All Things Strings: Practical Musician

Too Much, Too Soon?

Too much practicing and wrong playing techniques,
can catch up quickly with beginners

by Janet Horvath

We've all witnessed the spectacle of the 12-year-old playing Tchaikovsky's violin concerto. Where once the exception, the outstanding child artist is now a fixture on the concert scene. But at what cost? Among teachers, doctors, and therapists, there is a concern that developing muscles and bones may be damaged by repetitive activities. As a longtime teacher, I have been called by parents of younger and younger instrumentalists in pain. Even among youngsters, the number of symptoms is alarming.

Overuse is a loose term applied to several conditions in which body tissues have been stressed beyond their biological limits. Repetitive action, especially when combined with poor posture, excessive force and tension, and insufficient rest or breaks, can bring about an overuse injury. Other factors also contribute to risk—our body size and build, our conditioning, muscle imbalances, fatigue, and stress—as well as the obvious: our "technique" or physical attitude to our instruments. These considerations are pertinent to all beginners—adults and youths—and may even apply to intermediate and advanced players who have developed poor technique that is injurious to their health. But young people have additional concerns.

Adolescents experience growth spurts that put them at particular risk for injury. "When young people grow, their bones grow first and then their muscles catch up," write Barbara Paull and Christine Harrison in the book The Athletic Musician (Scarecrow Press, 1997). Studies are finding that some types of stress on the growth plates (the areas next to the joints where bone growth in length occurs) may cause problems during development. When bones grow faster than muscle, it is important to strengthen and stretch the muscles to protect them from strains and microtears that may result from intense use.

"An untoned body is more injury-prone by being less resilient and by failing to provide the needed support for the muscles more immediately involved in performing. . . Playing instruments is a physical, highly demanding, and coordinated activity. Overall physical conditioning is of the utmost importance to prevent injury," Alice Brandfonbrener, M.D., an arts-medicine specialist with the Rehabilitation Institute of Chicago, writes in The American Music Teacher magazine (April/May 1988).

Too many young students sustain injuries that may lead to chronic difficulties that thwart their musical lives. Education in prevention strategies, such as the importance of taking breaks during practice, increasing practice load gradually, and varying repertoire while practicing, is essential.

Parents and teachers should acknowledge that tolerance levels vary with every individual. Some students are more susceptible to injury. Parents should insist on realistic goals, appropriate assignments of repertoire, and monitored numbers of performances, contests, and competitions. Too much, too soon is a setup for injury. Also, be wary of sudden increases in practice or playing time, a change in instrument or teacher, or preparation before a jury, recital, or audition. Students are especially vulnerable to injury at these times.

Parents should always seek a teacher who pays attention to all the physical attributes of the student. It's most important to pay attention to good posture, ease of technique, and proper technical setup at the onset of study—before problems grow too difficult to correct. Practice habits, type of repertoire, instrument size and weight, stress levels, schedule, and outside activities should all be taken into account. Use common sense when monitoring your young person's activity level and improvement.

Choosing the right instrument size and setup, and the right playing posture, is critical for the musical and physical development of a young player. Today stringed instruments are available down to 1/16 sizes. Violas are available at 12 inches, a couple of inches shorter than the standard-size violin. Cellos are available down to 1/8 and even 1/10 size. Double basses are also available in 1/8 size, and some come with adjustable bass stools. Student bows for the beginning player may be acquired at 1/4 sizes.

Choose instruments carefully. Strings should be low, necks should be slender, bows should be light. Instruments must be in proper repair and function appropriately and easily. When in doubt, go with the lightest, smallest instrument.

There are many instrument modifications available to ensure the comfort of young players. The Kun Company (www.kunrest.com) now makes shoulder rests with extra long screws to raise the shoulder rest. There are new shoulder rests available as well for young children. One is the Up and Away shoulder rest, which reduces the effort of holding the violin. The Kinder Chinder is available for all size violins. This padded chin-rest cover also offers light padding for the shoulder.

Chair height is also critical. There are many adjustable student chairs and stools available so that youngsters can maintain good posture, sitting upright with their weight forward and their feet firmly on the floor. When you are seated, your back, hip and abdominal muscles must contract continuously. This can result in reduced blood flow to the area and increased pressure on the lower discs. This stress increases as you bend forward. Sitting as seldom as possible would help. Instrumentalists who are able to stand while practicing would be well advised to do so; alternating between sitting and standing is helpful. Be sure to maintain the natural curve in your lower back. Don't lock your knees; keep them slightly bent and be vigilant about posture. Make sure the torso is not turned or twisted, either when sitting or standing.

Among musicians, violinists and violists are four times more likely to have jaw pain. Our term violin "hold" implies a static, rigid grabbing of the instrument, but it doesn't have to be that way. Be aware that you may use more pressure holding your instrument when you're trying hard or you’re nervous. Forty-seven percent of chin string players have jaw pain due to the fact that the joint is subjected to years of pressure on the chin-rest side. Those who begin music at very young ages may even develop altered facial symmetry.

This "pain in the jaw" can result in headaches, hearing loss and ear pain, blurred vision, backaches, jaw clicking, sore and tight jaws, facial pain, and worn teeth. The two hinges at either side of your face can cause tissue damage and pain when they're not working properly.

Temporomandibular joint dysfunction (TMJ) is surprisingly common in the general population as well as in musicians, but not all jaw pain is TMJ. Muscular pain is actually more common from compulsive clenching or grinding of the teeth. Compulsive chewing can bring on jaw problems, but more often stress is the precipitating factor in those individuals who grind their teeth and who clench jaw muscles tightly.

Diagnosis is vital. A good specialist will be able to see wear and tear in your teeth and will likely take a full history before attempting diagnosis. Proceed first with gentle remedies. Jaw exercises, massage, acupuncture, biofeedback, stress management, cold packs for discomfort, and technique modification can all work.

Analyze your technique. Some teachers advise sticking your tongue out between your teeth when you are playing to prevent jaw clenching or placing a small chunk of carrot between the back molars. If you crunch, you are clenching.

Refit chin rests and shoulder pads to eliminate "grabbing" your instrument. All instrumentalists, make sure you're not clenching or misaligning your jaw while playing. Relax your jaw and mouth as often as possible during rests and take frequent breaks. Practice doing a "fish face" or an "air mouthwash" to aid in release.

Are you attending a summer festival or music camp or preparing for a competition where you'll have a sudden increase in the amount and intensity of practice? Do you think you must play every day or you'll lose your edge? Quite the contrary. You're probably overusing your muscles by never giving them a break. Or you might suffer from the opposite problem. Are you a busy parent who juggles practicing with family duties between orchestra services, showing up to play without adequate preparation or warm-up? In this case you tax your muscles with difficult repertoire without really being in shape for it.

Injury prevention is a matter of paying attention to changes in addition to carefully examining technique and posture. Be vigilant concerning any abrupt change in technique. Are you trying a new bow or instrument that is bigger, heavier, or balanced differently from what you're accustomed to? Are the strings too high off the fingerboard? Is the instrument set up in such a way that it is "resistant"? Make sure you avoid "marathon" practice sessions. Take a ten-minute break per hour of practice and take time to lower arms, wiggle, and stretch frequently.

Listen to your body and stop playing if you feel pain—the precautions you take now will enhance your ability to play in the future.