Integrative Care for Musicians: Upper Extremity Injuries

The Rock and Roll doctor is in. Dr. Ricky Fishman, San Francisco, CA-based Chiropractor and veteran bass player is uniquely qualified to evaluate and treat the challenges that musicians face. Back pain due to hauling gear, repetitive stress injuries due to hours of playing – the “Musician’s Chiropractor” has seen it all. Visit Dr. Fishman’s website for information about him, his philosophy and the Musician’s Chiropractic Project. Read his previous blog post: Rock And Roll Ergonomics: The Studio

Integrative Care for Musicians: Upper Extremity Injuries

Rockers play hard. Think Pete Townsend and his windmill power chords, or Jerry Lee Lewis frenetically pounding the keys. We all love the sound and feel of that hard-driving energy. But the physical effects on players can be significant. Repetitive stress injuries to shoulders, arms and hands can stop a player in his or her tracks with debilitating pain and / or numbness.

The first order of business is prevention. There are three things you can do to protect yourself from injury — cardiovascular exercise, stretching and strengthening.

Even though rocker and runner are not generally uttered in the same breath, the health benefits of cardio cannot be overstated.  Running, power walking, biking and swimming (note: no gym membership required!) all enhance circulation of the blood and help to distribute oxygen, flush away metabolic waste and deliver the body's healing chemicals to sites of injury.

And you may be surprised at the strangely euphoric feeling the workout produces, not altogether different from that mid-solo high.

Next up, stretching the upper back and arm musculature. Ideally this is done before and after playing. Self-massage will enhance the effects of your stretching regimen. Even better, for those who can, have at least one roadie certified as a massage therapist!

Finally, strengthening. Although you might think that power chords can substitute for pushups, the "mind-body disconnect," so common when playing, can easily push you beyond your physical limits and lead to injury. Do your light free-weights and crunches in the green room, and then hit the stage.

But if pain takes you down, how do you know where to turn, and which providers are best-equipped to understand and treat? Because these injuries are the result of over-using muscles and joints, pushing them beyond their limits, causing micro tears, inflammation and pain, seek a practitioner who deals with musculoskeletal problems daily.

Chiropractors work primarily with these types of injuries and can treat using joint manipulation, rehabilitative exercise and passive modalities such as ice, electrical stimulation and ultrasound. Acupuncture is another excellent choice. Using fine needles and herbal medicines to stimulate healing, this ancient art can relieve pain and help to restore proper function. Just be sure the acupuncturist has a musculoskeletal injury specialty.

If these approaches do not resolve the problem, you may have to take the medical route. Beyond the basic prescription of non-steroidal anti-inflammatories (ibuprofen  / naproxen), muscle relaxers and painkillers, a general MD may prescribe physical therapy, which can be very helpful.

If these strategies don’t do it, an appropriate referral would be to a physiatrist, a medical doctor specializing in rehabilitation.

These doctors can perform anti-inflammatory injections into the tendons, muscles or joints themselves if necessary.

As a last resort, one may have to go surgical. A carpal tunnel release could be the only effective treatment for that hand numbness.

Just be sure that the surgeon understands the unique needs and world of the musician.

We know that playing music is a great high, but we also know that it can be hard work. And hard work can be rough on the body, causing pain and dysfunction. But these injuries can oftentimes be prevented. Like Bruce, who pushed the E Street Band and himself into shape while on the road, we can all play well into our golden years.

Just care for your body like you would that ’57 Tele, and enjoy the musical ride in health.