My rule of thumb is: if it hurts use cold, if it is merely stiff use heat.
Both heat and cold applications can reduce pain symptoms. Heat can cause vaso dilation which can bring more blood into the area. Cold application can cause vaso-constriction reducing blood flow to the area.
So if you have a hot swollen inflammation, you probably don't want to apply heat because the increased blood flow might increase the swelling and prolong the healing. Whereas applying cold to an area of inflammation might reduce the swelling and thereby speed the healing process.
In cases where there is no inflammation or pain it is advisable to warm up the body part prior to performance. And afterwards if pain results from the performance to cool the body part down. (this is what sports athletes do - especially baseball
It is so common for a musician to visit my office complaining of shoulder/arm pain and requesting stretching exercises. They also, often request strengthening (see "strengthening" blog). Like strengthening, this is a very individual request. If someone is weak they might need strengthening, if someone is "tight" they might need stretching.
Stretching is not for everyone. Matter of fact, it has been thought that more musicians are loose jointed than the non-musician. If a finger or wrist joint is abnormally loose it is common that the surrounding muscles/tendons may have to work especially hard to stabilize the joints. If this is the case, why would stretching these muscles and tendons, creating possible increased instability be beneficial? When we have upper extremity aches and pains a natural reaction may be to relieve the soreness by stretching the area. This often helps to a degree, but preventing such aches and pains is probably not helped by stretching, especially if the stretched joints/muscles. etc are already on the loose side.
Stretching is advised for individuals with abnormally tight muscles/tendons. this should be determined by a health care provider and be properly instructed by a health care provider.
I am often asked by an injured musician to give strengthening exercises or stretches. This blog will address strengthening exercises.
Often musicians comment that their physician recommends squeezing a small ball to increase their hand strength. I find this very interesting. If the individual has hand weakness from either carpal tunnel syndrome or from being immobilized (in a cast for example) this might be an appropriate exercise. Otherwise, I don't understand the need for such an exercise. Playing an instrument employs tremendous hand dexterity and muscular endurance - producing a strong hand and fingers. If a musician has recent pain in the hand, due from some sort of overuse, or "mal-use" and has been playing for years, I doubt the hand muscles are weak and ball squeezing exercises might merely prolong the pain or continue the aggravation.
Now, there are strengthening exercises that most every musician would benefit from. Number one is to have a strong core (trunk strength) to assist in prolonged sitting or standing postures, helping to support the spine and ultimately the extremities. I highly recommend fitness center core classes or "Pilates" classes. Number two is to strengthen the shoulder blade (scapula) muscles called the trapezius muscles. These muscles move and support the scapula - and position the shoulder for musical performance. They are often quite weak (from disuse and poor posture) causing shoulder fatigue and painful tension. If the shoulder is not being well supported by these muscles other muscles in the arm (not intended for this) are called into action - these muscles are often the forearm muscles which try to help support the arm as well as move the fingers and wrist for performance. They quickly fatigue, become inflamed and tendonitis arises. So keeping the the trapezius muscles strong can help to prevent arm tendonitis!!! The specific exercises for these muscles can not be described in this short blog - a physical therapist or trainer knows how to teach these exercises. (be careful, there is a muscle next to the trapezius muscles called the rhomboids which most likely does not need strengthening and can be detrimental to shoulder support and action - make sure your trainer knows the difference when prescribing exercises).
And thirdly, cardio vascular strengthening is extremely important. Every musician should perform a cardio workout 2-3 times per week. Again, see your therapist or trainer for specific instructions (or join an aerobics class).
The word tendonitis shouldn't be that scary. If treated soon and effectively it should disappear within a few days. The trick here is "effectively". I discuss this is much more detail in my eBooks, but thought it helpful to present the topic in a blog. Anytime a body tissue is inflamed it is called an "..itis". Inflammation can be reduced by taking anti-inflammatory medicine such as ibuprofen (Motrin and Aleve to name a few). Don't forget, Tylenol helps pain, but it does not help inflammation. Besides medicine, the musician must figure out what happened to cause the inflammation. For example, did they change fingering, or practice more. Whatever caused the injury must be stopped. This does not mean stop playing - but stop playing incorrectly or reduce practice times or playing highly technical passages, while healing takes place. Seeking medical assistance is needed if one cannot figure out what caused the injury and if stopping the cause and taking anti-inflammatory meds does help. Ignoring this approach may lead to chronic re-injuring or chronic tendonitis. Don't wait long to have your injury assessed by a health care provider - your career is too important.
Firstly, there is no such thing as "double jointed"! Double jointed refers to abnormally loose joints. More and more literature is coming out about what is called Joint Hypermobility Syndrome. This involves joint looseness combined with multiple other symptoms besides chronic joint pain. Other symptoms may involve headaches, stomach problems, depression, cold hands, poor pain numbing with dental procedures... to name just a few. This syndrome is quite common in musicians. There is no cure, but the symptoms can be managed. I recently posted a powerpoint video in the "video" section of this website. Check it out and feel free to post a comment or send me an email.
Do you have cold hands even when the room and rest of your body is warm? Do you suffer from performance anxiety?
Well, chronic cold hands may mean poor circulation or it may be a sign of stress. When we get very nervous or stressed out, our nervous system often triggers the "fight or flight" phenomenon. The blood rushes to our hips and trunk in order to fight off any threat (an old animalistic response) and our hands become cold. It is common that this phenomenon last throughout our days as we get bombarded with many stressors. Besides the cold hands, our muscles become tense (thus the tension felt in our shoulders when nervous). Sustained muscle tension can lead to aches and pains and hinder our playing performance. In order to help these pains we will need to reduce the phenomenon and stresses. One way is relaxation techniques, such as meditation and deep breathing. The "fight or flight" tension should not last throughout the day if we want to prevent a music-related injury. (see eBooks)