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Instruction, Information & Inspiration for Players of Violin, Viola, Cello, Bass & Fiddle | Jan. 8, 2010

Learn to Avoid Overuse Injuries

We’ve all witnessed the spectacle of the 12-year-old playing Tchaikovsky’s violin concerto. Where they were 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. 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.

How Do Injuries Occur?
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 their book The Athletic Musician. 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,” writes Alice Brandfonbrener, M.D., an arts-medicine specialist with the Rehabilitation Institute of Chicago (from 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 ensue and are difficult to correct. Practice habits, type of repertoire, instrument size and weight, stress levels, schedule, and outside activities should all be taken into account. Is your youngster struggling physically with an instrument? This may portend trouble down the road.

Use common sense when monitoring your young person’s activity level and improvement.

By Janet Horvath, Excerpted from the February 2003 issue of Strings magazine

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