As I sit here right now, I am aware of a sharp pain in my neck when I turn to the left, lower back tenderness, and a persistent cramping in my right hand. I am a violinist, and I have come to accept these pains as occupational hazards. But two years ago, I was hit with something potentially career-threatening. My right shoulder developed tendinitis right after opera season ended.
There was a lot of pain… the kind that keeps you from sleeping at night. Motion was severely restricted, and playing the violin was very painful. I was loath to tell people because I had playing commitments that needed to be met, operas to learn, and I didn’t want to see my opportunities evaporate because I was perceived as too fragile and unreliable. So I tried to find a way to heal while still playing the violin. I found a shoulder specialist who interviewed me extensively about exertion and duration, then said “I am going to treat you the way I would treat an elite athlete.” After six months of physical therapy and a steroid injection, I am happy to say that for the most part my right shoulder now behaves. But it is a fact that it will always be weak, and that overuse (and sometimes, any use) will cause pain and loss of motion.
Studies of overuse syndrome in musicians cite muscle structure, cell structure, and even anxiety as possible contributing factors. It is estimated that at least 75% of instrumentalists suffer from upper extremity symptoms related to overuse. Both isotonic and isometric movements can be the culprit – so it might be both the loud passagework in Meistersinger and the Parsifal slow bits, or even just holding up your instrument that do the damage. Tendinitis goes beyond overuse into micro-damage and inflammation. Recovery, most agree, relies heavily on rest. And this is where LeBron and I start to have things in common, because when you have commitments to colleagues and the audience, rest is sometimes hard to come by whether it’s opera or the NBA finals.
Much was said about the work load LeBron James took on, and what his medical professionals did for his recovery between games. According to NPR, his daily routine included ice baths, massage, stretching, electro-muscular stimulation, cryotherapy, a three-hour nap, and lots of rehydration.
And here is another point made in the NPR report: the more you play on a worn-out body, the more injury prone you become.
With Lyric’s intense season, it is ridiculously easy to cause injury through overuse and very challenging to carve out proper recovery time. If your injury is severe and your recovery drags on into months, you can easily exceed the allowed disability. You are under pressure to keep up your playing and to learn upcoming operas. You don’t want to make a standby player come in for you. It’s a difficult situation that many of us have faced.
Wouldn’t it be wonderful if our injuries were treated as seriously as those of elite athletes? LeBron, I applaud you for stepping up and doing a hard job, and for bringing the subject of recovery from overuse into the public eye. Let’s help the public also notice the overuse of those smaller muscles by the elite athletes in the orchestra pit, and appreciate the serious nature of that.
 Han-Sung Lee, Ho Youn Park, Joon O Youn, MD, et al. Musicians’ Medicine: Musculoskeletal Problems in String Players. Clinics in Orthopedic Surgery 2013;5;155-160