jones, likens the quest to an "Underground Railroad for
> musicians." While Washington is home to thousands of performers, it is one
> of the few big cities that doesn't have a medical facility dedicated to
> their health care, like New York's Miller Institute for Performing Artists
> and the Cleveland Clinic's Medical Center for Performing Artists.
> Therapy Scaled to Fit
> But help is out there, and musicians say it's worth the effort to find it.
> When injured musicians make an appointment to see Dommerholt, he does one
> thing doctors rarely do: He asks them to bring their instruments. He
> their posture while they play and asks about their work environments. "Do
> they play in the pit and can't see anything so they slump over the music?
> The physical environment of the orchestra pit is abysmal," he says. That
> evaluation often shows that the instruments are the source of the problem.
> Dommerholt says he had one client with myofascial pain syndrome in his
> knuckles; an orthopedist told him he'd never play guitar again. As it
> out, the man had large hands and his guitar neck was so thin that he had
> use a pincher grip to play. Once the man got a wider-necked guitar, the
> problem went away.
> Gamboa says another reason for seeking specialized care is that
> physical therapy doesn't always work for musicians. A pianist, for
> may have pain in the hand and wrists, but trying to strengthen the hand
> muscles with weights or practice drills by Charles-Louis Hanon may only
> the pain worse. Wrist pain, she says, is usually caused by tightness or
> strain in the neck or upper shoulders from bad posture.
> In her Arlington studio, Gamboa tries to improve musicians' posture and
> build their strength and endurance to maintain that posture. She also
> to limit their practice time. But rather than waste her breath telling
> to stop playing, Gamboa offers a substitute -- shadow practicing -- for
> example, playing piano on a tabletop.
> Some musicians have also found relief from alternative therapies. Fleisher
> returned to the stage with both hands in 1996, after discovering
Rolfing --
> a form of deep tissue massage that loosened the muscles in his forearm.
> Others swear by movement training such as Feldenkrais or Alexander
> techniques.
> Three years ago, finger-style guitarist Nicholas Thompson, an editor with
> Washington Monthly magazine, was derailed by wrist pain after playing gigs
> every weekend and practicing two to six hours a day. His doctors treated
> for carpal tunnel syndrome. For 21/2 years, Thompson endured acupuncture,
> steroid shots, wrist braces, massage, huge doses of ibuprofen. At work, he
> tried voice-activated software, a pen mouse, typing while standing up.
> Nothing helped. The last doctor wanted to operate. Thomson declined.
> Recently, he moved to New York, where he saw a doctor who had treated some
> musicians. The doctor referred him to an Alexander technique teacher who
> completely changed the way Thompson played the guitar. The transformation
> was almost instantaneous. "It seems to have cured all my symptoms," he
> Thompson has a new CD out and is touring once more. With what he knows
> he says, "Sometimes I watch other people perform and I think, 'Oh, my God,
> you're going to get hurt.' ".
> Stephanie Mencimer is a piano-playing freelance writer and a contributing
> editor of Washington Monthly magazine.
> © 2003 The Washington Post Company
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