Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: balance

Musicians and Muscle Imbalances

Common sense will tell you that musicians (and athletes, dancers, or anyone who focuses on one human activity the majority of the time) will experience muscle imbalances at some point in their life or career.  They might not label their pain or adaptation as a result of muscle imbalances, but it's often at the root of our issues.  Let's backtrack first though.

I sort of love this picture focusing on the more aesthetic side of muscle imbalances- most imbalances won't be this obvious! I mage from Pole PT.

I sort of love this picture focusing on the more aesthetic side of muscle imbalances- most imbalances won't be this obvious! Image from Pole PT.

Muscles move bones through a combination of contraction and relaxation in tandem with opposing muscle groups (i.e. the hamstring group and the quadriceps group or opposing groups).  Contraction is also called facilitation, and relaxation as inhibition.  In the gait cycle, the hamstrings will contract to extend the hip and flex the knee, whereas the quadriceps will contract to extend the knee and flex the hip.  They work in opposition at various points in walking. (*Just to be clear, there are many other myofascial units that play a role in gait. This is just a simplified example!) Normal muscle function is when the facilitation/inhibition cycle is balanced, with no one muscle or muscle group dominating above the others.

Imbalance is when a muscle or muscle group dominates within its role in movement.  This may be due to overtraining, meaning that the opposite muscle may be weak, with limited range of motion, or have difficulty firing.  If we apply this to walking with hamstrings and quadriceps, many people over-fire their quadriceps, meaning that they don't relax after their work is done.  This may then pull on the knee cap (patella), affect the resting length of the hamstrings, and also affect movement actions like walking, extending the hip, etc.  This uneven relationship may be because of overtraining (i.e., way too much quadricep strengthening, lack of hamstring mobility or strength) or a combination of other factors.

One of the common theories to address imbalances is upper/lower crossed syndrome. This  simplified chart  demonstrates muscles that are weak, which may be inhibited, and muscles that are tight and perhaps overly dominant or overly developed. I would also suggest that the words weak vs. tight are not the best to describe the syndromes, because some muscles are weak and "long resting length" and some are weak and "short resting length." There's more to it than just weak=long and strong=short. This is still a muscle theory, which means that there are mixed feelings about whether these relationships are accurate!

One of the common theories to address imbalances is upper/lower crossed syndrome. This simplified chart demonstrates muscles that are weak, which may be inhibited, and muscles that are tight and perhaps overly dominant or overly developed. I would also suggest that the words weak vs. tight are not the best to describe the syndromes, because some muscles are weak and "long resting length" and some are weak and "short resting length." There's more to it than just weak=long and strong=short. This is still a muscle theory, which means that there are mixed feelings about whether these relationships are accurate!

Although this is still a theoretical model, many musicians do have many of these symptoms, including forward head posture, and overly kyphotic/rounded upper spine, and weakness in the back body.

Although this is still a theoretical model, many musicians do have many of these symptoms, including forward head posture, and overly kyphotic/rounded upper spine, and weakness in the back body.

What makes this issue more interesting, at least to me, is that it's not just a muscle issue.  Our nervous system plays a huge role in the way we recruit muscles and retrain them.  For example, a trauma to the tissues (accident, injury, etc) can affect the muscles long after the injury has passed.  Speaking from personal experience, I injured my knee in a bike accident 8 years ago, but my non injured hip and leg do weird compensations, even though the other leg is perfectly capable of healthy movement now.  Physical and emotional trauma can also take on an emotional/fear response- a past injury or emotionally traumatic event may evoke a sense of fear, albeit unconscious, when addressing that muscle.  Musicians who have experienced tendonitis in one arm or hand may have this sense when beginning to rehab, practicing a challenging passage, or receiving massage/bodywork.  This can also apply to more complex traumatic events like assault, physical violence, car accidents, and other events, which may force the person to dissociate from their body or areas of the body.  All of this can be labeled as a neuromuscular imbalance, which is more complex than simple "muscle weakness/strength" models.  

Putting it all together, when someone comes in with a pain symptom, either related to music or other events, it's a lot more complicated than "you're practicing too much" or "your instrument setup needs to improve."  Imbalance can be a result of 

1) Exercise/overtraining: musicians often overtrain the flexor muscles of the hands and forearms with little attention to larger muscle groups or opposing actions

2) Daily movement and lifestyle choices: This can include sitting posture, shoe choices, standing posture, sedentarism, how one holds one's case, cell phone, or belongings, and so forth.

3) Injury

4) Neurological disorders

5) Illnesses: arthritis, diabetes, chronic fatigue, and many other illnesses affect muscle tension relationships, pain, and strength.

6) Pain: Pain will affect the nervous system's ability to know where it is in space (proprioception) and will affect movement.  There have been quite a few good blogs on pain and movement, so here is one from guest writer, PT Arlyn Thobaben, to get started.

7) Stress: Stress, along with pain, can affect muscle tensional relationships.  Often when we're stressed, we move and breathe in a less than optimal way, which may enhance tension in the upper back, neck, and so forth.

How can we address these issues?  Bodywork, especially with someone who can address muscle imbalances and nervous system imbalances can be a great starting point.  General exercise can make imbalances worse if not addressed- seeking a knowledgeable trainer in pilates, corrective exercise, weight training, or other movement modalities can help restore balance to overworked muscles.  As I mentioned in the last post, everything starts with awareness, so finding a teacher in subtle body practices like Alexander Technique, Body Mapping, Feldenkrais, or other practices can be very helpful in feeling the imbalances in your own body.  Lastly, giving your nervous system the chance to relax, whether through constructive rest, massage, or meditation is a great starting point for moving out of the fight and flight sympathetic nervous system response.

Body Mapping, Flying, and Flute: Chatting with Vanessa Breault Mulvey (part 1)

I first met Vanessa last summer at the Andover Educators® Body Mapping conference in Portland Oregon, and we had connected earlier because of my blog.  Vanessa is a Boston-area flutist, instructor, and Body Mapping teacher, drawing from her many areas of interest to help musicians move better and play better.  She has an incredibly articulate bio on the AE® page, which will give you some of her background.  I spoke with Vanessa at the beginning of April.

Uncovering the intimate relationship between the best musical expression and movement is Vanessa Breault Mulvey’s mission. A Licensed Andover Educator, she utilizes Body Mapping along with experience in Pilates, Feldenkrais, flying trapeze and restorative exercise to guide musicians to uncover their expressive voice, as they eliminate playing limitation and pain.    Ms. Mulvey has presented workshops around the world for musicians, venues include: New England Conservatory, Longy School of Music, SUNY Purchase Double Reed Day, British Isles Music Festival, Trevor Wye’s Boston Master Classes, Harvard University, National Association for Music Education Conferences, and Boston Flute Academy. In addition to working with musicians, she has a special interest in applying Body Mapping to fitness. She is working on a developing a playful movement workshop for musicians to restore energy through movement, and co-teaches an anatomy infused Pilates class. Ms. Mulvey is on the faculty at Longy School of Music of Bard College, where she teaches a popular Body Mapping course and the Poised Performer Workshop.

Kayleigh: How did you first learn about Body Mapping and its application to music?
Vanessa: Around 2004 or 2005, I was applying to present at Flute Fair here in Boston, and I wanted to speak about body position and alignment, since it’s something that I’m always aware of as a teacher and performer.  My application was rejected for Flute Fair, and they said that they had a Body Mapping person coming, and since I didn’t know what it was, I thought, “I’d better go find out what that is.”  The presenter was Lea Pearson, and when I was there, I thought, “This is everything that I’m talking about and teaching about, but with more exact language.”
K: So Body Mapping gave you a precise lens to look through flute and alignment things.
V: Absolutely-so I bought the book (Body Mapping for Flutists: What Every Flute Teacher Needs to Know About the Body) that day, and I started studying it, and it just made so much sense.  I did more work with Lea when she happened to be in town, and I just kept running with it, and I saw the immediate impact on both me and my students.  Lea was very encouraging, remarking, “I think you’d be great,” so I went to Summerflute out in California, and I was hooked.  It made sense- it was fun, it was empowering, so I started studying and studying, and there were no Body Mapping instructors in the Boston area at that time, so I was on my own, and I went to Summerflute out in California three or four times.  I also went to a body mapping conference in Ohio, and it was the best place- the musicians and instructors were truly collaborative and supportive


K: Where did you initially study flute?
V: I did my undergraduate degree at the Crane School of Music up in Potsdam, NY, and then I went to Cincinnati Conservatory for my master’s.
K: Were those teachers interested in the body, or was that something that evolved for you separately?
V: My undergraduate teacher (Kenneth Andrews) always talked about the body, whether it was the relationship of the feet and posture and the flute, or breathing- it was vague, but it was there.    I was always aware of the body- I could see the changes in my playing as a result of cultivating awareness and connectivity.  My graduate school teacher was not at all inclined towards the body, and at CCM, there was nothing for the body or wellness, so I went through graduate school cold, so to speak.  When I got to experience the Body Mapping work, I realized, “There’s so much more that I can know and learn.”


K: You became interested in Body Mapping in 2004 or 2005, but how did this extend out into other forms of movement practices?                                                                                                      V: It began as an undergrad- I saw the power of movement when I taught at Longy as the head of the Woodwind department.  While there, I ran woodwind performance seminars, I ran juries and auditions, and I’d watch the way they moved.  I’d say to people, “Why don’t you orient yourself this way, or move this way,” and I would see immediate change.  I could work with just about anybody and make a difference.  My language was very vague at that time, and body mapping gave me the chance to very specific, and know why and how the body is organized how it is, making even more of a difference.  Of course, it was a lot of experimenting in my own personal practice, and that led me to this uncovering of movement, and it turns out that I’m very passionate about human movement- any chance I can, I’m moving.  In classes, I talk about how you have to cultivate a lifestyle that supports your music-making.  You might not be playing 12 hours a day, but chances are you are moving 12 hours a day, and those are opportunities to improve your quality of movement so that when you get to your instrument, overall awareness and movement has improved.


K: How do you define Body Mapping?  I know that’s not the easiest of questions to answer, but it’s an important one for people who may not be familiar with it.
V:  Body Mapping is understanding the body’s design for movement, and understanding it at the anatomical level, and then applying that into executing quality movement, and then taking that quality movement and integrating it into your playing.  It enhances fluidity and poise, but most importantly, in my opinion, is it creates the ability to be independent in your movement.  For example, blowing air faster, doesn’t mean tightening the arms or the neck; I can simply isolate my breathing and blow my air faster.  So it’s that independence that I love to uncover.
K: What’s interesting to me is that you didn’t come to this work from a place of injury- so many players and teachers become more interested in the body when there’s a total breakdown of the body, rather than being interested before injury.
V: I have absolutely been uncomfortable, I have had unreliable technique and sound, but no, I was never injured.  I’ve had pain between my shoulder blades, but it was never chronic, and I would always deal with it.  But what I like now is that when I do experience pain, I can use movement to restore good function.
K: I think that’s always the goal.
V: It can be anything- I was rock climbing with my daughter and fell hard, and my neck is feeling cranky.  I might see a chiropractor, but I can also say, “I know where this pain is coming from, I know what I need to work on to restore movement, and I can draw from all the things that I do to create micro movements and stretches and self care practices to address it.


K: What are all of the things, movement-wise that interest you, either currently or for future study?
V: Some of them I haven’t gotten to, but I flying trapeze has been one of the biggest bonuses for me.  I also started doing pilates at that time, I also do feldenkrais whenever I can, and there’s a drop in class near me, I do rock climbing periodically; this year the big thing has been Nia, which is a dance that draws from lots of different disciplines, primal movement chains- I did a class with Perry Nickelston (of Stop Chasing Pain) down in NY.  I’d love to do a parkour class at some time as well.  I was teaching a few weeks ago and I remarked, “we’re kind of like parkour athletes in a small way- we need explosive athletic movements but with a keen awareness of the ground.  We have to have that dynamism, but in very small ways.”  I think that’s a fun way to think of it.

K:  Are you a teacher of other forms of movement, or are you primarily a Body Mapping instructor?

V: I'm currently only a Body Mapping teacher.  I’m thinking of different things to train in, but trying to decide is tough.  I love all the movement practices, but I have to ask with certification, “is it worth it?”  I love Feldenkrais practices, and I co-teach a pilates class with a pilates instructor where we look at anatomy and alignment before the practice.  MovNat would probably be the highest on my list for certifying, because of the combination of athleticism and natural movement. (Kayleigh: Side note: I did my Level 1 training in MovNat in March- it was a blast!)
K: I sometimes want to train in everything, so I can understand.
V: I’m so busy right now, it’s hard to imagine adding anything else.
K: So what does your schedule look like right now, during the school year?
V: Right now, I teach body mapping classes at Longy and at NEC, and I’m coaching chamber music at Longy, teaching private students at home, and then doing body mapping workshops out and about.  Later today, I’ll do a workshop at Walnut Hill for the Arts for the high school age musicians there.  In the next few weeks, I have 5 workshops that I’m doing.  I'm also playing, not as much as I want, but that’s there too.

Vanessa and I had a lengthy conversation, so I've broken it into a few shorter parts for reading ease.  Part 2 to Follow Later this week, which includes talking about the trapeze and more! 

You Can't Actually Sit Still After All

If you teach children, either sitting or standing, you know that they are fidgety and constantly moving.  Our adult response is usually "sit still," "stand still," or "Stop moving."  Yet, the body can't actually be truly still while standing.  Something called Postural Sway keeps the body constantly adjusting to the effects of gravity in relationship to the body's base.  If you've ever taken a picture in low-light and noticed how much you shake (AKA blurry picture), you've experienced your own postural sway.  As you also know, stability is one of the greatest challenges of older clients/friends/people- many people over 65 are at high risk of falling, which then sets them up for the potential to have broken limbs/surgeries/etc, which they have a harder time recovering from.  What governs these elements of balance?

Your eyes, inner ear, and proprioceptors send signals to the brain about movement, stability, and balance, whether in an athletic context or day to day movements and actions.

Your eyes, inner ear, and proprioceptors send signals to the brain about movement, stability, and balance, whether in an athletic context or day to day movements and actions.

1. Vestibular system- These are your sense organs in your inner ear, located in the vestibulum.  This is the system that gives feedback about balance and keeping the body upright, or maintaining equilibrium. 

2. Somatosensory system- This is your body's ability to know where you are in space.  Sometimes called proprioception, these is sensed by special proprioceptors in joints.  (A wind player's ability to propriocept his or her diaphraghm will be most likely be superior to a desk worker's awareness of his diaphraghm.  A string player or pianist will have much more awareness in the hands or fingers then a singer.)  In relation to balance, your ability to propriocept the body affects how you respond to imbalance, like walking over unstable ground.

3. Visual system- Visual input to the brain about instability is the third piece of the puzzle here-the information from your eyes goes to your brain and helps shape the possible solutions to the imbalance or situation.  (Motion sickness is when there is a disconnect between what is felt in the body (movement), and what is seen (in an airplane/car, lots of outside motion).

If you want to get fancy with finding postural sway in balance, try lifting a leg while standing, perhaps into the yoga pose of tree.  Notice the postural sway in the body and how you're constantly adjusting in the ankle, foot, and lower leg.  Now try that with your eyes closed-much more difficult!  In addition, if you're on less flat terrain, say on grass or on a squishy surface, your proprioceptors are working extra hard to keep you upright.  Try both legs and notice the difference between sides.  At the end of the day, posture, standing, sitting, and balancing are dynamic processes- our body is always moving!

Summer Festival (and general life) Survival Guide

Last month, I wrote up a brief informational sheet about self-care and overuse injuries for a summer festival.  While most of you regular readers will be familiar with these concepts, I thought I'd give you the option to read the highlights of the article, and also have the pdf download.  (huzzah!)  

PDF to Download! 

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Did you know?

-Musicians often live with a certain amount of expected pain.  Not to paint a depressing picture for you, but a 1998 Survey of Symphony and Opera musicians by ICSOM (International Conference of Symphony and Opera Musicians) revealed that 76% of musicians during the course of their career had at least one medical condition compromising performance.  As musicians, we tend to underestimate the sheer mechanical repetition needed in order to perform in our jobs-many traditional symphonic works are thousands of measures long, requiring hundreds of notes per minute.  (Remember this post on statistics?)

-Overuse is a blanket term for muscle, tendon, ligament, bone, and joint issues which are induced through repetitive motion beyond typical limits.  Tendonitis is most common, which is an inflammation of the connective tissue that connects muscle to bone.

Prevention

-Move more! Exercising can't undo 6-8 hours of sitting, so add more movement to your day.  Walk more often, take the stairs, carry things- don't take the easy route unless you need to. Your body molds itself like silly putty to the shapes that you put it in-choose wisely (and move diversely)!

- Do simple mobility and stretching every day.  Stretching may not seem like the coolest thing to do at breaks or between rehearsals, but movement can make a big difference in maintaining healthy tissues.  In addition, try to warm up before serious practicing or rehearsals to increase blood flow.  Also keep in mind that when you can't control the amount of rehearsals you have in a given day, self-care should be a priority, not an add-on!

-Use your ischial tuberosities (your sitting bones!).  This Katy Bowman video is my personal favorite for explaining how to sit better, as opposed to sitting on your sacrum.  Poor alignment in sitting (especially if you rehearse more than 6 hours a day) can lead to many other musculoskeletal issues, including back pain and neck pain.

-Get a massage or try self-massage.   If you have residual knots, adhesions, or tight spots in your upper back, consider a serious deep tissue massage, myofascial release, or rolfing session.  Restriction in the trapezius and upper back can affect your whole upper body (shoulders, neck, forearms, etc.).  A good session can restore normal range of motion and increase blood flow as well as remove adhesions in the soft tissue.  Rolling on balls (YTU®, lacrosse, pinky) can also be incredibly helpful as well!

-Sleep more than 6 hours a night. Sleep is when your body takes on cellular repair, renewal, detoxing (!!), and provides rest for your vital internal organs.  When you don't sleep enough, you’re hungrier, more vulnerable to illness, less focused, increasing your odds for injury and disease, and preventing your cells from repairing adequately, which is important when you're playing often.  Sleep often gets sacrificed in the summer for revelry, which is great, until your forearm muscles feel like you've been doing crossfit "musician-style," and your body runs on a combination of all-day caffeine and nocturnal alcohol.

-Drink lots of water. Your body is 60% water, which is essential for cellular operation.  If you're in hot, humid weather, you need to drink more, and if you're moving and exercising in the heat, even more.  Keep in mind that soda, caffeine, and alcohol can contribute to dehydration, and that water helps in the cellular regeneration process.

dB Danger Zone chart!

dB Danger Zone chart!

-Protect your ears in ensembles.  Sounds above 140 decibels cause immediate damage to your auditory sensory receptors, and normal conversational levels are 60-70 dB.  Flutes and piccolo are between 111 to 145 dB, trumpets can reach up to 140dB, and a full orchestra can be between 120-150 dB.  We all know that hearing loss can be permanent, so wear earplugs if you're in the line of fire and ask for a sound shield.  I love the Etymotics brand, but even cheap foam ones can prevent damage.  Your hearing is not only the basis of your musical career, but a primary mode of our verbal communication

    Overall, pay attention to your body, your tissues, and your pain signals.  Pain is your body's way of telling you that something is not working in your movement patterns, habits, or duration of activity.  Shooting pains, numbness, and tingling are warnings of bigger potential issues, and you should stop playing immediately and see a medical professional if these are occurring.  No festival rehearsal schedule is worth long-term tissue damage, nor is a competition, a recital, or any other concert engagement.




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