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Linda Dessau : Taking a Look at Musicians' Injuries

Ouch! It hurts when I play (but don't you dare tell me to stop!)

Taking a look at musicians' injuries

By Linda Dessau

For this month's column I interviewed Dr. Sarah Mickeler, B.Mus., D.C. Dr. Mickeler is a former professional musician and a chiropractor who concentrates on musicians' injuries in her practice.

Q: What led you to specialize in musicians' injuries?

A: I have a very personal connection to musician's injuries. I had trained as a classical clarinet player and it was during my undergrad that I started to have all sorts of problems from playing too much and with poor posture. Unfortunately, I was told, as many others are, that I should just play through the pain and that maybe it would get better! Of course, it didn't, and it eventually led to the demise of my career as a clarinetist, because I was totally unable to hold up my instrument. So, I decided to pick a new career that would help others musicians — and hopefully before they got to the point that I was at! Chiropractic appealed to me because of the whole health care paradigm that it embodies — as chiropractors, we diagnose and fix the cause, rather than masking the symptoms.

Q: What is different about treating musicians than treating the general population?

A: Often, what I tell people who don't understand the specifics of musicians' injuries, is that "it takes one to know one". As a musician, it can be very difficult to explain to a physician or physiotherapist or even another chiropractor what the mechanics look like when you are playing your instrument. But when someone comes into my office and says that they play flute, or guitar, or tuba, or whatever, I know exactly what the physical component of playing their instrument involves. That is a very important first step.

Secondly, not only do you have to be able to have a good understanding of what playing that instrument involves, but you have to be able to see that person play. Even if someone tells me they play violin (I automatically think: "ok, so they will be leaning their head to the left and have right shoulder problems, etc..."), I am often shocked to see how over the years of playing they have contorted themselves into a little pretzel while they play! So, on the first or second visit, all of my musicians bring in their instruments and I do a thorough playing analysis to see what it is that they're doing right and wrong. It could be that their posture is contributing to their injury. Or maybe there's something about the instrument that we could change; it might just need a minor adjustment in the thumb rest or a key positioning. For instance, I have very small hands and found it difficult to reach some of the alternate fingering keys on my clarinet — so I had them sawed off and re-soldered on in a different direction so I could reach them.

Thirdly, it is important to recognize that there are some really common reasons for performance injuries. The most common ones are a change in repertoire, a change in the instrument (such as a new mouthpiece or something similar), a change in practice time or an upcoming recital. If we can pinpoint what it is that the performer has been doing differently lately to contribute to their injury, that helps immensely.

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