The Musician as an Athlete – Part 2: Corrective Exercise

Part 1 – Introduction
Part 2 – Corrective Exercise

In Part 1 of this series I mentioned Janos Starker’s lifelong routine of a daily swim, calling it ‘corrective exercise’, a term I would now like to clarify. Musicians spend several hours a day essentially working through one limited plane of movement. Pianists play with their hands in front of them on the keyboard, shoulders internally rotated; a cellist’s bowing arm is similarly internally rotated but their left is in a different position that can tighten up the muscles surrounding the shoulder blade; violinists often have their head tilted to one side and violists have all the problems that violinists deal with but worse, since they are holding a much heavier instrument.

Internal rotation of the shoulder joint contributes to imbalances, injury and eventually a permanent slump and poor posture. It is common theme for musicians (including brass and woodwind players) and also for anyone who has a desk job, so I am going to suggest an example routine that you can begin straight away if you fit into any of these categories.

The following mobilisation routine should be completed before you first practise of the day:
Begin by encouraging bloodflow to the shoulders and throughout the upper body with a series of arm swings. You can be as imaginative as you like here, just make sure to swing both arms forwards, backwards and sideways. I would then suggest holding a few stretches. Ease into the stretch and hold until you feel the muscle relax – the primary objective of these stretches is not to lengthen the muscles (although this will happen in time), but to stimulate a neural connection from the brain to the muscles so that they work optimally when you start to play.

Suggested stretches include:
1. Spine roll downs- from a standing position, roll down to touch the floor starting from the vertebrae at the top of the spine and striving for an even curve all the way down. Come back up slowly.
2. Spine openers – sit cross-legged on the floor and raise you hands above your head, palms facing inward shoulder-width apart. Think of your spine lengthening as you reach upwards and simultaneously keep your tailbone pressed into the floor.
3. Pectoral muscles – stand facing a wall with one arm against it and turn gradually away from that arm.
4. Neck stretch (particularly good for violinists) – to stretch the right side, with your right arm straight actively press the shoulder downwards. Tuck your chin and then gently turn your head to the left, tilting it slightly to help get more of a stretch. Take this one slowly as the muscles you are stretching are very slender and it is quite easy to overdo it.
5. Hip flexors – in a standing position, bend one leg and grab the ankle behind you. Pull it up until your knee is totally flexed and then contract your glute muscles in order to press the hips forward slightly. This should open up the flexors in the front of your hips which become very tight when sitting down.
6. Cobra spine flexion – lying face down, gently push yourself up on the palms of your hands (or your elbows if that is too much straight away). Repeat several times, moving your hands back towards you each time in order to flex the spine a little further.

I use some of these stretches after practising as well.

In terms of Corrective Exercise, everybody has different requirements, but if I had to pick three exercises that would be a valuable addition to every musician’s day they would be:

1. Face Pulls – holidng a resistance band which is fastened at head height in front of you, pull both ends (one in each hand) towards your face finishing by your ears. Think about initiating the movement from the muscles in your back between the shoulder blades.
2. Finger Fans – put a rubber band around your fingers and simply open out your hands against the resistance, keeping your fingers straight.
3. Hollow Body Holds – this one is difficult to describe but the video below gives helpful progressions and instructions. This exercise is great for that ‘core strength’ that we hear about all the time and very important to give you a stable platform from which to play your instrument, preventing fatigue that inevitably leads to poor posture.

Here are a couple of books I would recommend for anyone who finds this kind of thing interesting:

The Permanent Pain Cure Ming Chew

And if you get any sore spots, despite your diligent stretching (!) this is a great little self-treatment book that works a treat for athletes and musicians alike.

Trigger Point Therapy Workbook, Davies & Davies

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The Musician as an Athlete – Part 1

My first series of articles for this blog is going to address a topic close to my heart and central to my way of living.

Part 1 is really just an introduction. In Part 2 I will talk about my concept of ‘corrective’ exercise for musicians. Part 3 will take the athlete’s concept of ‘efficiency’ and apply it to instrumental technique. Please feel free to ask questions in the Comments section and I will do my best to address them, either directly or in a future post.

The fact that I engage seriously in both music and sports is often a source of surprise to both musicians and athletes. I hardly ever meet a fellow athlete while playing chamber music or a professional musician out on a training run. (The recent exception to this was a Saturday morning chaingang – that’s a fast bike ride – with Twickenham Cycling Club when I found myself riding alongside Anthony Hewitt, a concert pianist who also happens to be a pretty nifty cyclist.)

I have always loved sport and I do it for its own sake. I love being outside, I love to push myself to new limits and I have a competitive streak that is not fulfilled by my musical aspirations, since music simply doesn’t work competitively. There are also many parallels between the two including a shared requirement for coordination, dedication and mental strength. Many endurance sports reward a strong sense of rhythm and can also help a brass player develop strong lungs. The majority of musicians, however, give up sport from a very early age, especially those who show early promise and are often excused from school P.E. in order to get in a few more hours of practise.

An excellent example of my favourite tactic - protecting hands with face.

An excellent example of my favourite tactic – protecting hands with face.

Why do they do this? Often it is for fear of injury and it is true that many sports put a musicians’ hands at risk: rowing stiffens up and desensitises the fingers; rugby, netball and cricket all carry risk of broken fingers or worse. The sport that occupied most of my teenage years was lacrosse, which is played with a hard rubber ball thrown around at head height in netted sticks. In order to knock the ball out, opponents are allowed to hit your stick, inches from where your hands are holding it. I had in the back of my mind the possibility and consequences of a broken finger but I wore gloves and adapted and refined my technique in order to minimise the risk. I broke my nose four times and got a few black-eyes, but that didn’t bother me enough to change sports or modify my style of play…

Perhaps I was lucky, but many people sustain serious injuries simply tripping over the doorstep. I would rather enjoy the sports I love, taking a calculated risk, and benefit from the enhanced balance and strength which might in turn help me to catch myself before falling down a flight of stairs carrying a cello.

Furthermore, sports and particularly ‘corrective’ exercise can allow musicians to play their instruments more efficiently and for longer, both in the short and longterm. I will address specific types of ‘corrective’ exercise and give my suggestions on how to implement them in Part 2.

Roger FedererWhen I think of perfect, balanced cello technique the man who comes to mind is Janos Starker. Like Roger Federer flowing around the court, or a lithe cyclist dancing their way up an Alpine pass, he made even the most complex, acrobatic playing look easy. And guess what? Yes, Starker always approached his cello technique with the thorough detachment of an athlete, but he also swam every day, counterbalancing the hours of practising his instrument with corrective exercise.

Here is the great man performing the Kodaly Solo Sonata with utter physical poise –  all the passion is in the sound he creates and no energy is wasted in pointless extra movements or tension. ‘Efficient’ does not mean ‘boring’, and I will talk about efficiency in more depth with regards both sport and music in Part 3.

And for good measure, here is ‘that video’ of Fabian Cancellara descending at 40mph+ with a great soundtrack…

How I turbo-charged my recovery from a broken elbow

When I broke my elbow on 25th December, the prognosis wasn’t great – one month in a full arm cast and another month of non-weight-bearing. After that, it could be weeks to months before I got full range of motion and strength back.

From my point of view as a cellist this was obviously a disaster as it could be four months or more before I could get my playing back up to standard. Aside from the obvious loss of ‘feel’, the sheer strength in my fingers and the toughness of the skin on my fingertips that I have been cultivating for over fifteen years (I feel so old!) would be pretty much gone, requiring a long build back up to ‘form’.

As an athlete, it was frustrating because I was coming off a great winter of base training and ready to jump into my Pre-Competition. It seemed that was going to have to wait.

I did a lot of internet research and in general my two month sentence seemed to line up with what others had experienced with an olecranon fracture. I decided, however, to take every possible step to accelerate my healing, marginal gains being the name of the game…

Six weeks later and I just got back from a seventy-five mile ride in Suffolk, with plenty of riding out of the saddle. I also completed a 3km swim set yesterday and am running more and more. Two weeks ago I couldn’t drink a cup of tea and hold a biscuit at the same time. I have been playing the cello for a week and I am taking that slowly, capitalising on a rare opportunity to step back and re-evaluate my technique – the topic of a later blog post I hope!

Here is what I did:

Week One: Recover from my concussion symptoms which essentially involved a lot of sleeping. I ate very well as healing a fracture can have pretty high calorie requirements and I had three cracks to deal with. This is NOT the time to try to lose weight or control body fat. I minimised the amount of pain relief I took and after the first couple of days I stopped taking it entirely. Studies have shown that the kinds of pain relief prescribed to fracture patients can slow down the healing response and I was happy to endure a bit of pain if it got me moving sooner. With my athlete’s hat on, this was a timely recovery week anyway.

Week Two: Now I was starting to get restless, so I began some exercise including the following:

– Core: Hollow Body holds, supine leg raises – in short, anything that didn’t require the use of my arm.

– Legs: Shrimp Squats, Wall Squats, Glute raises, Calf raises, A-steps and Lunges with running arms – these hurt at first but I wanted to keep my shoulder as active as possible.

– Wrist and Fingers: lots of movement with no resistance up to the point of pain but not beyond.

– Walking. Lots of walking. I started small but for the next month I walked a minimum of 10km every day and I think it really helped mitigate the inevitable loss in running form.

Another important strategy I used was vigorous exercise of the other arm. This can help to stimulate protein synthesis (read – muscle growth) in the inactive arm through some sort of neuromuscular effect I don’t pretend to understand.

Visualisation was also a key strategy I used. I use lots of silent visualisation practise on the cello, imagining every movement required to play in the greatest detail I can, so while my arm was incapacitated I visualised using it in every way I would usually.

My first time trial over 25 miles. I still haven't found any arm-warmers that fit my puny arms.

My TT position, which I trained in on the turbo with my left arm in a full-arm cast at ninety degrees. Yes it got quite sweaty.

Finally I was lucky that my coach Tim Williams set me up to ride my bike on the turbo trainer, leaning on the tribars. As you can see from this picture that position does put weight directly through the elbow. The first doctor I saw actually said I shouldn’t do this until I reached eight weeks after the incident, but I sought out a second opinion and he gave me the advice that would become the overriding focus for my recovery: Listen to the elbow.

Some pain is good for healing, but pain that worsens overnight and lingers the next day suggests that you have done too much. Weight-bearing is good for bone strength – this is why patients with a broken leg are strapped up in a boot and told to walk without crutches. I decided that leaning on my tribars with the vibrations of the bike on the elbow would be an excellent stimulation to bone healing. I have little to no scientific back-up for this but I ran with it…

The cast was moulded to my arm much like a normal fibreglass cast. Those are velcro straps that I could take on and off myself.

The cast was moulded to my arm much like a normal fibreglass cast. Those are velcro straps that I could take on and off myself.

Week 3: Now that second doctor said I could remove my permanent cast and replace it with one that I could take off for showering. I began going to the swimming pool regularly and doing long kick sets and lots of single-arm drills, all the time trying to coax a little more range of motion out of my elbow which was pretty stuck at ninety degrees. I made sure to do plenty of self-massage all around the elbow joint and especially the forearm and biceps in order to get my arm straighter.

Week 5: My X-Ray showed that both the smaller fractures had completely healed and were in fact invisible. The larger fracture was at least three weeks ahead of scheduled healing time and I was given permission to start using it. Listen to the elbow.

Immediately I started playing the cello again although I didn’t have the range of motion to play in all the positions. I also started swimming and managed a total of 400m freestyle in my first session, supplemented with kicking. Two weeks later and I’m still a bit slower than previously but I am able to complete all the main sets with no pain. A little discomfort later is a positive thing – Listen to the elbow.

Clearly I didn't think it worth bushing my hair with the other hand.

Clearly I didn’t think it worth bushing my hair with the other hand.

I stayed indoors for cycling for another ten days, avoiding icy roads and building up the strength to control my bike and support myself in my road position but I was able to do some riding out of the saddle. The only thing holding my running back is my legs…

My arm still looks a little wasted and the triceps is weak but I am taking active steps to strengthen it. My main priority now is to avoid any injuries to my back that my be caused by faulty movement patterns, both in sport and cello playing.

So to round up, here are my strategies for speeding up bone healing:

1. Eat plentiful, healthy food so that your hormones and metabolism are working at their best to heal the injury.
2. Try not to take pain relief.
3. Visualise using your injured limb. This takes a lot of concentration to do properly so frequent shorter sessions are the best.
4. Exercise the surrounding muscles and joints as early as possible to encourage blood flow and discourage atrophy.
5. Start weight bearing as soon as you can in a way that does not put any shearing force through the bone – compression only.
6. Massage the surrounding muscles, gently at first and then more firmly as your pain allows.
7. See a physiotherapist or similarly qualified specialist who understands movement dysfunction and its contribution to injury.

Please ask questions below and I’ll do my best to get back to you as soon as possible!