Musicians and Injuries

Instrumental musicians are a special risk group for repetitive motion injuries. Sizable percentages of them develop physical problems related to playing their instruments; and if they are also computer users, their risks are compounded and complicated. My own computer-induced tendinitis was very much aggravated by my guitar and violin playing and did not begin to improve until I stopped all playing for several months.

Instrumental injuries often include the same conditions experienced from computer overuse : Carpal Tunnel Syndrome , Tendinitis, Bursitis , Tenosynovitis / DeQuervain's Syndrome , Tendinosis , Thoracic Outlet Syndrome, Myofascial Pain Syndrome, Cubital Tunnel Syndrome, and Trigger Finger/Thumb are particularly common among keyboardists, fretboardists, flute, and string players. But the particular demands of different instruments produce other problems as well, including hearing loss or TemporoMandibular Joints Disorder . (Note this new site from the TMJ Association ). Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain, disability, and the end of careers.

But while these problems are unfortunately common, it's NOT an unavoidable part of being a musician. If we're willing to listen to what's being learned in the field of arts medicine, we may be able to escape the bullet of occupational injury and recover our ability to play.

What Can You Do?

• INFORM YOURSELF. Take time to read the resources listed below. Causes and prevention are a complex topic, as Jonas Sen's excellent thesis makes clear.

• EVALUATE YOUR TECHNIQUE. Again, the materials listed have much more information, but in general musicians often need to reduce force, find postures that keep joints in the middle of their range of motion, use larger muscle groups when possible, and reduce body usage that involves fixed, tensed positions.

• ALWAYS WARM UP. Athletes do not abruptly start vigorous physical activity without warming up and stretching because they know it is an invitation to injury. Musicians are putting athletic demands on fine motor musculature and should similarly be religious about warming up before practice or performance.

• TAKE LOTS OF BREAKS TO STRETCH and RELAX. This means both momentary breaks every few minutes and longer breaks every hour or so. This may be the single most important thing to remember. Constant tension and repetitive motion does not allow the body to flush away metabolic waste products and this is traumatic to tissues over time. Even in the middle of playing a piece you may have a moment to relax a hand or arm to restore circulation. The marathon rehearsals that musicians pride themselves on have great potential to hurt us. Emerging research on athletes reveals that overtraining actually decreases performance. Try two or more shorter rehearsals in a day rather than one long, intense session, and limit total time on your instrument.

• PACE YOURSELF. It is very common for musicians to notice injury when we are...
  • preparing for recitals or concerts
  • attending music camps
  • heavily involved in multiple musical groups
  ...not surprising, because all of these can radically increase our playing time and exceed the limits of our body. (Yes, even for young people, who feel invincible. I have seen more than one gifted high school string player in my city seriously injured in this way.) Learning to pace ourselves and learning to say "No" to some playing is critical.

• GET MEDICAL HELP. Therapists and doctors know that musicians are notoriously hard to persuade to reduce or stop their playing to allow injuries to heal, and some instructors (or even parents) may tell students to ignore pain, or accuse them of trying to avoid practice. But "No Pain, No Gain" is a disasterous policy for a musician. If it hurts, back off. THIS IS SERIOUS STUFF: is it worse to have to not play for a few months . . . or to risk a permanent injury, disability, pain, and never playing again? Also, I hear of musicians with pain who are afraid to see a doctor because they may find out they have a difficult injury. It's better to know the truth and do something about it. Don't put off seeking treatment if you are in pain. Use the FindADoc Web page to locate knowledgeable medical care.

• EVALUATE OTHER ACTIVITIES. Your problems may be caused or aggravated by other things you do frequently. Computer use is a notorious example, but sports, carrying children, hobbies, and excess effort/tension in other daily things may have enormous impact too.

• PAY ATTENTION TO YOUR BODY. Pain is your body yelling that it's in big trouble, but learning what is comfortable or awkward for your body before you're in pain may prevent injury. "Physical re-education" through The Feldenkrais Method, T'ai Chi, yoga , The Alexander Technique , stretching, or dance classes all may be helpful.

• CHECK OUT YOUR INSTRUMENT. Are you using an instrument that is too large or awkward for you? Is it set up optimally for you? Tiny differences in playing action or tension can make a HUGE difference. Could you use lighter strings or reeds? Is there a strap or stand that could make playing less stressful? If it's big and heavy (like a string bass), can you get a cart to help transport it? And remember: if it is a new instrument, especially a larger one, you need to take time to adjust to it before you plunge into intense use of it.

• BE CAREFUL WITH STRENGTHENING METHODS. Building up muscle strength with special devices (GripMaster, putty) or musical exercises (Hanon) is very controversial. If you are already injured and in pain, such things may make it worse. And overdoing musical exercises while using bad technique, poor posture, or too much force may only speed you along to trouble. On the other hand, if you are not yet injured, or are undergoing rehabilitative therapy, properly conditioning muscles may help prevent injury or re-injury. Be patient in building strength, and talk to a qualified doctor or physical therapist.

I'll be putting more information here as I am able, but for now I highly recommend looking at some of the resources listed below. If you have pointers to similar literature, especially ergonomically oriented instrumental methods, or just have a tip or two of your own on safer techniques and injury prevention/recovery, drop a line so it can be added here. Please note that authorities in this area of study have differences of opinion about points of technique, treatment, or prevention: read as much as you can for the balanced view. Please note that several of the "reviews" below are written by persons other than myself: these have quotation marks and attributions to distinguish them. -Paul Marxhausen

Books . . .

Too Many Titles?... I know it is an very long list of resources. One reason I just keep adding new titles as they are brought to my attention is that it increases the odds that you will be able to find some of these in your local public or institutional libraries, where you can read them for free. Always check there first!

• MUSICIANS' INJURIES: A Guide to their Understanding and Prevention.
  . by Nicola Culf

  ISBN 1-898594-62-7 1998 Parapress Ltd, Guilford

  Nicola Culf has done musicians everywhere a service by packing into one slim volume (100 pages) a succinct and comprehensive account of the risk for injuries among musicians, and the means by which such injuries can be avoided. This contribution is notable in that it covers the whole range of music making; touches on every aspect of the problem, including practice habits, pain management, technique issues, recovery; and presents a wealth of fundamental, critical information quickly, efficiently, and readably.

  I would hope that the economy and accessiblity of Culf's writing make this a title widely read in our music schools as a matter of routine, and not simply a title that instrumentalists who are already injured and alarmed seek out after the fact.
  This book can be ordered online at www.parapress.co.uk or mail-order from : Parapress Ltd, The Basement, 9 Frant Road, Tunbridge Wells, Kent TN2 5SD (UK), Tel:(01892) 512118

• THE MUSICIAN'S SURVIVAL MANUAL:
  web A Guide to Preventing and Treating Injuries in Instrumentalists.
  Richard Norris, M.D.
  International Conference of Symphony and Opera Musicians, 1993. ISBN 0-918812-74-7
  MMBMUSIC,INC. Tel: 314 531-9635; 800 543-3771 (USA/Canada) ST262 $16.95 Web Site here.

  "The book is aimed at an audience of performers. It has chapters on recognition and prevention of injuries, thoracic outlet syndrome, some of the nerve entrapment syndromes, tendinitis, also "therapeutic exercise for musicians" and "returning to play after injury", among others. Very readable." (quote from Ann Chukurian) It had important insights for me as a musician, and much also applies to computer users. Musicians who are computer users need to read it. Here's the Table of Contents

  Appendix B (a list of performing arts clinics) from this book is included on my FindADoc list.
  Order MUSICIAN'S SURVIVAL from Amazon . . .

• "My current all-purpose recommendation for physical issues is Julie Lyonn Lieberman, YOU ARE YOUR INSTRUMENT, which covers all the mental/physical side of music, with lots of suggestions, physical exercises, and references to everything from chiropractic to yoga - she has done a lot of work with doctors on the physical side of musical performance. worth the money." (quote: Dave Sanderson)
  Huiksi Music, PO Box 495, NY NY 10024-3202 ISBN 1-879730-20-0
  [Note: I've read this book, and I agree with Dave. The book has great breadth and accuracy, funky but superb illustrations, and references for the additional reading musicians will want to do. - PMx]
  Order YOU ARE YOUR INSTRUMENT from Amazon . . .

• THE ART OF PRACTICING: A Guide to Making Music from the Heart
  Madeline Bruser
  Bell Tower, 1997 ISBN # 0609801775
  If a musician could only read a single book to learn about how to PREVENT injury, this would be the one. Madeline Bruser has assembled, from a host of resources (many listed on this page) terrific practical advice that does far more than help you find a healthy approach to using your instrument: The Art of Practicing also examines how to bring the highest level of artistry and communication to your playing. It includes question/answer sections throughout and instrument-specific advice. I really can't say enough about this book: if all teachers and students would take its guidance to heart, we would not have the levels of injury among musicians we now see, and music making would be both more human and humane. Excerpts and information is on her website.
  Order THE ART OF PRACTICING from Amazon . . .

• TEXTBOOK OF PERFORMING ARTS MEDICINE
  Sataloff, Brandfonbrener, Lederman, eds. New York: Raven Press, 1990.

  "The textbook is more for health care people. It has information on how to diagnose and treat many problems performers have, including tendon/muscle problems, also things like hearing loss, vocal nodes, and problems specific to dancers. I found it very useful when I was first starting to research my problems ("tendinitis" in forearms), especially when I needed to tell the doctor what to do. ...(has) extensive bibliographies. If your library doesn't have it, you could request that they be borrowed for you via interlibrary loan." (quote from Ann Chukurian)

  Note: this book is connected with the quarterly journal MEDICAL PROBLEMS OF PERFORMING ARTISTS, which can be found in some University libraries.
  Order TEXTBOOK OF PERFORMING ARTS from Amazon . . .

• PLAY IT SAFE: A Health Resource Manual for Musicians and Health Professionals
  by Christine Zaza, ARCT, BMus, MSc, PhD
  available from the Canadian Network for Health in the Arts
  The author sez:
  "Play it Safe" provides reseach-based information on musicians' health problems:
  • information on symptoms, risk factors, treatments, and prevention of playing-related health problems (including musculoskeletal disorders, hearing loss, performance anxiety, and other health problems).
  • an International Directory of health professionals who specialize in treating musicians' injuries
  • listing of health resources (books, videos, Internet sites, organizations etc.)

  The book sells for $19.95 US + $3.50 shipping and handling - order forms can be printed from the CNHA web site.

• THE MUSICIAN AS ATHELETE: Alternative Approaches to Healthy Performance
  by Dorothy Bishop
  Web Site here . . . Susan writes: "...written in 1991 by Dorothy Bishop, a Calgary, Alberta based cellist, teacher and herbalist and published by Kava Publications, 111-32nd Ave. N.W. Calgary, Alberta, Canada, T2M 2P7. She describes in great detail the physiological problems that can develop for musicians and approaches treatment primarily from a nutritional/herbal perspective, although she evaluates all manner of conventional and experimental treatments." Buy from Web Site

• ON PIANO PLAYING
  Motion, Sound, and Expression
  Gyorgy Sandor
  Schirmer Books, NY 1981 ISBN 0-02-872280-9

  This remarkable book is perhaps the most outstanding written resource available to pianists pursuing efficient, effective, pain-free technique on their instrument. In a little over 200 pages, Sandor provides an exceptionally thorough and readable analysis of piano technique with ample diagrams, photographs, and musical samples. At every turn he displays a detailed understanding of human physiology and the means to use it to produce musical effect without excess strain and effort. Very impressive, very accessible, it's a "must-read".
  Order ON PIANO PLAYING from Amazon . . .

• WHAT EVERY PIANIST NEEDS TO KNOW ABOUT THE BODY
  Thomas Mark
  Gia Publications ISBN 1579992064

  I haven't read it but I've read an article of his that tells me he knows his stuff. He's also got a bunch of good info at www.pianomap.com.
  Order WHAT EVERY PIANIST from Amazon . . .

• ' . . .A new book authored by classical pianist Stephanie Brown has tips for avoiding repetitive stress injuries, applicable to both computer and musical keyboards. "The Hand Book" uses clear and simple language to describe righ and wrong positions in keying, with easy-to-remember names for no-nos, such as the "spider" and "cobra" positions. Brown recommends allowing wrists to "float" above the keyboard, and hands and forearms should follow a natural line ("relax into the rainbow"), rather than being held too close to the body or arched out like chicken wings. The book is available from Ergonome (800) 222-6996. (St. Petersburg Times 7/3/95 A8)' Also can be ordered from 212-222-9600. $19.95

  More reviews of the book and info about the upcoming "Keymoves" software based on the book can be read here.

• PIANO POWER:A Breakthrough Approach To Improving Your Technique by Richard Prokop
  Web site here.
  I have not read this book but from the description and reviews from both musical and medical professionals it sounds like it is a useful resource. (Though at least one reviewer at Amazon dissents.) Read it and send me a review . . .
  Order PIANO POWER from Amazon . . .

• TENSIONS IN THE PERFORMANCE OF MUSIC : a symposium edited by Carola Grindea ; foreword by Yehudi Menuhin ; preface by Allen Percival London : Kahn and Averill, 1978. An excellent collection of articles on physical and mental tension in music with implications for injury. Includes: String Playing - Kato Havas; The Conductor - Vilem Tausky; The Composer - Alfred Nieman; Voice Production - Walther Gruner; Actors & Opera Singers - Leigh Howard; The Alexander Technique - Nelly Ben-Or; Piano Playing - Carola Grindea; Clarinet Playing - Gervase de Peyer; A Psychologist's Perspective - Paul Lehrer
  Order TENSIONS from Amazon . . .

• LEARNING THE CLASSIC GUITAR, Part I Aaron Shearer Mel Bay Publications, Inc. #4 Industrial Drive, Pacific, MO 63069-0066 Toll Free 1-800-325-9518 FAX (314)257-5062

  This prestigious teacher had his own concert career ended by tendinitis. In this book he gives invaluable advice on learning how to play without injury through proper positioning, technique, and practice habits. Even experienced guitarists should consult this. Includes sections on: Conditioning and Coordination Exercises, Procedure for Stretching Exercises , Economy of Movement, and an entire chapter dealing with Repetitive Strain Injury. Here's a quote about the Four Principals of Efficient Muscle Function.
  Order LEARNING THE CLASSIC GUITAR from Amazon . . .

• CLASSIC GUITAR TECHNIQUE: Process and Essence Christopher Berg Mel Bay Publications, Inc. #4 Industrial Drive, Pacific, MO 63069-0066 Toll Free 1-800-325-9518 FAX (314)257-5062

  The author sez: "It is the only guitar technique book, to date, that discusses the relationship between the requirements of a musically sensitive technique and the physiological capablilities of the body. I also integrate some of the concepts developed by Feldenkrais and F.M. Alexander."
  Order CLASSIC GUITAR TECHNIQUE from Amazon . . .

• THE PHYSIOLOGY OF GUITAR PLAYING by Ricardo Iznaola
  International Centre for Research in Music Education

  Ricardo Iznaola's "The Physiology of Guitar Playing" is markedly different than many of the titles emerging on the topic of healthy, effective musicianship. As a text, it is not structured towards the popular audience but is purposefully aimed at providing detailed, focussed information to guitar teachers. The text includes a short course in human anatomy with a focus on the musculoskeletal and nervous systems, with particular comments on those components that are key elements in guitar playing. Another departure is that the author, having explained many aspects of bodily function, does not proceed to develop a detailed and exhaustive prescription for technique. The examples he gives instead point out how rigid formulas and dogma in regard to technique do not adequately take into account the constantly changing positions in playing guitar, or the variations in human anatomy between players. Instead of producing yet another "guitar method", Iznaola supplies the guitar teacher with resources, valuable background information, and challenges.

• THE WHOLE GUITARIST
  by Peter Inglis
  I haven't read this but the Web site and comments by the author on-line demonstrate an approach to the guitar rooted in the Alexander Technique and an awareness of the body.
• ERGONOMIC GUITAR TECHNIQUE
  Joakim Zelmerloow
  Lulu.com January 2012 ISBN 1471062058

  Author's Website.

  "The book is for classical guitarists who want to improve their guitar technique while preventing injuries. It deals with physical as well as psychological factors that are relevant for ergonomics, physical and psychological strain, stage fright etc. and comprises fifteen chapters divided into three main parts; psychology, ergonomics and technique."
  
  Order ERGONOMIC GUITAR TECHNIQUE from Amazon . . .

• THE ATHLETIC MUSICIAN : A Guide To Playing Without Pain Barbara Paull and Christine Harrison

  A review on Amazon.com says the following: "Every musician who wants to avoid a playing injury or is recovering from such an injury should own this book. This is not a read-once book but a book to use and refer to until one has it memorized. It gives easy-to-follow instructions for safe warming up, exercises and stretches to do at home and even some for doing on stage, ways to avoid injury and means to stay healthy when one has recovered. The psycological and social aspects which confront injured musicians are sensitively dealt with in "The Athletic Musician". The title already tells us that this is a relevant approach to treating the subject of musician's health. Read it, it could save your career!" Alan sez: "YEAH, I DID READ THE BOOK. IT'S NOT BAD. THE BOOK WAS WRITTEN BY A PHYSIOTHERAPIST (...) AND A VIOLINIST. THEY OFFER SOME GREAT ADVICE ON THE ERGONOMICS OF PLAYING YOUR INSTRUMENT. THEY ALSO DISCUSS HOW MUSCLES INTERACT WITH EACH OTHER....AND HOW ONE CAN BECOME MORE DEVELOPED THAN IT'S COUNTERPART...CAUSING PAIN. VERY INTERESTING STUFF!"

  The authors also run the The Stouffville Musicians' Injuries Clinic , provide treatment, consultations, and workshops.
  Order ATHLETIC MUSICIAN from Amazon . . .

• PLAYING (less ) HURT:An Injury Prevention Guide for Musicians.

  Janet Horvath

  I haven't read this book myself, but as you can see from the website, it comes highly recommended by some Big Names in the realm of healthy musical technique. Sounds good! If you read it send me a review.

• FIT AS A FIDDLE: The Musician's Guide to Playing Healthy by William J. Dawson, M.D.

  While I haven't read it, I note that the author is both a medical doctor and a symphonic basoonist, and has served as president of the Performing Arts Medicine Association, so I assume he's got some good things to share. A reviewer notes that he touches on a subject not often covered, the issues of aging musicians. I just hit 54 myself, maybe I better get my hands on a copy.
  Order FIT AS A FIDDLE from Amazon . . .

• NEW DIRECTIONS IN CELLO PLAYING: How to Make Cello Playing Easier and Play Without Pain Victor Sazer Ofnote Publishers, P.O. Box 66760, Los Angeles, CA 90066; telephone 310.391.9787; fax 310.391.1251.
  Web Site here.

  The author explains: "Directions in Cello Playing introduces natural, tension-free ways of playing the cello. It presents anatomically-improved ways of sitting and holding the cello, a new approach to left arm and hand techniques and fundamentals of bowing. It also addresses musicians' pain problems, including causes of pain, types of injuries and pain prevention."
  Order NEW DIRECTIONS from Amazon . . .

• BODY MAPPING FOR FLUTISTS: What Every Flute Teacher Needs to Know About the Body Lea Pearson, DMA
  2007 GIA ISBN 978-1-57999-500-3
  Website: FLUTIBIA

  The author sez: "Flutists all over suffer from sore backs, neck aches, hand problems and inadequate breathing. Now there is a book that can help determine the causes of these problems and offer practical, easy-to-understand solutions. Body Mapping for Flutists contains information about the body that can help you prevent pain and injury and enhance performance, including: Balance in standing and sitting - How to use arms to prevent injury - Free and supported breathing - Anatomical information on how the body works - Training the kinesthetic sense - The importance of movement for musicians - Practical exercises for students and teachers

  Also good information on her Website: FLUTIBIA
  Order from Amazon . . .

• ESSENTIAL BASS TECHNIQUE Peter Murray

  "The book is a 52-page in-depth exploration of the essential elements of bass guitar technique . . . focuses on how to practically train your hands to play with efficiency--which will in turn benefit your chops, tone, endurance and flexibility." (This book is exceptionally well researched and packs a lot into 52 pages. It really is "essential." - PMx) 08/02/2002 - The author sez the 2nd edition is now out. - PMx
  Order from Amazon . . .

• "...I believe very strongly in the principles set out by Tobias Matthay early this century and published by Oxford University press.They are not easy to read for most Americans but his FIRST PRINCIPLES and THE VISIBLE AND INVISIBLE IN THE ACT OF TOUCH might have an answer for you. The way you use your body determines what happens to you, the piano, and the music. If you have physical problems, you're doing something wrong. Fundamentally you're either working against your body's natural way of working, or the piano's natural way of working." (Lisa Thein)

  It appears that there is an American Matthay Association with a Web page, check it out for contacts with persons involved in training based on Matthay's work.

  TITLE The visible and invisible in pianoforte technique, being a digest of the author's technical teachings up to date, by Tobias Matthay.
  AUTHOR Matthay, Tobias, 1858-1945.
  PUBLISHER London, New York, Oxford University Press [1960]
  Note: Matthay's books appear to be available through the on-line Advanced Book Exchange.

• PIANO TEACHER'S COMPANION.
  Guy Maier.
  NY: Belwin Mills Music, [c1963].
  Steve writes: " I have read much about Matthay, yet we had at one time here a teacher whom, I believe, made the many of the prinicples that Matthay was trying to get across in his volumes, simple and understandable for simple folk to understand.. and with humor. His name was Guy Maier. You might find this compilation of his writings, actual questions he answered while writing for the old Etude Magazine, interesting: "The Piano Teacher's Companion" published by Belwin Mills.

  Maier was concerned with many of the problems I have read in this web site. Check him out if you haven't already. Kind of surprising that he hasn't been mentioned by any of the folks who are concerned with injuries."

• MY THOUGHTS ON PIANO TECHNIQUE
  THOUGHTS ON THE SUZUKI PIANO SCHOOL
  Haruko Kataoka
  I've heard that this Suzuki instructor has much to offer on healthy, tension-free piano playing.
  Order #1 from Amazon . . .
  Order #2 from Amazon . . .

• ABBY WHITESIDE ON PIANO PLAYING
  Indispensables of Piano Playing - Mastering the Chopin Etudes and Other Essays
  Abby Whiteside
  '...the overall co-ordination of the body . . . is a subject covered in great detail in the suberb "...On Piano Playing" ... by the late American piano teacher Abby Whiteside, whose concept of an "emotional rhythm" - a sense of physical continuity, freedom and expert timing, resulting primarily from an emotional connection with the music, and producing both musical continuity and beauty and virtuosity - has implications not only for piano playing, but for the playing of other instruments and for other art-forms.'
  (Comments by Stephen Marquiss)
  Order ABBY WHITESIDE from Amazon . . .

• "I strongly recommend the teachings of Kato Havas when it comes to violin/viola playing. She has helped many play again when they thought they couldn't. There is an organization (KHANA) the Kato Havas Association for the New Approach and she has several books and a video: " (Recommendation by Tim McCarrick)
  A NEW APPROACH TO VIOLIN PLAYING; Kato Havas (Bosworth Pub)
  STAGE FRIGHT; Kato Havas (Bosworth Pub)
  12 LESSONS ; Kato Havas (Bosworth Pub)
  Bosworth & Co. Ltd
  14/18 Heddon St. Regent St.
  London W1R 8DP
  
  The Editorials of Kato Havas - Kato Havas -
  Castle Enterprises, 3478 B Pleasantbrook Village Ln, Atlanta GA 30340-5661 USA. US$10.00 + $2.00 shipping in the USA; US$3.95 international shipping. Info from: stos@mindspring.com
  Freedom to Play : A String Class Teaching Method
  Published by Alexander Broude September 1981 ISBN: 9992292784
  You might also note that "Freedom to Play" is a teacher's guide for string class instruction...no student books exist.

  I'm told that Havas' books are available from Timberwood Industries, Inc., Box 82, South Salem NY 10590 USA (914)533-2020.
  For information on KHANA, contact International Membership Chairman, Robert Stoskopf, 3478 B Pleasantbrook Village Ln, Atlanta GA 30340-5661 USA. E-mail: stos@mindspring.com
  Order FREEDOM TO PLAY from Amazon . . .

• New Approach violin tutor books for beginners by Gloria Bakhshayesh based on the teaching of Kat�Havas A structured course of lessons suitable for individual, class or group teaching.
  DANCING BOWS
  Open string patterns and tunes in duet form. PUPIL’S BOOK: 14 lessons; 32 pages; 9 bowing patterns;21 pupil/teacher duets;22 photographs PRICE 3.70 plus p&p: UK 1.50, Europe 2.30, Other countries: Air 3, Surface 1.50 TEACHER’S BOOK: Manual on the use of Pupil’s Book,including teacher’s parts for folk song duets. 60 pages;49 photographs PRICE 5.50 plus p&p: UK 1.70, Europe 2.70, Other countries: Air 4, Surface 2.50 p&p for both books: UK 2.50 Europe 4. Other countries Air 6. Surface 3

  RINGING STRINGS
  Introduces left hand fingering BOOK 1: 12 lessons; 62 pages; 25 exercises with finger patterns; 12 bowing patterns; 44 pupil/teacher duets; 11 photographs. Supplement of 7 Concert Pieces with piano accompaniment. BOOK 2: 12 lessons; 54 pages; 27 exercises with further finger patterns in 1st position, including the 4th finger; 11 further bowing patterns; 47 pupil/teacherduets. Supplement of 12 Concert Pieces with piano accompaniment. TEACHER’S BOOK : A manual on the use of both books. 54 pages; 13 photographs. PRICE Each book 5.50 plus p&p UK 2 Europe 3 Other countries Air 5 Surface 2.50 p&p for all THREE or all FIVE books: UK 5 Europe 6.50 Other countries: Air 12 Surface 5

  The books incorporate Kod�y principles of rhythm, ear training and inner hearing. The development of listening, performing and composing skills is an intrinsic part of the lessons.
  Available from G.Bakhshayesh, 3 Beacon View, Marple, Stockport. SK6 6PX. England. Payment in sterling please. US Agent: Timberwood Industries Inc., c/o Box 82, South Salem, NY 10590. USA

  Gloria Bakhshayesh is a peripatetic string and singing teacher who studied with Kat�Havas for many years and has become her Personal Representative in England. Working with the New Approach, she is specialising in the prevention of tension and anxiety in children learning the violin and in-service training courses for school instrumental teachers and college students. She is Administrator and Treasurer of the European branch of KHANA.

• THE COMPLEAT VIOLINIST
  VIOLIN, SIX LESSONS WITH YEHUDI MENUHIN
  Yehudi Menuhin
  "Yehudi Mehnuhin published a book in the early seventies called Six Lessons of Violin....He discusses posture and warmup techniques as means of avoiding tension and playing fatigue. ...the pictures are wonderfully informative, and it's easy to know that he teaches from real knowledge." (Quote:wcm1@cornell.edu) "Look in your local library for his The Compleat Violinist. I'm not sure when it was published (this could be the same book) but the first few chapters have excellent stretching/warmup excercises. " (Quote:Ian & Laurel MacCulloch )
  Order from Amazon . . .

• THE TEACHING OF ACTION IN STRING PLAYING
  BASIC PRINCIPLES OF STRING PLAYING
  Paul Rolland
  Paul Rolland led some extraordinary research with the University of Illinois String Research Project. This included the production of a whole series of films under the TEACHING OF ACTION title, and a book (with Marla Mutschler) as a guide to it. The films and book, first made in the early 1970s, draw from a variety of contemporary string pedagogues and are greatly concerned with healthy, effective use of the body in playing strings. Your nearest university library may hold these films as video cassettes. The TEACHING OF ACTION book (Boosey & Hawkes, c1986) is intended to accompany the films and could have been better edited for stand-alone reading, but is full of good discussion and illustrations. I have not seen the BASIC PRINCIPLES book (Presser, 1979) but judging from Rolland's other work would assume it is a useful resource as well.

• THE VIOLIN BOOK Eden Vaning-Rosen
  The publisher says: " While The Violin/Viola/Cello Book Series do not present themselves as a cure for any injuries, these books teach techniques on a completely step-by-step basis (not step 7, 28, 107; but rather, step 0, 1, 2, 3, etc.) fully illustrated, and the books anticipate poor techniques creeping in, and handle them individually before they become bad habits. We have experienced zero students developing painful injury using these books, and that includes people in their 60's. The books are not available in the stores generally and can only be obtained from The Violin Book Website .

• PREVENTION AND CORRECTION OF CHRONIC INJURY FOR HARPISTS Laurie Riley
  Box 249 Vashon WA 98070 Price $7 plus shipping $1. E-mail: harp@seanet.com

  The author says: "Who said harping could be pain free? If your teacher didn't, you need this book! Playing a musical instrument can and should be comfortable. Discomfort can lead to permanent injury. Why take the chance? Find out how easy it is to avoid and/or correct problems now! "

• UNDERSTANDING DRUM TECHNIQUES
  Dave Hughlett
  The International Foundation for Performing Arts Medicine says, "This book is a great asset for those who teach percussion. Especially useful are the large, clear illustrations, including anatomical pictures."
  To order: send $15.00 (bank check or US currency) to:
  IFPAM
  16 Spruce Road
  North Caldwell, NJ 07006
  201-519-2441
  A portion of the cost of this book is donated to IFPAM. Non-US orders $20.00

• What Every Singer Needs To Know About The Body
  Melissa Malde, Kurt-Alexander Zeller, MaryJean Allen
  2nd Edition ISBN 159756494X "...gives singers and their teachers a Body Mapping resource from anatomy and physiology to body awareness that helps them discover and correct misconceptions about the way their bodies are built and the way they function. In doing so, it provides maps with detailed descriptions of the structures and movement used in breathing, phonation, resonance, articulation and gesture illuminated with numerous illustrations and supported by many exploratory exercises. " Written by three Andover Educators.
  Order from Amazon . . .

• KEEP YOUR VOICE HEALTHY: A Guide to the Intelligent Use and Care of the Speaking and Singing Voice
  Friedrich S. Brodnitz
  2nd Edition Paperback October 1987 ISBN: 089079331X
  A thorough and readable manual by an otolaryngologist - every serious singer should read this title.
  Order from Amazon . . .

• CHANGE YOUR VOICE, CHANGE YOUR LIFE: A Quick, Simple Plan for Finding and Using Your Natural, Dynamic Voice
  STOP COMMITTING VOICE SUICIDE
  Morton Cooper
  1986 ISBN: 0064637123
  1996 ISBN: 0879804378
  Both of these books explain Dr. Cooper's simple keys to avoiding common voice usage problems. The central concepts and information could actually fit in a small pamphlet and his writing suffers from repetition, filler, and name-dropping, but the core information is important and simple - I recommend finding these in a library if you can.
  Order CHANGE YOUR VOICE from Amazon . . .
  Order STOP COMMITTING from Amazon . . .

• THE MUSICIAN'S WAY:A Guide to Practice, Performance, and Wellness
  Gerald Klickstein
  September 2009 ISBN: 0195343131
  Another good "playing well" title to help avoid injury and deal with challenges of practice and performance. Author also has a good website , including a newsletter and blog.
  Order from Amazon . . .

• Shoulders, Upper Back, & Neck: Free Yourself from PAIN!
  Rosemarie Atencio
  HWD Publishing, PO Box 220 XA, Veneta, OR 97487. (503)935-1608 FAX (503)935-0705 $17.95 + $2.50 s/h

  Good all around practical information on preventing and alleviating upper body musculoskeletal pain.
  Order from Amazon . . .

  Also good is her book Carpal Tunnel Syndrome: How to Relieve & Prevent Wrist "Burnout!"
  $13.95 + $2.50 s/h; the VHS tape (20 mins) is $2l.95 + $2.50 s/h or you can buy book+tape & get a free 8 1/2 x 11 laminated poster for $39.15 including s/h.
  An excerpt from Carpal Tunnel can be read here.
  Order from Amazon . . .

• Recommended by many on the 'Net is . . .
  Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries: A Self-Care Program
  Sharon Butler
  Advanced Press, Paoli PA USA, 1995.
  1 800 909-9795 (U.S.) or +1 610 889-9795 (Int'l) (US$18.95 + 2.50 shipping) Discounts for groups & multiple copies.
  This book emphasizes an extensive collection of stretches intended to rehabilitate tight and injured tissues. Good multiple indices help you find the stretches for your pains and/or your occupation. More info and ordering here.
  Order from Amazon . . .

• REBELLION OF THE BODY
  Understanding musician's focal dystonia
  Dr. Joaquin Farias
  " This book gathers together some thoughts which emerged during the process of reeducating musicians suffering from a movement disorder known as focal dystonia."
  Available as a Kindle download here.
  Also, see the Author's Website at www.focaldystonia.net.

• THE EGOSCUE METHOD OF HEALTH THROUGH MOTION
  by Pete Egoscue, Roger Gittines
  Harperperennial Library 1993 ISBN 0060924306

  PAIN FREE : A Revolutionary Method for Stopping Chronic Pain
  by Pete Egoscue, Roger Gittines

  In "The Egoscue Method", Pete Egoscue has a very accessible manual for identifying dysfunctional habits of posture and motion that are the source of much musculoskeletal pain and disability. His book also lays out a series of exercises to correct these problems. Very readable, do-able, recommended by RSI recoverees. Egoscue's clinic also has a Web Site.

  PAIN FREE in some ways simply revists the same material in THE EGOSCUE METHOD, and includes many of the same "E-cises" recommended in the earlier book. However, it organizes itself by body section, working from the feet up to the head, and thus it's easier to get to the material that applies to your particular pain. All these areas are functionally related, as Egoscue continually points out, and the same corrective postures and "E-cises" may apply to different pains. Like many authors presenting a personal approach to wellness, Egoscue is very optimistic about his ability to remedy a great many problems; but on the other hand, his methods are very reasonable and rational and he explains physical problems and his proposed remedies in careful detail, so I haven't got any quarrel with him. There's nothing "off-the-wall" here.

• THE ANATOMY BOOK FOR MUSICIANS
  by Susan L. Weiss, CMT.
  "I recently published a book entitled "The Anatomy Book for Musicians". It contains diagrams of the muscles of the head, neck, and upper body, and lists:
  • - Each muscle
  • - Its action
  • - Which instruments use it
  • - How an overuse might occur (other than performance-related)
  • - Symptoms of overuse
  • - Solutions
  
  It is a wonderful resource for performers to communicate more fully with physicians, and for the teacher to help avoid posture problems. It can help a teacher to figure out what a student is doing that is creating problems." The book is softcover, spiral bound, and sells for $18.00 + 7.75% tax (IL residents) + $4.00 s/h. The address to order from is:
  Muscle Dynamics
  P.O.Box 431
  Glenview, IL 60025
  (888) 729-3770

  Payment is accepted in the form of checks (made out to Muscle Dynamics), Mastercard or VISA.

• Sean P. Gallagher, PT writes: "The new issue of Orthopaedic Physical Therapy Clinics of North America (June 1997, Published by W.B. Saunders * a division of Harcourt Brace & Company) is titled "Physical Therapy for the Performing Artist, Part II - Music and Dance". I was the guest editor and contributors include:
  Linda H. Hamilton, PhD - A psychological Approach to the Rehabilitation of Injured Performers.
  Nicholas F. Quarrier, PT - The Biomechanical Examination of a Muscian with a Performance-Related Injury.
  Richard Norris, MD and Jan Dommerholt, PT - Applied Ergonomics: Adaptive Equipment and Instrument Modification for Muscians and Physical Therapy Management of the Instrumental Musician
  Blair F French, PT and Gina Giammanco, PT - Developing a Work Hardening Program for the Performing Artist.
  There is one other article in this issue that deals only with dance. This clinics on Performing Artists . . . became two issues because there was to much information to put in just one. The first issue was mainly on dance but there is also articles that deal with musicians . . . That issue was published in December of 1996 and was titled Physical Therapy for the Performing Artist, Part I - Dance I am not sure Amazon will carry these since it is published for subscription. If not people can contact me and I would be able to order it for them through our ArtsCare Catalogue. I'm at spgpt@aol.com so if you have any questions please e-mail me."

• INDIRECT PROCEDURES: A Musician's Guide to the Alexander Technique.
  Pedro de Alcantara
  Oxford [England] : Clarendon Press ; New York : Oxford University Press, 1997. ISBN: 0198165692
  This book is excellent in two ways: first, it does the best job I've yet seen at explaining the Alexander Technique, a body-awareness method used by many musicians. It cleared up a number of misconceptions I had about A.T., and anyone interested in the Technique should see it, musician or not. On top of the Alexander material, the author has many intriguing discussions of musical applications, rehearsal techniques, and mental attitudes that bear careful consideration even if one is not involved in Alexander training.

  New: Pedro de Alcantara has his own website at www.pedrodealcantara.com, with book excerpts, original articles and essays, news of seminars and workshops, and links to pages of interest to musicians, fellow Alexander teachers, and laypeople.

  Order INDIRECT PROCEDURES from Amazon . . .

• CURIOSITY RECAPTURED : Exploring Ways We Think and Move
  Jerry Sontag, Editor
  MORNUM TIME PRESS,October 1996 ISBN: 0964435217

  The editor sez: 'The 15 essays in Curiosity Recaptured provide a compelling introduction to the Alexander Technique. Whether you are interested in the performing arts, problem-solving, the field of health, or simply a more satisfying way to live, this book can open the door to a new world. ' Includes articles by Edward Avak, Anne Bluethenthal, Deborah Caplan, Walter Carrington Barry W. Collins Galen Cranz, Robertson Davies, Mary Holland , Barbara Kent, Ilana Machover.

  Order CURIOSITY RECAPTURED from Amazon . . .

• PLAYING WELL: Prevention and Biomechanics of Musician Injuries
  With a focus on Accordionists, Concertinists and Bandoneonists
  
  Lynda Griffith
  ISBN 978-0-615-51970-8
  :

  From the website: "PLAYING WELL is written and illustrated by Lynda Griffith, Doctor of Physical Therapy, specialist in biomechanics of orthopedic injury to musicians, dancers and athletes, player of accordion, concertina and bandoneon, and certified repair technician for accordion family instruments. PLAYING WELL is a detailed reference for instrumental musicians, players, parents and teachers with regard to injury, injury prevention and performance. Also appropriate for physicians, physical therapists, occupational therapists, massage therapists, chiropractors and other practitioners who treat injured musicians and would have academic or professional interest in knowing about instrumental musician injuries."
  

• More good books on RSI in general here . . .

Tapes and DVDs

• THERAPEUTIC EXERCISE FOR MUSICIANS - VIDEO
  "This one hour instruction video is designed to guide musicians in the right direction Based on the course "Physical Education for Musicians," which Dr Norris taught at the New England Conservatory, it offers a balance of warm up and breathing exercises, strengthening, strething, nonimpact aerobics and instrument-specific exercises drawn and blended from Dr Norris' extensive background in Yoga, Tai Chi and dance, and from his medical training in Rehabilitation Medicine and Orthopedics. "
  Duration: 60 minutes.
  MMBMUSIC,INC. Tel: 314 531-9635; 800 543-3771 (USA/Canada) VHS Video ST248 $35.00

• Dr. Norris told me that the difficulty some persons have finding good care for computer or musical RSIs prompted him to create a VHS tape titled "NONSURGICAL TREATMENT OPTIONS FOR UPPER EXTREMITY OVERUSE INJURIES", targeted at folks whose physician may not be too hip to this stuff, available directly from him for $65. (Excerpts from this are being reprinted in the RSI Network newsletter: click here to read the article.)

  Dr. Richard Norris, Director
  National Arts Medicine Center & Center for Repetitive Motion Disorders
  National Rehabilitation Hospital
  3 Bethesda Metro Ctr. Suite 950
  Bethesda, MD 20814
  (301) 654-9160
  

• Choreography of the hands [videorecording] : the work of Dorothy Taubman
  / produced and directed by Ernest Urvater.
  PUBLISHER Amherst, Ma. : JTJ Films, Inc., 1986.
  (60 min.) VHS format. Dorothy Taubman and various performers and Master Class students present her techniques for playing musical instruments which help to prevent injuries and reduce pain.

  Note: So far I haven't found any method books by Dorothy Taubman but have been told that you can reach the Taubman Institute for instructor references at 518-239-4756. In addition there is now a Web Site for the institute.

• The Taubman Techniques: An In-depth Analysis of a Technique for Virtuosity and the Prevention of Injuries among Musicians

  "There is now a set of five videotapes published by the Taubman Institute which give a detailed account of many of the most important aspects of her teaching. The tapes are based on lecture/demonstrations given by Taubman's associate Edna Golandsky at the Institute's summer school at Amherst MA. Further details available from Enid Stettner, tel (518) 239-4756 or 1-800-826-3720. The focus is almost entirely on the piano. They are expensive, but worth it IMO for their wealth of information and detail. (I've bought them myself!) Reviews have appeared in Clavier Vol 36 No 5 May/June 1997 (Jane Magrath) and in Piano and Keyboard No. 186 May/June 1997 (Wilma Machover). " (submitted by:Henry Micklem)

• The You Are Your Instrument Video is a companion piece to the book. While enhancing the material from the book, it has been designed to function as a separate resource. Julie Lyonn Lieberan explains many new approaches to music-making; leads you in a number of powerfully useful mental and physical techniques; uses live musicians to illustrate important concepts that are key to fluid, pain-free music-making; interacts with a professional physical fitness model to demonstrate all of the muscle balance techniques outlined in her book.
  
  
  
  • You ARE YOUR INSTRUMENT FOR INSTRUMENTALISTS:
    This exciting two-hour video addresses such issues as six-fold memory, channeling nervousness into increased playing ability, the four planes of movement, the usefulness of gravity, the role of proper breathing in relaxation, and how to use the muscles and joints in harmony with anatomy. Also included are individual segments in which Julie presents detailed information on the specific challenges of the bowed, fretted, wind and keyboard/percussion instrument families. Through interaction with experience musicians in each of these fields, Julie will demonstrate many new mental and physical approaches to practice and performance.
    
  • You ARE YOUR INSTRUMENT FOR VOCALISTS:
    On this unique two-hour video, Julie explores such important issues for vocalists as singing from whole brain/whole body, breath support and control, vocal stamina, the causes of vocal dysfunction and injury, and the effect of diet and environment on the body's ability to produce sound well. She is joined by three experts in the field: Maitland Peters, professor of voice at Manhattan School of Music, Jeannie Deva, the author of The Contemporary Vocalist, and Katie Agresta, teacher to such artists as Phoebe Snow, Cyndi Lauper and Bon Jovi.

  To Order: Call 1-800-338-2737 or write to Homespun Tapes, PO. Box 694, Woodstock, N.Y 12498 Price: $49.95. Visa or Mastercard accepted. (Add 7% sales tax if delivery is in New York State) Postage and Handling: U.S. and Cananda $4.00, Europe and South America: $12.00, Africa, Asia and Australia: $20.00

• FREEING THE CAGED BIRD
  Developing Well-Coordinated, Injury-Preventive Piano Technique
  with Barbara Lister-Sink 160 minutes
  
  Wingsound Productions
  PO Box 10912
  Winston-Salem, NC 27108 for . Phone = 336 945 2304
  $39.95 + 4.95 P&H

  Web Site here . . .
  "This is a video about acquiring a tension free piano technique in order to avoid injury . . . It is fairly extensive and features many people who had injury and fixed their problems by retraining. The end of the tape details techniques for learning advanced material without injury. Very practical and competent in its approach to both music and human physiology." (Recommendation by Dick Norton)

  The author of this tape was good enough to give me a copy and it is superb. It is very thorough (2.5 hours) and well produced. More than Ms. Lister-Sink's clear and insightful verbal presentation, it provides ample on-camera demonstrations by the presenter and several students at various levels of experience, enhanced at times with slow-motion playbacks. It is especially aimed at piano instructors, and does not claim to be a replacement for skilled teachers. Even so, every pianist may gain valuable insights into healthy technique by watching it, and the price is very reasonable for the value received, in my opinion. - Paul Mx

• THE KATO HAVAS TEACHING VIDEO
  
  a practical, hour-long, teaching video, on the causes and cures of physical injuries in violin and viola playing (can be applied to 'cello and bass also). It has detailed exercises on the release of tension and the prevention of anxiety in performance.
  Available from Lakeland Home Music
  Watermillock, Cumbria CA11 0LR ENGLAND
  or
  Timberwood Industries, Inc.
  Box 82
  South Salem NY 10590 USA (914)533-2020.

• ". . . last week I saw an excellent video: " Keyboard Comfort" produced by USC instructional TV.
  The instructions were given by Greg Dempster, pianist and typist. He discussed one's approach to the keyboard and gave tips which he said pianists began to use in the 40s, such as "Rest Down" (resting/relaxing your hand when the key is down).
  Those interested might want to ask their friendly librarian to try to find this video!" (Joan Garvin)

• CC writes: " I have a great videotape called Healthy Hands: Wrists and Forearms , made by a guy named Martin Gray who is a juggler, massage therapist and really cool guy. The video has an hour of stretching, strengthening and care information just for the hands. I recommend it for listing on your site- which is such a great resource! I will recommend it to all my students. Check out http://www.sacredsites.com/nomad.html .... for more info on the Healthy Hands video. "

• THE TEACHING OF ACTION IN STRING PLAYING
  Paul Rolland
  University of Illinois String Research Project produced series of films. See book of same name above.

• Repetitive Strain Injury? Rx: Yoga!
  by Gail Dubinsky, M.D.

  Pamela writes: "A reminder that there are special yoga tapes available that are targeted specifically to RSI patients. Information can be found at www.rxyoga.com. The author of Rx:Yoga! is Dr. Gail Dubinsky, who treats soft-tissue orthopedic injuries, and is also a long-time yoga practitioner. I reviewed the tape for MC Journal (see here ), and found it to be extremely appropriate -- I suffer from carpal tunnel and tendonitis, and found the yoga poses to be very doable and helpful."

• CARPAL TUNNEL SYNDROME: CAUSES AND TREATMENTS
  TRIGGER FINGER: SURGICAL AND CONSERVATIVE TREATMENT APPROACHES
  Eileen Apfel
  Order through Web Site.

  CARPAL TUNNEL SYNDROME: CAUSES AND TREATMENTS
  This educational video describes the causes, surgical, and conservative treatment approaches for Carpal Tunnel Syndrome. It specifically teaches important basic concepts, such as anatomy, and effects of hand positioning and hand use on nerve compression. Home programs such as range of motion exercises, scar massage, cold application, splint use and care, and ergonomic modifications are demonstrated. Individual tape price is $59.00.

  TRIGGER FINGER: SURGICAL AND CONSERVATIVE TREATMENT APPROACHES
  A Hand Surgeon and two Certified Hand Therapists describe the causes and various treatment approaches for Stenosing Tenosynovitis of the digital flexor tendon (Trigger Finger). Viewers will learn about the pathophysiology of Trigger Finger, and are specific therapeutic techniques such as splint use, cold application, and differential tendon gliding exercises are demonstrated. Individual tape price is $59.00.

  Eileen Apfel says: "I am a Registered Occupational Therapist and Certified Hand Therapist with 24 years of experience treating Upper Extremity Disorders. I also have a strong music background, with a subspecialty in treatment of the injured musician. I work on a physician referral basis only ( by written physician prescription). I am located in Coastal North San Diego County. I prefer to be contacted by email at apfelroberts@worldnet.att.net."

• Yuri Ziskin offers a personalized videotape instruction based upon video recordings of individual students who want to learn non-injurious technique. He can be e-mailed at yuriz@pcweb.net and has an interesting website at www.pianoinjurycure.net .

• PLAYING WITHOUT PRACTICE
  Dr.Joaquín Farias
  The publisher says: "A simple, revolutionary method which lets you reduce the practice time required to play a musical instrument. The system is ideal for the prevention and treatment of professional injury to musicians. The full sequence takes only 20 minutes and can also be used to warm up before playing. Since the first two weeks of practice you will develop the control you have over your muscles, thus improving the efficiency of your movements. The perfect tool for all instrumentalists. DVD includes: Muscular control exercises / Tone up exercises / Relaxation session

• WOMAN TO WOMAN GUITAR is "a comprehensive course of study which can take you from being a guitar player with basic skills to an accomplished guitarist." Charlotte Adams puts a strong emphasis on healthy playing and has excellent articles on her website.

Links & On-Line Articles

• Jonas Sen's superb Playing the Piano,Playing...With Fire?A Study of the Occupational Hazards of Piano Playing - important reading for non-pianist musicians, too.

• A similar excellent document is Valerie Kampmeier's dissertation, The Impact of RSI on Creativity in Musicians .

• An unusually good and professionally done resource is the Athletes and the Arts website, dedicated to keeping musicians healthy and, well ... athletic. Impressive.
• Arts Medicine, an excellent European site.

• Dr. Richard Norris NONSURGICAL TREATMENT OPTIONS FOR UPPER EXTREMITY OVERUSE INJURIES

• Website for the International Foundation for Performing Arts Medicine . (E-mail address: ifpam @ optonline . net ). Includes message boards to leave questions.

• New . . . Web page of the The Performing Arts Medicine Association .

• Performing Arts Medicine at Ithaca College - this school is taking a lead in this field and their Web site has good resources.

• An important group concentrating on performing arts injuries is the Performing Arts Special Interest Group of the Orthopaedic Section of the American Physical Therapy Association. This site includes affiliated clinics that deal with performing arts injuries.

• About Seats and Sitting for Cellists and Other Musicians by Victor Sazer is an excellent explanation of how sitting can give you back pain.

• HANDS ON! ONLINE, the performance health newsletter for flutists. Great stuff!

• Oregon's CROETWEB site has a section on artist safety that includes articles on performing arts safety, musicians' hearing protection, and musculoskeletal injuries.

• Dr. Joaquin Farias has posted the this site that discusses his treatment of musicians' injuries.

• Hearing Problems are common among musicians, classical and rock alike. A good resource list is the Tinnitus Frequently Answered Questions Web site. Definitely see HEARNET , the Web site for H.E.A.R. (TM) ( Hearing Education and Awareness for Rockers.) Also, read this thread on How Loud is Too Loud? , and Doug Yeo's article on Noise levels on stage/hearing .

• More insights on musicians' hearing loss is found on Ken Laberteaux's "When It Hurts To Play: A Look Into Injuries Common Among Musicians"

• Phil & Vivian Williams write on TENDINITIS PROBLEMS OF MUSICIANS - IDENTIFICATION, PREVENTION, TREATMENT

• Andover Educators , "a network of teachers saving, securing and enhancing musical careers with accurate information about the body in movement", training aimed at preventing musicians' injuries. Includes an interesting and growing on-line book, At Last! Music Education on a Secure Somatic Foundation . Check it out, some interesting stuff here.

• Six Golden Rules for Conquering Performance Anxiety by David Leisner. In addition he has a good article on Curing Focal Dystonia, or How To Play The Guitar With Large Muscles.

• Vox Cura , a Canadian voice care clinic, has useful information about taking care of your voice.

• The Texas Center for Music & Medicine includes an interdisciplinary team of musicians, music educators, clinicians, and research scientists. The Center represents educational, medical and musical resources, brought together to study, treat, and prevent various medical problems associated with learning and performing music. Clinical resources are available for both students and non-students. Clinical care is provided through the Center for Performing Arts Medicine at the UNT Health Science Center in Fort Worth, the UNT Counseling and Testing Center, and the UNT Speech and Hearing Center.

• The Classical music department of the WWW Virtual Library used to have excellent sections on Medical Issues for Performers , Coping With Performance Anxiety , and Medical Clinics for Performers (in the US and Canada) . Old versions of these are archived on this site.

• JAMES R. OESTREICH wrote this article discussing the impact of musicians' woes for the New York Times.

• Musicians are also afflicted with Focal Dystonia, a baffling and controversial loss and distortion of muscular control. Read this first-hand account of this condition. The National Institute of Neurological Disorders and Stroke has a the NIH Dystonias Information Page and a Dystonias Fact Sheet. Also see the Dystonia Dialogue page from the Dystonia Medical Research Foundation, which includes a bulletin board for discussions of the disorder. I am told this board has more traffic than the alt.support.dystonia USENET newsgroup. Also: Read Constraint-induced movement therapy for focal hand dystonia in musicians in The Lancet . An excellent new dystonia resource and advocacy groupis Care4Dystonia, Inc.

  Some possible insights on musician's dystonias are discussed in How To Resolve Dystonias: A Movement Perspective by Barbara Conable.

• Dr. Tim Jameson, D.C. contributes articles on:
  
  
  • advice on alternative medical care;
    
  • trigger finger;
    
  • Carpal Tunnel.
  Also see his new Musician's Health Web site for many more articles, suggestions, and stretches.

• Another health clinic has some interesting articles, see the Performing Artists Health Center.

• A forum for on-line discussions of musicians' injuries has been set up by PrivateLessons.com. Join in!

• Andover Educators site promotes their What Every Musician Needs to Know about the Body course, also includes some on-line articles well worth reading.

• Related information on computer injuries is on the RSI Page . . .

• A list of performing arts clinics is included on the FindADoc list.

• Many musicians report that The Feldenkrais Method and The Alexander Technique are helpful in learning non-injurious use of the body. A Feldenkrais practitioner has some good info on his Somatic Options page. Another Feldenkrais practitioner assisting musicians in particular is Aliza Stewart.

  Also there are many good reports on the effectiveness of Hellerwork , Trager Approach, Rolfing , and The Pilates Method in treatment of RSI. You may want to read Three Musicians Talk about the Alexander Technique. Music-oriented Alexander info is found at Alexander Technique for Musicians .

• John Link writes on The Feldenkrais Method for Singers (and Instrumentalists) here.

• GUITAR-SPECIFIC LINKS:
  • Sitting & Proper Positioning with the Guitar By Nitin Arora - read this on his Humane Guitarist website.
  • The Paul Anders Sogaard Website has good information from a professional guitarist who is also a qualified Music Medicine Therapist and a Practitioner for The British Association for Performing Arts Medicine.
  • William R. Cumpiano has developed his own wedge shaped ergonomic guitar.
  • A most excellent site, Dan Smith's The Guitarist's Guide to Hand Care with info on exercises, callouses, nails, warm-ups, etc. Go there, read that!

• Paul Adams relates his experience with traumatic injury to his hand.

• Health and Safety for Guitarists and Other Musicians, a good resource site with an emphasis on guitar.

• Charlotte Adams has excellent articles and resources on her website. Well worth spending time with, whether or not you get the videotape.

• PIANO-SPECIFIC LINKS:
  • Jonas Sen's superb
  Playing the Piano,Playing...With Fire?A Study of the Occupational Hazards of Piano Playing - important reading for non-pianist musicians, too. A text-only version is now available here .
  • Thomas Mark's PIANIST'S INJURIES: Movement Retraining Is The Key To Recovery. In addition, he now has set up a web site at www.pianomap.com and has a book, What Every Pianist Needs To Know About the Body .
  • Portland State University has created the Coordinate Movement Program for Pianists , a program of study to "allow a limited number of applicants to pursue a degree option while recovering from pain, injury and physical limitations."
  • Niks Piano Technique and Hand Guide page provide information on another low-tension piano technique, as well as a special practice tool used to help learn the technique.
  • Dr. Teresa Dybvig's The Balanced Pianist presents a variety of short, intensive programs for small groups of pianists, high school age and above, amateur and professional. In The Balanced Pianist programs, pianists improve their practice, performance, and teaching skills while growing to enjoy all these activities more. The goal of programs is removing tension in practice and performance through good musicianship, healthy movement and positive mental attitude, removing tension in teaching through use of learning styles, and general wellbeing. The web site has information about Taubman technique, Dunn & Dunn Learning Styles, about what constitutes a healthy approach to practice, performance, and teaching, and the curriculum of programs.
  • David C. Stanwood has developed technology to modify piano keyboard touch, thereby reducing the chances of injury. (See article on Key Weights listed below.)
  • Sheila Paige facilitates regular Piano Wellness workshops and seminars.

  • WIND INSTRUMENT SPECIFIC LINKS:

    • Article on a sax student's injury . . .

    • DOUGLAS YEO , Bass Trombonist with the Boston Symphony Orchestra has a Web site with, among other things, articles on Hand tension while playing and Noise levels on stage/hearing .

    • Brad Howland, another brass player, also has a Web site discussing how to Play Without Pain .

    • Excellent discussion of flute ergonomics is found at Flutelab/De Fluitstudio

    • David Sawyer has built a nicely illustrated Hand care for musicians page, aimed at shakuhachi players but applicable to other instrumentalists as well.

  • STUFF:
    Some ergonomic accessories for various instruments are appearing on the market. Here's some on the web. I don't endorse all of these, just passing them along. Such items may be very useful indeed, but don't go looking for a gadget to "fix" all your problems. If you are already injured, for CERTAIN don't be thinking you can get an accessory or new instrument and then go right back to full-speed, full-time playing with no other changes and with no visit to the doctor. It doesn't work like that!
    
    
    • The new Y-strap ergonomic guitar strap is on the market.
    • Slider Straps are available from different vendors and for different instruments but I no longer find a company website.
    • Similarly, sax players may want to check out The Smart Strap
    • The Neck-Up guitar support.
    • Gracie Stands, makers of no-strap stands that hold your guitar in playing position. I use one of these myself - PMx.
    • Quodlibet Inc. sells ergo supports for Clarinet, Basset Horn, Oboe, English Horn, Oboe d'Amore, Bass Oboe, and now saxophone.
    • The Guitar Chair , optimized for classic guitar performance.
    • "BassBrace is a guitar belt - a revolutionary new way to support an electric bass or guitar that will shift the weight of the instrument off the shoulder and place it comfortably on the hips. At the same time, it provides for more optimal instrument positioning to relieve wrist strain." [Paul adds: I got one of these and use it with my solidbody electric guitar to give my hurting shoulders a break. I *do* endorse these.][2013-Aagghh, but they seem to have gone out of business. I still use mine.]
  • Ton Kooiman designed and markets a number of woodwind thumb rests on his Woodwind Ergonomics website.

    Nitin Aurora is compiling a list of guitar supports on his website.

  • Hm, seems like an obvious idea: The Boom Stand . OTHER ERGONOMIC PRODUCTS: A whole lot of other ergonomic products, services, devices, etc. (mainly computer-oriented) are found on this Web page.

  ---

  Discussions

  (Note: Most of the following articles are taken from discussions on USENET newsgroups and as such represent only the opinions of individuals. Also note that as of 1 January 1997 I will strip identifying names from the threads reproduced here to protect privacy.)

  Guitar Discussions
  

  • Guitar Article 1
  • Guitar Article 2
  • Guitar Article 3
  • Taylor guitars: are thin necks good or bad?
  • Leo Kottke's injury
  • Guitar positions
  • Fingertip Pain
  • Hand Fatigue
  • Don't Blame the Guitar . . .
  • LH pinky "locks up" . . .
  • Don't Say "But I Can't Quit Playing . . ."
  • Focal Dystonia
  • Dr. Tim's Advice
  • "Correct" Thumb Use and Barre Chords a Problem?
  • RH positioning, holding guitar, stands.
  • Electrical Shock Hazards from grounding problems.
  • Finger picking hand and arm placement
  • Gracie Guitar Stands
  • Elbow pain, good classical advice.
  • Classical positioning discussion
  • Impact of Nail Length on Guitarists Injuries
  • Cut Fingers, Traumatic Injuries to Hand
  • Left Thumb Parallel or Perpendicular to Neck?
  • Guitar Changes in Response to Tendinitis
  • Right Arm Soreness
  • Defining Tension in Guitar playing
  • Doctor's Comments on Guitar; Standing Posture
  • Finger Pain & Callouses
  • Right Arm Protectors
  • Tilting Guitar Face
  • Segovia's "Deviant" Position
  • Numb Finger
  • Pinkie Wars!
  • Back Pain, Seating Options
  • Fingertip Irritation
  • Help, Left Wrist Pain
  • Hand Strength
  • Lowering Left Shoulder
  • Flat Picking Technique
  • Shearer's Injury, etc.
  • Using Hand Strengthening Equipment?
  • Use Lighter Strings!!!
  • 3 Letters Guitarists Fear the Most!
  • Wrist Pain After Long Recording Session
  • Playing Pain Also Psychological
  • Damping Strings?
  • The evil of barre chords
  • Left Hand Pain
  • Building Endurance on Acoustic
  • Tension in Right Shoulder
  • Paul's recovery
  • Shorter Scale solution for problems?

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  Piano / Keyboard Discussions

  • Piano Posture
  • Piano Article 2
  • Sore Wrists?
  • Discussion of Weighted Electronic Keyboards
  • Changes to Piano Key Weights
  • Dorothy Taubman
  • Comments by Kay Hooper
  • Leon Fleischer's Injury
  • Plug for the Feldenkrais Method
  • Too Much Practice?
  • A Therapist's Advice
  • One Pianist's Recovery
  • Piano Ouch
  • Another Piano Story
  • Injured At Young Age, What Helped . . .
  • Muscles/Fingers (was Re: Hanon)
  • Roland RD-600 Keyboard; Bench Height (was Re: Hanon)
  • Cold Fingers/Hands
  • Recovery; Small Hands?
  • Back Problems, Solution
  • Cramping in Hands
  • Cracked Fingertips
  • Boy, my Arm Hurts!
  • Finger Muscles
  • Tight Shoulders
  • Tense Fingers and Wrists
  • Piano Suggestions from a Therapist
  • Why Does My Arm Ache?
  • Backache!
  • Harpsichord Thoughts

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  Percussion, Strings, Voice

  • Dutch drum articles
  • Handbells
  • Timpani
  • Drum Corps Injuries
  • Breaking Drum Heads
  • General Drum Comments
  • Earplugs for Drummers
  • Drum Problems, Tips
  • Carrying Bass Drum in marching band
  • Weak LH 4th Finger (violin)
  • High Action = Trouble (violin)
  • Sitting, Back Pain w/ Violin
  • Violin, left arm buzz/numbness
  • Common Violin Playing Faults
  • Shoulder & Chin Rests
  • TMJ From Classical Singing
  • Singing Causing Hand Pain?

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  Winds

  • Use Oboe Strap
  • Equipment Setup Matters! (bassoon, but applies to ALL instruments.)
  • Recorder, rehearsal techniquest

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  Other . . .
  • Conductors get hurt too . . .
  • Advice for harp . . .

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  Univ. of Nebraska-Lincoln / Music Injuries Web Page / Paul Marxhausen