Disempowerment in Injury Treatment and Recovery
So last week I touched about Injury Shaming in the music field, as specifically related to employment, education, festivals, etc. However, I did want to discuss some of the other issues related to injury treatment and recovery, as pertaining to musicians. First, let's look at some of the problems with seeing medical professionals about a musical issue.
1. The classic answer to overuse injuries, which sometimes prevents musicians from seeking medical attention for more serious issues, is "stop playing and take some anti-inflammatory drugs." While there are some fabulous medical professionals out there willing to look deeper, many musicians don't seek help as quickly as they might otherwise because they receive a less-than-helpful answer. If music is your profession (not your hobby) and how you make money, then casually telling someone to stop playing until they feel better isn't the most helpful. Also, about those anti-inflammatory drugs- inflammation is your body's way of bring more blood to an area that has been damaged, irritated, infected, etc. It can be a way of protecting against further damage, (unless we're talking chronic inflammation, which changes the type of cells present at the site), and is accompanied by pain, swelling, redness, and heat. When we constantly take NSAIDs (non steroidal anti-inflammatory drugs), we are disrupting our body's process for dealing with tissue damage.
"Overuse of the muscles causes cells to break down, releasing waste products, which produces pain and inflammation. Cleanup crews in the form of white blood cells, known as macrophages, carry away the cellular debris. If you take anti-inflammatory drugs, the natural inflammation process is disrupted and instead of being cleansed away in the bloodstream, the trash settles into scar tissue." (Emil Pascarelli, Repetitive Strain Injury for Computer Users, New York: Wiley, 1994)
Interesting. Another stat I heard in an interview with Jonathan FitzGordon last week stated that while Americans make up only 4.5% of the world's population, we use 80% of the world's (!) pain-killers. Yikes! Maybe it's time to reconsider a few things?
2. While healthcare reform is a great thing for us musicians, especially freelancers, it's been a long time coming, and many of us have had to pay for some expensive stuff along the way. Because of my pre-existing condition, I was denied healthcare and paid out of pocket, which was awful. Even now, many insurance policies have a high deductible which may discourage patients from seeking the treatment they need because of the high up front cost. (If a deductible is $1500, that means that you will pay all costs up to that deductible, which can be a lot of money! MRI's are very expensive...) In addition, that can prevent musicians from getting the PT they need long-term.
3. Many homeopathic treatments are not covered by insurance- acupuncture, chiropracter, rolfing, etc. For a musician in a professional orchestra with a good salary, that might be ok, but for a freelancer or someone with a lower salary, paying $140 for one session is prohibitive. I had a rolfing session (structural integration) which was amazing, and really changed how I felt in my muscles and soft tissues, but it was really expensive and I can't justify going again for a long time. I would love to see more professionals offer their services at a discounted rate for people who could benefit from their services but can't afford it. I know there are quite a few great community acupuncture clinics in the US-what about sliding scale rates for other modalities? Yoga, pilates, and gyms can be outrageously (!) expensive, and I know that also turns people off too. In my fantasy land, orchestras, schools, and arts organizations would make health a priority for their employees/students.
4. Many musician injuries are chronic, i.e. they never really go away. A musician might stop playing for a bit, and feel ok, and then 6 months later, the pain comes back. We need to both look at our own actions and how we're contributing to our own pain, but we also need medical professionals who are interested in creating long term change, not just a treatment of symptoms. It's a combination of taking responsibility for one's own health, combined with assistance from homeopathic and allopathic folks interested in changing the problem, not the symptoms.
5. Lastly, it's really hard to be injured, in pain, or with undiagnosed symptoms of illness. A few years ago, I was consistently unwell. I had headaches, digestion issues, low energy, etc., many of which were difficult to treat or identify. After a period of a few months, I was eventually diagnosed with a non-cancerous pituitary brain tumor, which explained a lot of my issues. Yet, during that time of non-diagnosis, I felt terrible. Generally, we like to take steps in maintaining our health, to be in control if possible. If we move enough and eat vegetables and sleep well, we expect to feel ok. When those things don't happen, it can be devastating, regardless of the injury or issue. RSI's don't go away quickly, and there's rarely a quick fix solution. The process of healing and diagnosis can be awful in itself, especially if the body doesn't heal itself quickly. That combines with the stress of school or a job and a lack of compassion in both the medical and job/education setting can be damaging long term.