Thursday, 5 March 2009

Careful With That Axe, Eugene

There's nothing like having part of your body hacked-open while you're asleep (albeit extremely professionally) to make you appreciate just how fortunate you are to live in a technologically-advanced 21st century society with socialised medical care. Arthroscopy may have been part of the surgical toolkit for over 80 years, but taking my kids to the park less than 24 hours after having some duff cartilage excised - almost exactly as per the illustration, except with a wee side order of chondromalacia in my case - is a (minuscule) tribute to modern techniques, not to mention an 'interesting' experience. Not exactly part of the official rehab programme, admittedly, but then who ever followed those things to the letter?

That's not to say I wasn't extremely glad to leave hospital in one slightly-smaller piece...

"Between February 2006 and January 2007, the NPSA received over 24,000 reports of patients being wrongly identified and mismatched with their care." (National Patient Safety Agency)

...and with the correct limb heavily bandaged. Wrong-side/site surgery has been reduced in recent years, largely thanks to the introduction of a checklist...

"This includes advice for surgical teams on where, how and when the patient should be marked to show where an operation should take place, who should mark the patient and the people who should be actively involved in the process." (NPSA)

...but I still heartily recommend that when asked,"..and which leg is it again?", by the person standing at the end of the bed (hopefully one of the hospital staff, not just a random surgical procedure obsessive), you emphasise it's your left/right/whatever, not theirs. I know, incredibly unlikely that anyone would ever make that error, but the potential consequences surely make the effort worth your while?

Ok, so far so nothing really to do with music (apart from an excuse to use a great Pink Floyd title. I nearly went with "The first cut is the deepest" instead...), but indulge me, please, it's coming up next.

For all that the surgery has apparently been great, for the first week or so afterwards I found it extremely difficult to practice - stiffness and pain in the knee joint meant it was hard to find a comfortable position to play a guitar (of any description), and using my electric upright bass was completely out of the question. Playing duration was also an issue, partially due to bruising around the I.V. site on my left hand. Good thing that these days I'm only a 'not-very-nearly-was', with delusions of recapturing a fragment or two of my previous obscurity, rather than a full-time professional with important gigs scheduled. This got me thinking about some of the often-lesser-regarded risks to which musicians expose themselves, and what medical assistance might be available.

Aside from the bleedin' obvious, (and entirely avoidable with even half a brain - yes, it's 'personal responsibility' time, ooh, how very un-rock-'n' sue me), dangers of booze, drugs, and playing 'tag' with hippopotamuses, and the occasional unfortunate demonstrations of the havoc excess electrical energy can cause, a lot of musicians' aches and pains are caused by:

a) Playing the wrong instrument
b) Playing in ways that damage ourselves
c) Bloody ageing. Dammit.

The first one isn't always as straightforward as you might think. Yes, there are famous examples like Paderewski suffering terribly because of the action on the Steinway pianos he was contracted to use, but let's talk about me a bit more instead. Regrettably, a couple of years ago I had to sell a perfectly decent DeArmond, 35"-scale length 6-string bass (that I'd acquired very cheaply indeed), because it was damaging my left wrist. My current, identical string-spacing, 34"-s.l. TobyPro VI is absolutely fine. At a fret-by-fret level, those are very small differences we're talking about - and insufficient to cause pain during/after a check-it-out-in-the-shop session. Even one of mine, which always go on far too long if I like something (although never too loud - that's just rude).

A friend in York developed tendonitis principally from changing to an Epiphone Thunderbird, simply because it was necessary for the professional tribute band he was in at the time. [That's Big Rich on the left, 'rocking out' with the offending bass]. We finally worked out what the problem was by comparing his stance, grip, shoulder/elbow/wrist angles, overall playing movements, etc, with those employed when using his other (pain-free) basses. (Oh, if you're experiencing similar issues, a small thing that a lot of 'therapists' overlook - 'dynamic' and 'contextual' posture are probably more important than the traditionally-addressed 'static' version - see the extended footnote quoting from the late Dr. Mel Siff for more details).

As to what we're playing, and how we go about it, well, this is the kind of patently-ridiculous thing I used to find highly entertaining to inflict on audiences:

An "unpleasantly difficult" G7 (b5 #9) with a little finger barre. Mmmm....

That was when I was a foolish, seemingly-invulnerable youth back in 1990...since then I've developed a far healthier dislike of "extreme barre chord madness". Too much of this sort of thing, for long periods can cause all sorts of cramping (and more serious, long-term agonies), if proper warm-ups (not shredding up and down a bunch of scales, however much fun that might be), regular breaks, and sensible self-monitoring are not applied.

Some of that, of course, might be ascribed to creeping decrepitude - as could less of an inclination to jump up and down on stage quite so regularly and vigorously, perhaps - muscular recovery times have lengthened somewhat over the years. Certainly the body can become a lot less tolerant of a 'heavy' instrument, no matter how efficient the player's posture and technique. Fortunately, help is at hand...

Music (and "Performing Arts") medicine is quite the growth area these days, and as you might expect, there's some handy stuff easily available online. For instance, SHAPE in Canada provide a useful PDF document outlining a whole range of musculoskeletal injury symptoms associated with different instruments - strangely fascinating, and perfect for any hypochondriacs in the band, too.

And for more direct assistance, well, keeping things relatively local, Musicians' Health Scotland looks like a good place to start. A brief bit of googling should turn up something similarly useful in other locales. As long as it isn't one of the quacking, back-cracking fraternity you toddle along to, naturally...

Finally, if all else fails, we can always turn to 'appliances' to assist us where our bodies seem to have failed. They may not be 'cool', but I'm seriously considering either a Y-strap, a Dual Shoulder Strap or something similar (suggestions?) for bass playing. And for those amongst us who prefer to do it sitting down, but are having problems 'keeping it up', this could be the perfect technological solution...?

The most radical idea I came across, though, was one that, as an ex-flautist, I found truly astonishing - simple, yet with an incredible "what the...?" factor. Laydeez and Gentlemen, I give you...the Flutelab vertical flute headjoint:

Check out the picture of someone playing one on their website. It just looks....wonderfully wrong. Not exactly cheap, either, at 1800 euros (probably worth about £27,356 by the time you read this), but if you want pain-free music, and you've got the cash, it's priceless.

Hope a tiny morsel of all that was of some practical use to somebody. All being well I'm off to Bergen again next week, so there'll just be the usual delay before anything new appears in this vicinity.


Footnote on 'posture' for anyone interested:

"A few things always concern me about the whole "postural
correction" or "realignment" concept:

1. Structural or observed symmetry all too often is regarded as the
optimal and safest end state for all humans. The body very typically
is an asymmetric system which displays a level of plasticity and
adaptability that is not always as homeostatically "perfect" as seems
to be implied by many posture police.

2. Posture often is regarded as something that is invariant and
should not vary to any noticeable degree from some hypothetical ideal
or universal model, despite the fact that any given motor problem may
have more than one unique solution.

3. Assessment of posture is far too often based upon static
measurements; very rarely is the topic of "situational"
or "contextual" posture raised, nor is dynamic posture ever measured
under a wide range of conditions. Just as some people display rather
unaesthetic speaking voices, they may sing exquisitely. Similarly,
someone may display unaesthetic static posture, but exceptional grace
while in motion.

4. Sometimes individual posture is regarded as pathological, yet it
has never been established exactly which is the optimal postural
reference model for all static and dynamic situations.

5. It is too frequently proclaimed that the human body left to its
own devices will simply perpetuate "imbalances" or "imperfections" --
only special therapeutic interventions will ever restore the body to
its hypothetical ideal state. Yet, it is not uncommon for the body to
spontaneously rectify so-called imbalances.

6. The concept of long lasting static posture runs contrary to how
the body functions. Speeded up video studies have shown that our
bodies are always indulging in subtle or gross movements to ensure
that one precise posture is NOT held for prolonged periods, thereby
ensuring that stresses are not imposed upon the same physical
structures in exactly the same way. Even in sporting and other
complex movement situations, the same external movement pattern may
be produced by different musculoskeletal and neuromuscular
strategies, so that the idea of an invariant, highly stable single
posture is misleading.

7. It can be very misleading to assess the validity of postural
correction on the basis of changes in perception of pain, because
absence of pain does not necessarily imply the absence of pathology
and vice versa.

8. A given postural intervention may not be the direct effector of
change; it might simply serve as the "last straw" in a long sequence
of automatic and therapeutically mediated changes, especially since
many processes in biological systems appear to be nonlinear in
(Dr. Mel Siff, originally posted on his 'Supertraining' website)


Mel Siff Fan said...

It is amazing where the wisdom of Dr Mel Siff arises. He was the man - may he Rest In Peace

Andy Gilmour said...

Heh! Cheers "Mel Siff Fan". Doc S was indeed the man.

(I came across his work when I used to be an exceptionally mediocre weightlifter, and had been looking for a topic I could attach some of his considerable wisdom to for a while...)