How do you get to Carnegie Hall? Practice. Perfecting your skills as a musician takes enormous determination and focus, and a drive to excel can be very helpful in maintaining the discipline required to succeed.

Sometimes, however, our focus on a goal or outcome can be so consuming that we ignore aspects of our lives that are important in maintaining overall health. Unreasonable expectations of perfection can cause us to push beyond our limits. We may even disregard signs that something is wrong.

Performing as a musician makes significant physical demands on the body. No it’s not the same as lifting 100 pounds or running a marathon, but singing or playing a musical instrument can take a toll over time. Because of the demands involved, musicians are at risk for occupational health problems that can have a significant impact on their ability to perform.

Perhaps you’ve heard of repetitive strain injuries, overuse syndrome or musculoskeletal injuries. The words alone are enough to make you groan and think you’ll worry about that some other time. But it’s important to be aware of potential problems so that you can avoid them if possible, and intervene early before any significant damage is done. Some of the different kinds of injuries include carpal tunnel syndrome, tendinitis, bursitis, focal dystonia, sciatica, and trigger finger among others.

If not recognized and treated properly, repetitive strain injuries can limit, interrupt or even end a career as a musician. Some studies have shown that as many as half of all professional musicians and music students experience some significant symptoms. In order to have a long and productive career, it’s important to be aware of early signs of a potential injury, what factors can cause or aggravate these health problems, and what some of the strategies are that can reduce the risk and impact of injuries.

SYMPTOMS

Some common symptoms of repetitive strain injury that musicians experience include pain, weakness, stiffness (reduced range of motion), numbness, tingling or a loss of muscular control that interferes with the musician’s ability to perform at their usual level. Sometimes musicians assume that the symptoms they are experiencing are normal and they find ways to disguise the effects. They may also feel pressured to disregard any discomfort because the “show must go on,” or they’re fearful of being labeled as injured.

RISK FACTORS

Some of the risk factors for injury are awkward postures that are difficult to comfortably maintain, repetitive motions, force, vibration, and a long duration of exposure to risk factors. A factor that has been shown to put musicians at greatest risk is the lack of a warm-up and inadequate breaks during practice sessions.

PREVENTION STRATEGIES

It’s important to insure that your body is strong, fit, well-nourished and well rested. A solid foundation of health helps to prevent injury and permits a more rapid recovery from the physical demands of practice and performing.

Pay attention to your environment when you practice. Is it too cold, too hot, too dark? Work on developing good practice habits. Make sure you warm-up (physically and musically), and take frequent breaks. When muscles become fatigued and unable to do the same amount of work, the physical demands of playing then shift to other soft tissues such as tendons and ligaments, and this is when injuries can occur. With periods of rest, muscles become stronger and able to do more work.

Avoid overly strenuous repetitions of demanding musical phrases, and work instead on a variety of pieces or exercises. After a break or a holiday, or when beginning preparation for a new and demanding piece of music, gradually increase the duration and intensity of your practice. This allows your body to adapt to the changing demand.

One of the most important prevention strategies is to heighten your awareness of what’s going on in your body. If you’re more aware of your posture, of when you’re using unnecessary force, when you’re getting fatigued or beginning to experience pain you can begin to make the necessary adjustments. There are a number of movement disciplines that can help you to develop better awareness, and can improve the way you use your body. These include the Alexander Technique, Feldenkrais Awareness Through Movement, Yoga and Tai Chi.

TREATMENT

Learn to recognize the early warning signs and symptoms described earlier in this column. You may have been told to “play through the pain.” Don’t. Pain is a signal that something’s wrong, take a break until it subsides. Usually, it will only get worse if you try to keep going. If symptoms occur every time you play, get worse, or seem unusual for you, seek medical attention from a health-care professional knowledgeable about musicians’ injuries.

As always don’t hesitate to contact the Musicians’ Assistance Program if you have questions, want more information, or help with a resource or referral. Our hours are Monday, Wednesday and Friday from 9:30 to 5 and we can be reached at (212) 397-4802.

This column was based on information found in “Preventing Muskuloskeletal Injury (MSI)” in “Musicians and Dancers: A Resource Guide.” This excellent manual is published by Safety and Health in Arts Production and Entertainment, a nonprofit professional association in British Columbia, Canada, and can be downloaded from their Web site: www.shape.bc.ca.