shedding light on an old problem....sort of

December 25, 2005 at 05:30 PM · Back again, after a few more chiropractic visits and doctor meetings and an MRI last sunday...

this: http://www.violinist.com/discussion/response.cfm?ID=7905

has possibly reached a new level of information- the MRI said that it was bulges of the vertebre (C-6, C-5), something about them ever so slightly off place and that was irritating the surrounding nerve(s) and causing all the pain in the shoulder, arm, neck + back- and the tingling down the arm as well. it's so minor that surgery doesn't make sense.

he said the position of (my) head and neck for violin was most likely what caused it, or at least what irritates it more, and the only way to maybe find relief is to stop doing all things that hurt, and not start again until the pain is gone.

that means no track/running (pouding=compression of vertebre+cushions)

and no violin

??!?!!?!

i didn't play all summer because i was working at a camp, and that didn't help- so i know it would mean more than 8 week off.

i really don't know what to do now

i can't not play, but i can't take this discomfort.

help? of any kind...

Replies (21)

December 25, 2005 at 06:35 PM · Hi,

The only way to prevent permanent damage is to fix your posture. Very few violin teachers are good at it as most don't understand body use and posture well. Your best bet most likely is to find an instructor and get involved in Alexander Technique and learn how to use your body well. Though I have not done it, it has saved many.

Cheers!

December 25, 2005 at 09:46 PM · Greetings,

Christian beat me to it. Try contacting the Conables via their web page. Just google Conable Alexander. You could read their bookMusicians guide to AT.

If what tyhe doctor says is true then the solution is relatively straightforward with time , courage and patience. Don't give up.

If you are near New York I can recommend a -fantastic- Alexander Teacher.

Feel free to e mail e at

brivati@gw7.u-netsurf.ne.jp

Cheers,

Buri

December 26, 2005 at 04:55 AM · Massachusetts? haha

I worded my post poorly; I also clarified with my parents what the issue really was.

The disks between the vertebre are slightly out of place, that is creating the bulges-->nerve irritation etc.

(and spinal fusion is out of the question, because that is too drastic and cause more problems in the end)

December 26, 2005 at 06:50 AM · Whatever your way out of such a problem will be: make sure that any body related therapy you'll take relates to the actual instrument you are playing and its setup (chin, shoulder rest and more). Any body related (physical and/or psychical) therapy will most likely fail in the moment when the dimensions and position of your instrument and bow versus your body come into the picture.

I hope this helps in choosing the right partner for solving your problem.

FMF

December 26, 2005 at 07:47 AM · Greetings,

please note that the above comment does not apply to Alexander technique which is not instrument related as such but how one achives awareness of infeecicient use of energy and then shows one how to create the conditions in which the body will do -any activity- in a less harmful way, one most apprpriate for the action in question.

But Alexander Technique isn't really classifiable as body related therapy anyway since it asks one to use the mind to reclaim a healthy way of living, polaying the violin, driving a car and, perhaps most importnatly thinking, since one of my teacher s pointed out that thinking is 'movement.'

Back sooon,

Buri

December 26, 2005 at 10:19 AM · And here comes the problem: However good and helpful Alexander technique is, overselling its capabilities will not do it a favor. So it is very important to understand: with lots of Alexander applied, the musician can still (and will most likely) make fundamental mistakes around the physical placement of the instrument in relation to the player. Otherwise the Alexandrian player would be able to switch instruments in no time, even from violin to violoncello and back to another violin again via maybe a viola. And we all know it's not true. Alexander technique will never help you to find the right compromise between good technical abilities, endurance and a health protecting posture. It will help you, however, in using your personal compromise to your musical advantage.

Why compromise? Because not playing the violin at all is certainly better for your health than spending hours, days, weeks, months, years of your life in this unnatural position. So this compromise needs to be found for every shape of player and shape of instrument. And in finding this compromise one should seek the best professional help exactly on this field, since playing an instrument is healthwise a bit like smoking: you will not get your permanent damage right away.

FMF

December 26, 2005 at 12:44 PM · Greetings,

as someone who has several hundred hours of AT lessons and seminars under my belt I would note that the follwong statement is untrue:

>Alexander technique will never help you to find the right compromise between good technical abilities, endurance and a health protecting posture.

It is precisely what the technique does except taht in using the term posture Michael is indictaing only slight familiarity with the AT.There is no such thing as a single good posture for playing. There is always movement and change.AT places the neck proprioceptors in a condition that this flexibilty , ease and comfort can be achived through a meaningful flow of data to the mind.The result is of course, fantastic endurance where technique can move freely according to the need s and abilities of the player. I do not understand the point of the refernce to changing instruments. If one wanted to do that then AT would be a big help, assuming one got a good teacher and knew what one was trying to do. That Michael denies this shows he has little experience of AT.

Suppose someone took ten AT lessons and raise dtheir awarness of the habits they adhered to while playing IE dropping the head down and back (very common) compressing the spine and hindering the free flow of energy and breathing. Would the player then continue in that way? of course not. No one is that stupid. They would say somethign like "here is where I am comfortable and using my body well. In such a case the chinrest is too low or whatever changes need to be made. " In other words, the technique provides the rational awarness and data to make changes that are more than just cosmetic. Changes that are much mor elong term than trying a new rest, liking it for a few months and then having to look for a new type because the old habits of the body have not been addressed and the pain is back again.

I suppose One can choose to belive either these kind of non too common vague criticisms or the major institutes (Julliard, RCM, RAM, Guildhall, ) that employ Alexander teahcers, pedagogues such as Weilerstein or even check out Fischer"s new book Practice which shows specific Alexander approaches, more oblique references and is dedicate d in part to one of Alexander's students.

Cheers,

Buri

December 26, 2005 at 01:37 PM · Hi,

Buri, that is a good point. I think that the bottom line is that once one is aware, increasingly aware of the body, then the acceptance of old flawed habits becomes less prevalent, and one looks elsewhere.

I am not an Alexander student, but have spent great time on body awareness. I have fixed the equipment and setup. Funny that now, even demonstrating a bad habit for a fraction of a second in explaining a point to a student causes instant pain. It doesn't take much. When the pain becomes constant, then the damage is done (that I know from a chiropractor/researcher).

I think that both are important. Finding rests that do not force one into bad physical habits is crucial as well.

Cheers!

December 26, 2005 at 01:50 PM · While I absolutely agree that you need to examine your posture, the repetitive nature of playing the violin, and how to treat the muscles, is one that that is missing in all of the messages I've read.

Regardless of how perfect your posture becomes, you are still using the levator scapulae muscle to raise your shoulders to play your violin. This muscle originates on C1-4 and as it shortens due to repetitive use, it will pull these vertebrae out of alignment. Every vertebra is attached to the one above and below it, so it becomes a negative chain effect.

Also, the anterior scalenes originate on C3-6 and unilaterally work together to bring your head down. You hold this contraction for hours while you are playing. The static contraction of the muscle will eventually cause it to shorten (called "muscle memory") and when you try to lift your head the non-shorter muscle is pulling C3-6 down, putting pressure onto the vertebrae and your disks, and pulling the vertebrae out of alignment.

Tension on the scalenes causes the muscle to impinge on your brachial plexus, the bundle of nerves that give sensation to your shoulders, upper back, upper chest, down your arm and into your hand. It not only causes pain and numbness, but also can cause edema in your fingers.

Unfortunately to just tell someone to adjust their posture is impossible since you must have your head down in order to play the violin. It is important to massage these muscles so you can flush out the lactic acid (a toxin that forms during muscle action, and becomes entrapped because of the static contraction). The biggest problem here is that you need more massage than you have the time to receive!

You need to work on the muscle at least once a day, at the end of hours of practice, and even better is to work on the muscle several times a day. So, the thing to do is to learn how to do self-massage on the muscles.

I suggest that you go to www.aboutcts.com and take a look at the section called "Anatomy Lessons." You'll see a graphic of the scalenes that will make this discussion easier to understand. It's logical that the muscles will shorten from the repetitive nature of playing the violin, and it's also logical that you are the most important person to treat the muscles so you can continue to play your instrument while maintaining healthy muscles.

Wishing you well,

Julie

December 26, 2005 at 02:25 PM · Thank you, Buri, for your experienced insight. I am always ready to learn. Let me summarize what you've told us here: With proper Alexander technique players will find the optimal approach how to handle the instrument by themselves. It comes sort of naturally then and will be the best compromise independent what type of instrument of what dimensions one is using. So we could consider the Alexander technique as a kind of prerequisite for very beginners so they start with the right positioning and posture automatically when picking up their first instrument. So would you say that Alexander technique is the better alternative compared to the Suzuki approach for beginners then?

FMF

December 26, 2005 at 03:36 PM · I have to echo Buri's comments, Rachel. It is absolutely possible to play without pain by learning how to carry your body, allowing it to recover its natural poise and alignment, and discovering how to balance the violin in motion. I would argue that Alexander Technique should be your primary source of knowledge. Doctors, therapists, chiropractors, i.e. specialists, tend to view problems from a very narrow (acute-care) perspective. Their approach is to diagnose, then cure, in a formulaic, causal line of reasoning. e.g. Symptom: there is pain while playing violin. Diagnosis: pain is caused by misalignment of neck while playing, i.e. vertebrae of neck are compressing/impacting nerves. Cure: remove cause of misalignment, i.e. stop playing the violin (or the other extreme: fuse the vertebrae so they can't be misaligned - talk about cutting off the head to cure the headache!!!) But that is precisely what western medicine is best at, namely the drastic measure - fixing things when nothing else will help. Too bad it too often gets (mis)applied to the everyday, mundane problems of life. I think any reasonable person could only accept such drastic measures if, having consulted every source, and having considered every option available, those were the only remaining choices. Notice also that unless the specialists can see the cause of disease (i.e. the germ under a microscope, the tumor with a c.a.t. scan, etc.) they can only base their diagnosis on the answers they derive from the patient. What if the patient doesn't know the right answers? Worse, what if the specialists don't know the right questions? I think it's clear that the patient's first line of defense (responsibility, even?) is to know herself. And that is precisely the aim of the Alexander Technique: self-knowledge through self-observation, concerning poise and movement (and, as it turns out, much more).

Although I can't prescribe the same for you (most people say you can't really learn AT from books) I've learned a great deal by reading the following (I look forward to taking some lessons in the near future):

*How to Learn the Alexander Technique:

A Manual for Students* and *What Every Musician Needs to Know About the Body* by Barbara Conable see: http://www.bodymap.org/barbara.html

other useful books:

Body Learning by Michael J. Gelb

The Use of the Self by F. Matthias Alexander (a little difficult to read unless you're familiar with the writing style of the day)

see also: http://www.alexandercenter.com/index.html

You'll find pages for musicians here and further references to material for musicians.

You have to undo before you start doing again. Start a new thread when you're ready.

Best,

JK

December 26, 2005 at 03:24 PM · Julie, you are absolutely right. If you play repetitively tight, you will be tight. The repetitive nature of moving (or playing the violin in this case) does not in and of itself lead to tension, contraction, misalignment, etc. As you say, 'static contraction' (or not-moving) is the culprit. But you don't have to play with raised shoulders, or head down. And if you do, you don't have to do it permanently. Alexander Technique is not about posture, although it will help you attain it. It's more about rediscovering the natural poise and balance that we were all (most of us) born with. But it's difficult to (re)achieve balance without guidance, and especially without self-awareness. So I think the first step to take for anyone who needs to move in life, is to become self-aware (and although it's not the only way to achieve self-awareness, it happens that F. M. Alexander has methodically - i.e. scientifically - developed a technique of self-observation which most effectively and efficiently teaches self-awareness).

Best,

JK

December 26, 2005 at 03:44 PM · Another thought, Rachel. Do you have pain while running? If so, I would guess that your alignment problem is not isolated to violin playing alone. The spine is designed (or has evolved - however you view it) to withstand the "pounding" of daily activity, i.e. if you balance your spine properly, maintaining its natural curve. Again, sounds like AT should be your first resource.

JK

December 26, 2005 at 04:58 PM · No advice, really, but I sympathize: I know exactly what you're talking about. C-5 is my weak spot; I go to a chiropractor every week to have my spine and wrist bones realigned (sounds painful, but it isn't). That helps for me, but of course it's only a temporary solution, and I'm still trying to figure out how I'm going to survive if I go to a 3 or 4 week strings camp this summer away from home. I've tried searching for AT instructors in this area, but I can't find any except in Minneapolis/St. Paul, a two-hour drive away. I've heard it's not worthwhile to read about it without having a teacher guiding you. Is this true, Buri?

December 26, 2005 at 08:33 PM · On running: the only pain I get from running is the swinging of my (left) arm- because I can feel a tension/pull type of pain from the elbow up the arm to the shoulder up to the neck (to the base of the head).

(And thanks to everyone who's been responding, I can't thank you all enough.)

December 27, 2005 at 08:58 PM · FMF wrote (in the original thread http://www.violinist.com/discussion/response.cfm?ID=7905):

I am feeling still a bit uncomfortable using something like an (instrumentwise) unspecific Alexander technique as a cure for some problems specific to playing the violin. Let me give you my reasons:

1. I could not find a single statistical proof that Alexandrian violinists have longer or just more successful professional careers than Non-Alexandrians.

2. We all know of quite a few violinists who either for historic reasons (lived before Alexander) or out of total dedication to the craftsmanship of handling the fiddle the best way never came up with the idea to use a "universal" approach to very specific issues and still became happy, non-handicapped violinists known to the world.

3. I have a first hand experience of at least fifteen real life cases where violinists advanced from pain, out-of-tune, stumbling playing to quite the the opposite just be getting help in "how to handle the fiddle and bow". Yes, some of these musicians took additional therapy to loose the pain faster. But the pain and problems were gone for good just by controlling and maintaining the proper fiddle handling.

One of my hobbies are languages (the more, the better); in this field we have got also something similar like Alexander technique: Latin. Many teachers send the message "Learn Latin first, its the basis for a lot of languages and you will later on learn other languages faster." But this is a fake! EVERYONE learns a second language faster than the first one. But only in very rare cases so much faster that it makes up for the time lost in Latin at the beginning.

FMF

December 27, 2005 at 10:03 PM · I'm not quite sure what your objection is FMF. To my knowledge, no one is suggesting that AT, in and of itself, can teach specific violin technique. So, AT will not show you directly how to play a lightening fast up-bow staccato, or how to vary your vibrato, it won't even show you how to hold your bow or your violin - only a violin teacher can show you these things - we all agree on this point.

What AT does for musicians (dancers, actors, atheletes, people with back problems, speech impediments, anyone who moves and uses their muscles to move on a daily basis) is to help them discover all the layers of habitual muscular responses they have developed throughout their lives, regardless of how old they are when they start. For most people, there are bound to be certain habitual responses that restrict motion, cause tension, misalignment, pain, etc. AT helps bring these habits to our attention so that we can inhibit them before they take hold in the moment, thus allowing us to develop new habits which make us more free to move.

Does this mean that AT is the only way to counter bad habits? An emphatic no. But it is a very effective and efficient tool to help you become more aware, have a deeper understanding of how and why we are the way we are. As Buri mentioned earlier, AT helps us think through our bodies, helps us to eliminate that age old illusion of the mind/body division. And insofaras practicing is largely a thinking activity, AT can give us a firm foundation for good practice skills.

So how can AT be of help to you (anyone)? Only you can discover that for yourself - it will only help the willing (which I would assume applies to individuals who are not so lucky as to have teachers, doctors, therapists, at their side who know how to help them alleviate their pain).

Yes, good technique can often help us play in a healthy way; but just as often a way of playing that helps one can be disasterous if directly applied to another. Not all teachers know how to apply technique to the myriad different shapes and sizes that violinists come in. We're lucky if we find one. So AT can help the individual become aware of how to balance and move, so that she can better understand how to apply her teacher's instruction to her body type, geometry, flexibility, ability, etc.

In a very important way, AT is very much like Latin in a way that you didn't mention. An understanding of Latin gives the student a deeper understanding of the Romance languages by providing a common lexicon of etymology (meanings of the root words upon which these other languages are based). *Deeper understanding* is the key here. AT gives us a deeper understanding of movement, particularly our own movement, and in many ways ourselves.

Hope that answers your questions.

Sincerely,

JK

December 28, 2005 at 04:26 AM · Thank you for your excellent response to my objections. I had no problems with the positive effect of AT at all. Overselling it in terms what it can do for a violinist and thus deviating attention and time from other equally or even more important aspects of healthy and joyful violin playing is my problem. I am so grateful that someone experienced it AT clearly states "Not all teachers know how to apply technique to the myriad different shapes and sizes that violinists come in. We're lucky if we find one."

So however worthwile it is applying AT for better understanding what's going on with your body when moving, it's also worthwile to find or even become yourself a teacher who knows how to apply violin technique to different shapes and sizes for the best possible compromise between ability and health.

FMF

December 28, 2005 at 06:30 PM · I don't know if it's already been recommended but a really good book about these issues is Playing (less) Hurt, by a cellist in the Minneapolis orchestra. It doesn't address specific issues, but overall care of yourself as a musician prone to repetitive motion injuries.

December 30, 2005 at 12:10 AM · One last response, FMF. I would argue that training in the Alexander Technique is one of the most effective and efficient ways (if not the most direct way) for a violinist/violin teacher to learn how to apply violin technique to all different types of players, WITHOUT compromise. I don't understand why one has to compromise health for playing.

JK

January 25, 2006 at 06:45 AM · I’ve had the same problems starting at the C6 area of the spine: severe pain (back, left shoulder, and arm) with constant tingling and numbness in the arm and hand (mostly the first finger) and a considerable loss of strength in my left hand. This started about three months ago. After visits to five doctors I am now able to play for an increasing number of minutes daily and have every reason to believe that I am on my way to a 100% recovery. The following three things have helped: 1) the prayers of my wife and many friends, 2) neck traction (I ordered a Neck Pro cervical traction device off the internet.), and 3) the one to two hours of stretching exercises that my fifth doctor, a chiropractor, told me to do.

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