Musicians' Health Collective

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

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Disempowerment in Injury Treatment and Recovery

I just thought this article  needed a picture.

I just thought this article

needed a picture.

      So I’ve previous discussed 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."  Let’s be clear, rest is important. But if the solution is to tell people to completely stop their career without looking at the whole picture of what’s creating an injury, we’re setting up for a problem. 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 for a long term solution.  If music is your profession and how you make money, then having a medical professional dismiss your concerns is incredibly insulting.  

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 and repetitively 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 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, regular check ups, and care they need long-term.

3.  Many homeopathic and alternative 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 or sliding 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 by supporting these resources, rather than expecting students to pay out of pocket.

4.  Many musician injuries are chronic.  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 very stressful in and of 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.     

 

The Sour Side of Sugar

I recently asked fellow YTU teacher and health coach, Christina Medina to write a short piece on the consequences of sugar.  Like many people, I was impressed and disheartened by the documentary, "Fed Up," and have been shocked at some of the truly detrimental consequences of refined sugar. 

Christina Medina, RYT 200 is an Integrated Yoga Tune Up® Teacher and an Integrative Nutrition Health Coach. Her passion in life is to age with grace AND share that passion with others by helping them to live, move, and feel better in their body naturally. When she isn¹t spending time with her husband of 30 years or her four adult daughters, you can find her studying topics like anatomy, biomechanics, or nutrition, coaching clients to live the healthiest version of themselves, or cooking up something gluten, grain, and sugar free in the kitchen.

“Like heroin, cocaine, and caffeine, sugar is an addictive, destructive drug, yet we consume it daily in everything from cigarettes to bread.”

~ William Duffy, author of Sugar Blues

I’m sure you’ve been there – countdown to show time, time to get it done, time to do
your thing, show up, perform – whatever that means to you in your current situation. For me, it’s teaching movement classes and working weekly on a few big projects. Either way, I’m expected to show up with my “A game” and be ready to go. But lately, my energy level has been lower than normal and dragging me down, which gets me thinking about reaching for a little pick-me- up. You know, something to jumpstart my energy and propel me towards my goal. As a recovering sugar addict whose been on the wagon for three years now, I confess, there are still times when I long to grab something sweet and sugary and (misleadingly) satisfying, something that I think will give me the boost I need to get the job done and maybe make my heart sing all the while. The truth is that I know enough now about sugar and how my body will respond to the consumption of it. Sugar isn’t going to really give me what I want – the energy to be my best or perform my best for whatever the task is at hand. Quite the contrary, it’ll do me more harm than good.


Sugar, I know, gets a bad rap. But, it does so for good reason. Scientific research is clear. And, more and more evidence is coming out validating the sour side of sugar, the negative effects it can have on the body and mind, things like: brain fog, fatigue, moodiness, nervousness, arthritis, headaches or migraines, mild memory loss, immune suppression, emotional instability including depression, asthma, low blood sugar or hypoglycemia, which can cause confusion, irritability, and forgetfulness. The list goes on and on. 1 None of these sour sides of sugar will help me bring my “A game” to the table or allow me to perform at my best.

Image from the documentary Fed Up courtesy of  Eater.com .

Image from the documentary Fed Up courtesy of Eater.com.


But what about a little bit, I ask myself? Just this once? Maybe you’ve thought that too. Unfortunately, the one time, the “spoonful of sugar that helps the medicine go down”, so to speak, lights up the brain like the brain of an addict on crack. 2 Sugar stimulates the brain, tickles the reward center, and releases dopamine. Blood sugar quickly goes up in response to the sweet thing eaten, then comes crashing down just as fast, leaving you feeling low and slow and wanting more. Recent research shows strong evidence supporting the idea that sugars and sweets can induce cravings almost comparable to addictive drugs. Therein lies the problem: for many, the occasional becomes a habit, and the habit becomes an addiction. In this way, sugar and the craving for more pushes out the nutrient-dense foods that might otherwise be eaten.


Let me be clear here: I’m talking about refined sugar like good ole’ C&H pure cane sugar, from Hawaii, growin’ in the sun (anyone remember the commercial?) – aka table sugar or granulated sugar. I’m talking about any sugar that has been so refined it no longer, in any way, shape or form, resembles anything near to what it was as it is grew from the earth. I’m not referring to natural sugars like in a piece of fruit, or that in honey or maple syrup, etc. which also comes with vitamins, minerals, and fiber. I’m talking about the stuff that has been extracted from either the sugar cane plant or from beets (which, by the way, are typically GMO these days). Once extracted, these sugars are then devitalized, meaning stripped or depleted of all nutrients. And, if the sugar is white, it has been bleached.
Some folks say that sugar is sugar, but I disagree. Yes, sugars may be isocaloric, meaning they contain similar calories, but they are not isometabolic, meaning they are not metabolized by the body in the same way. The body processes natural sugar, for example in an apple, completely differently than the refined stuff, in say a Snickers bar, and even more so than the man-made stuff (those alternative sweeteners like Splenda, aspartame, Equal, etc., which are toxic) found in something like a diet Coke. The beauty about natural sugars is that they contain easily digestible micronutrients that make it possible for the body to process and metabolize the sugar, as it should be, at the cellular level.
Some of these micronutrients are B vitamins, and minerals like magnesium, phosphorous,
iron, and zinc to name a few. Refined sugars are void of these micronutrients and fiber, which are necessary to break down the sugar to use it as energy. There are no added benefits to eating it; it’s mostly just calories (hence the term: empty calories, meaning no nutritional value).

This for me is one of the most astonishing.  Commercial smoothies and juices are SO high in sugar.

This for me is one of the most astonishing.  Commercial smoothies and juices are SO high in sugar.

That’s another sour side of sugar: since refined sugar doesn’t have any built in micronutrients, it’s a micronutrient depleter. Let me explain: eating an average orange is like making an energy deposit in the body of approximately 60 calories plus loads of vital micronutrients. To digest and metabolize the orange and the sugars therein, the body uses the necessary micronutrients from the orange to do so. Simply put, eating the orange is like making a deposit to the body’s energy bank. Now, for the same number of calories (60) you could eat 4 teaspoons of sugar. However, there are no micronutrients – no fiber, B vitamins, minerals, etc. in the sugar to help the body turn the sugar to fuel. The body has to take all the micronutrients to digest and metabolize the sugar from the body’s micronutrient reserve. In eating the 4 teaspoons of sugar, the energy withdrawal far exceeds the energy input. Herein lies another sour side of sugar: continual energy withdrawals without valuable energy input will deplete the body of vital nutrients. If the
energy withdrawal is done consistently enough, for long enough, the body goes bankrupt. This is how sugar can cause so many problems in the body. Micronutrient and energy bankruptcy could lead to depression, adrenal fatigue, chronic disease, inflammation, and more.

So, the next time you’re feeling like you need a little pick me up to get the job done, grab something more wholesome and healthier than your usual sugar laden treat, something that is sweetened with natural sugars. When choosing pre-packaged snacks, look for items containing unprocessed and unheated such as honey, molasses, maple syrup or sugar, coconut, palm, or date sugar, green stevia leaves, or dehydrated sugar cane juice like Rapadura or Sucanat. These last two natural sugars are also great choices to use as substitutes for granulated sugar when you’re baking.

You say you prefer savory and don’t eat many sweets? Chances are that you’re probably eating more sugar than you think. Refined sugar is in just about everything that’s packaged on the grocery shelves: yogurt, granola bars, peanut butter, and your favorite chips and salsa. Start reading food labels. You’ll be surprised where you’ll find sugar once you do. Unfortunately, sugar is ubiquitous. This fact was exposed in the recent documentary, Fed Up. It is currently estimated that the average American eats about 130 lbs of added sugar a year, or approximately ½ cup (22 tsp.) a day. This far exceeds the USDA’s daily recommendation of 9 teaspoons for men and 6 teaspoons for women.

The bottom line is that there are times when we crave a little pick-me- up and we want it to be sweet. When that time comes, try some of my go to favorites: a raw milk latte sweetened with raw honey and a dash of cinnamon, a banana with raw almond butter, a Hail Merry Chocolate Mint Miracle Tart 5 and kombucha. In choosing to fuel the body with natural sugars found in nutrient-dense foods, which are loaded with all the other micronutrients needed for digestion and metabolization, you’re choosing to make an energy deposit, not just an energy withdrawal. In this way, you’ll stay off the sugar roller coaster; you won’t experience the high from the blood sugar spike followed by the debilitating letdown. And, you’ll have the energy you need, when you need it to perform your best in daily life and on the concert stage.

2014 Recap and Looking Ahead to 2015

            I was in a small symphony promo on the daytime news yesterday, and in reviewing 2014, the news highlights were the "year of Taylor Swift" and "J-Law made 1.4 billion dollars."  Other topics included Kim Kardashian's bottom, Justin Bieber's clash with the news, and fitness resolutions for 2015, including "exercising and drinking water."  I'm not a huge fan of big sweeping resolutions, and I could care less about KK's derriere, but I do happen to like reflecting on the past year's successes and the future year's possibilities (Note the lack of the word resolution).  Inspired by Katy Bowman's health recap, here's a combo career/health recap as well as suggestions for looking ahead to 2015.

Most of these questions can apply to your career, personal life, (musical, administrative, etc.) or to your health, so feel free to tailor them to your needs!  I like to journal/write/think about plans, goals, or aspirations, and then follow up on them throughout the year to make sure I don't totally derail myself. 

Reflecting on 2014

1.  What was your biggest health success in 2014?  What was your biggest career/personal life success?

I have a problem with filling up journals...some of these are from 15 years ago!  Sometimes I write about new year goals, practicing, challenges, sometimes, what movie I saw and what food I ate.  Post from January 1998, "I want to get in shape and that will be a challenge."  Did I even know what that meant then?  Not sure. 

I have a problem with filling up journals...some of these are from 15 years ago!  Sometimes I write about new year goals, practicing, challenges, sometimes, what movie I saw and what food I ate.  Post from January 1998, "I want to get in shape and that will be a challenge."  Did I even know what that meant then?  Not sure. 

2. What was the smartest health decision in 2014?  (ex. I made the decision to walk 3-5 miles almost every day, no matter what, and that was an excellent choice. )

3. What was the greatest lesson your learned about your own health?  What was the greatest personal/career lesson learned?

4.  What was your greatest health/career/personal life challenge?  How did you address this?

5.  What about your health/career/personal life are you most happy with right now?

6.  Name three people who impacted your personal/health/professional life (for the better) this year.

7.  What was a risk you took this year?  What was gained or lost from taking said risk?

8. What did you intend to do (any area of life) in 2014 and fail to follow through on? 

Here's a picture of my mostly blind dog, just because.  She had eye surgery this summer and with care, we've been able to transition off of all of her glaucoma meds and most of her antibiotics.  She still likes short walks and daily carrots.

Here's a picture of my mostly blind dog, just because.  She had eye surgery this summer and with care, we've been able to transition off of all of her glaucoma meds and most of her antibiotics.  She still likes short walks and daily carrots.

 

Looking ahead to 2015

1.  When you think ahead to December 2015, what would you like to be proud of having accomplished in 2015? 

2.  What health/personal/career advice would you give yourself for the coming year?

One of my goals for 2014 was to expand my understanding of embodied anatomy, and start to share my knowledge/learning process with people.  I also wanted to try crossfit (check) and keep running a few 5ks (check).   Anatomy is a HUGE subject, and I 've barely scraped the surface, but I've learned a lot and I'm excited to learn more.

One of my goals for 2014 was to expand my understanding of embodied anatomy, and start to share my knowledge/learning process with people.  I also wanted to try crossfit (check) and keep running a few 5ks (check).   Anatomy is a HUGE subject, and I 've barely scraped the surface, but I've learned a lot and I'm excited to learn more.

3.  What's one thing you can do to improve health/career/personal life this coming year?

4.  What makes you happy and how can you incorporate more of that into your life?

In addition to walking daily, self-massage with squishy rubber balls has helped SO much with shoulder, back, neck, and hip pain, either from music-ing or just life in general.  I live with less pain and more mobility than ever before.

In addition to walking daily, self-massage with squishy rubber balls has helped SO much with shoulder, back, neck, and hip pain, either from music-ing or just life in general.  I live with less pain and more mobility than ever before.

5.  What's something you'd like to learn more about in 2015?

6.  What's something you've dreamed of, but never been able to make happen?  (Be semi-pragmatic here, folks.  "I'd like to marry celebrity X" is perhaps not the best dream to make happen, though I support that dream anyway.)  What steps can you take now to make that dream a reality?

7.  What about your health/career are you most committed to changing/improving in 2015, and how do you intend to do that?

8.  What's one word to summarize your plans (career/health/etc) for 2015?

I totally understand if this sort of reflection isn't your thing, but I happen to find it really helpful, and I hope you do too.  I realize that not everyone needs to read about my personal health journey/music health journey, but if you have some epiphanies, I'd love to hear about them!



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