Get Moving: Looking After Your Body With Performance Medicine

Get Moving: Looking After Your Body With Performance Medicine

Take that well-deserved break, and get to know how to help your body. 

Get Moving: Looking After Your Body With Performance Medicine

Take that well-deserved break, and get to know how to help your body. 

Musicians often practice for long stretches of time without a break. What effect can this type of work have on your body long-term? Are there ways of preventing ongoing problems like RSI from early on? 

Any activity that is performed repeatedly impacts the tissues in the body. This is where the term RSI (repetitive strain injury) came from as it is a result of just that - repetition. In the short term, aches and pains can develop in the muscles and joints and if they are rested appropriately, usually resolve quite quickly with little harm done. The more serious issues come about when there is little or no recovery time between sessions. The most common injury musicians see in this case is tendinopathy - where the tendon isn't coping with the load it is being asked to undertake and there is a maladaptive response to this in the tissues. The best way to prevent this is to be smart about your loading. If you know you need to do 6 hours of practice per day, can you arrange your schedule so that rather than doing 6 hours straight you are doing 3 blocks of 2 hours? This will give your body recovery time throughout the day and break up the loading. If that is not possible, make sure your set-up is optimal - check the height of your music stand, your positioning at the instrument, and your technique to name a few things. Finally, try to vary your repertoire within the session. For instance, if you are playing something fast paced that requires a lot of intensity, finish your session by playing other pieces that are slower or that require less intensity. This will mean that you are using your body differently within the session, thus providing a lot of variability in load for the tissues. Thinking more holistically, there has been countless research done on the sedentary nature of many occupations. Recent studies show that sitting for greater than 30 minutes can increase your risk of cardiovascular disease, obesity, stress, as well as reducing your life expectancy. The best way to reverse the effects of this is to take a 2-minute break every 30 minutes, where you get out of your chair and do something else. 

When tired and/or sore at the end of a practice session, could musicians benefit from stretching or warming down in some way? How do you make this a habit?

In short, yes! Just like every practise session you warm yourself up to prepare your body and prepare your instrument, it is just as important to warm down. If you are sitting to play, it might be useful to do some spinal mobility exercises to counteract the effects sitting has on the body. As most instruments encourage a forward posture, lying on a foam roller on your back will counteract this and assist with opening up the front of the body. Using a hot pack on the neck can be effective in reducing neck stiffness, or you may find that ice on some joints in your arms may be relieving too. There may be other instrument specific things you want to do as part of this process. In terms of making this a habit, think about how you made your warm up a habit and apply the same principles. A cool down should take no longer than 5 minutes, so if time is an issue I would suggest finishing your session a few minutes early so you can include your cool down within this time period too.

If you absolutely have to cram the practice in, for example before examinations or important performances, what sort of measures should musicians take to keep their bodies fighting fit? Should diet and hydration be a consideration?

Sleep is one of the most important things to promote recovery in the body. The first thing you should do is make sure you are getting an adequate night's sleep. Understandably this is not always possible for many reasons, but do your best! Diet and exercise are also important factors to promote a healthy body. The body requires substances found in food like protein for muscle repair and development, calcium and magnesium for bone and muscle health, adequate water intake (8 glasses per day) for tissue health and hydration, as well as other vitamins and minerals. Eating well will give you more energy, and when we have more energy and are well rested we are more efficient, therefore you will be more productive in your practise sessions, so it is worth making time for good food. Green tea is a great one for tendon health too. 

There is a lot of stigma around injury in the classical world, which can often lead to problems going untreated, making them a whole lot worse in the long run. If you think you might have an injury, what should you do? 

The first thing you should do is see someone about it. Even if you don't have an 'injury' as such, but have pain or stiffness, it is important to get this managed so that it doesn't turn into something worse. A physiotherapist is a good person to start with because they have expert knowledge in the biomechanics and pathophysiology of the human body. If you have a physio who is familiar with performers and the demands of this industry even better, as they will be able to work with you to ensure the least amount of time possible away from your instrument. You will get the best result if you address a niggle early. Prevention is the best treatment so anything you can do to prevent one in the first place is ideal!

Is meditation or yoga beneficial for musicians to help develop healthy posture and good breath technique? 

Things like yoga and Pilates can be very beneficial for musicians as they provide whole body conditioning and postural training. Pilates in particular can be useful because it can be tailored to suit the individual when they partake in clinical Pilates. In terms of breath technique, strengthening the pelvic floor and lower abdominal muscles will allow you to have more awareness of what these muscles are doing when you play or sing. These muscles assist with breath management and it is important that the musician has good awareness of these muscles to have good breathing technique. If taking a bigger breath is the issue, cardiovascular exercise will increase your lung volume. Swimming is a great one as when you blow against the water, a positive airway pressure is created, which helps to expand your airways. Bike riding, walking, jogging and other forms of aerobic exercise are also good to do.

When dealing with a non-music related injury that has affected how you play your instrument, how do you approach getting back into it? 

Really the approach is the same as if you had a playing-related injury. Depending on the severity of the injury, a period of rest may be required. Of course, we would make every effort to ensure this rest period is as little as possible, but in some cases time away form playing is needed for tissue healing. Then it's all about a gradual return to playing. Sometimes splints and braces may be used to help with recovery and quite often strengthening exercises and stretches are used to help with preventing further injury.

Music and sport don't always get along, but swimming and working out is often recommended to music students. Is playing sport dangerous for musicians (who are really worried about their fingers!) or is that a myth? 

It really depends on the sport. Things like swimming, running and gym work that are in a controlled environment where you can do it at your own pace are pretty low risk. Other contact sports like AFL come with a higher risk of injury to anyone because of the unpredictable nature. Ball sports like cricket carry with them an element of risk of injury to the hands purely because of the nature of the game. It is important that musicians exercise daily though as there are huge benefits to the body and mind, but also for your general health and well-being. Anything is better than nothing so if you're worried I'd stick to safer things like walking, swimming, light gym sessions and bike riding or jogging.

Singing is a bit different from other instruments, as the singers' body literally IS their instrument. Can you tell us about vocal unloading, and how that helps singers with their vocal maintenance? 

Vocal unloading is a type of physiotherapy that acts as a neuromuscular cycle breaker to enhance the performance voice. Treatment often targets the myofascial and cartilaginous structures of the larynx and surrounding perilaryngeal region to produce efficient vocal fold vibration and voice production. It assists with voice retraining as it helps to break the 'maladaptive voice cycle' some singers often find themselves in. Voice is not just vocal fold vibration, but a complex coordination of systems and structures including breath, muscle tone and recruitment and posture. If you are experiencing vocal problems consistently it is important that you speak to your vocal coach about this. You may need a multidisciplinary approach to resolving these issues, which can include other specialities such as ENT surgeons, speech therapists/vocal coaches as well as physiotherapy. Even if you aren't experiencing vocal problems, remember that if you are a singer you are using your body in a similar way to any other athlete. Just like a footy player would have regular physio for maintenance and injury prevention, singers are in a similar situation and vocal unloading can help with maintaining your voice throughout your career.

Finally, all of us - musicians and otherwise - seem to have "text neck" these days. Do you have a recommended exercise for people stooping their neck over their music, instrument, mobile phone or computer screen right now? 

Not so much an exercise, but there is a great app developed by an Australian physiotherapist to help with just this problem called "Text Neck". It is free to download and puts an alarm on your phone to go off when you are holding your phone in a position likely to compromise your head and neck posture. That brings me to my next point about posture - this is the best way to avoid problems like text neck (which is actually a formal diagnosis these days!). Make sure when you're using your computer, tablet, phone or instrument you set up yourself with good head and neck posture. If you do this the chance of developing any issues is much less and you will need to do fewer exercises all up... win win!

 For more specific help, contact Catherine at Performance Medicine on (03) 9686 2373, or via their website . 

For more specific help, contact Catherine at Performance Medicine on (03) 9686 2373, or via their website