Hopeless

February 27, 2007 at 09:03 PM · Hello everyone... I'm in need of some advice.

I'm a third-year university student, majoring in viola. For the past four years or so, I have been unable to play without some sort of intense pain. Sometimes it's in my lower back, sometimes my upper back, or my elbows, or my shoulders (especially the left shoulder). Sometimes it's all of those places at once! I can't even properly wear a seatbelt, because it cuts into my left shoulder, which is constantly on fire. Thankfully my wrists and hands have been spared so far.

I can barely make it through an orchestra rehearsal, let alone a concert. I can't even DREAM of practicing four hours a day, because the pain is just so intense. I have to stop every few minutes. I can't even hold the viola without pain. I've been trying different things, like chiropractic, physical therapy, and cortisone shots, but I've been trying to get to the root of the problem.

I'm so afraid that my pain is going to force me to give up my career. I would be unhappy for the rest of my life. I NEED to be a violist. I've thought about switching to violin, because it's smaller and so much easier on my body, but viola is my passion.

I've been feeling so hopeless for the past couple of years. I feel like my body is deteriorating, and I'm only 20! I'm afraid that this pain is going to rule my life.

Has anyone else ever been in this situation? How did you get out of it? Did you go on to become a professional, in spite of the pain?

Replies (39)

February 27, 2007 at 09:23 PM · Amanda, have you spoken to Peter about this? He's really good with teaching you how to play relaxed. Don't give up, there's obviously a reason that you're feeling this pain. Once you find out what it is, you'll find a solution. Don't worry, you'll get this taken care of.

February 27, 2007 at 10:02 PM · A few questions:

What do you already know about the root cause from your research and treatment?

Does the physical therapist seem helpful and competent? The chiropractor? What have they tried and what were the results?

Do you have background info on musicians' injury prevention and treatment? I bought a dozen copies of Playing (Less) Hurt by Janet Horvath (Associate Principal Cello of the Minnesota Orchestra) at a bulk discount for injured students at UIUC, because the information is not often readily available.

Has your teacher ever been injured? This is sometimes a problem, where they maintain damaging expectations of an injured student, which it sounds like you have internalized.

The bad news: According to a therapist who spoke in a School of Music seminar here yesterday, you probably should not be playing now with the level of pain you report.

But I'm pretty sure that the v.com community will help you get through this. :-)

February 27, 2007 at 10:47 PM · Something is wrong there somewhere, no need to tell you that, though. Have you had an MRI or CT Scan? I'm no medical expert, but I bet there is one cause for all this pain.

Do you exercise at all or lift weights. I'm wondering if your muscles are weak and not supporting yor back very well. Don't start with weights without expert advice. Expert advice is usually not from a "trainer" at a local Ballys, but a physician or trained Therapist.

February 27, 2007 at 11:06 PM · Greetings,

Alexander Lessons are a very good place to start.

If you begin this kind of work then whatever kind of exercis eprogram is necessary will be enhance dbeyond belief because you will have relaible input about what you are actually doing with your body. AT doesn`t heal, it just tells you what you are doing wrong and gives you the space and tools to make choice sthat will help you heal.

But, these kind sof problems are really complex and deep. I have been -eactly- where you are now and so have many others. It builds up over years and we ignore it because music is what we love and we have to do it whatever the cost. But we nee dot take the time to step back and look at the big picture. This is also going to include past traumaus and psychologicla issues that cannot be dealt with here. It also involves food to a very large extent, something the music community tends to ignore completley.

So, have faith, kick back for a bit, get the help you need and maybe v.commie can help you with a few bits and piece sof the jigsaw.

Best o f luck,

Buri

February 28, 2007 at 12:02 AM · You sound a lot like my daughter, who is also a violist and plays in pain. She's been through years of physical therapy, chiropractor visits, orthopedist visits, and has had multiple MRIs and other diagnostic tests. But the pain persists. Alexander Technique hasn't cured her, but it is the ONLY thing that has helped (we haven't tried accupunture yet. It would be great if you could find a therapist who works with musicians, particularly string players. We were fortunately enough to find an AT practitioner who does specialize in musicians. But it is a very hard, frustrating road.

My daughter's teacher is very young and has no pain in her own playing. The other thing I want to do is change to a new teacher who can work on position and posture issues with her (but she doesn't want to leave her teacher yet.) Good luck with your problem. I think helps to shop doctors and therapists until you find someone who has experience with your type of problem and who understands how much you *need* to play viola.

One other thought-- there are some more ergonomic violas out there, with cut-outs and unusual shapes to help avoid stress. Have you considered a different instrument.

February 28, 2007 at 06:05 AM · I'm so sorry to hear this. It must be a torture to have this happen doing something you love.

I would second Ray's advice, go to a good certified doctor. It is worth it even if it is expensive. I'm not so sure about alternative practices like acupuncture. I'm sure she won't mind me telling this to prevent future musicians from getting hurt, a family friend of ours by the name of Pamela Frank (who's father was my mom's piano teacher) got into a car accident, was having all kinds of problems recovering from the injuries she sustained, and decided to go to a acupuncture 'clinic' in Chinatown (NYC) I believe. Apparently after getting the acupuncture 'treatment', she started to develop an infection (due to the fact the needles weren't sterile), and also I think some nerves were damaged.

These places are very dangerous, I would avoid them, and I am part Chinese, take my word! :)

February 28, 2007 at 12:21 AM · My professor told me of accupuncture therapist in Cleveland. He's Chinese, and apparently half the Cleveland Orchestra flocks to him. He tells them to come back when they start to hurt again, and they don't come back for 2 years (an example he gave me). I'm not sure of the name, but I can ask him for you if you'd be interested in making the drive (either of you).

February 28, 2007 at 12:24 AM · Thanks for you support, everyone! I'll try to answer everybody's questions, without forgetting anybody.

I think the pain is mostly caused by tension, and a bad setup. I'm currently using a Kun Bravo and a Flesch chinrest - the one shown here: http://www.sharmusic.com/itemdy00.asp?T1=1120+FBV&Cat=

While I like the chinrest, something about the Kun really bothers me. It just doesn't sit right on my shoulder, and the viola keeps wanting to slide off, so I have to almost clench it in place, which is definitely causing me pain. Next I'm probably going to try the Comford shoulder cradle, which hopefully will be better contoured for my shoulder.

The physical therapists were really nice, but I felt that they didn't really know what to do about it. They were used to dealing with old people, not musicians. The chiropractor was also nice, but after a while I began to realize that it wasn't having any effect at all. I had an MRI done a couple of years ago, and it showed a bulging disc in my spine. The doctor didn't really offer me any solutions at the time. He offered me pain pills, but I never filled the prescription because I didn't want to become dependent.

I used to lift small weights but they started to make the pain worse, and I became terrified of messing up my muscles, so I stopped. I'm fairly small and weak, so maybe I should start swimming or something. I feel pretty pathetic when I can't even hold up my viola.

Buri, I'm going to try Alexander Technique. There is an AT teacher who comes through here every once in a while. She's given masterclasses, but I had a hard time understanding what was going on, and how to apply it to my own playing. Next time she comes I'm going to ask her for a lesson or two.

I think part of my problem is that, just a few months after I started playing, I was in rehearsals at school every day for at least an hour. At that point I didn't have much of a concept of how to hold the instrument (no lessons!) but I was still constantly in rehearsal, from then on. So, I guess I found my own way to do it, but since it wasn't the right way and I had noone to show me, I instantly started messing up my muscles. Then, when I got to college and was sitting through 2 hour rehearsals with no break, my pain got so bad that I literally could not bend my back at even the slightest angle without excruciating pain, and I had to go around wearing a back brace. So, I guess I didn't have the proper muscles built up from years of playing.

Elizabeth - I've thought about the ergonomic violas, but I just bought a new instrument, so it will be a while before I get another.

Marty - thanks for the advice! I'll try catching Peter at a time when he's not phenomenally busy.

February 28, 2007 at 01:00 AM · Oh, and about the acupuncture - do any of you know of any place in the South that does it? As can be expected, it's not exactly popular down here.

I just remembered another source of pain that I keep forgetting to mention - driving! I drive a LOT more than the average person (often three or four hundred miles per week). The seat kills my back, and the steering wheel cause me pain in my shoulders and elbows. Does anybody know what I can do about that? Anybody else have this problem?

February 28, 2007 at 02:04 AM · the v.com guy is without a name, but amanda you need a diagnosis. myofascial pain syndrome comes to mind. google it.

hopeless may be, but not helpless. OU has a pain service in the medical ctr..probably run by anesthesiologists, in conjunction with neuro-rehab people. sounds like it is time to take this seriously. usually it is a multi-discipline approach, a team, including a psychologist. i like buri's emphasis on nutrition,,,you are what you eat. also, swimming is very therapeutic.

sounds like the prior patches do not work, thus you may need to find ways to reconstitute your physical well being. but you cannot do it alone.

i think alternative med has its place, but only after you are cleared by the conventional approach. major med ctrs currently all have acupuncturists, massage therapists on staff. chiros are a different breed,,,to some a bit too savvy and enterprising.

nowadays, acupuncturists not using disposable needles are essentially unheard of. you have a much higher chance catching an infection if someone sneezes across the hall than from the pins.

on driving...my wife always gets that pain from holding wheels at 10 and 2 oclock, with elbows unsupported, thus the shoudler region lifts weight of the 2 upper limbs the entire trip.

i am simply lazy,,,i hold the wheel at 5 or 7, one hand at a time, resting my elbows on something. makes a difference in terms of letting the traps relax.

instead of saying good luck, i will suggest you to make the call.

good luck.

February 28, 2007 at 02:00 AM · Amanda, I pulled these out of the B'ham Yellow pages:

Acupuncture Clinic, Dr. Gregory Chen, 205 979 4079

Alabama Oriental Medical Arts 205 324 6003

Chinese Herbs Acupuncture Center 205 822 5552

Chiropractic Acupuncture Health Center 205 408 5600

I will be in T'Town in a couple of weeks, and if you want to try my Comford (violin) rest, let me know, and I will bring it along.

February 28, 2007 at 03:21 AM · Greetings,

Amanda, you probaly need at least ten lesosns to begin getting long term and useful help from AT. It has taken years for you to learn how to misuse the self. Returning to your real self takes time.

Cheers,

Buri

PS You can start tyring to help yourself with the exercise I sugget in the new blog. Mail me if you wnat more explanation.

February 28, 2007 at 03:17 AM · Hi...We feel your pain. Like others, my pain was severe, supposedly permanent....switched from a 16 1/2" viola to a 15 1/2" and viola...er...voila, the pain subsided and I am able to blast thru a 3 hour Strauss Waltz gig, playing afterbeats on the G and C strings without resting the elbow on my knee or having to nearly OD on Schnitzel&Schnapps. Have your tried a smaller vla ?

February 28, 2007 at 03:29 AM · I would tell you to take a little break as you figure this out but I can't follow my own advice. But I think Alexander and aerobic conditioning while minimizing the hours of practice seems a starting point since the therapist didn't do it, nor did the chiropractor.... And though you didn't grasp the Alexander the first time, don't give up on that-from what I've read of it and tried to apply, as well as something else related to tension free playing I was shown has helped tremendously.

My first year and a half were constant chronic pain, so I do not envy your condition--especially as an advancing player.

Symbolically I just transformed your hopeless into winsome. So there's a start.

al 'the society for naming Kokopelli nicely' justice

February 28, 2007 at 04:39 AM · Hi Amanda,

It's not hard for me to imagine what you are going through, as my first job in my past life (life before Canada) was a nurse in Shanghai Longhua Hospital. I practiced Chinese traditional medicine (including acupuncture and herbal medicine) along with China’s very top CTM doctors. These days I try to avoid the topic because it’s so political and the opinions are divided. But I feel v.comers deserve my $0.02: Be very very careful what you get yourself into if you want to try acupuncture.

I know how to do it myself and I did it on daily basis on many patients of mine back in China (because it was my job) and I did receive frequent positive feedbacks from them. But I don’t believe it so I won’t do it to anyone unless I’m forced to. Some of my best CTM doctors will not use acupuncture on themselves or their loved ones when they are sick. Interestingly enough, some CTM doctors in North America are CTM trained in China but a lot more aren’t. Two of my CTM trained doctor friends (one came from a famous 3-generation CTM family) changed their careers as soon as they had moved to North America and started to pursue different career paths in their late 30s, despite the fact that they didn’t’ speak very good English and it’s a lot easier for them to make money by practicing CTM instead. When asked why not CTM, their answer will offend a lot CTM practitioners so I’m leaving it to your guess.

When it comes to health care, belief is a big part of it. If you want placebo effect, there are a lot less intrusive alternatives around. If you are curious about it, read up the theories behind to see if they make sense to you. Look for the claims they are making, are they doing science? If so, what kind of science they appear to be doing?

One thing I like Alexander Technique is that it doesn’t purport itself to be doing science, even though it’s highly empirical. It is the least intrusive and most sensible approach to taking care of one’s body that I’ve seen. I hope you’ll give it a good try before taking up anything drastic such as acupuncture.

February 28, 2007 at 06:28 AM · Hi Amanda,

you obviously encircled the central problem already, there're several institutes of specialized hospitals relating musicians injuries and their prevention in the U.S., maybe it's no waste of time to write a mail to some of these institutes to get similar addresses in the south. Since they're specialized (most of the doctors in institutes likes those here are very active musicians) they can make refined diagnosis and provide you with specific training-programs to prevent problems. Another opportunity is to seek help at the Musicians Clinic in Hamilton-Canada, it seems to be a kind of Lourdes for violinists. Maybe they have good addresses after a short phone call.

If you visit one of these institutes, don't forget to bring your viola with you. When I had similar problems like you, a visit there gave me finally the feeling to stop fighting symptoms, this feeling was priceless.

February 28, 2007 at 01:21 PM · Hi,Amanda, I feel a lot of sympathy and concern for you. I would like to suggest you take a break from playing. One thing this would do would help you determine if your pain is truly caused by something about how you are playing, or an unidentified medical condition. You might have some kind of arthritis, a spine, muscle, or connective tissue disorder, or fibromyalgia. Sometimes doctors don't arrive at a diagnosis for years (or ever), but it is worth trying to get one, since your choice of treatment and programs like Alexander, yoga, Feldenkrais, etc., could hinge on that. As to different violas, you could borrow from shops. The good ones will ship you two or three to try. Tell them something of your concerns. Also, look for a teacher who is "enlightened" about rest design to help you. I have strong opinions about this, so have probably 10 different models of both shoulder and chin rests, and am developing a knack for seeing what is likely to suit various players. I am surely not the only one out here paying serious attention to this with my students.You shouldn't have to buy a box of rests one at a time in hopes of finding something. Luck! Sue

February 28, 2007 at 03:51 PM · It sounds a lot like some of the problems I've been having, though of course mine are different. But also viola related and driving related. Each orchestra I play in is about 3-4 hours away...so I make the drive to each one one or two times a month. Driving like that before and after a rehearsal is hard....

It really does sound like there are some medical issues in the equation here. There are a handful of diagnosis in basically the same category of immune problems. Fibromyalgia, arthritis, myofascial pain, lupus, and many others.

It could be that you have a biological (organic?) problem that was exascerbated (sp?) and brought to light by repetitive strain that for some reason your body could not repair. Some new research is starting to link bad sleeping patterns to the type of pain you describe.

Going to doctors isn't always the answer. But it is kind of necessary in order to get pieces of the puzzle so you can lay them out for yourself and figure out how to solve them.

I take pain medication daily. It is not the best solution. But it does make things better. I still know when to stop, it doesn't make the pain un-noticeable so that I will further injur myself (that was my primary concern). If prescribed by a really good doctor, it will also have no affect cognitively for your playing, which is also a very big concern.

Mind you, pain medication is last resort...and if you are certain that there aren't certain things wrong that are going to get WORSE by continuing to play through pain.

All that said....until you know why you are in pain, be so very careful with your body. All day. NOt just while playing. Turn your every focus to picking apart every motion, reaction, cause, effect, and what helps.

As for the viola setup. I'm in the same boat with you. And financially unable to really just go out and buy whatever will fit better. I tried the comford rest, but it didn't fit my viola, so...

Definately having to clench the viola to keep it in place (I am small as well and the viola also slides and doesn't fit...and the shoulder rests that fit the viola don't even sit on my shoulder because of narrow shoulders....) is not going to help matters. It very well might be the cause and root of the pain.

Referred pain is where the actual muscle or area of the body that is damaged sends messages to the brain and gets rerouted to other areas either close to it or similar in "wiring" in the brain. That might be why you are feeling pain in all sorts of different places at once. There is nerve pain, muscle pain, localized pain, referred pain, and get this....sometimes when there is chronic severe pain in one area it changes the dynamics of the place on the spine that sends the signals and damages the nerve there. So it starts sending pain messages to the brain when there is nothing actually in pain (if that makes sense). So you are in excruciating pain while playing, but it is just a messed up signal.

K. I'll stop blabbing now :).

All the best of luck to you. It sounds like you might need to get your overall health built up which is no easy task and I'm still in the beginning stages of that, so I understand the enormous challenge that is. Don't give up! But don't ignore the pain either. Or someday, maybe soon, you won't have a choice!

Isn't that cheery?

Sincerely,

Jennifer Warren

February 28, 2007 at 11:17 PM · I think the bulging disc in your spine might be the root of your problem. You might be creating tension in other parts of your body trying to compensate for the pain caused from your disc. Perhaps you should find a doctor that can heal or correct your bulging disc. Then after you give your body a chance to recover from the stress it has endured, perhaps you will be able to play without pain. I wish the best of luck and hope you find a solution so you can play pain free.

March 1, 2007 at 12:50 AM · Thank you all so much for your responses!!

March 1, 2007 at 01:06 AM · This is going to sound unorthodox to a lot of people, but a doctor named John Sarno established a relatively famous and controversial theory many years ago that most chronic pain that people have is NOT caused by structural problems with their bodies--their bodies create the pain (through oxygen deprivation, it's believed). The idea is that when rage, fear, etc. in the unconscious reaches a certain point, the unconscious directs the brain to create pain (itching, etc.) as a distraction to prevent the undesirable feelings from surfacing. In particular, this tends to happen to people who are perfectionistic, insecure, competitive, and self-critical.

Most people actually get better just from accepting this diagnosis, and relatively quickly, at that.

There are lots of websites on this--search for Tension Myositis Syndrome.

Dr. Sarno has had better results with this than any type of medical doctor I've ever researched--over 80% of his patients who accept the theory are pain-free, again, usually pretty quickly.

Consider a number of studies that have determined that 1) people without back pain are just as likely to have bulging and herniated discs, etc. as people WITH back pain.

All this is very researchable. Look up books by John Sarno, and search the web for "tension myositis syndrome."

In my experience, his theory is correct. I've been a chronic pain sufferer numerous times, and have gotten better after accepting what he says is the true cause of the pain. Many thousands of people have.

Think about it--tons of young people are out thereweight-lifting, playing rough sports, etc., and many elderly people with some degree of arthritis are not in terrible pain. ESPECIALLY if you're relatively young and otherwise in good health, a structural reason for the pain does not make much sense, in most cases.

Again, I know this sounds unorthodox and controversial, but I believe it to be true, and I hope it helps people.

March 1, 2007 at 01:19 AM · Amanda,

I read your post again. I beg you--please look into John Sarno's theory. I guarantee it will help.

A major sign that it's "tension myositis syndrome" (TMS), by the way--you said your pain is all over your body and moves around. If there were really a problem (TMS is benign), the pain would probably be pretty consistent, AND tests would pick it up...

March 1, 2007 at 02:21 AM · Excellent post, Stephen Brivati!

I have a family history of autoimmune disease and was diagnosed with with arthritis when I was 19 years old. 53 now, and there's little I can't do.

Alexander (or similar), diet and exercise can work miracles.

March 1, 2007 at 04:08 AM · If you were willing to drive to GA, I'd send you to my teacher who has been able to "set people free" from tension. I am in the midst of being "remade" myself because I was set up wrong, and therefore developed a lot of tension in my left hand.

If I were you, I would definately look into getting a Comford Cradle. As a violinist, I LOVE it.

March 1, 2007 at 04:08 AM · One of the reasons I quit violin for 5 years after college for 5 years was that the back pain during a 3-hr orchestra rehearsal was getting to me. I just couldn't stand sitting there anymore and so not playing was a relief. But then I started playing again, found a violin teacher, and found an AT teacher at the same time. I think it helped when I was coming back to get a fresh start. You don't need a 5-year break like I had, but I wonder if something shorter like 2 weeks to a month could help you break some bad habits.

As a violinist who started playing viola recently, I'm finding that I just can't hold the viola up without some left arm support. Well, technically, I "can," but after about 20 minutes of playing that means clenching and stiffness that goes up into my head and down into my arm, also ruining what little vibrato I have in the process.

So I've been trying to hold the viola up just a little, not much, using my left arm. To have a balance between my shoulder and arm so that the entire weight of the viola is not supported by my chin. I thought my vibrato would be worse this way, but actually it's a little better and I can do it longer.

One issue I just noticed recently is with tuning. I habitually tuned both my violin and viola by holding the instrument up with my chin only and manipulating the pegs or fine tuners with my left hand. I did this for years and that's how I started every practice session, every rehearsal. By clenching my chin and shoulder. There's got to be a better way to start.

March 19, 2007 at 03:49 AM · I have been watching two of the best players I have ever seen go through chronic pain which does not allow their left arm the strength they need to play as much as they need to. One is actually the best player I have ever heard—a soloist who did a lot of work in Europe, etc. The other is one of the busiest studio players in the history of L.A. session work. Both have seen a multitude of doctors, one is getting better, but both are far from where they need to be. So you are not alone.

I called one of them tonight after reading your thread so I could give you some information from him. The two biggest names in physical therapy for string players are on the coats: in New York there is Tatz, who has worked on some of the biggest names in the string industry www.tatzstudio.net/articles/Lifestyles01.htm

In Los Angeles there is a therapist who also worked on some of the biggest names in the industry, including many in the L.A. Philharmonic: Lyn Taylor. I do not have his website address but I can get you his number if you want it.

Both of these people have a history of helping people when nothing else seemed to work. Which is not to say that it is the cure-all, it is to say that these two have had a lot of success.

There is also an osteopath in Montreal who has had a lot of success treating people who were just about hopeless. I can get you his number too if you would like.

I realize that these people are not next-door, but I also know that when someone really wants to keep playing, miles may mean little.

I wish you the very best!

Ray

March 19, 2007 at 10:44 PM · amanda, get that situation looked after! a lot of the suggestions above seem to suggest structural misalignment or muscular tension, but it seems to me that you may have a pinched nerve somewhere in your spine. that's nothing to sneeze at. definitely see a doctor and get some x-rays done.

March 22, 2007 at 03:29 AM · There right. That's not supposed to happen just by playing the viola. You really need to get that checked out. There are... dang I forgot what those injuries are called. You could have one of those injuries. Who knows. But get that checked out. AND DON'T GIVE UP ON THE VIOLA!!!

March 24, 2007 at 03:57 AM · Thanks for the inforation, Raymond.. and thanks for everybody's support!

It's still been pretty rough lately, although I've got a different chinrest which helps out a little.

I think I'm going to start by seeing a doctor in Birmingham (conveniently close by) that my piano professor reccomended to me, who specializes in musicians' injuries. He helped my piano teacher's daughter (a violinist) after she got tendonitis from practicing so much at Encore. Hopefully this man can help.

Also, I'd like to get to a violin shop soon, and try out different combinations of chinrests and shoulder rests. Unfortunately I have to drive to Atlanta to do this but I need to get a new bow anyways, and can do both on the same trip.

For now, I'm just trying to make it through one rehearsal, one day at a time. I can't practice as much as I'd like, but hopefully that'll change soon.

March 24, 2007 at 12:11 PM · Nothing is ever hopeless until you give up.

"Non illegitimi carborundum" (Don't let the bastards grind you down)

Cheers, Sandy

April 8, 2007 at 04:29 PM · There is nothing more difficult to learn to do in this world than to learn to play the violin. There are a thousand roadblocks that stand in your way. And for every problem you solve, there are another 20 waiting to take it's place.

If on top of all of those problems, you've got medical problems that make it difficult, it may seem like a hopeless task.

But, if it's what you want, as with anything important in life, then you must never give up, no matter how dark the night and how late the hour. If what you want to do is master the violin, you must work and work and work and keep knocking at the door, banging at the door, smashing through it if you have to, until you find a way in.

In the movie, Any Given Sunday, Al Pacino (as the football coach) gives an incredible inspirational talk to his team. That speech is worth hearing (and more than once), even though it's about football and is put in the mouth of a fictional character. The message is as true for playing the violin as it is for playing football.

In part, Pacino says "Life is a game of inches; so is football. Because in either game, life or football, the margin for error is so small...Half a step too late or too early, and you don't quite make it. Half a second too slow or too fast, you don't quite catch it. The inches we need are everywhere around us. They're in every break of the game. Every minute, every second, on this team, we fight for that inch."

So, if you want it, you too have to fight for that inch, every minute of every day. You need to keep looking for an answer, keep trying different ideas, different methods, different treatments, even different doctors or coaches, until you find something that works.

Cordially, Sandy

PS. You can see and hear the Pacino speech in its entirety at - http://www.youtube.com/watch?v=WO4tIrjBDkk

April 8, 2007 at 04:27 PM · I'm really sorry to hear about the pain you're having. Although I haven't had pain to that extent I hope the following might give you some ideas. In all of my time at the university so far (just a little longer than you)...I've seen both people who had to completely give up, and those who, even though their undergrad took like 7-8 years (including time off), they were able to find ways to work around their pain.

You may want to evaluate how your body works, or how you deal with stress in general. If you bottle up a lot of emotions, or tend to be a stressful person, that can come out in your technique and other places.

Also, many times the place of the pain is not always the source. I had a huge knot in my back that, although it didn't hurt, it prevented me from bending my left arm...I could not use it for a few days! Your muscles and all these things in your body are all connected.

As for viola, if you have the funds, I'd suggest trying to find a good maker that can make you one. My one friend had really small hands...and she had a viola made whose body was a beast, but the neck was made especially to suit her hands, and was slightly smaller than the normal viola. (I'm pretty sure it was a McCaig or something like that).

Hopefully a combination of these approaches coupled with other advice will help you! Good luck and try to take it easy on yourself.

April 9, 2007 at 05:12 AM · Dear Amanda,

Sorry to hear about your problems and pain. It is great so many people are coming out with so much diverse and good advice. Let me add my two cents.

In my experience as a violinist and teacher, we often forget to make our bodies strong for the job of holding our instruments. Our bodies should really be the foundation of anything we do. I have gone through many forms of Yoga, that have all helped me at different levels. Also Alexander Technique has given extra awareness, and at times some moderate weight lifting has been beneficial as well. During masterclasses I organise myself I always try to offer a combination of Yoga and AT.

I think that when your body is not strong it is hard to expect it to hold up a viola without pain. I have found that it is important to actually hold the instrument more with the left hand and less with the shoulder. This makes your left arm work harder, but relieves your back a lot.

Of course a good set-up is incredibly important, and mostly a change of shoulder rest would give some relief for a while. Still, as long as the instrument hangs from the shoulder, the back will be working really hard. Tell us how the Comford Cradle works for you!

Good luck, and don't disregard the possibility that a solution to this is much closer than you may think.

April 9, 2007 at 06:10 AM · “The inches we need are everywhere around us.... Every minute, every second ... we fight for that inch."

Wow, Sandy, so true and so wonderfully put! I’ll pass it on to my friends and I’ll always call it Sandy’s quote.

September 22, 2007 at 06:47 PM · Hi, My daughter underwent surgery for TOS and is doing very well. Along the road to recovery, we found an incredible yoga/violin/viola teacher in the Baltimore area who 'specializes' in setup. She has done amazing work for my daughter and many professional musicians in the Baltimore area. Her name is Melissa Hullman, email: hullmanstudio@earthlink.net

Good luck! It has been my experience (as a professional Opera orchestra musician) that posture/setup can make all the difference in the world.

September 23, 2007 at 07:41 AM · I'm not sure if this will help but Clayton Haslop(he battled focal dystonia) is a big advocate of reducing tension and mind power, I like reading through his blog:

http://www.violinmastery.com/violinsecrets/index.html

he learned much from Nathan Milstein and I always enjoy watching Milstein's videos because he is a true master of relaxed playing, check them out on youtube!

September 23, 2007 at 12:33 PM · Amanda:

I have had to deal with this issue from advising my students to friends/colleagues.

Disclaimer: I'm not a physician or a therapist, so I will not try to diagnose and fix your problems. However, I will give experiential evidence for you to consider and pursue, as you see appropriate.

1. Aside from incorrect positions, etc. Often times, injuries happen in music or sports because of the lack of "prep" work. Like a runner preparing to run a marathon, all instrumentalists need to realize the importance of stretching hands/fingers before their workout. Failure to do so, will have a high % chance of resulting in injury. Just doing scales or etudes as a warmup is not enough.

2. It would have been better if you were able to prevent the injury from happening. Since it happened, you need to consider sources to remedy the situation. Pianist Leon Fleisher introduced my mother (a fabulous concert pianist) to a technique called rolfing. It was through his guidance that my mother made a comeback after 25 years of silence. As anyone in the business side of music knows, making a major comeback is almost impossible but she is thrilled that she can make music and share it when given the opportunities. My mother and I are high proponents of this rolfing method as it has done wonders for many musicians, including Leon Fleisher himself. (There was a CNN profile on rolfing and Fleisher's comeback last year).

I'm so sorry that you're going through this situation. I hope you will be able to find the solution to help you play again and do what you really like to do -- make music.

I would also study another major just as a backup before you graduate from your university. More education is not a bad thing, but it will provide you with an "insurance" just in case your injury takes longer than expected.

September 23, 2007 at 02:55 PM · I've got a bee in my bonnet about what I'm about to say, so I might be just resorting to my "stump" speech, as it were. Still, it bears looking into.

Namely, are you trying to hold the instrument halfway down onto your chest? In other words, from your perspective, is the left "shoulder" of the viola held significantly higher than the right? This would explain a great deal. Your left elbow would then constantly be forced further and further forward, causing pain in your back and shoulder, an excessive rotation in your left forearm (palm towards viola neck), and the pain would probably be transmitted through sympathetic tension into your right arm as well. Moreover, if some basic setup question were overlooked at some point, it wouldn't be a stretch to say that there might be other setup questions overlooked. Such as issues with your bow-arm which could also cause tension.

For instance, I had a student for the summer this year who came in with a diagnosis of tendonitis. For some reason, no one had ever looked closely at how low she was holding her right elbow, which forced her right wrist into an unnaturally acute angle. By addressing the elbow elevation, I was able to resolve the pain issues without medication, meditation or breathing through one's eyelids or whatever. Just basic logic and observation.

In your case, I'd look at how far off to the right you're holding the instrument and work on getting it comfortably positioned on TOP of the shoulder (with a very low SR, of course, in the case of a viola). A simple test would be the ability to play a three octave scale with a penny positioned on the upper left quadrant of the top plate of the instrument. If it doesn't slide off, the instrument is horizontal (though try not to cheat and lean your back into a concave curve) which, in turn, would mean that it's positioned correctly, on TOP of the shoulder.

Gotta run! Good luck!

September 25, 2007 at 12:44 PM · A violinist friend of mine had a similar problem and came to realize that it was a result of the way he sort of slumped in the driver's seat, leaning with his left elbow on the arm rest. He changed his driving posture and the pain went away. I've also heard of back pain being caused by carrying a wallet in a back pocket while driving. Good luck. I hope you can overcome the problem.

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