Klarinet Archive - Posting 000104.txt from 1995/04

From: "Steve L. Gordon" <SGordon688@-----.COM>
Subj: references
Date: Sat, 8 Apr 1995 01:39:41 -0400

I was able to access the U of W Medline and found some of the articles I was
familiar with concerning overuse syndromes in musicians. I thought these
might be useful for some. I have treated professional musicians, including
symphony musicians here in Portland. Using ice after practice or performance
is useful. The nonsteroidal antiinflammatories (Eg., Motrin, Alleve,
aspirin) are also useful for mild chronic strain and tendonitis. Changing the
thumb position and support is an excellent idea as noted by many, as are
neckstraps and other means of support of the instrument. Everyone should
realize that daily significant pain means it is time for a rest. Seek help
from a physician and referral to a physical therapist. Teachers have a
responsibility to watch for overuse syndromes in their students and to be
willing to reduce practice and recital schedules and suggest referral. The
longer you wait, the more likely it is that you could develop permanent
impairment, or at very least a requirement of much more prolonged rest (up to
a year as described by H Fry).

I threw in the article on performance anxiety because I happened to run into
it in my search. Again I have some experience in this area. Anxiety is, of
course, variable, and excellent preparation is a must. But it is an
emotional state which is otherwise beyond many performers control. While low
level anxiety is reported to improve performance through heightened attention
and cerebral activation, for many it is at a higher level which clearly
erodes performance ability. Most physicians should be willing to prescribe
propranolol (20 - 40 mg taken 1-2 hours prior to performance) or another
beta-blocker to blunt this primarily hyperadrenaline response.

Steve Gordon, M.D.
Clarinetist
Beaverton, OR
SGordon688@-----.com