musician injuries

Playing Music – It’s Like Fireworks in Your Brain!

This video is a great illustration of how playing music engages practically every aspect of the brain. Whereas listening to music results in certain parts of the brain being activated, playing music is like a full body workout to the brain. It engages the visual, auditory and motor parts of the brain and increases the size and activity in the corpus callosum.

Singers & Speakers: Caring for your Vocal Instrument The 6 Top Tips for Vocal Hygiene – Part 2 of 2

In The 6 Top Tips for Vocal Hygiene – Part 1, the first three tips for vocal hygiene were outlined: Hydration, Warmups/Cool-downs, and Avoiding Stressing the Vocal Folds. Read on to finish off the top tips to keep your voice in its best condition!


i) Rate of speech should be legato (or smooth, flowing and slow).

ii) Try to keep your speech around the pitch where you naturally say ‘Umm-hmm’; this can be assumed to be your most comfortable speaking pitch and the range in which injury is least likely.

iii) Avoid starting your speech with a glottal attack: going from zero vocalization to a forceful expulsion of air and sound. Instead, begin releasing air before initializing voicing, thinking of it as easing in to sound production.


i) Practice silent, deep breathing, allowing the air to expand and contract the lower torso, abdomen, back and sides. This encourages relaxation in the throat and less risk of injury.

ii) In daily speech, try to take breaths at natural breaks (it can be hard on the vocal folds to squeeze the breath out beyond what feels natural).

iii) See a vocal professional to learn proper breathing techniques for singing and vocal projection, as improper technique can do damage to your vocal folds!



Figure 4

i) While singing or speaking, be attuned to your overall body balance and signs of muscle tension in the neck and shoulders. Hint: try videotaping yourself singing/speaking to assess improper balance and tension.

Posture assessment by a physiotherapist can also be very helpful if you think this may be an issue for you. If you are singing or speaking while seated, use a comfortable chair suited to your build, with good lower back support.

ii) Music, scripts or notes should be at eye-level (and on a stand, if possible), and it’s best to have clear sight-lines to your accompanist and audience.

iii) Keep your upper and lower teeth separated and relaxed; avoid clenching, to allow the jaw to remain passive.

iv) Improving singing posture is showing correlations with improved vocal production!  A case study of a classical singing student who underwent physical therapy for breath support and lack of stability. In nine physiotherapy sessions over four months, the patient experienced significant improvement and satisfaction with her resulting vocal production. [It should be noted that this patient was very well motivated to make postural changes and follow her physiotherapist’s recommendations. (Staes, 2011)]

v) A healthy body promotes a healthy voice! Regular exercise, good nutrition, regular eye and ear check-ups, and times of relaxation are going to support extended use of the vocal instrument. Note that obese singers face poor respiratory and abdominal conditioning, a limiting factor in a discipline that relies on strength and stamina.

Exercise tip for optimum vocalization: 

Focus on free movement exercise with cardio (running, swimming, dancing). Avoid diving and underwater swimming (risks of nasal congestion and ear issues), and limit weightlifting and overdevelopment of the neck muscles.


As with many things in life, awareness is half the battle; hopefully these tips can help you highlight areas in which your vocal hygiene can improve! If you find you have more questions or need further help in applying good vocal habits, please feel free to give us a call at 604-568-4628 and book in to see physiotherapist and musician injury specialist, Grace Cheung.



Contributor: Tracy Schaan is studying at McGill University in the Masters of  Speech-Language Pathology program.



“Advice for Care of the Voice,” Texas Voice Center, (2002). Retrieved from

“Fit to Sing; Factsheet 3” British Association for Performing Arts Medicine, (2007). Retrieved from

Mathis, B. (PhD). “Singers, Let’s Prevent Vocal Problems!” The Voice Teacher, (2003). Retrieved from

“How to Get the Best Mileage from your Voice: Vocal Hygiene,” Canadian Voice Care Foundation.” Retrieved from

Staes, F.F., & Jansen, L., & Vilette, A., & Coveliers, Y., & Daniels, K., & Decoster, W. (2011). “Physical Therapy as a Means to Optomize Posture and Voice Parameters in Student Classical Singers.” Journal of Voice, Volume 25 (3).

Figure 4. Posture types (vertebral column) classification by Staffel, from Image Creator ru:User:V-Ugnivenko; Posture Types (Veterbral Column); Wikimedia Commons, the free media repository; Russian Wikipedia; 2008; Web:; Accessed March 21, 2014.


The notes I handle no better than many pianists. But the pauses between the notes – ah, that is where the art resides!

-Artur Schnabel (Austrian pianist)

The pause is as important as the note.

-Truman Fisher (American composer)

UBC Symphony 2013 Fall

The more I grow as a musician, the more I have come to understand that the pauses and spaces in a composition are equally important as the notes played. As a young musician in an ensemble or group improvisation setting, the temptation for me was to play all the time, often to exercise my zeal in a recently new found skill or technique. But how much more there is to the musical experience when one stops to listen to not just the individual parts but to the piece as a whole, including the spaces and pauses in between.

Which leads me to this. The pause.

What are you doing your pauses when performing and practising?

You are likely listening to the music or perhaps counting measures.

Here are a few other tips I encourage the musical athletes I work with to practise:

  • Reset your posture: Find that neutral position again where your head and shoulders are sitting on top of your pelvis, with equal weight exerting through both legs or both sides of your buttocks when sitting
  • Deep breaths: Take a deep, slow belly breath (diaphragmatic breathing). This helps you relax any nervous tension that may have developed when playing.
  • Shoulder rolls:  No matter what instrument played, most musicians will carry some sort of tension in their shoulders. A simple way to reset the muscles is to roll the shoulders forward and backwards a few times during your break.

These few practises will help to prevent unnecessary tension in the muscles. This will benefit you by decreasing your chances of injury; easing your tension when playing, both from the physical and mental aspect.



Study Postures

The student – musician’s body undergoes much asymmetrical stress with repetitive motions during practice and rehearsals, as well as prolonged static postures in sitting, usually at a desk and computer.

Here are a few tips to consider when studying:

Study Postures – Musicians

For mini-break exercises, visit us here!





Musician, athlete, or both? Part 2.

Tips to playing and performing pain-free. 

Vancouver Canucks at Rogers Arena.

Vancouver Canucks at Rogers Arena.

Musicians are often compared to athletes.  You push your body for hours at a time to practice and perfect your skills so that you  can perform better. But sometimes, your  bodies become overused, and playing  becomes painful. The terms below are often associate d with the performance of elite  athletes. But did you know that these same
issues affect the performance of a musician as well?


PLAYING WITH PAIN  doesn’t always happen right away. Sometimes it starts with “fatigue” or “tension” that eventually goes away. But as time passes, you may find that these symptoms linger for a little
longer and don’t go away as easily as they used to. So you take a long break from your instrument and the pain goes away.


B U T   W H A T  H A P P E N S    W H E N    T H E     D I S C O M F O R T R E T U R N S     W H E N     Y O U   S T A R T    P L A Y I N G    A G A I N ?

Musician Injuries often happen because playing your instrument, whether it is the violin, piano, cello, guitar, flute, drums or even the glockenspiel is REPETITIVE and ASYMMETRICAL.

Muscles and tendons need time to recover and rebuild after use. Without adequate rest, their fibres will break down and inflammation and pain occur. We call this tendonitis. It first starts with fatigue or an ache, and eventually turns into pain and swelling with any type of use, leading to loss of ability to play.

Asymmetry combined with repetition is the perfect environment for an injury to brew. It may not appear immediately, but at some point down the road, an injury is likely to occur.

Often times, changes in technique, practice habits,  instrument set-up, posture, and other life changes can contribute to injury. You may want to examine whether there have been any changes lately and whether they were introduced quickly versus gradually.


Warmth, pain, and loss of function are signs of inflammation.  Use the acronym “R.I.C.E”. Rest, Ice, Compress, Elevate.
REST from the aggravating activity.
ICE on the area for 15 minutes at a time.
COMPRESS with a tensor sleeve or brace.
ELEVATE the area for 15 minutes at time if it is swollen
Then, consult your physiotherapist to help you get to the
root of the problem to prevent the injury form recurring. You
can find more tips for musicians at

Violin-related Neck and Back Pain

Many injuries I see amongst the novice  to intermediate violinist are quite easily preventable. Watch this video for a few practical tips to include when you are next playing your violin. Many of these principles apply to the high performing violinist as well as other instrumentalists too!

There are SO many things to think about when playing, and these are just a few to prevent neck and back pain when playing violin.

Here are a few things to think about:

  • Equal weight through both legs
  • A neutral, elongated spine
  • Knees unlocked
  • Head on top of shoulders
  • Shoulders on top of hips

Happy playing!

Musician, Athlete, or Both? Intro

Vanessa Mae, violinist and skier. Photo from


These are all words you might associate with an elite athlete, but do they apply to musicians?

British violinist, Vanessa Mae, will be competing in the 2014 Winter Olympics in Sochi this year, representing her father’s native country, Thailand. Though quite a contrast in disciplines, I am not surprised that she was able to qualify under FIS standards, as she is probably quite experienced in practicing and perfecting  her skills to perform to a certain standard.

I often like to compare musicians to being like athletes.  They push their body for hours at a time to  practice and perfect their skills so that they can perform better. However, the resources for high-performing musicians are limited. Whilst elite athletes have access to doctors, physiologists, sport psychologists, dieticians, sleep consultants, in addition to their variety of technique coaches, musicians do not often have  the same access to resources that enhance their performance.

The goal of this website is to educate the high-performing athletic musician and performing artist in order to enhance their performance. With my background in physiotherapy, the majority of posts will come from a musculoskeletal perspective. However, don’t be surprised  at the global health and wellness topics I hope to address in the near future.