How has the coronavirus crisis affected you as a professional performing artist so far?

Obviously all of my work (as I usually know it) has completely dried up. I’m fortunate that I currently have financial stability in my current job for at least the next few months (I’m meant to move to Germany this year!), but who knows what the next few months might bring. I’m also very aware of a lot of my friends and colleagues who aren’t in such a fortunate position, which is just really awful. 

Are you exploring any alternatives for staying connected to your art and to your audience during this time? Do you have any suggestions for other dancers?

A lot of groups (including the ACO) are turning to digital platforms. I think this is a really good way of keeping connected with our audiences, but it’s SUCH a learning curve! It’s a good thing to get on top of, and I’m sure the skills will come in handy down the line.

I don’t think everyone has to do this, however. If it’s going to cause you more stress or anxiety during this time, I think it’s most important to look after your mental and physical health first and foremost. 

What strategies are you using to take care of yourself during this time of uncertainty and isolation?

I go through periods of ups and downs – sometimes I feel really good about the fact that life has slowed down a lot, and there is time for things that one usually wouldn’t have time for, and other times I feel totally stuck and like I’ve lost a lot of purpose. In these times it’s good to just take some deep breaths, go for a bit of exercise (whether that’s in the house or a walk/jog/run outside) and try to recalibrate. It’s ok to let yourself have “nothing” days, I think! It’s also good to touch base with friends and realise that we’re all in this together. 

Do you have any other comments to make regarding the current crisis in regard to performing arts healthcare?

We will get through this – and hopefully on the other side we will come out stronger as a sector. It’s my hope that people have been turning to the arts during their times of isolation, and might start to rethink how necessary they are for the mental wellbeing of our world! Let’s look out for each other.

I presented my research at ASPAH in 2015. I was identifying the most common postural issues in children learning music and finding what cues and strategies we could give these kids to help them improve. Unsurprisingly, the research shows that if you tell kids about this stuff, they do improve, unless they really don’t care. I was never told any of this. I was always just told, “Sit up” and that was it.

What do you think the main points of your research were?
I think you should tell kids it’s not normal to be feeling pain. You can feel uncomfortable, but if you’re feeling pain, that’s not something you need to keep practicing through. You should talk to your teacher about it and your teacher should be equipped with lots of different ways to help you. I teach my kids stretches now and we do stretches regularly. I do stretches myself and go to the gym twice a week because I find for me – after years of abusing my body – an upper body workout is the way I get those muscles to relax. The physio who I work with now is very preventative. He taught me a bunch of stretches and then said “when you’re not in pain every day you can go and do workouts, and go and build those muscles instead”: the preventative approach. Unless I’ve been really stressed and working at a computer late in the night, I don’t have any pain in my shoulders, which I don’t think I could say for a single week during undergrad. There wasn’t a week where I woke up and said “Wow, I’m not in pain today.”

What is the biggest challenge you’ve faced in your career so far?
I had to think about what I wanted to be. Which is a bit of everything. I want to play and I want to do chamber music and I want to do orchestras – I’m in 2 orchestras as their principal flute at present. Physically, I had an ulnar nerve entrapment at the elbow. I got it in grade 12 when I was practicing a lot for MOST. I bombed that audition because my fingers stopped working. I went to a doctor and they were like, “it’s probably just repetitive strain injury,” and said, “rest it for a week.” And it kind of got sort-of better, but it remained a constant problem for 9 years. But not enough… just enough that I wasn’t very good with these two fingers. During my masters, they stopped working more and more. I was doing an hour at a time of practice, ‘ergonomic’ practice I guess, not five hours at a time – because I couldn’t practice any longer or my fingers would stop working. And this isn’t something you publicise if you want to keep on playing principals in orchestras, because nobody wants someone whose fingers don’t work. And I think there’s a lot of shame around injuries, especially if they are career stopping or career pausing injuries, because “You don’t want to tell anyone about that or they won’t give you a gig. And you won’t get paid. And then someone else gets the gig and they keep getting the gig, and you don’t get the gig because you’ve got crippled fingers.” But now I realise, I don’t really care so much about that.

I was misdiagnosed with focal dystonia. Then I went away and read about it, and came back and said, “I don’t agree. Actually, none of the literature supports what you are saying and none of my experiences support what you’ve diagnosed me with.”

How did they react?
Well, he said, “tell you what, I’ll send you to a hand specialist and they can do an EEG.” And he didn’t find anything. And so I called him up and said, “Can I just come into your office for twenty minutes and do this [demonstrates fingering]”. Because when I saw him I wasn’t showing any severe symptoms because I hadn’t been practicing that day. So I went and sat in his office and did this until my fingers literally… it feels like they’re going to sleep and then they feel dead, like you can’t feel them properly. So I went and did that and then he shocked me, and that was fine. And he said, “hey look at that, you have nerve entrapment at the elbow, my God!” And then we scheduled surgery the week after… and I woke up and I can move these fingers – I can’t believe it!
And I think the worst part about it was that I’d always complain to my teachers, but because these are the worst fingers anyway [3rd and 4th], they’d say, “No, just practice more, because they’re weak naturally – you’re right handed, and they’re your two worst fingers on your left hand.”

I think students who are learning – even if you don’t experience injuries personally, you should make at least a cursory effort – you should do at least one semester of courses where you look over performance injuries, performance injury prevention, and discuss it in a more open environment. I think people just need to be more open about it. The more people discuss physical disabilities or the issues they are having and try to solve them, rather than just acknowledging them, I think we can actually move towards doing something about them. And making a more positive culture about it. Because so many people I meet have horrendous injuries. And they’ve just accepted that pain is going to be a part of their everyday life from now. And regardless of whether you’re good at playing music, I don’t think that’s a good pedagogy because it’s not good to push your students so far that they are physically crippled. And I know that’s not a PC word to say, but I get really angry about that.

#aspahcommunity #don’ttellmetorest #therealityofperformingartshealthcare

1. How did you get involved in the performing arts? Why did you decide to pursue a profession in the performing arts?

I started playing violin as a four year old in Mackay, Queensland, and always loved performing for other people. I was involved in many local community music organisations throughout my youth, and loved the social aspect of playing with other people, working towards a common goal and producing a final product that everyone could be proud of.

“One good thing about music, when it hits you, you feel no pain.”
Bob Marley

Growing up in Kingston, Bob Marley experienced the poverty and desperation that was to underpin these lyrics from the song ‘Trench Town Rock’. The line quoted celebrates the capacity of music to sweep you up out of everyday worries and pain and carry you to another, better place. For some people who work in the professional world of music however, it is music making itself that may be the cause of pain.

The occupational health of musicians has been examined in several studies over past years. The figures emerging from these studies are that up to 93% of musicians can experience pain due to playing their instrument.

Many previous studies have looked at musculoskeletal health as a major contributing factor. As musicians we do some of the most highly refined and complex moving done by humans, requiring thousands of hours of training. Professional musicians also routinely expect, and are expected, to continue to play long into our middle and older age. Think of Menuhin and Casals still playing strong into their eighties! So what of the potential impact on quality of life from all those years of bringing music to life for others?

In an interview on Radio National’s Body Sphere program in 2014, titled “Fit to play: musicians and their bodies”, a young music student cites awareness of movement problems as “half the battle”. Another wonders if it is “actually possible to play without injuring yourself whilst ticking all the boxes of a modern performer”.

The comment resonates with how we, as musicians, evaluate playing-related physical problems. Do we view these as inevitable by-products of our chosen profession? How deeply are these problems impacting our studies, careers and lives?

Earlier this year I wrote “The Pain and Discomfort Survey for Musicians” for Body Mapping Australia to find out more. AUSTA members took part, along with a wider community of musical performers of all ages, both professional and amateur, including all instruments and genres.

The scope of previous formal studies done both here in Australia and overseas has often been larger and many surveys have targeted particular groups – professional or tertiary level musicians, school age students, stage and pit orchestral musicians or specific instrumentalists. Environmental, hearing and mental health has been included by some in their focus.

In contrast the BMA survey’s fifty-seven participants had varying backgrounds and their playing experience ranged widely – between just three through to sixty years. Respondents represented staff and students of different conservatoriums, members of instrumental and vocal ensembles, beginners through to professionals. The BMA questionnaire addressed playing-related discomfort and movement and the results are quite consistent with those of previous studies with 96% of respondents experiencing some level of discomfort while playing their instrument or singing. For a third of participants, that experience is frequent or constant while engaged in making music.

Intensity of discomfort, registered on a scale from none (1) to high (5), was rated at level 3 by 39% of survey participants, while 23% scored their pain as high intensity at level 4 or 5.

The majority of respondents experience problems in their neck and shoulder, with back and wrist the next most common problem areas. 61% of respondents report pain or discomfort in three or more areas with a third reporting recurrent flare-ups of a problem while their pain is either staying the same or getting worse over time.

Considering these figures while at your next rehearsal, the chances are very high that the person next to you is in some kind of physical distress while playing, at least some of the time. And the discomfort isn’t always over “when the fat lady sings”, with 92% of respondents still experiencing issues post performance.

That musicians experience playing-related discomfort from the earliest years and then can go on to reach professional level while enduring continuing or increasing problems is cause for concern.

The student interviewed in the Body Sphere program was fortunate to be provided with a well-being course at his college. As a result, playing without injuring oneself is something that he realises he is “starting to be convinced … might be possible”. The second student adds, “ the more I think about this well-being program, it just seems so silly that it doesn’t happen everywhere”.

When the research proves that movement health is at issue for so many performing musicians, it is difficult to accept the situation where students with many years of tuition behind them, reach a high level of performance with little or no exposure to a “well-being” approach.  Establishing and preserving healthy movement in music teaching and performance programs is clearly not given serious, sustained priority in spite of the fact that playing-related movement issues can severely compromise or even terminate a career. To address this problem requires a major rethink at every level of a musician’s education and training. As performing musicians we wholeheartedly accept technical and expressive facility as worthy of development and refinement over the span of a lifetime of playing. Ensuring that skills in healthy movement are promoted as equally deserving would be an evolutionary first step.

My own musical education, like that of many of my contemporaries, did little to equip me with knowledge or skills to deal with any pain or discomfort that I encountered as a result of my playing. Nor could it act as a model for teaching in a way that integrated wellbeing into instrumental technique. My experience as a student was of the “masterclass” tradition, where knowledge is passed, sometimes unquestioningly, from one generation of players to the next. It was all I’d known when it came to the teacher-pupil relationship and while my musicianship benefited greatly as a result, the tradition did not ensure my health. To find a different perspective on playing and teaching I had to look outside the traditional music setting for comprehensive, quality information.

I first engaged with Alexander Technique almost a quarter of a century ago and was convinced of the wisdom in equipping musicians with movement skill, both for the health benefits and the added bonus of the skill enhancement it produced. Instinctively I knew that tailoring the information specifically to music making was necessary, if this was ever going to make a positive change in the culture of music teaching.

Later I chose to pursue study in Body Mapping with Andover Educators, an organisation of musicians committed to saving, securing and enhancing musical careers by providing accurate information about the body in movement. Their mission is to place music education on a secure somatic foundation – a very different approach than the way music has been taught over centuries now. The term “somatic” refers to sensing the body in movement and so it follows that the music student is encouraged to add their sensory input to the teaching equation, to ‘listen’ not just to the sound they are producing, but also, to the kinaesthetic information coming from their own experience of moving to play.

Informed and enhanced by practical information in anatomy and movement design, musicians are taught to trust their kinaesthetic experience as the basis for engaging the body’s mechanisms of balance and support. This method of movement re-education fits like a glove into the practice and teaching of an instrument and allows it to become an essential approach, not something viewed as adjunct to mainstream tuition. Being fully integrated into the teaching studio also ensures Body Mapping can withstand changing priorities in programming and budget cuts within institutions. Ultimately we can grow professional performers and music teachers who naturally and independently include healthy movement in the way they approach each modality of their art.

In the same spirit of respecting each musician’s unique experience, the BMA survey has used a self-reporting method for the collection of data from its participants. Self-reporting assists in drawing out an individual’s account of discomfort and can help the study to detect mild symptoms that can act as the body’s warning signal in response to the threat of more serious injury. Self-reporting can also throw up some anomalies that may offer insight into how an individual is evaluating the significance of playing-related discomfort.

While answering ‘never’ to experiencing pain during or after playing, a respondent may go on to answer that they did indeed experience playing-related pain in the back and wrist. Some respondents reported that movement quality had no impact on their performance and yet nominated movement as affecting several of the elements of performance as listed in the survey question. The segregation of our actual physical experience of playing from the outcome achieved may well reflect how we were taught to assess ourselves as performers. If we fail to examine the connection of our kinaesthetic experience, especially discomfort or pain, with the quality of sound we produce, we are essentially becoming deaf to our body. How loud must the noise become before we respond? Holding off until requiring medical or other serious and costly intervention does not seem a sensible approach to management.

Cultural themes add complexity to this situation. We live in the age of recording where an artificial perfection, particularly in ‘reproductive’ classical music performance, can seem the norm for many listeners. Classical music carries the concept of “error” where predefined expectations and constraints are placed on a performer. Some of these originate from the score itself, the history of recorded performances of a piece and from the audience, who can buy recordings and compare performers. The artist is increasingly reduced to a commodity in a marketplace, with a value that is rated as “bankable” or not by management. The pressure to be ‘note perfect’ can undermine more artistic goals of seeking a perfect connection to our music and audience.

It is regrettable that disclosure of a musculoskeletal health issue in such a competitive environment can have negative impacts. Many musicians understandably wish to avoid appearing injury-prone or blemishing a hard-earned reputation that is closely tied with work opportunities. The consequent underreporting of problems ends up limiting exposure to early intervention and does little to improve the health outcomes of an individual or those of the profession as a whole. Musicians may be staying silent on their own suffering or that of a professional colleague when dealing with management, while simultaneously using medication for pain (7% of BMA survey respondents) or seeking out physical and alternative therapies for respite (79%).

The survey shows that a large majority of respondents believe that movement is impacting their endurance, their technical facility and their enjoyment in performance. Three quarters are feeling the impact of playing-related pain on the rest of their lives.

It’s clear that solving the issue of movement health for musicians is pivotal to bringing individuals and the profession as a whole to a better place. As in other professional fields, preventative training can support us in the freedom to pursue our work pain-free. A skill set in healthy movement can address existing issues in concert with delivering ongoing benefits for the next generation of aspiring musicians. To be embodied performers is to play our part in the beginnings of a healthier paradigm in music education.

Jane Shellshear has a Bachelor of Music in Performance from Sydney University and pursued postgraduate studies at the Royal Northern College in Manchester and in London. Through presentations, workshops and lessons she works with musicians and others to develop healthy movement patterns through the practice of Alexander Technique and Body Mapping. Jane is a member of the Australian Society of Teachers of the Alexander Technique (AUSTAT) and the Australian Society for Performing Arts Healthcare (ASPAH).

(This is not a complete assessment of all factors in addressing playing-related pain, it is simply a summary of reflections and lessons from my own personal experience. I hope it will inspire further and continued discussion.)

STRETCHING is very useful in prevention of injury and I have a series of stretches that covers regions of my body from my neck down to my toes. However, I have learnt over the years that stretching can only get us so far. It is really essential to combine regular and targeted stretching with regular and targeted strengthening.

STRENGTHENING can be achieved through specific isolated exercises to target an area that may be injured or weakened. But another way to approach this side of our fitness is to have a regular routine of low-impact, strength-building exercise like yoga, Pilates and/or swimming.

ASKING your teacher about the pain you are experiencing can sometimes be useful for you and can lead to them incorporating targeted technical exercises into your practice or sharing their own experience and knowledge of stretches and/or recommendations of medical professionals. It can be daunting to have these conversations, but it is important that we encourage our teachers to address these questions and to take responsibility for providing informed answers or informed recommendations of where to seek help if they don’t have answers. The culture around injury for performing artists needs to change and the teaching studio is an important place for these shifts to occur.

WARM UP TIME is set up time. I see my warm up time as a time to focus in on my technique, my posture at the instrument, my breathing and my body. I use this time to set my body up for playing, and it gives me a fighting chance of not falling into old habits when I am working on repertoire later in the session where my mind is preoccupied with co-ordinating a million aspects of playing music all at once.

PRACTICE CREATIVELY so that you don’t have sessions in which you strain particular muscles, and learn how to practice without playing your instrument. When deciding what to do in a session, try to select repertoire or exercises that don’t all work the same area of your technique or your body. Find different ways to practice certain things so you don’t strain muscles unnecessarily. For example, if I am refining intonation in chordal passages and my right arm tires from playing the chords over and over again, I play the passages pizzicato so I can still address the intonation in my left hand, while my right arm can be more restful. I also found that learning how to do mental practice allows you to work productively away from your instrument and is also an extremely valuable practice technique especially for areas like memorisation and even performance anxiety.

TAKE MOMENTS within your practice session to stop and relax a bit if you’re feeling tense or tired. It can be hard to stop sometimes when we feel we just have that one 60 minute slot to get work done before the next commitment, but 30 seconds of standing up and stretching out and shaking out and drinking some water can go a long way and is very worth it considering the greater productivity and sustainability of playing it can create.

TENSION begets tension! Ensuring you drink water before and after a performance can be really helpful for keeping muscles in a good state to be useful, and staying hydrated during practice sessions is really important too! I also learnt last year that when we are stressed our magnesium levels become depleted, and magnesium helps our muscles to release after use – so the stress of playing under pressure can lead to our muscles struggling to relax. Try to incorporate some magnesium enriched foods into your regular diet or you can also take a supplement if you don’t mind this method.

MEDICAL PROFESSIONALS are important people to turn to when we are not able to overcome pain, injury or weakness ourselves or with the help of our teachers and peers. Increasingly, there are medical professionals who have a specialised interest and experience working with performing artists. You can search for some of these professionals in the ASPAH Members Directory.

YOUR VOICE is important in discussions with medical professionals. I have had problems across the board with medical professionals whose main interest is getting me out of their consultation room and into the billing area. It is important to find a balance between respecting medical knowledge and advice, and remembering that we probably know our bodies and our experience far better than anybody else. If something is not working for you but the medical professional insists it should be, consider getting a second opinion. If you feel you are not getting clear enough information or not having the issues important to you addressed in your consultation, interrupt the medical professional and insist they clarify things or answer the questions important to you. They are being paid well for their time. You know your experience, you know your instrument: make sure there is a two-way dialogue in the consultation room and you leave feeling you understood that dialogue and were heard in it.

Copyleft – Camilla Tafra 2016
camilla.tafra@gmail.com