Just as in sport, any musician who applies their body to the cause is putting themselves at risk of injury, and if anything, it is string players who are more likely to hurt themselves. From repetitive strain injury and back pain, to tenosynovitis and poor posture, all injuries can affect their ability to perform – and, ultimately, have a damaging effect on their lives.
Sarah Upjohn is a chartered physiotherapist with clinical experience in the UK, the US, Canada and Australia, with a particular interest in preventing injury among performers. ‘I was a senior lecturer on the BSC(Hons) Physiotherapy course at the University of Hertfordshire for eight years, before having two children and returning to clinical work,’ she tells me, adding that she obtained an MA in Teaching and Learning while working at the University of Hertfordshire.
Understanding anatomy
‘Since 2008 I have been working as a specialist physiotherapist in performing arts medicine, both at The Purcell School for Young Musicians, and for the British Association of Performing Arts Medicine (BAPAM). In addition to treating injured musicians at the BAPAM clinic in central London, my role includes delivering workshops and training events that focus on health promotion for musicians.’
Earlier this year, she completed a Doctorate of Education (EdD) at the University of Cambridge, which looked at the prevention of playing-related injuries, promoting health among elite young musicians. She also works regularly with the National Children's Orchestras of Great Britain during their residential courses and is a part of the Healthy Conservatoires Network as well as the Musicians Health Advisory Board of Help Musicians UK.
But why the need for such a rigorous understanding of performer injury? What kinds of demands are placed on the body by, for example, string playing? ‘String playing places different demands on the left and right upper limbs, with fast, repetitive and small movements frequently required by the fingers of the left hand, while the shoulder remains relatively fixed,’ Upjohn says. ‘For the right hand, the fingers are relatively fixed, while the elbow and wrist work harder. For upper string players, the neck and shoulder girdle are influenced by the shoulder and chin rests.’
Because of the specific strains that string players place their muscles under, regular physiotherapy is unlikely to provide all the answers, since musicians really need tailored treatment. Upjohn says: ‘The vast majority of the injuries that I treat are muscular and are caused by overuse or are related to posture, technique or the set-up of the kit. Less commonly, we see pain or dysfunction from pinched nerves, resulting in pain or weakness in the upper limb.’
Taking care
And is it true that prevention is more effective than relief? If so, how can a string player prevent injury before it happens? ‘Prevention is always better than cure, and this applies to playing related injuries in musicians as much as anywhere else,’ Upjohn says. ‘The vast majority of playing related injuries are preventable, and with a clear understanding of the risk factors, it can be significantly reduced. Add some simple measures such as warming up, as well as gentle stretches after playing, and injuries can – and should – be prevented.’
On 10 November, with the European String Teachers Association, Upjohn will be leading ‘The Playing Body for String Teachers’, a workshop in Cambridge that offers information about basic upper limb and spine anatomy and biomechanics. In a relaxed and informal setting, she will be tailoring this information to the demands of string players and offering the chance for attendees to ask questions.
‘Delegates attending should come away with an understanding of the anatomical structures of the upper limb and the spine, as well as the positions and postures that place increased or decreased demand on different structures,’ Upjohn says. ‘They will acquire knowledge of risk factors for playing related injuries, as well as strategies for reducing risk.’
Finally, delegates will be introduced to the concept of the musical athlete, where parallels between the demands of instrumental playing and the demands of performing in sport – or dance – are overtly shown. They are then provided with practical and useful strategies taken from sport and dance to make them a ‘healthy performer’.
With prices starting at £5, the workshop offers an unmissable opportunity for all string tutors to learn how to
To find out more about the event, visit estastrings.org.uk
