Janet Horvath  

Too Much, Too Soon?

Janet Horvath
May 4, 2019

Editor's Abstract (Click to Hide)

Janet Horvath, Minnesota Orchestra's Associate Principal cellist and author of Playing (less) Hurt - An Injury Prevention Guide For Musicians, has agreed to excerpt parts of her wonderful book for polyphonic.org.

Janet's first column addresses the issue of young players and whether hours of playing (repetitive action) can damage developing muscles and bones. She presents some basic rules to prevent overuse injuries, and offers sound advice to teachers and parents.

Janet goes on to discuss ergonomic issues, such as choosing the right-sized instrument and accessories (shoulder pads, chin rests, etc.), and sitting correctly. Jaw pain is a frequent complaint of violinists and violists, and Janet has many suggestions for dealing with it.
Finally, Janet presents an Injury Susceptibility Quiz, which can help you determine if you are at risk for a playing injury.

Polyphonic.org is very pleased that Janet has agreed to share her wealth of knowledge with all of us through our website. Check back often for additions to Janet's column.

- Ann Drinan

We’ve all witnessed the spectacle of the twelve-year-old playing Tchaikovsky’s violin concerto. Where they were once the exception, the outstanding child artist is now a fixture on the concert scene. But at what cost? Among teachers, doctors and therapists, there is a concern that developing muscles and bones may be damaged by repetitive activities. Younger and younger instrumentalists play in pain. Even amongst young players, the length of symptoms is alarming, and can become chronic or career threatening.

How Do Injuries Occur?

Overuse is a loose term applied to several conditions in which body tissues have been stressed beyond their biological limits. Repetitive action, especially when combined with poor posture, excessive force and tension, and insufficient rest or breaks can bring about an overuse injury. Other factors also contribute to risk: our body size and build, our conditioning, muscle imbalances, fatigue and stress, as well as the obvious, our "technique” or physical attitude to our instruments. But young people have additional concerns.

Adolescents experience growth spurts that put them at particular risk for injury. “When young people grow, their bones grow first and then their muscles catch up,” write Barbara Paull and Christine Harrison in their book The Athletic Musician. Studies are finding that some types of stress on the growth plates (the area next to the joint where bone growth in length occurs) may cause problems during development. When bones grow faster than muscle, it is important to strengthen and stretch the muscles in order to protect them from strains and micro-tears that may result from intense use.

“An untoned body is more injury-prone by being less resilient and by failing to provide the needed support for the muscles more immediately involved in performing … Playing instruments is a physical, highly demanding and coordinated activity. Overall physical conditioning is of the utmost importance to prevent injury,” writes Alice Brandfonbrener, M.D.

Too many young students sustain injuries that may lead to chronic difficulties that thwart their musical lives. Education in prevention strategies is essential. Here are four important rules:

  1. Warm up
  2. Take breaks during practice
  3. Increase your practice load gradually
  4. Vary your repertoire while practicing

Be wary of sudden increases in practice or playing time, a change in instrument or teacher, or preparation before a jury, recital or audition. Students are especially vulnerable at these times. Also, watch out for extremely intense summer music camps with repertoire requirements that seem unrealistic.

Tolerance levels vary with every individual. Some students are more susceptible to injury. It is important to set realistic goals for levels of performance, by appropriately assigningrepertoire, and monitoring the number of performances, contests and competitions. Programming should be considered as well, avoiding recitals or programs that contain several works that are new to the student at one time. Too much, too soon is a set-up for injury.

Concerted efforts to reduce stress are paramount. There are many excellent programs to take advantage of, including yoga, Alexander Technique, Pilates programs and the like, but swimming, a baseball game, or a bike ride can work well too! Avoid weights, and use common sense when engaging in sports. Overall conditioning is important, and so is warm up before rigorous activities and before practicing and performing!

Always seek a teacher who pays attention to all the physical attributes of the student. The most important thing is that attention bepaid to good posture, ease of technique, and proper technical set-up at the onset of study, before problems ensue and are difficult to correct. Practice habits, type of repertoire, instrument size and weight, stress levels, schedule, and outside activities should all be taken into account. Be wary if a young person is struggling physically with an instrument. It portends trouble down the road. Use common sense when monitoring the musicians’ activity level and improvement.

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