How can instrumental musicians practice in a way that reduces their susceptibility to symptoms of overuse?
The repetitive movements used to play an instrument for long periods of time places instrumental musicians at risk of developing PRMDs, or performance-related musculoskeletal disorders. These are sometimes referred to as repetitive use injuries, of which tendonitis is the most common. In fact, research has shown that 80% of musicians will develop an injury at some point during their musical career.
The greatest risk of developing an injury occurs either during the freshman year of college when students adjust to new practice expectations, new teachers and ensembles, and longer hours of rehearsal, as well as in the months prior to recitals and auditions. Inadequate rest, physical and emotional stress, and overplaying contribute to this increased risk. Those with knowledge on postural alignment, efficient technique, and healthy practicing—including warm-ups, cool-downs, regular breaks, and limited practice of loud, fast passages—will be at an advantage compared to peers who practice excessively.
A certain amount of tension is expected to play an instrument, but musicians must develop an understanding of where tension is required, so they learn to relax muscles that are not being used and use only the amount of force necessary for the desired sound. The following guidelines can be used to help students learn how to practice in a healthy way, and they include information on how yoga can be helpful in learning these strategies.
1. Always warm up. Warm up away from the instrument using dynamic movement of the muscles that would be used in playing your instrument. Begin with slow, soft playing at the instrument using idiomatic material at a slower tempo with a short sustain. Dynamic range, velocity, and pitch sustain should be increased incrementally along with gradual stretching of the hand and extension of movement. Avoid stretching when cold.
2. Avoid sudden increases in practice time. In the first year of college, when preparing for a recital, and when preparing auditions, musicians are at particular risk for injury. Avoid suddenly increasing the amount of practice and the difficulty of your repertoire. Increase practice by no more than ten minutes per day (including ensemble rehearsals).
3. Take breaks to stretch and relax. Do not play longer than 45 minutes without a break. Take about a ten-minute break for every hour of playing.In addition to reducing susceptibility to injury, regular breaks help you to stay focused and achieve more in less time. Two or more shorter sessions are far more productive than a single marathon session. In performance, find opportunities to relax a hand, arm, or embouchure to restore circulation. Yoga stretches can provide a relaxing mental break to enhance concentration while also stretching and strengthening the body to increase endurance and reduce muscle fatigue.
3. Pace yourself. Avoid excessive repetition and excessive force. Alternate soft, slow playing with loud, fast playing.Minimize the repetition of difficult sections to five minutes at a time. In addition to warming up, cooling down after practice allows the body to relax and restore while also increasing retention of what was practiced.
4. Evaluate your technique. Reduce force, keep joints in the middle of their range of motion, use large muscle groups when possible, and avoid fixed, tense positions. Check your alignment and posture. Avoid excessive twisting or stretching of the hand.
5. Evaluate other activities. Computer use can cause or worsen conditions like carpal tunnel syndrome and tendinitis. Even looking at your phone and texting regularly can cause tension and pain in your neck and hands.
6. Pay attention to your instrument. Consider whether your instrument places stress on your body. Is it set up optimally for you to relieve pressure on hands and joints? Is there a strap, carrier, or stand available to relieve the stress? Also consider the size of your instrument and how you transport it.
7. Be prepared to modify practicing if you experience pain. Only rarely is it necessary to completely stop playing. The sooner you address the issue, the less likely it is that you will develop a chronic injury. In discussion with your teacher, devise a plan to reduce force, avoid unnecessary repetition, and perhaps modify your technique. Your practice sessions may need to be shorter and you may need to make changes to your repertoire.
8. Incorporate mental rehearsal and mindfulness at the instrument. Listen to recordings, study the score, and audiate (“hearing” the piece in your mind, exactly as you want it to sound).
9. Use a practice journal. Record-keeping will help to emphasize quality of practice over quantity.
10. Get medical attention if you have had pain while playing for over a week. The sooner you contact a physician, the less likely it is that your injury will negatively affect your long-term playing ability.
11. Getting enough sleep, exercising regularly, and balancing work, rest, and play all help to reduce the risk of injury. Try to get 7-9 hours of sleep each night, drink 6-8 glasses of water a day, and eat a diet of colorful, non-processed foods. Eating regular meals and snacks helps to keep blood sugar even. Eat breakfast every day for better focus, memory, and energy.
12. If you experience pain: Tell your teacher, including your ensemble director. You may need to modify your practice and/or your repertoire. See a physician if the symptoms last longer than one week. Ice reduces swelling and inflammation for an acute injury during the first 24-48 hours. In most cases, ice is the appropriate treatment. For chronic conditions, however, heat relaxes the muscles. Over-the-counter analgesics or anti-inflammatory medications help to reduce pain, but may also mask the pain and cause you to overwork.