Why Musicians Get Injured and How Alexander Technique Can Help

Successful musicians have devotion; a strong committed passion that transforms into hours spent practicing alone, additional hours of group rehearsals, often in tight spaces. There are two basic playing options- sit or stand, with some instruments only a stool will work. The finger patterns and sense of touch must be precise and refined day after day. For a professional musician stakes are high, sound is affected instantly by small changes in embouchure, breathing, hands and the rest of the body. A musician’s practice requires consistent refinement and attention. Life as a musician is a life of physical endurance; that causes wear on the body. Alexander Technique is an educational system that teaches the practitioner how to reduce physical strain, allow body movement and find sustainable practices for life as a performer.

Why do injuries happen?

Injuries can happen for a variety of reasons: commanding the body to habitually play the instrument without ample movement, precise and repetitive motion, inability to rest during long rehearsals and the drive to get the music right. Sometimes, a musician can create undesirable habits by imitating an instructor or idol with poor habits or a different body type. As well, many musicians begin to play young; as they grow their body and mind may require a different approach. If you learned to play the violin when you were 8 and are now 45, the conditions of your physical self have changed, as well as how you use your body. The directions you were given may no longer apply, although without realizing you continue to follow outdated advice.

Though repetitive motion is common in many trades, the musicians’ scrupulous conditions and time restraints often force them to continue, even when their body screams- TAKE A BREAK! Musicians have refined their fine motor movements; the fingers, hands and wrists are critical to the outcome of the sound. The larger muscles in the arms, back, torso and legs need to stabilize for an extended period. These two together: refined small movements while large muscles are overworking to sustain a position or hold an instrument can be tiring. The rehearsal requires persistence in that moment and can therefore quickly spiral down, leading to pain and injury.

Injuries common to musicians:

There are two basic injury categories:

  • acute- sudden and short term
  • chronic– pain continues for three or more months

It is possible an injury can be both- “acute on chronic”. There are several injuries in both categories common to musicians: carpal tunnel syndrome, tendinitis, De Quervain’s tenosynovitis, bursitis and strained vocal cords, to name a few. Common areas of pain include back, neck, shoulder, arm and fingers. These injuries frequently occur because of overuse, misuse, lack of muscle support and bad luck. Here is a brief description of each:

Overuse– tightly holding the same physical position for extended periods of time without alternative range of motion options, change or rest causing stress in one or more area of the body.

Misuse– using your body in a way that defies natural physical design. This comes in numerous forms and can happen when you rely heavily on one part of the body without paying attention to the way you are using it or how it affects the rest of the body. Example: concentrating on your finger movement while ignoring the rest of your hand, arm, back and body.

Lack of muscle support- having underdeveloped musculature necessary for holding the instrument or position required. The physical stamina required is not necessarily built through rehearsals alone. Example: a professional athlete building upper body tone would do push-ups and the opposing muscle building exercise; pull-ups.

Bad Luck- being in the wrong place at the wrong time or are subject to something outside your control.

Injuries need to be addressed through various avenues:

Use common sense when addressing an injury: Are you in a lot of pain? Is it affecting your life? Do you wince when executing specific movements? If the answer is yes to any of these, medical treatment is recommended. Other ways to address the injury is dependent on the situation. The acronym RICE lists aid for acute injuries: rest, ice, compress and elevate swollen or injured areas. For some chronic injuries heat offers relief. By finding out what the problem is, it will be easier to address the injury. See a doctor or specialist if the pain is not going away, getting worse, or causing you concern. If recommended, get physical therapy and follow through with exercises, including strengthening exercises for overall physical well-being and pain management. Ask for recommendations- Is the doctor and physical therapist familiar with a musician’s life? Talk to your medical team openly about what you do as a musician. It is important to seek help sooner than later; as injuries get worse they take longer to heal.

I think of a musician as an athlete. Musicians work specific parts of their bodies for hours and injury affects productivity. The difference is that athletes tend to injure themselves through large muscle movements or blunt force, whereas musicians’ injuries are generally caused by fine motor skills or posture positioning. Musicians need to address their injuries just as a runner would their pulled hamstring. Long-term damage can happen if an injury is ignored.

If I am seeing a doctor would Alexander Technique still benefit me?

Yes, Alexander Technique can aid in the healing process. The best way to incorporate Alexander Technique into healing and pain management is to:

  • Identify what causes pain
  • Address how the movement choices can be different (re-mapping)
  • Prevent continual aggravation
  • Prevent compensatory injuries
  • Prevent future injuries from occurring

Alexander Technique can be helpful for preventative injury education, if injured, and in conjunction with medical treatment. Alexander Technique teachers look at your whole body, how you use it and its relationship to your environment.

Whole Body- psychophysical self- you are part physical, mental, and emotional; these cannot be completely separated. Furthermore, the entire body- backside, front-side; top half, bottom half; head, spine, arms, ribs, organs, pelvis, legs, feet; sensing yourself in entirety, instead of focusing on the pain or part in use.

Environment- the world you live in, both macro and micro. The chair you are sitting in, the people around you, the shoes on your feet.

Use- how you manifest physical movement and execute activities. How you fulfill what you do.

While addressing major pain with a doctor you can use Alexander Technique to investigate how you injured yourself, re-educate your body movements around the injured area, address overall body use, and improve your use in the long term. This education can be very helpful in the healing process and as a lifetime study to renew your playing. Incorporating whole body dissolves the juxtaposition of holding large muscles versus unrestricted small muscles. Throughout the lesson you foster the ability to include your environment and direct your thought process. As you heal, you are learning a new way to sit, stand, hold and play your instrument.

What will a lesson address when I am injured?

Generally, there are two major themes that are addressed with an injury. First, the injury is often a side effect of misuse in other parts of the body. So during lessons we integrate your body and movements. For example, a clarinet player is over extending their cervical (neck) and lumbar (lower back) spine to achieve an upright posture. She is also holding her shoulders to create stability while playing. For this student, I would address the relationship between the fingertips and back, all the way down to the feet and how she has ground support from the floor and chair. This would allow movement throughout the player’s back- ribs, spine and arms, changing how her fingers move on the keypads. By eliminating strain in shoulders, neck and head her fingers would feel less restricted. This is a different approach from working locally with how fingers move on the keypads; focusing in on a specific area of the body without attention to the rest. Second, injuries often cause trauma and we protect the injured area by avoiding in some way, this is called guarding. Guarding can be voluntary or involuntary and is a response to pain that leads to new habits, eventually causing new problems. Alexander Technique teachers will help to gently reuse the area in a way that is healthy and will lead to integration of mind and body; whole self. With injuries it is important to have ongoing dialog with your teacher throughout the lesson about pain or discomfort. A large part of the education in a lesson is listening and responding to your kinesthetic awareness (felt sense of self) and not suffering through pain. Movements are usually gentle and non-pushing, yet as you are the one experiencing the situation, you must speak up if you feel pain. A teacher cannot address what is not brought up in the lesson.

What is the time commitment needed to address pain through Alexander Technique?

Alexander Technique can help injuries, although it does not treat the injury specifically. Alexander Technique is not designed to eliminate six months of pain in one 50 minute lesson. If you are coming to the Alexander Technique because of an injury, I will first address the question: What medical resources are you using to manage the injury? For pain related to playing, I will also recommend many Alexander Technique lessons during a short period of time. Three, one hour lessons in one week is not out of the question and at least one lesson a week is important. If you are coming to Alexander Technique for other reasons, lessons can be less frequent. Many beginners come once a week or every few weeks, depending on circumstances. Think about how many hours you have put into training your body to move a particular way. If you are interested in changing these patterns it takes physical re-education, this takes time. The education in Alexander Technique builds upon itself; if you have habits of holding and tension that lead to pain, it will take attention and restructuring the way you think about yourself and use your body.

I cannot necessarily fix your pain today, but over time, you can learn to help yourself and live without or with less chronic pain. If you are pain free, the benefits of the Alexander Technique are still valuable to your playing. Some benefits from long term Alexander Technique study at Kansas City Alexander Technique include:

  • Letting go of a fixed idea of what or where your problem is and finding freedom in relating to yourself in a new way.
  • Identifing ground support and moving from the stability of ground.
  • Approaching familiar activities with a sense of newness each rehearsal.
  • Finding movement understanding within seemingly held positions.
  • Apply playing your instrument and how it relates to your physical structure consistently over time, to enhance your comfort and ease.
  • Integrating inhibition or pausing to include more, a term developed by F.M. Alexander; instead of block out, as is the definition used by Sigmund Freud.
  • Learning to redirect; thoughts guide movement (and cause) action; to change your use, you redirect your thinking.
  • Self directed rest as a part of your daily practice to enhance your body awareness as well as your movement awareness while playing.
  • Body mapping, a technique of learning about anatomy and applying directly to your own movement choices.
  • Breath awareness and understanding.

It is easy to think only about the parts you use most: fingers, arms. There is a system of support within you that is reliable if given attention. Time spent learning about the stability of bones, the strength of muscles, the stacking of organs upon themselves will refine your physical understanding. As humans, we each have the ability to “right” ourselves. Humans were not designed without structure, like an amoeba. Without support in your body, you would be a puddle on the ground. Human bodies are designed to be upright. As a child you sought out this ability and it can be accomplished again without excess effort. The Alexander Technique seeks to regain the ability to relate and respond easily to your musical instrument while supporting your upright stature.

If you would like to talk about Alexander Technique please contact me through your preferred communication: email: kansascityalexandertechnique at gmail dot com, (989)-506-5327, 30 minute tour of the studio with discussion and Q&A or schedule a lesson (fees apply.)