• Finger and wrist pain
• Rotator cuff tendinopathy
• Poor embouchure

Wrist overuse injuries

Fingering, plucking and sustained holds are only some of the dexterous movements that you as an instrumentalist need to achieve. The nature of long rehearsals, practice and gigs can mean that the muscles of your fingers and wrists are working in a repetitive nature and can place them at risk of a tendon injury or inflammation of the tendon sheaths that surround the many tendons of the fingers.

Working with your physiotherapists, an assessment of your biomechanics, joint mobility and muscle strength enables you to have tailored treatment so that you can mange any tendinopathies or tendon sheath issues.

You don’t have to have an injury to your wrists or hands to look after them. Unloading the accumulative muscle tension that builds up over the course of your practice is important to be able to sustain the health of your hands and forearms. The expert myotherapists at Performance Medicine understand the types of load you are putting through your arms and can use manual therapy, cupping and dry needling to alleviate increased tension. This not only helps with myofascial health but also with your awareness of the dexterity of your fingers for more accurate playing.

Rotator cuff tendinopathy

Rotator cuff tendinopathy is a common shoulder overuse injury that is commonly seen in musicians.

In particular, shouldered instruments such as a violin, viola or flute. Any instrument that requires a sustained elevated shoulder position with or without bowing can place increased load through the shoulder girdle. If you have a spike in rehearsals or gigs that means you are playing longer and more frequently than your shoulder is used to, you may develop a tendinopathy in the shoulder girdle.

Treatment for tendinopathy requires a review of your load management and strength training. Some of this may include manual therapy to unload other areas of your body (such as increasing movement through your upper back) and designing a strengthening program for your shoulder so that it can support the practice and rehearsal that is required.

The best way to manage rotator cuff injuries is to recognise them early. So if you are experiencing out of the ordinary fatigue, a niggle or pain, don’t ignore it. There may be a simple solution in the short term that can minimise the risk of long term injury and prolonged rehabilitation.

Poor embouchure

Creating a sustainable and effective lip embouchure is challenging for even the most expert wind, reed or brass instrumentalists. For each instrument, your best strategy will differ depending on many factors including – the type of embouchure, if you have a reed, the duration of your rehearsal or gig and the genre of music you are playing. External factors such as facial nerve weakness, Bell’s palsy, dental surgery, soft palate dysfunction and jaw dysfunction may also contribute to your ability to produce an efficient embouchure.

Facial muscle fatigue and facial pain may be signs that your embouchure is under strain. An assessment by your physiotherapist can help you understand and treat musculoskeletal and postural components to this issue. We know that embouchure is very much technique and instrument dependent and your physiotherapist will work with your instrument teacher or coach so that we understand exactly what you need to achieve so that you can elevate your playing excellence.