Musicians' Health Collective

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

Filtering by Tag: stance

Suzuki Turn-Out No More

Who decided that we should all stand with one foot forward and externally rotated?.jpg

     I started my humble music career as a Suzuki violinist, beginning at the age of 6.  While there are many useful and important things I learned in my early training, standing position was one that has posed confusion as I've aged.  Let me explain a bit more, for those non-violinist or violists out there.

This is a perfect example of learning "proper" violin stance.  Start with the feet together, then turn the feet out (externally rotating hopefully from the hip, hopefully) and then step the left foot forward.

This is a perfect example of learning "proper" violin stance.  Start with the feet together, then turn the feet out (externally rotating hopefully from the hip, hopefully) and then step the left foot forward.

When one learns beginning violin, often one is told to turn the feet out and step the left foot forward.  I learned this way, and stood this way for a long time.  (Over 15 years, at least).  A few years ago, I started noticing that in yoga, pilates, and weight training, we were told to have both feet pointing forward, at least sometimes.  I instead wondered, why do I always turn my feet out when I play, and does it actually serve me?  I have since started experimenting with this concept. 

This adorable image is from Shirley Givens' violin series, showing that left foot turnout.  In addition, the illustrated girl puts much more weight on her left foot, enhancing the asymmetry of the stance.

This adorable image is from Shirley Givens' violin series, showing that left foot turnout.  In addition, the illustrated girl puts much more weight on her left foot, enhancing the asymmetry of the stance.

So what's the big deal?  Our feet naturally point forward or with a minimal turnout, and you may already remember that when you walk with your feet extremely turned out, there are potential consequences for foot, knee, and hip issues.  (In addition, when feet point forward rather than externally rotated, the musculature of the foot is better able to support the body in standing and walking, and the ankle joint is able to articulate more fully.)  From a biomechanical perspective, I don't understand why music educators have been teaching students to externally rotate their hips while standing, and I definitely don't understand why one foot needs to be in front of the other.  I just don't.  (Who decided this was a good idea?)  However, I don't only care about the feet, but I care also about what is happening in the hips too.  When one hip is perpetually externally rotated (left hip), we can exaggerate that asymmetry out of the practice room, and in our daily walking, standing, and movement lives, even if we don't intend to.  That means that one set of external hip rotators is constantly working more than the other set, which can affect the muscles, bones, and connective tissue over time.  What does that mean? 

See how the right side is higher than the left?  Mine is the opposite-my left side is shorter than my right.  Pelvic tilt Image from http://medical-dictionary.thefreedictionary.com/

See how the right side is higher than the left?  Mine is the opposite-my left side is shorter than my right.  Pelvic tilt Image from http://medical-dictionary.thefreedictionary.com/

Side note, I came to this conclusion because of certain issues I was having in my hip, and that I was seeing in other colleagues of mine.  Here are some of my personal symptoms, which may or may not be yours:

1. My left hip has consistently turned out more than my right, whether I'm in music mode, standing, cooking, walking, running, etc. This can simply manifest as the foot turning out, at least in appearance. Both hips want to turn out in standing though.  I've been working on gently bringing the legs back to neutral, and found that to be helpful.

2.  This in turn can cause my left external rotators of the hip and the low back muscles to be unruly.  (Muscles include my gluteus medius, TFL, Quadratus lumborum, and the iliotibial band of fascia.

3.  I also have the beginnings of a baby bunion on my left foot which may be impacted by the external rotation of the hip.

4.  From a combination of asymmetrical music-making, left side dominance, and a host of other things, my entire left side is loads tighter (less range of motion from sole of the foot up to the shoulder!) than my right, which means that I sometimes have back pain and other issues on just the left side.  

So what's the solution?  Start to get curious. It's also important to remember that correlation does not imply causation- my left hip/back issues aren't inherently caused by the turn out, but I would venture to say that the perpetual external rotation has impacted things.  I will say that my pain has diminished exponentially since I've been doing pilates and other movement activities that have challenged my hip range of motion and stability.   

Ask yourself:

-How do you stand when you're playing? Where are your feet, knees, and pelvis?  What sort of shoes do you normally wear?  How might those be affecting your lower body?

-How do you teach your students to stand?  If you have a specific way of teaching stance, why do you teach what you do? 

-Try standing differently.  Maybe feet closer together, more parallel, right leg in front, both legs in the same orientation...give yourself permission to experiment, and perhaps that will change how you teach.

-Do you sit when you practice at home, and if so, what are your legs doing?

-If you photograph yourself (or video) while playing, what does your standing look like in context?

-Do your feet turn out when you walk/run/play/sit/etc?  Start experimenting with changing that setup gradually and see if it changes how you feel.  It can have ramifications all around the lower body, specifically feet/knees/hips/spine, but maybe affects other aspects as well.

Playing an instrument requires movement within the body- it's not meant to be a static endeavor, but repeating the same position in perpetuity for twenty plus years may not be the best.  

 

I Turn Out My Feet-So Now What?

If I don't think about how I stand, this is what happens.  My right leg is basically pointing forward and my left leg/foot turns out.  You can also see that one's toes don't necessarily point forward-they may deviate to the side, so "toes point forward" is not the most accurate of cues.

If I don't think about how I stand, this is what happens.  My right leg is basically pointing forward and my left leg/foot turns out.  You can also see that one's toes don't necessarily point forward-they may deviate to the side, so "toes point forward" is not the most accurate of cues.

1.  Take a look at your feet.  It can be helpful to compare this with a wall, line, etc.  First, are your knees pointing in the same direction as your feet?  Where are your toes in relation to everything else?

2.  Place a book or block between your feet to start to test it out.  This is not your true parallel, because you're bringing the whole inner line of the feet together. (I visualize feet as more triangular than rectangular, so if you bring your heels together, your toes turn out slightly).

Getting better-now my "toes point forward", but if I look at my knees and hips, they're turning out slightly.

Getting better-now my "toes point forward", but if I look at my knees and hips, they're turning out slightly.




3.  Now try to bring your outer edges of your feet to parallel, using the book as a spacer.  What that will do is demand that your heels will separate slightly, and the inner edges of your feet will touch the book.  That is your truest approximation of feet point forward.  If the book/block concept doesn't fit your bones (you might be smaller or larger than me), than try a different size book.  (A yoga block is about the size of a Harry Potter Book.)  In addition, try these different spacing activities and see how it feels not only in the foot and knee, but in the hip and spine.

Here, my heels separate slightly from the book, the front and insides of my feet contact the book, and the outsides of my feet are pretty close to parallel.  This is my optimal stance.  (I also could use a pedicure.)  Can you see how my left big toe deviates slightly to the left?

Here, my heels separate slightly from the book, the front and insides of my feet contact the book, and the outsides of my feet are pretty close to parallel.  This is my optimal stance.  (I also could use a pedicure.)  Can you see how my left big toe deviates slightly to the left?

Why am I slightly obsessed with this principle?  Because changing the way I stand and walk has decreased any pain or discomfort in my feet, knees, and hips considerably, and I do believe that the way we teach our students to stand will affect their long term movement patterns.  Feet/knees straight is simply a good foundation towards achieving neutral pelvis, neither internal nor external rotation in the thighs.  There are good reasons that one may not be able to do this, and you would probably already know this based on your medical experience (PT, pediatric diagnosis of bow leggedness, tibial torsion, hip retroversion, etc.), and later this week, I'll detail some of the movement patterns that would prevent someone from doing this easily.  For the public at large, neutral rotation of the thighs is a soft tissue issue, and a habit, rather than a structural restriction.  What that means is that the muscles of external rotation (in the hips and thighs) may be stronger or tighter than the muscles of internal rotation, and that the body is not used to standing in a neutral position.  

In addition, music making is an incredibly complex and intellectual process, and naturally, we might be focused on what's going on with our instruments, baton, etc, rather than our feet and legs.  Having a solid foundation in the lower body has been incredibly helpful for me in stressful performance situations, and also gives me a sense of stability in confidence in other movement disciplines.  When we can make music from an awareness of the whole body, it creates an embodied performance that is palpable and powerful.  Just as Andrea wrote in her most recent post, this is also process of exploring your own movement patterns, and just becoming aware of your habits and tendencies is incredibly valuable feedback.


Working with Children and Students on Standing Better-From the Feet Up

Following a request, here are some fun suggestions on standing that go beyond the classic "Draw your feet on a piece of paper" activity.

IMG_1212.jpg

Here are some of the close-ups of the suggestions- Post-it stars that have little arrows on them, and then I can line up my feet with them.  You can also put stickers on your young student's feet or shoes for extra fun.

With the dinosaurs, you can see that my feet point forward, but the risk is that one foot will creep ahead of the other.  With little kids, this is not a big deal, since they are fidgety, but it is a good basic border.  

With the dinosaurs, you can see that my feet point forward, but the risk is that one foot will creep ahead of the other.  With little kids, this is not a big deal, since they are fidgety, but it is a good basic border.  

The Classic texting "Shlump" that can be seen in teenagers (and most people walking down the street).  My spine is rounding and my head is forward and I will probably run into something. Don't believe me?  Look at this video below!!!

The Classic texting "Shlump" that can be seen in teenagers (and most people walking down the street).  My spine is rounding and my head is forward and I will probably run into something. Don't believe me?  Look at this video below!!!

The position of the feet and knees are really the base of a good standing posture, and affects everything up the chain.  Feet affects knees, which affects the tilt of the pelvis, which can affect the curvature of the spine, and finally the position of the head.  Are there legitimate reasons that you or your student can't point your feet straight?  Yes-and I will talk about those next time.

Remember this comic from a few weeks ago??  See how curved the spine is?  While I can't claim it's due to feet, I do see it in students, teenagers, and people at large, and beginning to notice it in the people around you is the first step.

Remember this comic from a few weeks ago??  See how curved the spine is?  While I can't claim it's due to feet, I do see it in students, teenagers, and people at large, and beginning to notice it in the people around you is the first step.

Turn-out Turn Coat

How did we come to this point of turning out our left leg so much while performing?

1.  Western civilization used to be one of dancing and military turnout, both of which demand external turnout on a regular basis.  While we are no longer a culture of formal dancing, the turn out remains.

2.  We learn our habits of standing, walking, etc from our parents/teachers/elders as a child.  If you compare your habits with your parents', you'll probably find that you have a similar gait, stance, or way of holding yourself.

3.  Musicians, on the whole, resist change.  For hundreds of years, musicians have been turning out legs/hips/feet, standing on one leg, balancing precariously, etc.  Many notable pedagogues have touted their stance technique as promoting balance.  While many of these folks are important teachers and musicians in their own right, our understanding of the body is constantly changing, which means we should change our teaching and habits accordingly.


What are the short and long term effects of turn-out?

These are some of those external rotators of the hip, which may in fact be asymmetrical contracting, weak on one side, etc.

These are some of those external rotators of the hip, which may in fact be asymmetrical contracting, weak on one side, etc.

1.  Transference-whether you're a little kid learning twinkle, twinkle, or a grown-up who plays viola and runs, it's likely that your standing habits transfer to all of your other activities.  This means that you have a slight turn out when you walk, squat, run, etc.  This transference is what can really lead to injury, tightness, and extreme asymmetry down the road.  Kids are fortunately very malleable, and their bodies are perpetually changing, as are their abilities to propriocept.  

2.  Feet-I know I've mentioned it before, but bunions and hammertoes are also correlated with turn-out as well as tight shoes.  Also, your feet may be supination or pronating, in addition to the turn out issue, which can compound issues.

3.  Knees- When we turn our feet out, we can try to turn out from the lower shin/ankle, or externally rotate the whole leg and hip.  When we just turn out the lower leg, this can put undue stress on the knee, because one is facing forward and one out.  Then imagine putting load onto that asymmetry-running, crossfit, etc.  Add foot instability, or collapsed arches, and there is an issue!  The video shows how gait changes a bit on that one side.

4. Hip woes- So the cause of this external rotation could be tight muscles on the same side hip, which in turn prevent the hip from turning internally as needed.  (AKA. Your abductors are adaptively tighter than your adductors).  This article fantastically explains how this happens.  What that means is that one side of the body may in turn be shorter than the other, and there may be discomfort on the side of the hip. 

In the end, the goal is to at least keep both legs in the same plane to start (one leg is not in front of another).  If you have extreme turnout, or have been turning out for many years, then gradually strengthening your adductors and slowly changing stance is the way to go.  If the body is exploring a new range of motion or posture, it won't be sustainable to stay in the "new normal," but it would be over time. 


Highlights of the Last Two Months

In case you're new to the site or want to revisit some of the earlier material, here are a few highlights from the last two months of posts. 

Look at the postural change from adding heels!

Look at the postural change from adding heels!

Shoulders- From anatomy to stretches, learn about what constitutes the shoulders and how to work with restriction.

Stance and Posture-  Musicians are often told to stand in a certain way which may or may not be good alignment for their body. 

Feet and Shoes- From flip flops to heels to thick padded running shoes, we often pick shoes that don't support us while performing, walking, and standing.

Developing Awareness of the Body, by the fabulous Andrea Kleesattel.

And as always, you can search at the bottom of the site for anything you might be looking for, or click on the tags at the end of each post to see related posts.

 

 

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