Tag Archives: health

Health Care Open Enrollment
Health, Resources

Don’t Miss Health Care Open Enrollment Now Through January 2017

Did you know that an unexpected trip to the hospital could cost you and your family more than $2,000 a day? The hefty price tag does not even include prescription drugs or medical procedures, which easily can add up to tens of thousands of dollars. Medical bills are the leading cause of all bankruptcies in the US. Health insurance can protect you from an unexpected financial hit due to accident or illness.

Not only that, as of 2014, you are required to have health insurance or pay a tax penalty. The period to shop for and switch coverage for next year, November 1-January 31, 2017, has just begun. Even if you already have coverage, you might want to re-evaluate your current plan.

Reasons to re-evaluate your current plan:

• It costs too much.

• It does not provide the coverage I (or my family) need.

• Your current health insurance company does not pay medical bills quickly and efficiently.

• Your current health insurance company does not provide good customer support.

• You do not have dental or vision coverage.

Plans fall into four categories, from lowest cost/least coverage to highest cost/most coverage they are: bronze, silver, gold, and platinum. Coverage also varies based on category, provider, and geographic area. If you feel confused when it comes to comparing plans, you are not alone. That’s one of the reasons the Working American Health Care (www.workingamericahealthcare.org) was launched.

AFM members and their families are eligible to shop for a plan through Working America Health Care. In partnership with Working America and Union Plus, AFL-CIO affiliate Working America Health Care connects union members to quality health insurance. The plans available through the marketplace include important consumer protections that meet or exceed coverage requirements to avoid the tax penalty. Unbiased, licensed professionals at Working America Health Care can help you:

• Figure out if you qualify for financial help in paying for a plan.

• Identify plans available to you in your geographic area.

• Evaluate plans to find the best fit (cost versus coverage) for you and your family.

Once signed up with a plan, you can access additional vision and dental discount programs. (Call 1-877-570-4845 or visit: workingamericahealthcare.org/why-working-america/dental-and-vision-coverage).

In addition, Working America Health Care Advocates (available 24/7) can help you coordinate medical care, locate the right providers, explain conditions and treatment, resolve claims, and answer coverage questions. Best of all, these advocates will help you understand your coverage and protect you from being wrongly charged or over-charged.

Avoid the Flu
Health, Resources

Avoid the Flu this Season: What You Need to Know

Avoid the FluIn North America, millions of people are sickened, hundreds of thousands are hospitalized, and more than 100 million workdays are lost, due to the flu each year. It’s important to take every precaution to not have to cancel gigs. Don’t risk sidelining your career due to illness. Do your best to avoid the flu this season. 

Your best defense may be to get vaccinated. Flu vaccine effectiveness depends on how well the vaccine matches the dominant strain of influenza circulating in a particular year. This year’s shot will offer protection against the H1N1 flu virus and two other flu viruses expected this season. A vaccine that protects against four strains of the virus will be available, as will a high-dose flu vaccine for adults age 65 years and older. According to the Centers for Disease Control and Prevention (CDC), when the vaccine is well-matched, it can reduce the risk of flu by about 50%.

It takes up to two weeks to build immunity after receiving a flu shot, but you can benefit from the vaccine even after flu season is underway. Typically, the flu hits in October, peaks in January or February, and can run well into spring. Experts say that for some populations, like the elderly, the vaccine may wear off faster. But because it’s unknown when the flu will strike, it’s best for people to get their flu shots sooner rather than later.      

Who should not get a flu shot?

Check with your doctor if you have had a serious reaction to a previous flu vaccine. Generally, it’s inadvisable for these individuals.  

Most types of flu vaccines contain a small amount of egg protein. A mild egg allergy is not cause for alarm, but if you have a severe egg allergy, you should be vaccinated in a setting with medical personnel who can respond to a severe allergic reaction. There are flu vaccines approved for use in people age 18 years and older that do not contain egg proteins. Consult your doctor about your options.

What are the flu vaccine delivery options?

This year the vaccine is recommended as an injection only. The CDC no longer recommends nasal spray flu vaccinations because in the last three flu seasons, the spray has been ineffective.

The injection is usually given in a muscle in the arm. The FDA has also approved an alternative for adults aged 18-64. The intradermal flu vaccine is injected into the skin, instead of the muscle, and requires 40% less antigen than the regular flu shot.

Can the vaccine give me the flu?

The vaccine’s killed (inactivated) viruses enable the body to develop the antibodies necessary to ward off influenza viruses, but cannot give you the flu. However, you may develop flu-like symptoms—muscle aches and a fever—for a day or two after receiving a flu shot. This may be a side effect of your body’s production of protective antibodies.

It takes about two weeks for the flu shot to take full effect. If you are exposed to the influenza virus shortly before or during that time period, you may catch the flu.

What other illnesses mimic the flu?

Flu symptoms include fever, chills, malaise, dry cough, loss of appetite, and body aches. Because this is the body’s natural response to fighting infection, other illnesses mimic flu symptoms. Some of the more well-known conditions include meningitis, tuberculosis, food poisoning, hepatitis, Hodgkin’s disease, and Lyme disease.

What kind of protection does the flu vaccine offer?

The flu vaccine is generally more effective among healthy children two years old and older and adults age 64 and younger. The elderly and people with particular medical conditions may develop less immunity after receiving a flu shot.

According to the CDC, when the match between the flu vaccine and circulating strains is more precise, a flu shot is 71% effective in reducing flu-related hospitalizations among adults. The flu shot may reduce a child’s risk by 74%.

What are other ways I can avoid the flu?

Most flu viruses are not spread directly by airborne particles, like coughs and sneezes, but by direct contact. Hand washing is the first line of defense. Wash your hands often and avoid touching your face, especially your nose and eyes. Carry hand sanitizer and use it throughout the day.

Bar soap can be a breeding ground for many viruses and bacteria. When possible, use liquid soap. Hand towels should be changed frequently for the same reason. Wipe down surfaces such as stair rails, telephones, countertops, desks, music stands, doorknobs, and grocery carts. Clean your mouthpiece each time you handle it and avoid touching any part that will make contact with your lips.

Germs survive in stagnant air so open the windows and air out your home or practice room. Avoid breathing in smoke. Smoke can increase your susceptibility to viruses. If you have no choice but to play in a smoke-filled room, step outdoors for fresh air during breaks.

Rest, exercise regularly, stay hydrated, eat a nutritious diet, and try to manage your stress.

How do I determine if I have a cold or the flu?

Cold symptoms include runny nose, sneezing, and coughing. Influenza symptoms are more acute, accompanied by fever, extreme fatigue, sore throat, headache, and muscle aches.

Prescription medications, such as Tamiflu, may reduce the length of the illness, but  must be taken within the first 48 hours of showing symptoms. You can sometimes get a prescription before showing symptoms, if a family member has been diagnosed with the flu.

Although there is no cure for the flu (or the common cold), you will recover more quickly by following some simple advice. First, stay at home and rest. Try to avoid spreading the illness to colleagues and other musicians with whom you are in close contact. Physicians recommend drinking plenty of fluids and avoid alcoholic beverages, which are dehydrating.

On average, the duration of the flu is about a week. Seek medical advice immediately if you experience high or prolonged fever; difficulty breathing or shortness of breath; pain or pressure in the chest; dizziness or fainting; confusion; or vomiting.

Where can I get vaccinated?

Flu vaccines are offered at doctor’s offices. If you do not have a regular doctor or health care practitioner, you may be able to get a flu vaccine at a pharmacy, urgent care clinic, or a university  or public health center. To find a flu vaccine location near you, go to the flu shot map (http://flushot.healthmap.org/).

neck pain
Health, Resources

Finding Relief from Neck Pain

Editor’s note: Always check with a physician if you are experiencing pain, as well as before beginning a new physical activity.

Chronic neck pain stems largely from poor posture and daily exertion. Taking simple measures to realign one’s body can decrease the odds of having to live with chronic pain. 

Our bodies are designed to work in concert with gravity. Poor posture causes a slew of problems such as inflammation, nerve compression, and limited range of motion. In some cases, it leads to acute conditions such as degenerative disc disease. If the neck is habitually thrust forward, in front of the shoulders, the pull and weight of the head places undue stress on the vertebrae of the lower neck. Our heads can weigh 10-15 pounds, which is a lot of strain. The muscles of the upper back must compensate to balance the weight. Simple stretches and exercises performed on a regular basis can offer long-term relief.

The Alexander Technique

A popular component of voice and music instruction is the Alexander Technique, which focuses on the head and spine. This correlation determines the quality of overall coordination. The exercises within this curriculum are well established and offer positive physical benefits. The approach centers on not overworking the neck muscles and the head being properly positioned and balanced, at the top of the spine. For more information, go to the American Society for the Alexander Technique at http://www.amsatonline.org/alexander-technique.

Take Care Moving Instruments

Never carry a heavy instrument with one hand or on one shoulder. For better distribution of weight, straps should be long enough to go across the chest. Use a bag or case with wheels whenever possible to transport heavier stringed instruments. Bend from the knees and keep the weight close to the body when picking up heavy equipment.

Gentle Neck Stretches

Free Up the Muscles. Let your neck muscles relax, and let your head rotate slightly forward, and go up. Slowly, and very slightly lower the tip of your nose while the crown of your head moves up. Let your sitting bones release down into the chair, in opposition to your head moving up, neither slumping nor straining. Reduce the neck tension again. Let your head rotate forward, and go up.

With practice you can release neck muscles and reduce neck tension. In time, you will realize when and how you are creating tension in your neck.

Seated Neck Release. Sitting cross-legged on the floor, or in a chair with your feet flat on the ground, extend your right arm next to your right knee or along the right side of the chair. Place your left hand lightly on the top of your head and slowly tilt your head to the left. Apply gentle pressure with your hand to increase the stretch. For a deeper stretch, hold onto your right knee or the seat of the chair. This stabilizes the torso and allows you to isolate the stretch on the side of your neck. Hold for 30 seconds, slowly lift your head and repeat on the other side.

Seated Clasping Neck Stretch. For a deep stretch for the back of your neck and your upper back, sit comfortably in a chair or on the floor. Clasp your hands and bring both palms to the back of your head. Sitting tall, ground your hips firmly into your seat. From there, begin to gently press your hands down toward your thighs, tucking your chin into your chest. As you press down, use the heels of your palms to softly pull your head away from your shoulders to intensify the stretch. Hold for at least 30 seconds, slowly lift your head and release your hands.

Behind-the-Back Neck Stretch. This standing stretch provides a deep stretch in the sides of your neck. Stand with your feet slightly apart, about hip distance, arms by your sides. Reach both hands behind your buttock and hold onto your left wrist with your right hand. Use your right hand to gently straighten your left arm and pull it away slightly. To increase the stretch in your neck, slowly lower your right ear toward your shoulder. Hold for 30 seconds and then switch sides.

For more neck stretches to reduce tension, go to http://www.arthritis.org/living-with-arthritis/exercise/workouts/simple-routines/neck-pain-exercises.php.

Lyme Disease
Health, Resources

Lyme Disease Diagnosis and Precautions

According to the US Centers for Disease Control (CDC), Lyme disease is the fastest growing vector-borne infectious disease in the US. The number of cases has increased 25-fold since national surveillance began in 1982, now infecting some 300,000 people a year.

The disease is transmitted by the blacklegged tick and the Western blacklegged tick whose range is spreading north. The most recent surveys by CDC biologists show that they are found in more than 45% of US counties, compared to only 30% in 1998.

Once only in Ontario, Canada, Lyme-carrying ticks are now found in almost all the Canadian provinces. The Public Health Agency reported 500 cases of Lyme disease in 2014 and 700 in 2015.

Misdiagnosis

Chronic Lyme disease patients may face a long hard fight to recovery, but first it’s a battle to get the correct diagnosis. Songwriter and actor Kris Kristofferson of Local 257 (Nashville, TN) faced a diagnosis of Alzheimer’s, before he was tested and diagnosed with Lyme disease, according to recent interviews with his wife, Lisa. After many years of suffering with painful fibromyalgia, memory loss, and depression, he began aggressive treatment for Lyme disease and his health improved. Luckily, Lisa was an intuitive advocate who recognized that, cognitively, something did not add up.

The unfortunate reality is that Lyme disease often goes undiagnosed because doctors are not looking for it. Patients and physicians rely on telltale signs: a tick on the skin, the bull’s eye rash (Erythema Migrans (EM) rash), and joint pain. But research shows only 50%-60% of patients recall a tick bite, and the rash is reported in only 35%-60% of patients. Joint swelling typically occurs in only 20%-30%
of patients, and is easily masked by the prevalent use of over-the-counter anti-inflammatory medications.

Adding to the problem, people who have Lyme disease can test negative until their body builds up antibodies. Other patients can test false positive due to autoimmune disorders. The CDC recommends a two-tier testing process.

When Lyme disease is misdiagnosed during the early stages, it progresses to a chronic form that’s even more difficult to diagnose and treat. Symptoms can be debilitating, including severe fatigue, anxiety, headaches, and joint pain that mimic other conditions. Meanwhile, the disease causes complications involving the heart, nervous system, muscles, and joints. Patients may suffer through a complicated maze of specialists in search of appropriate treatment.

Treatment

If you live in an endemic area for Lyme disease and suspect you may have been infected, prophylactic treatment for at least three weeks is advised. Early treatment will prevent the body from mounting an antibody response, and subsequent testing for Lyme will be negative.

Antibiotic choice presents another host of problems. Doxycycline also treats other tick-borne pathogens, including Q Fever, and Rocky Mountain Spotted Fever. However, the parasites may carry bacteria not responsive to doxycycline. One side-effects are sun sensitivity and stomach problems. The typical 100mg twice daily dose may not reach therapeutic levels. Amoxicillin and Cefuroxime are better tolerated, but do not cover as wide a spectrum of infections.

Prevention and Precautions

Avoid tick-infested areas, especially in spring and early summer when nymph ticks feed. Adult ticks are more of a threat in fall. Ticks favor moist, shaded environments, especially leafy wooded areas and overgrown grassy habitats.

• Wear light-colored clothing to spot ticks more easily.

• Walk in the middle of designated trails.

• Wear closed-toed shoes.

• Avoid low-lying brush or long grass.

• Tuck pant legs into your socks to prevent ticks from crawling up your legs.

• Use insect repellents containing  DEET or Icaridin on skin and clothing.

• Check clothing for ticks often, then shower or bathe within two hours of being outdoors to wash away loose ticks.

While tick transmission is most common, new studies indicate that there may be other ways to contract Lyme, including blood transfusions or mosquito bites.

For a symptoms checklist go to:
www.lymedisease.org.

Staying Healthy as a Musician
Health, Resources

Athletes and the Arts: Staying Healthy as a Musician

by Randall W. Dick, M.S., FACSM 

Staying Healthy as a Musician

Lessons from the Sports World

Performing artists are athletes. Just like “sport” athletes they:

• Practice or perform almost every day

• Play through pain

• Compete in challenging environments

• Experience little “off season”

• Face extreme competition

• Face real risk of career-threatening injury

Yet, performing artists rarely have access to the injury prevention, nutrition, and practice and competition guidelines afforded most sports athletes, even at the youth level. Performing artists—musicians, dancers, singers, conductors, actors, and marching band members—of all ages and their instructors need this information, along with education and research associated with optimizing  performance and unique performance related problems.

Why the Concern?

Consider these factors:

• In one year, 64% of world-class drum corps had members who developed stress fractures.

• 50% of all musicians have some form of noise-induced hearing loss (NIHL).

• 75% of orchestra instrumentalists will develop at least one musculoskeletal disorder from playing during their lifetimes.

Initiated in 2008 and formally launched in 2013, Athletes and the Arts (www.athletesandthearts.com) is a multi-organizational initiative that recognized that athletes exist throughout the performing arts community and that established performance, wellness, and injury prevention research for sport athletes is also applicable to performing artists. Health and wellness are generally foreign concepts in the performing arts community.

Athletes and the Arts (AATA) believes sports medicine physicians have the skill set to expand their practices to an entirely new and underserved population once they understand the needs and key risk factors of performing artists. Music instructors can address wellness, hearing, and cross-training, similarly to the way sports coaches introduce injury prevention initiatives.

Put Practice and Performance
in Perspective

At some point the number of practice hours may hurt rather than help. Consider focused practice segments with different goals in each session. Rote repetition for extended periods of time has not proven successful.

Large increases in the time spent practicing increases the risk of injury. If the volume or intensity of practice must increase, do it gradually.

Cross-train: employ a mental or physical activity that allows the body to focus on something different. Emphasize both mental and physical rest and recovery.

How to Put These Findings
into Practice

Select appropriate repertoire for yourself and your students. Select repertoire that challenges growth but does not overwhelm  physically or musically.

Learn and teach healthy practice strategies. Seek a problem-solving strategy
to avoid mindless practice. Break up
practice sessions to enhance concentration and avoid overuse.

Observe, record, and review the strength and posture needed during practice. Don’t underestimate the value of core strength when it comes to posture and being strong enough to hold their posture (or instrument) for long stretches.

Promote the joy of performance. Open yourself and your students up to a range of different performance opportunities in order to feel comfortable in any performance setting.

Avoid Overuse/Burnout

Consider repetitive motion, a major source of injury in the sport world.

• About 150 pitches per team are thrown in a professional baseball game.

• Around 8,000 steps are taken by each field player during a soccer match.

• Approximately 50,000 steps are taken in a marathon.

• About 3 million musical notes are played in a full-length Broadway performance.

Youth in today’s culture are driven to train early and extensively. Early specialization and extensive training creates documented risks of overuse injury, burnout, stress, and less enjoyment in youth sports.

The performing artist faces many of these same challenges, but specific research for this population is scarce. Minimize the risk of physical and mental overuse by monitoring how often and intensely you perform.

Noise-Induced Hearing Loss

Be aware of exposure to both the intensity of the sound (measured in decibels or dB) and its duration. Government standards for occupations with high noise exposure have
a foundation exposure value of no more than 85 dB for an eight-hour period. For every three dB increase, time exposure should
be halved:

• 88 dB for four hours per day

• 91 dB for two hours per day

• 94 dB for one hour per day

The dynamic range of music, live or recorded, can peak at or above 95 dB. Normal piano practice ranges from 60 dB to 90 dB, more intense, 70 dB to 105 dB. Hearing damage can occur when exposed to 94 dB for 60 minutes or less daily. Protect your hearing by limiting your exposure to loud noise when not performing, using musicians’ ear plugs on stage, and getting an annual hearing test with an audiologist.

Find a Health Professional
and Wellness Coach

Establish a relationship with a health professional before an injury occurs. Let your physician know you are a performing artist, demonstrate your craft, and explain how often/intensely you perform. Keep a performance diary to document a “typical” week of practice, performance, and other related activity. Insist on regular hearing checks. Your healthcare provider needs to understand how you play your instrument in order to counsel on injury prevention.

Resources

The Athletes and the Arts (AATA) website, www.athletesandthearts.com, is a resource  for artist health information through its own content and links to the 13 collaborating organization websites. There are one-pagers on subjects ranging from hearing loss to performance anxiety to nutrition. Use the website to educate yourself, your colleagues, and your students to enhance their long-term wellness and performance.

Summary

Performing artists are an underserved population related to medical coverage, care, injury prevention and wellness. Your short-term and long-term health will benefit from a knowledgeable medical team that understands what you do (including the volume and intensity of your activities). Your body is an extension of your instrument. Be as proactive about protecting your health as you are your instrument.

—Randall Dick, M.S., FACSM, is a member of the American College of Sports Medicine. He worked for 20 years with the National Collegiate Athletic Association, managing its sports medicine and injury prevention programs. He has authored more than 50 peer-reviewed publications and serves on the US Lacrosse Sports Science Committee and as a consultant for Major League Baseball injury surveillance. He began developing the Athletes and the Arts initiative after a conversation with the New Orleans-based Preservation Hall Jazz Band.

exercise as medicine
Health, Resources

Exercise as Medicine for Your Music

by: Patrick Gannon, PhD

We all know that exercise is good for you. But you may not know all that exercise is good for.

Besides promoting general fitness, musicians need exercise to strengthen their legs, core, and upper body to meet the physical demands of daily practice and performance. This is particularly important because musicians are vulnerable to performance-related injuries. Exercise promotes muscle balance that offsets the physical asymmetries that commonly occur among instrumentalists. And it offers the added benefit of reducing stress.

Now, a broader recognition of how exercise impacts the mind and body is emerging. The American College of Sports Medicine, in concert with the American Medical Association, promote the idea that “exercise is medicine” to reduce risk factors for aging, diabetes, dementia, mood disorders, and sleep. Think of it as a longevity pill that is free, readily available, and has no side effects. 

Beyond being a medicine, exercise can also be a tool. The trick is to prescribe exercise purposefully to activate certain brain functions. For example, by varying the type of exercise (cardio/aerobic or weight training), as well as the intensity level (high/moderate), frequency, and timing of exercise (before practicing or performing), you can prime the brain to help with anxiety, learning, memory, mood—even creativity.

Anxiety Management

Cardio exercise may be the best natural treatment for performance anxiety, including state (situational) and trait (dispositional) anxiety. Exercise reduces anxiety by discharging muscle tension, increasing cardiovascular capacity, and disrupting negative thoughts. Physiologically, cardio stimulates the production of calming neurotransmitters such as serotonin, dopamine, and gamma-Aminobutyric acid (GABA), which dampen anxiety.

Two ways to use exercise to reduce anxiety:

1) Thirty minutes of vigorous cardio exercise will immediately reduce anxiety. Although musicians are often discouraged from exercising before performing, it can be helpful. However, the exercise must be completed at least three hours before stepping on stage, allowing sufficient time for rest.

2) For trait anxiety, ongoing exercise several times per week, for 30-45 minutes, will lower the resting heart rate.

Learning

Who would have thought that exercise could also be a learning tool? Several studies have shown that exercise improves working memory, attention, and processing speed. Exercise stimulates neurogenesis—the creation of new neurons in the hippocampus that builds capacity for learning. It also stimulates long-term potentiation (LTP) by binding neural cells together that encode learning.

Two ways to apply exercise to learning:

1) High intensity exercise (at 60% to 80% of maximum heart rate) redirects blood flow away from the prefrontal cortex (PFC), thereby inhibiting learning (recall how hard it is to think straight when pushing your physical limit). But blood flow to the PFC is gradually restored, which then optimizes brain functions for several hours afterwards. This is why exercising before practicing makes sense.

2) Combine moderate exercise (at a 120-130 bpm heart rate) with mental rehearsal of the material that you want to learn. Because exercise stimulates the brain-derived neurotrophic factor (BDNF), new neural circuits are created that encode learning. This is essentially self-directed neuroplasticity in action.

Try these exercises to promote learning and memory:

• Do 30 minutes of moderate cardio exercise while listening to the music that you want to learn or 30 minutes of high intensity exercise an hour before practicing that music.

• Divide the music up into sections and create associations to each section with your own memories, feelings, and images. These narrative links will serve as cues for memory retrieval.

• Follow up with moderate exercise while mentally rehearsing the music with the narrative imagery included. Repeat this process on alternating days until fully memorized.

Creativity

Studies show that creativity is stimulated by the interplay between the hippocampus, amygdala, and PFC. Creativity happens by holding diverse concepts in mind through working memory, using cognitive flexibility (and tolerance for uncertainty) to play with these concepts, and then focusing attention on the generation of new ideas.

Because exercise lowers the activation of the dorsolateral part of the PFC, old ideas are held back somewhat, allowing new ideas to emerge. But you must keep your mind open—and be patient with the process—until a new idea streams into consciousness.

Here’s how to exercise to stimulate creativity:

• Do 20-30 minutes of moderate cardio exercise on an elliptical trainer or stationary bike while mentally rehearsing the music you plan to practice that day. Allow new ideas to pop into awareness and then track the ideas as they unfold.

• The same technique can be applied to problem solving, procrastination, and planning. By holding the question or issue in mind while exercising, new ideas will emerge. Remember, listening to your intuition and “going with the flow” are what generates creativity.

Patrick Gannon, PhD is a clinical and performance psychologist working in San Francisco and nationally via Skype. He is a member of the Performing Arts Medicine Association and a national presenter on performance psychology. He welcomes comments and inquiries on this article. Visit his website (PeakPerformance101.com) or email him (drpatrickgannon@gmail.com).

avoid strain
Health, Resources

Play Fit: Tips to Avoid Strain

In a normal work environment, sitting and standing for long periods of time can result in a number of neuro-musculoskeletal problems. Add to this repetitive motion, rotation, even heavy lifting, and the risks are compounded.

For musicians, strain and stiffness can be minor at first, but over time problems escalate and become debilitating—neural compression, reduced blood flow, joint stiffness, and damage to connective tissue. Tendons must bear all the weight of the attached muscle and can tear if overstretched. Inflammation of the tendon, or tendinitis, often occurs at the shoulder, biceps, and elbow. The small sac that cushions and reduces friction in the joint is called bursa. Inflammation of this sac is called bursitis.   

Overworking some tissues and underworking others can lead to less flexibility, loss of strength, and misalignment of joints—arguably, collateral damage for professional musicians. In some cases, musicians must learn to use completely different muscle groups for playing their instruments or play in different positions.

Pianists, for instance, can get relief if they use more wrist action and less finger motion. Musicians who play guitar, mandolin, and other fretted instruments have high tendonitis potential. Too tight a grip on the pick can strain the thumb muscles, resulting in tendonitis in the right thumb. If you feel your wrist or arm start to tighten while playing, back off and try to find a way to keep playing with the muscles relaxed.

Play with Good Posture and Breathe

For playing ability and overall health, good posture is the first line of defense. Slouching causes restricted and shallow breathing and over-restriction of muscles and tendons. Over time, poor posture can actually shorten muscles and tendons and weaken abdominal muscles. Learn to develop internal coordination and posture, from the inside out. Strengthening core muscles is important to spine alignment and to the strength and control of the rest of the body.

Proper breathing restores everything, from alternating mechanics of dynamic movement and posture and gait to the ability to handle sensory input. Most people tend to take shallow breaths so the ribcage is lifted and flared, which compromises diaphragm function, requiring chest, neck, and upper back to do more work.

When inhaling, the ribcage and chest should expand without any lift from neck and shoulder muscles. The most substantial movement, during inhalation, should occur in the lower ribs as they externally rotate (open out) and expand out to the sides. When exhaling, lower ribs should internally rotate (close in), creating the necessary space for your diaphragm to dome inside the ribcage.

Following are some general tips to follow to help avoid strain and injury:

  • Exercise and strengthen your core muscles, including abdominal muscles, back muscles, and muscles around the pelvis. (Consider doing yoga or Pilates.)
  • Before rehearsal or a performance, stretch arms, wrists, hands, and back. 
  • Determine the size, weight, or shape of instrument that is right for you, and whether there may be an accessory that makes playing more comfortable.
  • Evaluate your technique. Find ways to reduce force, keep your joints in their middle range of motion, and try to avoid fixed, tensed positions.
  • When practicing, take frequent breaks to stretch and relax. Take a long break every hour or so, and short breaks every few minutes to allow the body to recover.
  • Always seek medical help if you experience chronic pain or numbness and tingling in your fingers.
Neuroscience
Health

The Neuroscience of Peak Performance and Flow

by Patrick Gannon, PhD

What is happening in the minds and bodies of musicians when they play their best? Are peak performance and flow simply subjective perceptions of performance excellence? Or are they distinct mental states, a defined set of optimal behaviors, a heightened sense of self-confidence, or some trick of human nature?

Despite the confusion, we do have language to describe these experiences—being in the zone, in rhythm, in a groove, playing unconscious, even the so-called runner’s high. For starters, peak performance refers to optimal physical behaviors while psychologists define flow as a mental state. For musicians, it is both mental and physical because they feel calm, alert, focused, challenged, but confident, fully present in the moment, and supremely engaged in the task. When that feeling is combined with the thrill of playing music, magic happens!

If only we could bottle it, right? Thanks to neuroscience, that may now be possible.

The Flow State

Research findings have identified three markers that reveal how and when flow occurs: alpha/theta brain waves, brain coherence, and deactivation of the dorso-lateral, pre-frontal cortex (DLPFC).

First, the flow state is located at the crossover point between alpha and theta brain waves (eight Hz and below). As brain activity slows from the relaxing alpha state into the hypnagogic theta wave (below eight Hz), the neural network becomes highly attuned. At the same time, super fast (40-100 Hz) gamma waves, triggered by theta, go into action. Gamma waves connect information drawn from various parts of the brain that are involved in music making, allowing skill learning, procedural memory, and self-expression to settle into rhythm.

Secondly, synchronization between the left and right hemispheres or brain coherence is another marker for flow. Both hemispheres must be working complementarily to integrate artistic expression and technical skills. Cardio exercise, meditation, and yoga along with brain-based clinical techniques, like eye movement desensitization and reprocessing (EMDR), all promote brain coherence through bi-lateral stimulation.

Enhancing Flow

Finally, a temporary brain state called transient hypofrontality has been identified that enhances flow by lowering the activation of the DLPFC. This part of the brain holds our inner critic, that voice of doubt that can trigger cognitive anxiety. Cardio exercise redirects blood flow away from the DLPFC to the motor parts of the brain, enabling a more embodied focus without interference from self-consciousness, distraction, or negative thinking.

These findings can be applied to mental skill training that has been the hallmark of sport psychology over the last 50 years. The six key skills are relaxation, imagery, goal setting, self-talk, concentration, and pre-performance routines.

1) Relaxation is the first key because performance anxiety usually inhibits peak performance. Anxiety and physiological arousal must be regulated before peak performance and flow can occur. Exercise is a basic treatment for all types of anxiety. Daily meditation over a minimum of eight weeks reduces both state and trait anxiety by lowering the resting heart rate and enhancing brain plasticity.

2) Imagery engages the power of the senses, especially visualization, to mentally depict what peak performance should look and feel like. Cardio imagery and rehearsal is a new technique that combines mental rehearsal with moderate cardio exercise (120-140 heart rate, using an elliptical trainer or stationary bike) to prime learning and reinforce process goals. Mental rehearsal is effective because mirror neurons activate various muscle groups via the peripheral nervous system in the same way as with physical practice.

3) Goal setting is a motivational tool for directing one’s efforts toward optimal learning. Goal setting supports deliberate practice that encourages musicians to concentrate their efforts on their most challenging repertoire. Exercising in the morning before practice, while mentally focusing on what needs work, helps identify practice goals and primes the brain for learning later on.

4) Self-talk reveals the psychological relationship between the person and the performer, such as having a positive outlook and being mentally tough when under stress. Research shows that positive thoughts and feelings promote creativity whereas negative emotions stimulate critical thinking that can lead to self-consciousness. Not surprisingly, a positive mental attitude is a key component
of flow.

5) Concentration emphasizes attention skills and mental discipline to focus on the challenges involved in music performance. The mind must be fully engaged in the moment, free of distractions, and immersed in the task. Quite simply, the best way to build focusing skills is to learn to live in the moment. Not so easy, as many of us have found out!

6) Pre-performance routines allow musicians to find that groove that activates a positive performance mindset. The key tools are breathing and centering exercises, locking into one’s optimal zone of activation and converting pre-performance jitters into excitement.

Ultimately, playing music in the flow state is its own best reward, one reason why musicians are so passionate about pushing musical boundaries. So when it happens, embrace it!

Patrick Gannon, PhD is a Clinical and Performance Psychologist in San Francisco available for consultation in person, phone or via Skype. Dr. Gannon is a national presenter and former competitive tennis player and coach as well as a member of the Performing Arts Medicine Association (www.artsmed.org). You can contact him at  PeakPerformance101.com and drpatrickgannon@gmail.com

Health, Resources

When the Sound Won’t Stop – 3 Ways to Battle Tinnitus

For musicians, tinnitus is an occupational hazard. Beethoven was famously afflicted. According to Hearing Education and Awareness for Rockers (HEAR), nearly 60% of the Rock and Roll Hall of Fame’s inductees are hearing impaired, many suffering from bouts of tinnitus. Although almost always described as a constant ringing in the ears, there is a litany of sounds that sufferers ascribe to the noise: clicking, humming, hissing, buzzing, piercing, throbbing, roaring, whooshing, or chirping—much like an orchestra of cicadas. 

Following a deafening noise, a car accident, or an especially loud concert, the average person will experience some form of tinnitus, but only a small percentage of the population lives with it. A rare kind, called objective tinnitus, or rhythmic, is associated with circulation and vascular problems because it often keeps time with the person’s heartbeat. A doctor can hear it with a stethoscope which, although still aggravating for the patient, can at least be heard by someone else. Subjective tinnitus, on the other hand, the most common kind, is only heard by the sufferer, but emits a seemingly phantom, yet deafening, noise.

Research shows that hearing loss results in less external sound stimuli reaching the brain. In response, the brain changes how it processes different sound frequencies, called maladaptive neuroplastic changes. Delicate hairs in the inner ear move to the pressure of sound waves, which triggers cells to release an electrical signal through the auditory nerve to the brain. The brain interprets these signals as sound. If the hairs inside the inner ear are bent or broken, they can leak random electrical impulses to the brain, resulting in ear ringing.

The American Tinnitus Association (ATA) estimates that 20 million people have “burdensome” tinnitus, and two million have “extreme and debilitating” cases. Most patients develop tinnitus as a symptom of hearing loss caused by age, long-term damage, or acute trauma to the auditory system. When the ringing occurs on one side of the brain it may be indicative of something more sinister, like a tumor. Ménière’s disease also affects the inner ear, causing vertigo, ringing, and eventual loss of hearing. 

3 Ways to Battle Tinnitus

People with tinnitus can find relief by using hearing aids and other sound-amplification devices. Like a microphone, amplifier, or speaker, hearing aids can supplement the volume of outside noise and increase the amount of sound stimuli received and processed by the body’s auditory system. A good sound therapy plan takes into account individual needs, but the most important factor is to provide background sound in a consistent, systematic way to encourage habituation.

Ear-Level Sound Generators—Ear-level sound therapy devices are worn on the ear, like a hearing aid, and deliver a variety of predetermined or programmable therapeutic sounds. They are appropriate for individuals with minimal hearing loss.

The sounds most commonly available are broadband sounds that many tinnitus patients find tolerable—rainfall or flowing water, for example. Some devices offer preset broadband sounds, and some offer broadband sounds that can be modified.

Any of these devices can deliver a controlled, consistent sound to the ears. This should provide not only some relief but also a feeling of control over tinnitus, which will aid habituation. The volume should be set to a very comfortable level that does not interfere with your ability to concentrate or communicate.

Hearing Aids—Normally intended to improve speech comprehension in a wide range of listening environments, hearing aids can also be programmed in ways that provide therapeutic intervention for tinnitus. The frequency of tinnitus is usually within the range of frequencies included in an individual’s hearing loss. For some people with tinnitus, the use of hearing aids to amplify sound in the range of their hearing loss can also help reduce their perception of their tinnitus.

Combination Units—A combination unit is an ear-level device combining the amplification of a hearing aid with background sound like a sound generator. The devices have an assortment of background noises, including a preset broadband noise, an adjustable broadband noise, and random chime-like tones. Look for a device that allows you to adjust the hearing aid volume and the generated sound volume separately. 

Now that most hearing aids have wireless Bluetooth capability, it is possible to stream additional sounds through hearing aids and combination units. As a result, any Bluetooth-capable device can be made into a customized combination unit.

Health

Top 10 Healthy Food Tips for Touring

by Karen Wang Diggs, nutritionist and author of Happy Foods: Over 100 Mood-Boosting Recipes

You want to perform your best on stage. But you’ve got jet lag, spent a fitful night in a hotel room with paper-thin walls, and have heartburn from pizza you gobbled down before rushing to the theater. While it’s hard to maintain equilibrium and eat healthy on the road, there are things you can do to buffer stress, boost energy, and keep your immune system strong, in order to perform at your best.

HappyFoods300dpi1) Get a lemon water jump-start. Upon waking, have an 8 oz. glass of room temperature water with two or three tablespoons of fresh lemon juice. This hydrates you first thing in the morning, detoxifies your liver, and alkalinizes your body.

2) Protein-based breakfast is best. Avoid bagels, donuts, and other starch-laden/sugar-drenched baked monstrosities for breakfast. The double whammy of carbohydrates and sugar will spike-up your blood sugar, and cause low energy, and possibly, mood swings. Not to mention, pastries are calorie-dense, but nutritionally empty. Instead, enjoy eggs, sausages, oatmeal with yogurt and nuts, or a protein-based smoothie.

3) Ditch the diet sodas. You may think that switching to sugar-free soda and snacks is better, but artificial sweeteners actually confuse our brain and body by tricking you into thinking that you are consuming real sugar when it’s fake. This leads to metabolic confusion and overconsumption. Even though we know that sugar is bad, it does provide fuel in the form of glucose and fructose. So, when you drink a diet soda your taste buds sense sweetness and send a signal to your brain that energy is on its way. However, since artificial sweeteners are devoid of nutrients and filled with toxic chemicals, your entire physiology gets whacked out. Your cells are expect fuel, but there’s nothing coming, so you overeat to compensate for the fraud. Instead, enjoy sparkling mineral water with lemon slices, kombucha (in moderation), or coconut water.

4) Banish candy bars. Most of them are made from high-fructose corn syrup and other unnatural ingredients that are toxic to the liver and cause binging and weight gain. Instead, enjoy dried dates with unsweetened peanut butter, tahini, or cashew butter. Or make and pack your own healthy sweet treats. (Go to www.InternationalMusician.org/Top-10-Healthy-Touring-Tips for a recipe for Coconut & Date Kisses.)

5) Cut out conventional chips. These are made with vegetable oils such as canola, or corn that are high in omega-6 fatty acids. High omega-6 intake leads to inflammation, which can cause joint pain and heart disease. They also contain artificial flavors that cause binging and zap your energy. Instead, enjoy raw nuts and seeds.

6) Curb coffee after 3:00 PM. While a jolt of caffeine can give you a boost, caffeine in the afternoon can upset your sleep, remaining in your system for six to eight hours. Coffee is  acidic and drains needed minerals from the body. Instead, enjoy black or green teas if you need an afternoon lift. Teas also contain a unique amino acid, L-theanine, which boosts concentration while keeping the mind relaxed with alpha brain waves.

7) Take Vitamin C. This helps to keep your immune system strong, and buffers physical stress. Choose a brand that does not contain GMO ingredients and is made from natural sources such as citrus or rose hips.

8) Probiotics please. Good gut health is the key to digestion, and also prevents constipation.

Probiotics also balance our gut terrain and keep harmful bacteria at bay. Choose a brand that does not need to be refrigerated and contains multiple strains of cultures, including: L. acidophilus, B. lungum, and B. bifidum.

9) Less EMR (electromagnetic radiation). According to some studies, radiation from cell phones, laptops, other wireless devices can cause subtle damage to our cells over time. It can also interrupt the production of melatonin. Place your cell phone and laptop far away from your bed at night.

10) Detox after touring. The angst of traveling and performing can create a lot of toxins in your cells. Over time, this can lead to physical illness and negative moods. Choosing the right detox can be confusing. It should be gentle and support your body with all the nutrients that it needs. The book Happy Foods contains safe, effective detox advice.

 

Coconut & Date Kisses

Cocoballs-for-online-recipe

 

 

 

 

 

 

 

 

 

YIELD: approx. 24 pieces

  • 15 medjool dates, pitted
  • 1/3 cup raw cashews, soaked for 5 hours
  • 2/3 cup raw walnuts, soaked for 5 hours
  • 2 tablespoons unsweetened cocoa powder
  • ¼ teaspoon ground cinnamon
  • ¼ teaspoon freshly ground nutmeg
  • ¼ teaspoon sea salt
  • ½ teaspoon cayenne (optional)
  • 2 tablespoons filtered water
  • 2 cups unsweetened shredded coconut flakes, for coating
  • Drain the soaked nuts and put in a food processor along with the other ingredients except the coconut flakes.
  1. Blend until ingredients are well mixed and form a ball.
  2. Add extra water one tablespoon at a time as needed to facilitate blending. The mixture should feel soft.
  3. Pinch off a well-rounded tablespoon of the mixture and roll it between your palms into a ball. Keeping your palms moist with water will prevent sticking and help make smooth, rounded spheres.
  4. Spread the coconut flakes on a large dish and roll the date balls in them to coat.

Once they are well coated, they magically transform into Coconut & Date Kisses! Yummy.

(Recipe from Happy Foods)

References:

  1. http://www.ncbi.nlm.nih.gov/pubmed/18296328

2. http://www.lifeextension.com/magazine/2007/8/report_cellphone_radiation/Page-01

 

—After graduating from California Culinary Academy, Happy Foods author Karen Wang Diggs flew to Hong Kong where she worked as a chef for the Mandarin Oriental Hotel and helped open two eateries. After certification as a nutrition consultant, Diggs began merging her culinary skills with her knowledge of holistic nutrition, helping people achieve optimal health through detoxification and nutrition. She lives in San Francisco, California.