For Musicians: Resources for Injury Recovery and Prevention
Interviews with Dan Bauch and Matt McKay, Boston Symphony, Benjamin Linz, Benchmark Physical Therapy, and Adam DeVito, Sama Therapeutics
Credit: First appeared in Percussive Notes. Reprinted by permission of the Percussive Arts Society, Inc., 110 W. Washington Street, Suite A, Indianapolis, IN 46204.
“Your body can always heal. It always has the ability to move forward, get more efficient. When you put a little attention there and start to listen, it’s powerful.”
Introduction
Injuries are common occurrences for many athletes, but for musicians, they can be challenging obstacles with less specific approaches and support. In the last few years, I have broken my right clavicle and had ORIF surgery, have had Golfer’s Elbow in my right arm from a repetitive motion injury, and have broken a finger on my left hand. After my teacher, Dan Bauch, dislocated his right shoulder for the third time and had surgery, we both felt there was a lack of information available for percussionists and musicians recovering from serious injuries. Some of the most valuable information I received in my recovery was the advice from my teachers Dan Bauch and Matt McKay. They provide accounts of their own experiences dealing with injuries as well as how to prevent them. I also spoke with my massage and physical therapists Adam DeVito of Sama Therapeutics and Ben Linz of Benchmark Physical Therapy. Their insights offer support on how to find specialized treatment options for injuries as well as how to use self-care methods to prevent and heal injuries. I offer my perspective on how to approach a long recovery by utilizing a healthy mental approach, an exercise regimen, and ways to stay productive while injured.
Daniel Bauch, Assistant Timpanist of the Boston Symphony
Biography
Dan Bauch joined the Boston Symphony in 2009 after holding the position of Assistant Principal Timpanist and Section Percussionist of the Detroit Symphony. He was a founding member of New Music Detroit and has been a guest performer with the New York Philharmonic, Boston Symphony, Boston Symphony Chamber Players, Boston Ballet, Marlboro Festival Orchestra, Hartford Symphony, Springfield Symphony, and the Orpheus Chamber Orchestra. He studied with Dan Druckman at Juilliard for his undergraduate degree and finished his graduate degree with Tim Genis at Boston University. He is currently on the faculty at the New England Conservatory, has presented masterclasses in the U.S. and abroad, and is sponsored by Zildjian and Dragonfly Percussion.
Selected Transcript from the Interview
P: During your recovery, how did you deal mentally with not having your range of motion and ability to practice and perform in the BSO?
D: I think my greatest advice would be to not underestimate how difficult it is to be immobilized like that for such a long period of time. I would liken it to a claustrophobic feeling. The recovery right after the surgery, everything is tender, and you are tired and weakened. Every aspect of our daily lives we take for granted: it’s not going to take us a long time to make a cup of coffee in the morning, do our morning routine, brush our teeth. Initially, I was trying to be really careful with the shoulder. My sleep was disrupted, and that I think affects anyone’s mental state. If you’ve been playing for years, it feels like you’re losing all this conditioning and fitness and dexterity, but if you have a solid base of practicing and playing, it really won’t take long for it to come back, and that was exactly my experience. You’re really well advised not to fight your doctor’s or PT’s recommendations to taking a measured and conservative approach to getting back.
P: What sort of preventative measures prevent playing-related injuries in the first place?
D: I’m a big proponent of developing a technique and a way of playing and spending hours and hours with your instrument that is the concept of efficiency. Economy of motion is one angle of looking at this philosophy. Another angle is using your body’s natural physiology, sort of the way it wants to be used. I know with percussion that the way to achieve it is through activating from the bigger muscles first as much as you can and making sure the bigger muscles stay relaxed even when you’re primarily relying on the smaller muscles. Meaning, even if you’re playing a passage that is utilizing wrist and fingers, oftentimes with students I see their back or shoulders are tight, and if that’s the case, the tension in the bigger muscles is triggering inflammation and will lead to smaller muscles which are much more susceptible to injury.
I’ve worked with a fair amount of students with playing-related injuries by trying to get to the root of the problem and fix it from the ground up. What we usually find is that I’ve never encountered anyone with a shoulder injury from playing percussion or someone that injured a bicep muscle from playing snare drum. It’s always the delicate muscles like wrist tendons or finger muscles, and the problem is if you try to address it there, you won’t find the underlying root of the problem. You really have to start with the muscles that initiate the stroke, which should be the back muscles. I like to slow everything down and have students play at a relaxed forte, so they’re forced to use big muscles groups, and everything has to connect. It’s basically learning to play strokes in a way that the angle of their shoulder and arm and body is relaxed, almost like they’re just standing there sleepwalking. Everything is fluid, joints feel lubricated, and then basically what you said is the other component. You use the weight of the implement, the weight of the mallet or stick, and you throw that because the human body wants to do a throwing motion and to put something in motion.
The other aspect that goes along with economy of motion and efficiency of motion is utilizing the rebound whenever you can, so you throw that and expect the stick or mallet to have a rebound. This is true with all of the instruments that have a skin head: timpani, snare drum, less so with the mallet instruments. You’ll get less rebound. Whenever you can utilize a rebound, and whenever the stroke makes sense or fits in musically with the passage you’re trying to play, you program your mind and your body to take advantage of that and follow that rebound back up so that you really feel like you’re moving seamlessly. There are no points of tension, no cutoffs, nothing is ever locked. Even when I’m playing only with my wrist for extreme articulation, I’m never tensing up my shoulder or locking the bigger muscles that lead to the wrist, and I credit that with helping me not to worry about ever having a playing-related injury.
Matthew McKay, Percussionist with the Boston Symphony
Biography
Matt McKay joined the BSO in 2012 after being a member of the Oregon Symphony for two seasons. He has performed with numerous orchestras across the U.S. including the National, Detroit, San Diego, and Jacksonville Symphonies. He currently teaches at NEC and the Tanglewood Music Center, performs as a chamber musician with ensNEWSRQ, and is a Freer Percussion Artist. He studied with Will Hudgins at NEC for his undergraduate degree and completed his graduate studies with Tim Genis at Boston University. After going through a shoulder injury in 2018, he shares his thoughts and experiences on recovering and preventing injuries below.
Interview Transcript
P: Can you talk about your shoulder injury and your experience?
M: When on tour with the BSO in September of 2018, I was hiking in the Swiss Alps and took a fall off of a ledge, landing on my shoulder and ribs a story below. I was fortunate to have stopped shy of the massive sheer drop-off that was ahead. Ultimately, my ribs healed up on their own as they do. Shoulders however, are much more complicated with all the moving parts involved. When I returned to the States a week later, I contacted a physical therapist in the Boston Area who specializes in working with musicians. Between the massage, iontophoresis, and daily rehab exercises, I started to notice improvement. An MRI in November however, confirmed that I basically sustained minor injuries to virtually every component of the shoulder joint. After consulting with multiple physicians, I started to believe what they were telling me. My shoulder would never be 100%. I stopped seeing any improvements even though I was continuing to go to PT and rehab. Fast forward to January when I started working with Adam Devito, a massage therapist who had recently suffered a shoulder injury himself. After just one session with Adam I felt I was already to 90% of my strength and range. The massage was incredibly beneficial, but even more valuable was the change in mindset he provided. He was able to help me believe that healing in the shoulder was possible. This allowed me the mental and physical freedom to stop guarding the shoulder, stop expecting it to hurt before it did, and just start letting it heal. And it did heal. I started rock climbing at my local gym again within a few weeks of that, and I have very few issues with the shoulder to this day. Mindset is everything.
P: What information would be helpful for the percussion community in terms of preventing injuries, recovering from injuries, and how to mentally approach being injured?
The most common playing-related injury I see is tendonitis in the forearms, wrists, and elbows. Our bodies are very adaptable, but overuse brought on by sudden changes in practice volume, playing a new instrument for hours, or changes in technique can be a few of the culprits. Even more commonly though, I see students who haven’t fully learned how to release tension while playing. When learning repertoire which is a bit more advanced than what we may have played before, we may try to control the outcome subconsciously. This can lead to unnecessary tension which reduces the efficiency and fluidity of the strokes we play. If unchecked, an injury can creep up. The good news is, with more mindfulness while playing we can learn to notice where and when this tension is appearing and hopefully learn to release it. If you are suffering from an injury, find yourself a musically literate PT or Massage Therapist to help.
P: As far as technique, what is your approach in playing that prevents overuse, and do you have regimens as far as a certain number of hours a day, specific instruments, off days, or using ice, heat, or stretching to help inflammation?
M: I’m going to keep it simple here. Listen to your body. There is no prescription that will work for everyone when it comes to the proper amount to practice, or even the right technique for preventing injury. If you start feeling any pain, or even a dull ache. Stop. Assess what body position you were in, figure out how to modify and release tension. Come back the next day and reassess. There are days when I am relaxed when I can play snare drum for 3 hours straight and feel great, and other days I’ll have to stop after 30 minutes because I’ve accumulated too much stress. Have a plan and be willing to alter it if necessary.
P: Do you have any specific routines for cardio, strengthening, yoga, or meditation?
M: When I was a high school and college student, I put incredible amounts of pressure on myself to “succeed”. I think musicians, especially young musicians in the current climate face even higher levels of stress. I know there isn’t enough time in the day to balance your life between practicing, rehearsals, classes, socializing. But if you can find even 20 minutes in a day to meditate, go for a walk in a park, or do a workout, you can take your body out of its sympathetic “fight or flight” mode and keep you fresh for another day. I wish I had done any one of those things when I was younger! These days, I make exercise and meditation priorities to make sure I can stay creative, productive and happy.
Adam DeVito, Massage Therapist and Yoga Instructor of Sama Therapeutics
Biography
Adam DeVito is certified as a massage therapist, yoga instructor, and meditation instructor, and he runs his own practice, Sama Therapeutics, which has recently moved from Boston to Asheville, NC. He was a competitive diver in college at College of the Holy Cross in MA and has suffered numerous injuries from separated shoulders to repetitive stress injuries at the gym. He completed a 720-hour massage therapy certification at the Bancroft School of Massage Therapy as well as a cadaver lab at the University of Rhode Island. He has worked with BSO percussionists, Matt McKay and Kyle Brightwell, and he shares his thoughts and experience in an interview we did together below.
Selected Transcript from the Interview
P: In regard to massage therapy, why should percussionists get worked on, and what areas of the body should they have work done?
A: I think everyone should get work done. As a massage therapist, I have to say that. You would want to spend a lot of time in the chest and opening the chest because you probably spend a lot of time hunching forward, kind of like I do for my job. The back, neck, and upper back would be important and down the arms and through the hands. Those are probably the tissues that get overworked the most for percussionists.
In massage school they taught us a lot of body mechanics. One of the things that happens is massage therapists burn out after 5 years, and it’s because they use their hands a lot. In my training, they really were so adamant about working from your feet. By learning how to shift your body weight instead of gripping with your fingers, you can push through your feet, have that travel through your core, and then use that to get your force. So as a percussionist, I would put a lot of attention on your core and learning how to stand with your weight balanced in gravity. I’m sure there’s a tendency to kind of lean yourself forward and jut the chin out.
I did a class with Kyle Brightwell actually with some of his students where we played around with body mechanics. They would play, and I would say focus on this part or that part. And what you’re saying with the lower body, a lot of the time we stand with locked knees. Just the idea of softening the knees a little bit can be ground-breaking because all of a sudden, you’re no longer hyperextending in your lower back. Your core can engage properly. You can almost think of your spine as a whip. If you’re not bending down awkwardly below, you’re not going to bend awkwardly above. All of a sudden the whole system integrates.
P: For percussionists that are looking to find a massage therapist, what should they look for and what type of massage should they have done: deep tissue, sport massage, Swedish, all the different types?
A: I guess it would depend on what’s going on in their body. If they have a strong workout routine and their body feels very open, and their body feels very supple, maybe all they need is a relaxation massage once in awhile. If they’re a little tighter, have been playing a long time and have some compensation patterns, which are showing up as pain in their neck, pain in their arms, pain in the wrist, I would look for an orthopedic massage therapist.
P:If it’s regular maintenance, how often would you recommend getting a massage?
A: For percussionists, I’d say at least once a month to start for sure, and notice how that affects your body. If it’s not enough, go more. If it feels like it’s working, you can back off. It’s going to ebb and flow the more you play versus the less you play. The more body work you get, you get better at receiving it. The results are more effective. The more you do it, it just builds on itself. If you do it once a month for a year, eventually you’re going once every quarter, and that’ll be enough. Then you’ll get some injury and go a little more often and work it out.
P: After working with Kyle Brightwell, Matt McKay, and I, were there any sort of similarities you noticed in terms of the muscles we used or the spots you had to hit? Was there anything you learned working specifically with percussionists?
A: It’s interesting. You all seemed to have a lot going on in the upper pec. Definitely figuring out a way to open below the clavicle, upper pec, pec minor, all these little muscles in here, I think is going to be huge. The thoracic outlet, all the nerves that go into your hand, it goes under your clavicle, across the top of the chest, so you want to keep space there. When you’re hunched forward playing, or you’re playing cymbals, those muscles are going to get tight. Figuring out a way to keep that open either through foam rolling, lacrosse ball rolling, or getting a massage would be huge.
Benjamin Linz, PT, DPT, CHT, COMT, OCS of Benchmark Physical Therapy
Biography
Ben Linz is a highly trained and specialized physical therapist with over 11 years of experience, and he currently treats patients at Benchmark Physical Therapy in Fayetteville, GA which is south of Atlanta. I had the privilege to work with him on both my arm from a tendonitis injury as well as my shoulder. Ben Linz shares his thoughts and ideas on working out to prevent injuries and what to look for in a physical therapist.
Selected Transcript from the Interview
P: How would you guide percussionists through an injury?
B: If we’re talking prevention, shoulder strength is really important. A strong rotator cuff gives you stability further down your arm. There is a lot of research to show that weakness in the rotator cuff or tightness in the neck can make you have tennis elbow, or it is highly correlated with tennis elbow. Posture makes a difference, watching how you’re doing things, keeping yourself active. If you want to think of yourself as a musical athlete almost, you’re using your hands all the time. You have to stretch them out regularly, and I showed you the putty stuff and tennis ball and stuff like that. You kind of have to maintain it right? You wouldn’t expect an athlete to just show up on the field, and here I am. You’re going to train for it, and to a certain extent you have to do maintenance stuff with your arms to prevent them from tightening up.
P: As far as doing that kind of work, do you recommend using ice or heat? I know we used the medical lacrosse balls to work out some of the tension.
B: Ice and heat are helpful, but really you want to be able to work out the tension. I’m a big fan of the pin stretches where you smash and floss, pinning with the lacrosse ball and working out that way. You’re going to get muscle knots, and that’s the best way to get rid of them. General strengthening of the rotator cuff, bicep, and forearm would help make it less likely that you’ll get knots in the first place and will build up your stamina.
P: Do you recommend any sort of yoga? Would any exercises like that be helpful?
B: Yoga is generally more for balance and flexibility. Yoga really strengthens the hips and would probably be helpful for the hands too. Any kind of exercise in general is good. You can’t discount general fitness. If you are exercising regularly it brings blood flow everywhere. When you work out, your body temperature increases, and that helps bring your blood flow everywhere and your overall fitness. I recommend cardio and strength training, and I don’t see why it would be any different for percussionists. An analogy I use: I kind of got off the strength training bandwagon when I had my second kid, and I was too busy. My arms started hurting. I tested them, and it said they were weak. I stretched it and needled it, but ultimately, what kept it from hurting was getting back to strength training again. Now I’m strong, and it doesn’t bother me anymore. When it’s weak, that’s when it’s going to bother you. You’ll forever be stretching and doing this stuff to maintain it, but the stronger you are, the less likely that will occur to being with.
P: For any percussionists that are having issues, what would you recommend in terms of them finding a physical therapist? What should they look for in terms of either their certification or what type of practice to go to?
B: If you are thinking about a forearm injury or a hand injury, there a few main things to consider. A Certified Hand Therapist (CHT) is the highest certification you can get in upper extremities as a certified specialist. You can only get that after 5 years of experience, and you’ve been treating hands and elbows for almost 5,000 hours. You have to take a part test. If someone is a CHT, they’ve done it for awhile and should be good. A PT or an OT, an occupational therapist, can also be hand therapists, so I would take a CHT or OT over a PT any day. A Certified Hand Therapist is probably the best bet. Additionally, if you can find someone that can dry needle, that can be very helpful in the forearms. OT’s can start dry needling, but boy is it hard to find an OT that can dry needle. There’s only a few of them. So if you’re looking for dry needling for muscles, you might want a PT. You might want to ask questions: do you offer dry needling, or do you have a CHT? All things being equal, you’re better off with a CHT.
P: My teachers and I have all suffered shoulder injuries from a dislocated shoulder to a broken clavicle. What kind of PT would be recommended for a shoulder injury?
B: A CHT should be good at shoulders as well. An Orthopedic Certified Specialist, OCS which I just sat for, should be good as well. Generally any therapist should be good, but if you know any specialists that have put forth the extra effort, then you look for extra letters after their name. And specialists, according to research, are better than people that aren’t specialists which just makes sense because you have more experience, so you generally get better outcomes. So if it’s me, and I’m injured, let me get an OCS or CHT because both of those will be very adept at the shoulder, or a COMT, Certified Orthopedic Manual Therapist. Almost any certification will be good. If you can’t get those, finding anyone that is going above and beyond will probably be a cut above a standard PT.
Parker Olson, New England Conservatory
Biography
I am currently in my fourth year at NEC in the studio of Dan Bauch on a Presidential Distinction Award. I have attended the Aspen Music Festival for two summers, and for 2021, I was accepted to the National Repertory Orchestra. I’m currently a substitute percussionist with the Billings Symphony in Montana, and I’m originally from Atlanta where I was a student of Tom Sherwood, Charles Settle, and Bill Wilder. I have suffered a series of injuries that inspired me to put together this article as a resource for other percussionists and musicians.
A Mental Approach to Recovery
The toughest part of recovering from an injury I experienced was the mental aspect of recovery. Although physical pain and discomfort make up the first part of being injured, I found the patience and resilience required to keep a positive attitude throughout the entire process were difficult to maintain. I’ll outline some ideas below that might be helpful in getting back to shape and making the most of the extra time that comes with being injured.
Give yourself a break. Now is not the time to beat yourself up about not being able to practice or perform. Get a reading list and Netflix list together that you haven’t had the time to do because you have been busy.
Pursue other interests than music you normally don’t have time for and that are within your ability to do, such as writing, art, cooking, attending concerts or shows, religious services, or sporting events.
Learn the concepts and exercises from your physical therapy, massage therapy, and doctors to help you come back with even more awareness and knowledge of how your body and muscles move and work so that you will be able to take care of yourself better than before and play in a more relaxed, efficient way.
As a percussionist, I found not performing in ensembles or being around the practice studios contributed to a feeling of less social interaction, and I had to make a conscious effort to connect with friends and go to concerts to keep myself involved with music.
Exercise During an Injury
I think finding the motivation and confidence to exercise is challenging when you have the inability to play music and are in physical pain, but exercise is essential to recovering from an injury. The most difficult part about exercising in recovery is making adjustments to fit your condition, and this change can be frustrating if your normal regimens are not possible. Here are some options for simple exercise.
Go for a daily walk, even if it is just for 15 minutes. With my shoulder injury, I wish I had kept this routine because it can help to clear your mind and improve your sleep.
Riding a stationary bike might be the best exercise tool for upper-body injuries, and I could ride a stationary bike just a few weeks into having a broken clavicle. If you have a gym membership, try going to a spin class, and you will not only have an intense workout but also have a place to socialize and be around other people.
Take your physical therapy seriously. It can become not only a place to gain back your range of motion and strength but also a normal routine in your schedule and a place to voice your questions and concerns about your injury to qualified professionals.
Productivity During an Injury
Although I found some ways to be productive, if I could go back and do it over again, I would have incorporated some different activities and techniques that would have helped myself to grow just as much as having been able to practice my instrument. I’ll list some ideas below:
Find any instruments that are within your ability to play with your injury, and work on those in depth. For my shoulder, I found I could still play soft snare drum with only slight discomfort, and who can ever really play enough soft snare drum? For my left broken finger, I found I could still work on bass drum and triangle with my right hand.
Research sports psychology to improve your mental toughness and approach to performing under pressure.
Dabble with meditation to not only increase your awareness and mindfulness of your actions and thoughts but also to give yourself a sort of structure and routine that you can look forward to doing.
Organize your music and study the repertoire by listening to recordings, looking at scores, and marking parts. I got on the iPad bandwagon, and now I have every instrument, excerpt, solo rep, and technique book all on fourScore, as well as my notes and tempos, which I can carry in a small bag.
Conclusion
Dealing with injuries, both playing related and caused from athletic activity, puts extra demands on our bodies since they are already used to play a taxing instrument like percussion. Some of the most important people in my recoveries were my physical and massage therapists, and their knowledge of the body and conditions from injuries can help to speed along the recovery process with less pain and frustration. Finding specialists with experience with musicians can be beneficial, and above all, keeping an active lifestyle with strength training, cardio, and proper rest will help to eliminate injuries in the first place.
Although injuries cause difficult recovery processes both physically and mentally, they challenge us to build mental resiliency, increase knowledge of our body, and help us to move forward with more awareness than when we started. In a COVID-19 impacted world, many percussionists are experiencing some of the aspects that come with injuries: isolation, the inability to practice and perform, and the mental, physical, and financial realities of dealing with our new normal. I hope that this article offers some insights into recovery and prevention of injuries and also can spark adaptive ideas for this year.
Bibliography
Adam DeVito (Sama Therapeutics), interviewed by Parker Olson, June 2020, YouTube Video, https://youtu.be/auZZa_kIXZs.
Benjamin Linz (Benchmark Physical Therapy), interviewed by Parker Olson, June 2020, YouTube Video, https://youtu.be/gxx-qN10J4g.
Borggreve, Marco. BSO Portrait of Dan Bauch. Accessed August, 2020. https://www.bso.org/percussion-timpani-harp/daniel-bauch.aspx.
Borggreve, Marco. BSO Portrait of Matthew McKay. Accessed August, 2020. https://www.bso.org/percussion-timpani-harp/matthew-mckay.aspx.
Matthew McKay (Boston Symphony), interviewed by Parker Olson, June 2020, Transcript, https://www.parkerolsonpercussion.com/articles/injury-prevention-and-recovery.com.
Quinn, Elizabeth. “How to Cope With a Sports Injury.” Verywell Fit. March 17, 2020, https://www.verywellfit.com/the-emotional-stress-of-a-sports-injury-3120689.