Injury Prevention for Musicians: Neck and Back Edition

Today I wanted to share some of the information I’ve received this year through a series of workshops held at Potter Violin’s shop in Takoma Park, Maryland! These have been offered free and to the public in collaboration with the NOVA Headache and Chiropractic Center’s Dr. Alexander Green. Keep in mind that all the information presented here should serve as a starting place for preventing performance related injuries and should not be taken as a personalized or prescribed plan. I am only a violin and viola teacher sharing what I’ve been told, but I am not a substitute for a doctor who can be familiar with your individual needs. I hope you use this as a starting point in your own practice and gives you some working knowledge when and if you choose to consult with a doctor.

Earlier this year I started to see a handful of workshops on injury prevention being listed on the schedule at Potter Violin Shop in Takoma Park, Maryland. While one of the things I love about living in Hagerstown is the proximity to DC and Baltimore, I often weigh the cost of traveling down against my other job related tasks and put off trips to the area as long as possible. As luck would have it, the first workshop was right around the time I knew my bows needed to be rehaired and I knew a trip to their shop was needed sooner rather than later. But with the added appeal of learning something new I decided to take advantage of the first Injury Prevention workshop and combined my bow errands into one trip. And I was so glad I did! I hope you find some of this information interesting and useful like I did. 

Let’s get the basics first. 

To start off the presentation, Dr. Green walked us through some anatomy 101 beginning with the nervous system. Most of us are aware that this system is responsible for the transmission of sensory information to guide movement and motion. This includes any information about pain or soreness you may feel throughout your body. Pain is a message that your body is being used in a less optimal way than it was designed for and putting more strain on your nerves than it can sustain. It is worth keeping in mind that once your nerves are damaged, you have a 50% chance that it will repair itself.

For this reason we can be hyper aware of any injuries to our back or spine, whose sole purpose is to protect those nerves and avoid that injury. This also introduces the importance of our skeletal system and muscular system – Since the bones of the spine are protecting the nerves in your back, those muscles also need to be prepared to move your skeleton. One of the most important muscles for musicians to be aware of is the trapezius as it helps support the arm, connects the shoulders and connects to the back of the skull. 

Systems are seen above in the following order: Skeletal, Nervous, Circulatory, Respiratory, Digestive and Muscular.

As you might be starting to realize, there are several systems functioning together in our bodies at any given time. Again, for musicians and the purposes of the workshop, we focused on how the nervous, muscular and skeletal systems work together. Ideally, we allow our body’s systems to complement each other in their roles, but throughout the day we may end up in less than ideal positions – Like holding a violin or viola. When these systems are not able to assist each other through the day, the forces acting on your body become much worse increase exponentially the further out of alignment you hold your body.

Some of the symptoms you might see is the development of arthritis from wear and tear, inflamed and swollen joints can develop and prevent healing. This will irritate the nerves and in turn generate any pain we experience. Others might experience bulged or herniated discs in the back. Once you reach the point of a herniated disc, you can expect surgery to be offered, but with failure rates up to 40%, it is best to catch these ailments before they get that far. 

In short, the study of biomechanics can really help us inform how we hold ourselves and what remedial tasks we can complete to counteract these unnatural movements. 

So what can we do?

Throughout the workshop, several attendees provided some scenarios from their own experiences and asked questions throughout. This lead to some great discussion as Dr. Green provided us some tips and exercises to put into our practice routines. Below I’ll try to outline the primary recommendations from the day. There is always going to be a degree of wear and tear as you go through life, whether you are a violinist, office worker, bus driver or anything else. But the goal is to delay and prevent this wear as much as possible. 

Posture

Throughout the day, check your posture. Many of us allow ourselves to slouch through the day as we type on computers, text on our phones and drive in our cars. Remember that when you have soreness or pain, it is there for a reason. What could your body be trying to tell you? Playing the violin and viola are physically demanding activities, with several quick and repetitive motions involved. But if you can maintain a good posture outside of the time you are playing an instrument you are already at a significant advantage!

So what does this look like? Focus on your head position. Is it lined up with your shoulders? Are you holding your back in a straight line? Or are you slouching? When another attendee asked about the inclusion of yoga in a musician’s routine, Dr. Green also recommended that any practice that improved body awareness like yoga or tai chi would be a good help in improving a person’s posture.  I found this “Guide to Good Posture” article with a some good visuals indicating ideal posture on Medline Plus. Take a look and I bet you’ll find yourself sitting up straighter more throughout the day!

Bruegger’s Maneuver 

One specific motion Dr. Green provided us on that day was the Bruegger’s Maneuver. I’ve shared this motion with a handful of students since the workshop and I’ve noticed this makes a significant impact in my own practice time and body – When I remember to do it! Let’s promise to incorporate this into schedules this week together, eh? If you would like a printed reminder that you can include in your instrument’s case or in your practice room, I found this article to be very helpful in covering the basics. 

If you would like a video to see the motion in action, I also found this video to cover the same points from Dr. Green’s workshop. 

Foam Roller

This one has been my favorite to incorporate by far! You may be familiar with foam rollers in the context of runners using them to work out tired muscles, which is certainly how I viewed foam rollers before attending this event. After this workshop, I went out to find my own foam roller though and it has given me the most relief for when I have acute back pain. Foam rollers are designed to aid and maintain mobility for everyone, not just serious athletes. Keep in mind when you use a foam roller on your back, use multiple part of your body to complete coupled motion. As you roll the foam roller along your back, go slowly and feel free to hang out in one spot or another. Do not give into the temptation to go up and down your back over and over again like a rolling pin to some cookie dough though! This will only aggravate your back more. For a sample of how to use a foam roller on your bag, I found this handy video on Youtube as well. While it shows more rolling than recommended during the workshop, many of the other points agree with what Dr. Green demonstrated during our workshop. 

Herbal Supplement: Turmeric

One final recommendation from the day was including the herbal supplement turmeric into your routine. Studies show that taking 1 gram or more a day can have the same effect as taking other anti-inflammatory drugs like ibuprofen without the negative side effects. This can be great news for those of us who have chronic inflammation that needs some assistance in getting relief. For more information about the benefits of taking turmeric, you can check out this article I found on HealthLine. Including turmeric into your daily vitamin or medication regimine may be a great idea for you, but check with your doctor, as it doesn’t mix well with some medications. 

Going into this workshop, my primary concern was getting some new tools to deal with some chronic back pain I have. While I have long used yoga and regular massaged to help alleviate the symptoms, I’ve been giving the other recommendations a try since April, too! I have experienced some significant relief after using these tips and tricks, so I hope you find them useful in your own practice! It is always best to start having done these things before you experience any soreness or pain, so go ahead and give these a try today. 

Over the next couple weeks I hope to share more information from the two other workshops I’ve attended at Potters on hand and wrist pain as well as performance anxiety. Is there anything in particular you’d like to know? Let me know in the comments and I’ll be sure to include any pertinent information I’ve received.

Happy practicing!