|Healthy Musician Workshop||
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).
Dr Quarrier has specialized in music-related injuries for well over 20 years. He has directed the Healthy Musician Workshop at Ithaca College