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Health

Don’t Call It Stage Fright! New Ideas About Treating Music Performance Anxiety

by Patrick Gannon, PhD

Stage fright, or more accurately, music performance anxiety (MPA), is one of the most commonly cited problems for professional musicians.

Surveys show that upwards of half of all musicians, regardless of instrument, genre, and expertise, suffer some degree of MPA. It may be comforting to know that famous sufferers include Frederic Chopin, Maria Callas, Vladimir Horowitz, Arthur Rubenstein, Sergei Rachmaninoff, Carly Simon, Barbra Streisand, George Harrison, Janis Joplin, and even Jimi Hendrix.

How did these expert musicians treat their MPA? Not very well. In fact, standard treatments for performance anxiety—cognitive behavioral therapy (CBT) and relaxation techniques that were borrowed from sport psychology over the last 50 years—have had mixed results when applied to musicians.

For this reason, many performers, such as New York Philharmonic Orchestra violist, Kenneth Mirkin of Local 802 (New York City), have relied on beta-blocker medications such as Inderal. Mirkin, who wrote an essay in Psychology Today about his lifelong struggles with MPA, says he experimented with all types of therapies, but only beta-blockers gave him the symptom relief he needed. While this medication is generally effective at reducing physiological activation of the heart, it does not eliminate the other categories of MPA symptoms—emotional, cognitive, psychological, and behavioral—that can also impair performance.

Recent findings in neuroscience and clinical psychology have given us a better understanding of what causes MPA and how we might improve treatment effectiveness. Neuroscientist Joseph LeDoux’s work at NYU shows that the body’s threat detection system unleashes a barrage of symptoms that go far beyond the simple activation of the sympathetic nervous system. MPA can trigger upwards of 50 symptoms of varying intensity and duration.

The somatic nervous system, the neuroendocrine system, the limbic system and amygdala, as well as the vagus nerve are hardwired to activate a “defensive response” that impacts many aspects of mental functioning essential for playing music. For this reason, treatment needs to target the physiological symptoms first because it appears they drive symptom formation across the other categories. The primacy of the physiological response to threat is why beta-blockers work—and why standard techniques are less effective.

Psychologist Dianna Kenny, who has done extensive research with Australian orchestral musicians, has reconceptualized MPA as a more multifaceted condition. MPA can occur days or weeks prior to performance, aggregate over the long term, and carry forward in an escalating cycle before the musician ever steps on stage. Kenny has identified three sub-types, each emanating from a different biological and/or psychological source that require different treatment plans.

Exposure-based treatments, coupled with “brain-based” techniques, including the time-limited use of beta-blockers, offer the quickest path to symptom reduction. Musicians must learn how to self-regulate their anxiety down to manageable levels, on demand. Mastering this skill, while being exposed to increasingly challenging performance situations, will degrade symptom intensities. While not as simple as taking a pill, this comprehensive treatment strategy offers significant, long-term relief from anxiety—without reliance on beta-blockers.

One overlooked source of MPA is early performance anxiety. Negative performance experiences are often encoded in the brain as trauma. One new “brain-based” treatment is Eye Movement Desensitization & Reprocessing (EMDR). EMDR accesses the implicit memory system in the hippocampus that stores emotional learning, desensitizes traumatic reactions to old performance, and then “installs” new mental scripts that model optimal performance.

The most eagerly awaited treatment for MPA is virtual reality (VR). VR involves using a headset that provides realistic 360-degree visual immersion into a given performance situation. Combining simple CBT and relaxation techniques, while experiencing a virtual performance (without the stress of an audience), desensitizes the psycho-physiological activation that produces the MPA symptoms.

The take-away message is that MPA is treatable—with or without beta-blockers—but you have to have the right plan. Musicians with severe and persistent MPA need to be aggressive in their treatment strategies. One cautionary finding is that, if MPA symptoms are not sufficiently managed, it is difficult to deploy peak performance techniques that can take your performance to the next level. And if MPA is allowed to persist, it may get worse. Like any multisystem mind-body condition, it needs to be adequately treated in order to offer any realistic expectation of sustained relief.

—Patrick Gannon, PhD is a clinical and performance psychologist in San Francisco and a former musician and tennis coach. He is an active member of the Performing Arts Medicine Association (www.artsmed.org). His website is PeakPerformance101.com and his email is drpatrickgannon@ gmail.com. He welcomes questions and comments about this article.

Health

The A, B, ZZZZs of Sleep Disorders

How well you sleep can affect your ability to perform, as well as your physical and mental health. Looking at the five stages of sleep we can begin to understand why. Stage one is characterized by light sleep. Rapid eye movements stop and brain waves slow as we enter stage two. Extremely slow brain waves, called delta waves, become more frequent during stages three and four, which are characterized by deep sleep. Finally, we enter rapid eye movement (REM) sleep where breathing becomes quicker and irregular, and the eyes jerk rapidly. Following REM sleep, the cycle starts again, with each five-stage cycle averaging 90 to 110 minutes.

Adults spend about 50% of their sleep time in stage two and about 20% in REM sleep. As the night progresses, the REM sleep stages increase in length, while deep sleep stages shrink. If REM sleep is disrupted, the next time you sleep your body may jump directly to REM sleep in order to catch up.

Circadian Rhythms

Circadian rhythms are mental and physical changes to your body over the course of a day. They are controlled by the body’s biological clock, which takes cues from environmental factors such as light.

When you do not maintain your normal external time cues—for example, when traveling to another time zone—circadian rhythms are disrupted, and you experience the uncomfortable sensation of jet lag. These same symptoms can occur when you perform gigs until the wee hours of the morning.

Sometimes it’s just not possible to get the perfect amount of sleep, but there are strategies that can help you on a nightly basis.

How Much Is Enough?

While most adults require seven to eight hours of sleep, some need as few as five, or as many as 10. People are typically not able to adapt to getting less sleep than they require. Eventually, lack of sleep affects you. Warning signs are daytime drowsiness, falling asleep within five minutes of lying down, and episodes of sleeping while “awake.” However, you may never experience these warning signs, or you may be masking them with caffeine.

Eventually, sleep deprivation can affect your career. Tests have proven that the hand-eye coordination of a sleep-deprived person can be as bad as that of a drunk person. Lack of sleep also affects the nervous system, leaving you unable to concentrate or with impaired memory and social skills. Long-term sleep deprivation can also lead to mood swings and even hallucinations. Because REM sleep stimulates the regions of the brain used in learning, a lack of sleep may even make it more difficult to learn new music. Caffeine may keep you awake, but it cannot overcome the side effects of sleep deprivation.

Tips for Better Sleep

Here are seven ways to get a better night’s sleep:

1)    Set a schedule—Go to bed at the same time each night and get up at the same time each morning. Gradually ease into a sleep schedule of 2 a.m. to 9 a.m. before your next tour begins. “Sleeping in” occasionally to catch up on sleep actually makes it harder to get up the next day because your sleep cycle has been reset.

2)    Exercise—Maintain a daily exercise routine of 20 to 30 minutes that finishes at least five hours before bedtime.

3)    Avoid caffeine, nicotine, and alcohol—Coffee, chocolate, soda, tea, and some medications are stimulants. Smokers tend to sleep lightly in the early morning because of nicotine withdrawal. Alcohol disrupts sleep cycles, keeping people more in the lighter stages of sleep.

4)    Relax—Create a bedtime ritual of calming activities like a warm bath, reading, or listening to music, to make it easier to fall asleep.

5)    Sleep until sunlight—If possible, wake up with the sun and/or use bright lights in the morning to reset your biological clock.

6)    Don’t lie in bed awake—If you can’t sleep, get up and do something else like reading or listening to music until you feel tired again.

7)    Control the temperature—Maintain a comfortable, consistent room temperature.

Sleep Disorders

If you consistently have problems getting enough sleep, you may be one of the 40 million Americans who suffer from more than 70 different sleep disorders. Here are a few:

Insomnia—Almost everyone occasionally suffers from insomnia because of stress, jet lag, diet, and illness. Doctors may prescribe sleeping pills, but the best cure could be to improve your sleeping habits

Sleep apnea—Common causes of interrupted breathing during sleep, or sleep apnea, are fat buildup and loss of muscle tone, which allow the windpipe to collapse during sleep. One symptom is loud snoring. Sleep apnea can often be overcome with weight loss, but if that doesn’t work there are special devices you can use while sleeping.

Restless legs syndrome (RLS)—The symptoms of RLS—crawling, prickling, or tingling sensations in the legs and feet that lead to insomnia—can sometimes be relieved with drugs.

Narcolepsy—Narcolepsy causes “sleep attacks” of varying length during the day, even when sufferers have a normal amount of nighttime sleep. It is often hereditary. Drugs and timed naps are sometimes used to control the symptoms.

Health

Work Those Fingers

All athletes have a common goal to develop and maintain strength, control, endurance, coordination, and dexterity to ensure their competitive edge. Musicians are no different. Professional sports trainers, athletes, and therapists use Gripmaster because of its unique ability to provide an effective isolated resistance workout. Gripmaster conditions the fingers, hand, wrist, and forearm with a unit you can carry in your pocket.

Your hands are the direct link between your brain and your instrument. But your hand is really five separate systems–the fingers—which work in seamless unity. The only way to develop superior hand strength, endurance, and coordination is to challenge and develop each finger. Work those fingers. The patented Gripmaster hand exerciser can isolate and strengthen each finger individually.

The pocket-sized, durable device isolates each finger, supplying it with its own spring loaded button. Small size means you can practice anytime, anywhere. Gripmaster is available in three different tensions: blue (light, five pounds per finger), red (medium, seven pounds per finger), and black (heavy, nine pounds per finger).

-visit www.gripmaster.net for dealer information and exercise program suggestions.
Officer Columns, Secretary-Treasurer

Are You Getting the Most from Health Care Reform?

It’s been five years since Congress passed health care reform, but many people are still missing out on possible savings, like lower premiums and out-of-pocket costs, just because they don’t know about them. The Center for Medicare and Medicaid Services (www.cms.gov) and www.healthcare.gov are two websites that can provide detailed information on how you can save on health insurance. The chart below can be used as a general guide.

Are you thinking about getting coverage, but finding yourself overwhelmed by all your options? Visit the Working America Health Care (WorkingAmericaHealthCare.org/AFM) website, or call 1-855-589-4253, to get personalized, unbiased support before, during, and after plan enrollment. As a member of the AFM, you can have a complimentary personal health advocate answer questions about coverage, help you understand your benefits, recommend doctors, help negotiate medical bills, and much more.

Health Insurance Lingo

 

When people try to explain how the Marketplace health insurance under the Affordable Care Act (ACA) works, it may sound like a foreign language. Here is a glossary of some key health insurance words to help you better understand the jargon:

Network: the facilities, providers, and suppliers your health insurer has contracted with to provide health care services. Through your insurance provider you should be able to find out which providers are “in-network,” sometimes called “preferred-providers” or “participating providers.” It may be more expensive to see an “out-of-network” provider. (These networks do change, so check with your provider each time you make an appointment to find out how much you will need to pay.)

Deductible: the amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services, subject to the deductible. The deductible may not apply to all services.

Co-insurance: your share of the costs of a covered health care service, calculated as a percentage of the allowed amount for the service. You pay co-insurance, plus any deductibles you owe. For example, if the health insurance plan’s allowed amount for an office visit is $100, you’ve met your deductible, and your co-insurance payment is 20%, you would pay $20. The health insurance or plan pays the rest of the allowed amount.

Co-payment or co-pay: an amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or prescription drug. A co-payment is usually a set amount, rather than a percentage. For example, you might pay $10 towards a doctor’s visit, lab work, or prescription.

Premium: the amount that must be paid for your health insurance or plan. It is paid monthly, quarterly, or yearly, and is separate from your deductible, your co-payment, or your co-insurance. If you don’t pay your premium, you may lose your coverage.

Out-of-pocket maximum: the most you pay during a policy period (usually one year) before your health insurance or plan pays 100% for covered essential health benefits. This limit includes deductibles, co-insurance, co-payments, or similar charges, and any other expenditure for a qualified medical expense. This limit does not include premiums or spending for nonessential health benefits.

Explanation of benefits (or EOB): a summary of health care charges that your health plan sends you after you see a provider or get a service. It is a record of the health care you, or individuals covered on your policy, received and how much your provider is charging your health plan. If you have to pay more for your care, your provider will send you a separate bill.

Health Insurance Checklist

health care

CLICK TO DOWNLOAD PDF VERSION

With more than 10,000 options through the Affordable Care Act (ACA) Marketplaces, it’s critical to know what you want from your health insurance to get the most value for your family. Here’s a list of items you will want to consider.

  • Does the plan provide coverage for pre-existing conditions, maternity care, mental health services, prescription drugs,  and dental and vision care?
  • Does the plan have long waiting periods?
  • Does the plan provide other support and wellness services for its members?
  • How much will the plan cost each year, including the premium, deductible, co-payments and/or co-insurance, and out-of-pocket maximum? What is the lifetime limit on coverage?
  • How large is the plan’s network and how close are you to the plan’s doctors and hospitals?
  • Does the plan have a clear arrangement for specialist referrals?
  • How does the plan’s disputed claims appeal process work?

Even if you’re already insured, it’s still a good idea to shop around with the Working America Health Care program.

Health

Finding the Right Physical Therapist for Musicians

By Shmuel Tatz, P.T., Ph.D.

For musicians, professionally related physical trauma can be one of the worst kinds of trauma because working musicians can repetitively, step-by-step, hour-by-hour continue to damage their bodies.

Musicians’ injuries usually don’t happen overnight, and healing doesn’t happen in one day. It takes time. Injuries related to the music profession can become aggravated because they are generally related to overuse and are difficult to avoid.

It is the job of a good physical therapist to help a musician heal in the shortest amount of time because the next day he or she may be off to London, Moscow, or Tokyo. Whatever the case may be, working musicians must be in excellent physical condition.

I have been working with musicians for more then 30 years. Using a hands-on physical therapy method, I have learned to feel the musician’s pain so that I can help him or her heal as quickly as possible.

I also have learned that being a musician is not just a profession, it’s a lifestyle. In order to play, you have to be in top shape, but you have to be prepared for injuries as well. This means you must know how to find the right kind of physical therapist in whatever city you are playing, just in case treatment becomes necessary for the show to go on. To help I have compiled a list of frequently asked questions:

How severe can structural misalignments requiring physical therapy become?

Naturally, the worse the problems are, the longer it takes to correct them. And, as time goes by, the original problem can become worse and create secondary problems. For instance, when a vertebra moves out of place, the body tries to compensate. It gradually adapts so one or more vertebras are forced out of place in some other parts of the spine. What’s more, it is likely that the vertebrae have built up a resistance to change. It takes time and regular physical therapy to “re-educate” the vertebrae and get them to hold their proper position.

How long should treatments last?

It’s impossible to answer this question simply. It depends on your specific problem and on the severity of your condition. And, of course, it also depends on the physical therapist’s education and experience. An experienced therapist who has worked with musicians can achieve positive results in 20 minutes, while a therapist with less experience may take 90 minutes to achieve the same results.

How rapidly will my body react to corrective physical therapy?

Healing time differs with each individual. It is possible that your symptoms will disappear shortly after you begin physical therapy. But healing and rehabilitation involve not only relief of symptoms but, more importantly, correction of the underlying cause. It’s a mistake to assume you are well just because your pain or symptoms are gone. Until the cause of your condition has been fully corrected, you should never stop physical therapy.

Always follow your physical therapist’s instructions carefully. He or she usually can estimate the minimum time and number of treatments it will take for any given condition to heal. Give yourself time, even if it seems longer than you hoped for. Remember, that complete cooperation with the therapist’s recommendations is the best way to shorten the time it takes to regain your health.

How can I find the right physical therapist?

One way to find a good practitioner is to ask your colleagues because you might have a physical problem someone you know has or used to have. A good physical therapist should give you some improvement even at your first session.

I believe that manual therapy is the cornerstone of good physical therapy, so a good therapist will combine manual therapy with other appropriate treatments, such as laser therapy or auricular therapy. While physical therapists can accomplish quite a bit using their hands alone, the added dimension of machines and exercises create a therapeutic counterpoint with many possibilities. Think of combined therapy like this: a violin solo is lovely, but add a cello and a piano, and you may have something extraordinary!

It is crucial that a musician get his or her main instrument–the body–checked out and tuned up from time to time, before minor issues have a chance to become serious problems.

–Shmuel Tatz is a Licensed Physical Therapist. Learn more at www.tatzstudio.net.

Memorable Gigs
Health

Don’t Sweat It: Your Guide to Managing Stress

Memorable GigsProfessional musicians all deal with varying levels of stress. National and international tours, performance anxiety, a hectic schedule, and separation from friends and family for long periods of time are just some of the unique challenges musicians face.

When traveling from venue to venue, the body must constantly adapt to new settings, which can disrupt sleep patterns, aggravating the body’s stress response. The more stress a musician feels, the more harm that could occur to his or her playing, since inappropriate muscle tension can hinder performance.

Stress is something everyone experiences and is the normal physical response to events or changes in the environment that make people feel threatened, upset, or off-balance. The body’s stress response, in small doses, can actually be helpful in an important performance or recording session, since it helps you stay focused, energetic, and alert. But chronic stress can cause serious damage to one’s health, mood, productivity, and quality of life, if it isn’t managed properly. Since a musician’s bread and butter is the ability to play an instrument, keeping the body in good shape and maintaining overall health is essential. Long-term exposure to stress can raise blood pressure, suppress the immune system, increase the risk of heart attack and stroke, and can leave musicians more susceptible to anxiety and depression.

Dr. Stephen Sideroff, clinical director at Moonview Treatment and Optimal Performance Center in Santa Monica, California, and assistant clinical professor in the psychiatry department at UCLA, works with musicians, athletes, and other members of the entertainment industry on overcoming and coping with stress and pressures related to career burnouts. “One of the issues musicians deal with is the performance anxiety of getting up in front of audiences and having to perform perfectly,” says Sideroff. “In other areas of life we don’t have to be that perfect; 90% is pretty good. With a musician and a performance, the mistakes are even more magnified and there is a lot of pressure to be perfect.”

How to Deal with Stress

If you are starting to feel some of the mental, physical, and emotional side effects of stress, there are things you can do on your own to cope better. Sideroff suggests training yourself to relax using exercises like deep breathing, meditation, or yoga. Physical exercise is another way to relieve stress. If you don’t have access to a gym or dislike the traditional ways of working out, something as simple as a walk around the block can help ease the stress response. “If muscle tension builds from that ‘fight or flight’ response to stress, the heart rate goes up,” says

Sideroff. “Physical exercise provides the opportunity to release that built-up energy and tension in the body.” Sideroff also recommends learning to practice self-appreciation to curb performance related anxiety and stress. “If you have success and have done well, own that success and appreciate the abilities and skills you have in order to build confidence,” he says. “The more you do that, the less those situations are perceived as dangerous or uncertain.”

Making a point to take vacations and regular breaks during practice is another way a musician can recuperate from job stress. While gigs at night are unavoidable, Sideroff suggests avoiding unnecessary job-related tasks late at night. Most things can wait until the morning when you are more alert and rested.

Building and maintaining a strong network of friends and family is one of the greatest protectors against stress. If you have people in your life that you can turn to with problems and depend on for support, pressures from work don’t seem as bad. If you are in a situation where you travel and tour frequently, make sure you always have phone and e-mail access to keep in touch with your family and friends.

There are plenty of other resources to help musicians cope with stress and related health concerns. Contact your primary care physician or visit artsmed.org to find a doctor or treatment facility that specializes in performing artists and musicians.

Symptoms and Signals that Stress Is Taking a Toll Look out for these chronic stress warning signs:

Cognitive

• Memory problems
• Difficulty concentrating
• Poor judgment
• Negative thoughts
• Constant worrying
• Anxiety

Emotional

• Moodiness
• Short temper
• Agitation
• Feeling overwhelmed
• Sense of loneliness and isolation
• Depression

Physical

• Aches and pains
• Diarrhea or constipation
• Nausea or dizziness
• Rapid heartbeat and chest pain
• Loss of sex drive
• Frequent colds

Behavioral

• Changes in eating patterns
• Sleeping too much or too little
• Isolating oneself from others
• Neglecting responsibilities
• Nervous habits (nail-biting)
• Using drugs/alcohol to relax

Some of the information in this article came from the HelpGuide.org.

Health, Traveling Musician

Perform at Your Best: Eating Well on the Road

by Karen Stauffer, nutritionist
eating-healthy-on-the-roadWe all know what’s wrong with eating too much restaurant food on the run. Too much fat, sugar, and salt combined with hurried eating can lead to weight gain, fatigue, sluggishness, and even worsening pre-existing health conditions. Often there’s also a lack of fiber in a road diet, and usually fresh greens are in short supply.

When we’re young, these shortcomings don’t affect us as much. However, the body becomes less resilient the more it has to endure a poor diet, especially when it’s combined with the stress of travel and work. The easiest step to better nutrition, even if on a “road diet,” is to take an enzyme digestive aid. This helps break down food so the body can absorb it more readily, so you will get more nutritional value from food and less indigestion and gas. Taking an enzyme supplement is particularly important for people older than 40 or those taking acid-reducing medication, which might cause you to produce less stomach acid for digestion.

Chewable enzymes are not unpleasant. One brand is Zand’s Quick Digest. It tastes good and helps the body digest all food components: fats, starches, and proteins.

To cut down on unhealthy foods buy a small cooler, about the size that holds six cans of soda. Often these come with shoulder straps and are so convenient, they can become part of your carry-on luggage. Also, buy a refreezable cold pack or fill a zipper bag with ice. Fill the cooler with an apple, an orange, cheese portions, hard-boiled eggs, cherry tomatoes, pea pods, red and green peppers, and carrots. All these healthy foods travel well.

Another way to get a healthy snack on the road is with a small day-pack. Raw nuts, crackers, energy bars, and dried fruit can go in here. Also, toss in a few small aseptic (no refrigeration needed) packs of soy milk, a perfect quick breakfast. Don’t forget a bottle of water. If traveling by car, keep a stock of bottled water in your trunk.

Restaurants are convenient, but that’s where poor eating often happens. Make the most of choice, and substitute healthy items whenever possible. The other week I heard a waitress offer broccoli instead of French fries. That’s a good choice: steamed veggies, with a squeeze of lemon! Also, request “no salt,” “heart healthy,” or “low carb” options, and ask for whole grain breads.

Many of us enjoy fast food now and again, but avoid relying on it on the road. If there is no choice but fast food, avoid soda and milkshakes (substitute low fat milk or juice instead), cheese (fast food “cheese” is not cheese at all), and French fries (ask for a baked potato). Remember, many fast food restaurants offer healthy alternatives now, such as salads, applesauce, and fruit cups.

If traveling through time zones has upset your daily routine, a fiber supplement can keep you regular. Discuss with a professional nutritionist which is the right supplement for your needs: soluble, insoluble, chewable, or a blend.

Health food stores offer other nutritious ideas for traveling musicians. Vitamin supplements are one. Another is to pick up a “green drink” powder. A packet can be mixed with water or juice to make an instant nutritional beverage. Another great, easy-to-pack beverage is Emergen-C. Mixed with water it provides vitamins C and B, minerals, and alpha lipoic acid in a tasty fizzy drink.

If you’re having trouble with insomnia, avoid using alcohol to relax. Instead, try Koppla, a soothing, pleasantly sweet drink mix, which contains lemon balm and other herbs. There are other drink mixes containing magnesium, which acts as a muscle relaxant. One problem with alcohol, especially overindulgence, is that it can cause your blood sugar to drop, waking you up in the middle of the night. Eating too late at night can do the same.

Early morning flights or less-than-regular sleep schedules may mean you have to wake yourself up quickly. Many people turn to coffee, but green tea is a better option. Lower in caffeine than coffee, it’s also rich in antioxidants and contains an amino acid (called theanine) whose calming effects may help balance the caffeine.

Adapt these suggestions to your own needs and limitations. Some people travel well, and they have fewer needs than others. For instance, despite my careful planning, my husband drove to Atlanta and back eating bread, peanut butter, jelly, bottled water, and chocolate soy milk. (At least he took his vitamins!) A weeks worth of PB&J sandwiches would have had me headed for a burger joint, but he thrived on them.

I don’t mean for you to pass on any good regional cuisine that appeals to you. After all, delicious barbecue, jambalaya, or homemade pie can make a trip memorable. But be smart, and don’t live on fatty, salty, sugary, fiber deficient foods, either at home or while traveling. If you eat right, you’ll play better, feel better, be more alert and relaxed, and, hopefully, live longer!

–Professional nutritionist Karen Stauffer is owner of River of Life Natural Foods in Lahaska, Pennsylvania. Nutritional counseling is available by calling her at 1-800-651-3820. Read more articles on her specialty–nutrition for musicians–at www.professorpooch.com/Karen.htm.

Stretches That Every Musician Should Do Before Playing
Health, Resources

Stretches That Every Musician Should Do Before Playing

by Janet Horvath, author of Playing (Less) Hurt: An Injury Prevention Guide for Musicians available at musicdispatch.com

Stretches That Every Musician Should Do Before PlayingEditor’s Note: In this article Janet Horvath suggests some stretches she devised to help musicians alleviate body stress. Always check with a physician before trying stretches, especially if you have an injury. Always stop any movement that causes pain.

When I was a young student I was criticized for moving too much when I played. “Don’t beat your foot! Don’t wiggle! It’s too distracting,” said my teachers. Unfortunately, these mantras were more important than just limiting comfort and self-expression. Although playing music is expressive and creative, we sought to quell the tendency to move and flow with the music. We were admonished to never “stick out.” As a result, we often sit like statues.

Studies today indicate that humans are born to move. Being static, still, and motionless is detrimental to our health. Static effort, or holding a position, is also much more strenuous on the body. Muscles tighten, blood flow is constricted, oxygen is not replenished, and waste products are not flushed out. Static positions make us tire sooner, and then we hurt. On the other hand, we can engage in a dynamic movement for a long time because blood is replenished with fresh oxygen.

There are unobtrusive ways to reduce tension build up and give our bodies mini breaks. I have devised a series of moves I call Onstage Tricks™ to alleviate tension even while performing. The essential guiding factor is to do the opposite motion of the positions we are required to hold while we play.

Sitting properly is the first step. Make sure that you are sitting in the optimum position for your height and instrument. Your chair should be high enough so that your knees are lower than your hips. If you are diminutive, sit forward so your feet don’t dangle. Your weight should be forward with a slight lumbar curve in your spine and feet flat on the ground. Keep your shoulders down and facing forward. Avoid turning or twisting your torso, leaning left or right.

Starting with those targeting the top of the body, try some of the following moves during practice or performance, or whenever you have a few bars of rest. These exercises are effective even if you only have time to do them once. However, if you are able to do them more than once, it’s all the better.

The following are stretches that every musician should do before playing

For the neck:

  • Keep your head erect and tuck in your chin gently. This is a very small movement.
  • Tuck your chin as above. Keeping your shoulders relaxed and down, slowly turn your head to the right and look over your right shoulder; return to looking forward. Repeat, turning your head left, looking over your left shoulder.
  • Again, start with a chin tuck. With shoulders relaxed and down, slowly tilt your head so the right ear is over the right shoulder. Return to neutral. Repeat on the left side.

For shoulders and pectorals:

  • Do one big shoulder shrug bringing the shoulders toward the ears, while taking a deep breath. Relax, release your shoulders, and breathe out.
  • Do one big shoulder circle. Bring your shoulders forward, then up toward your ears, then back opening your chest, and relax bringing your shoulders to normal. Repeat, reversing the direction of the circle.
  • While keeping your shoulders down, squeeze your shoulder blades together.
  • Clasp your hands behind your back, and while keeping your elbows straight, but not locked, pull your shoulders gently backwards.

For the arms:

  • Let your arms uncurl often and hang by your sides. (If you must hold your instrument, do one arm at a time.) While keeping your elbows fairly straight, but not locked, turn your palms outward, with your thumbs pointing away from your body. Moving slowly, reach gently backward.
  • Place your hand palm down on the chair behind you. While keeping your elbow fairly straight, but not locked, lean gently onto your hand, stretching the inner arm. Repeat with the other arm.

For the back, spine, and pelvis:

  • Take a deep breath in and then empty your lungs. Now, contract your abdomen. Imagine pulling your belly button inward. Release.
  • Roll your pelvis forward and back, putting your back into a “C” curve. Momentarily press your lumbar spine backward and then return to neutral. This is a very small movement. Rock from one gluteus to the other, side to side.
  • Squeeze your buttocks and release. This can be done while standing or seated.

For the hips:

  • Keep your feet on the floor and turn one knee inward as you sit, rotating the hip joint. Repeat with the other leg.
  • Adjust the position of your feet often.

For healthy overall circulation:

  • Keep your heels on the floor and lift your toes. Then, keep your toes on the floor and lift your heels. Do circles with your ankles.
  • If you are able to, alternate playing seated and standing. While standing, avoid locking your knees; keep them slightly bent with feet apart. Avoid overarching your back and crouching or slumping forward. Keep your head and torso erect and face forward with shoulders down.

Awareness is the key to injury prevention. These and many more “moves” for musicians are displayed in my book. Make up some of your own as well, with the goal of maintaining fluidity and ease, while avoiding tightness and tension. You’ll feel better and you’ll play better too.

Health, Resources

Music & Memory: Every iPod Brings a Lifetime of Memories!

by Dave Roth, Member of AFM Local 802 (New York City)

Broadway Alzheimer’s iPod Drive collects used iPods, chargers, and monetary donations for residents of nursing homes.

Broadway Alzheimer’s iPod Drive collects used iPods, chargers, and monetary donations for residents of nursing homes.

“Everything has gotten too complicated these days!” That is the familiar sound of my father. You see, he is a man in his early 80s who was born in a time fresh off the Great Depression and in the infancy of great technological discoveries. As time marches forward, we find that advancements in technology are no longer coming in terms of years or months, but rather at lightning speed. By the time you learn of a new breakthrough, they are already developing and releasing the latest and greatest device. To the elderly these changes aren’t nearly as welcome as they are to their successors. They are confusing, frustrating, and downright frightening, and even more so to someone suffering from Alzheimer’s disease.

But Dan Cohen, founding executive director of Music & Memory, saw technology as a gateway to breathing life back into those lost in the recesses of their own minds by reawakening their memories. Cohen is a trained social worker with a background in technology.

“Ten years ago I heard a journalist talking about how iPods are ubiquitous, and I thought, well, all the kids have them, but a lot of us adults don’t. My experience in the nursing home didn’t seem to show much being done there. And, if I were ever in a nursing home, would I have access to my favorite ’60s music? So I Googled “iPods and nursing homes,” and even though there are more than 16,000 nursing homes in the US, I couldn’t find one that was using iPods for the residents,” says Cohen.

So he set out to see if this modern technology could be used in a wide-spread format. Cohen’s work has been widely documented in a YouTube clip that went viral with more than 7 million views. Henry, an elderly man suffering from Alzheimer’s disease, “reawakened” while listening to music of his youth. It is part of the award-winning documentary Alive Inside that follows his use of this therapy.

Cohen discovered that it wasn’t just music that provided this therapy, but specific music that related to a patient’s past. It was personalized music. “Music has to have personal meaning to them and that’s really where you are reaching back into that part of one’s memory that is still very much intact. Our love of music is emotional and not cognitive,” he says. Not only was this effective for the patient, but incredibly therapeutic for the families as they were able to share their own memories in an effort to compile the favorite music of their loved ones.

After seeing Cohen’s documentary, I was personally inspired to bring my mom her favorite music as she was also in the throws of Alzheimer’s and had lost her ability to speak. My family and I were moved to tears to hear her once again singing words that we thought were lost forever. I, and so many throughout the world, who were beginning to use this technology, were quickly inspired to spread the word.

This is where the gift of modern technology comes into play. Through the use of iPods we are able to download a world of music on a tiny device. And in the case of the iPod shuffle, it is designed with ease of use, not only for those suffering from Alzheimer’s, but also for countless caregivers. Just one click and a door to the mind suddenly opens and reconnects the patient to their own memories and once again to those they love around them.

Music & Memory has expanded their work through nursing homes all over the country. Entire state health agencies have endorsed this therapy for use throughout all their eldercare facilities. In the groundbreaking case of Wisconsin, they have documented dramatic decline in the use of psychotropic drugs. This inspirational technology is also inspiring grass-root efforts to raise funds and collect used iPods all over the nation.

My personal experience with my mom called me to action and I formed the Broadway Alzheimer’s iPod Drive, now in its fourth year. We have collected hundreds of used iPods and raised thousands of dollars through Broadway’s spotlight, and we continue to spread awareness about this devastating disease. Brilliant minds have created technology that can reconnect broken minds. The irony is cruel but beautiful and only inspires us to find more healthy ways to care for those who deserve so much more.

The fourth annual Broadway Alzheimer’s iPod Drive is August 1-19. We accept iPods, iPod chargers, and monetary donations. And, of course, we accept these throughout the whole year. Please send your iPods and chargers, or drop them off, to: AFM Local 802 or Alzheimer’s Association NYC Chapter, 360 Lexington, 4th Floor, New York, NY 10017. Monetary donations should be made out to Music & Memory, with Broadway Alzheimer’s iPod Drive in the “memo” on the check, and mailed to: Music & Memory Donations; 142 Emory Rd.; Mineola, NY 11501.

To explore how you can help visit www.musicandmemory.org and Facebook.com/BroadwayAlzheimersiPodDrive.

Performance Preparation
Health, Resources

A Holistic Approach to Performance Preparation

“Feeling nervous before a performance is normal,” says Dr. Richard Cox, a musician, music educator, and psychologist at the Colorado School of Professional Psychology.

A certain amount of “concern” is probably good, normal, and useful, Cox continues, but anxiety is a physiological hindrance to good performance.

When the nervous system registers “anxiety,” it has already started the process of trembling, shallow or rapid breathing, perspiring, and stomach discomfort.

If these physiological symptoms are present, the first note will not be at its best. Cox suggests in his book Managing Your Head and Body So You Can Become a Good Musician that the psychology and physiology of anxiety can be greatly reduced by paying attention to these basics steps:

Mental Preparation

  • Anticipation–This is a matter of mind imaging. Close your eyes and visualize the music on the page, you with your instrument, the group or accompanist with whom you are playing, and the audience. Create a small picture show in the front of your brain. If you have a difficulty doing this, close your eyes, find a “center spot” in the middle of the inside of your forehead, and picture the entire situation as if it were a cartoon being shown frame by frame.
  • Relaxation–The body responds to anxiety by tightening up. If you have difficulty relaxing naturally, there are simple exercises that help. For example: Sit in a comfortable chair, or lie flat on a bed. Close your eyes. Breathe slowly and regularly, very deeply, and count slowly from one to 10, breathing in and out very slowly on each count. Talk to yourself. Tell yourself that with each breath you will become more and more relaxed.
  • Performing in your mind–By going through the performance step by step you can anticipate surprise feelings. It is very much like anticipating the next note when we play. The best way to play the next note correctly is to anticipate how it will be executed and how it will sound within the context of the last note and then the next several notes.
  • Center on the message–It is important to remember the message we wish to send to the audience. The audience will not remember the “wrong” notes nearly as much as they will remember the communication. Think through how the music will send the desired message. Then by keeping that message in mind, we can allow the technical performance to call upon years of practice and musical preparation. Many great musicians memorize the actual music straight from the printed page in their head, while humming it, and actually doing the fingering manually, then they put it all together in their mind, and only then on the instrument.
  • Center yourself–Get in touch with your emotions. If you are preoccupied, the music will show it. It is absolutely necessary to “get lost” in the music, otherwise you become a show person, not a musician. The “centering” technique discussed under Anticipation will work here. Deep meditation is also helpful as this aspect of mental preparation requires whole brain activity. You should be keenly aware of the intellectual and emotional demands upon you and the alertness and confidence you have stored up during practice. Fifteen minutes of meditation with relaxation, twice daily, is a tonic that cannot be equaled by medicine!

Physical Preparation

  • General health–Keeping one’s body in tone is essential to best performance. After all, the instrument is only an extension of your inner self. If you feel well physically, you will communicate better. It is surprising how many musicians abuse their bodies with inadequate exercise, too much caffeine, alcohol, tobacco, illegal and prescription drugs, and excess weight.
  • Nutrition–You are what you eat. Food plays a far more important role in good performance than most musicians acknowledge. Too much sugar, excessive caffeine, and excess fats are only a few of the things to avoid. Regular eating is difficult for professional musicians due to performance times, travel, and scheduling. However, it is important to keep your blood sugar level under control and within normal limits at all times.
  • Sleep–Loss of sleep produces serious effects. In fact, tiredness is only a symptom of the real problem–dream deprivation. When we do not sleep regularly, we develop sleep habits that skip important phases of sleep. One of these phases is the stage in which we dream. Dreams are essential for the repair of our entire thought process system. It also is particularly difficult for many musicians to obtain enough sleep before midnight. Research has shown that one hour of sleep before midnight is worth two hours after midnight. Some performers turn to medication and drugs to help them, but sleep that comes as a result of chemicals is not natural and does not produce the same beneficial results.

Other Considerations

  • Beta Blockers–All medicines are drugs and have both beneficial and harmful effects. Medicines containing beta blockers are used by some musicians to control stage fright. However, these medicines work by blocking certain impulses to the heart and can have profound effects upon the heart and nervous system that controls the entire cardiovascular system.
  • Other Medicines–The side effects of common medicines can dry you out (diuretics), make you drowsy (antihistamines), make you jittery (some cold and flu medications), cause nausea (some antibiotics), and some keep you awake. There are thousands of side effects of medicines you need to take into account. Medicines can also become a habit, both psychologically and physically. Be sure to discuss all the side effects of any medication you take, whether prescription or over-the-counter, with your doctor.
  • Doctors–Be sure your doctor knows you are a musician and understands that treatments and medications can effect your ability to study and perform. When undergoing surgery, if at all possible, request local anesthetic. General anesthesia puts the nervous system of the whole body to sleep and usually requires considerably more time to “bounce back.”
  • Dentists–If you are a wind instrument player, remind your dentist that your lips need to be treated gently. Even small changes in tooth structure, muscular ability, dry mouth, and myriad other considerations can effect your playing.
  • Your Brain & Music–Thinking about how your brain functions when you produce music will help you balance your artistic interpretation with your technical abilities. The two sides of your brain are called “hemispheres.” The left side is known for its analytical functions–putting the technical aspects of playing together. It is where we have logic and order. Right brain activity is emotive, artistic, romantic, and creative. Learning to truly listen to and appreciate what music does to the psyche and the soul is important to the right side of the brain. When the brain is functioning as a whole–connected by the structure that bridges the hemispheres, called the “corpus callosum”–you are in a great place to artistically perform with correct technique.
  • The Whole Person–The concept of wholeness, or holistic thinking, encompasses the mind, the body, and the spirit. It includes what you think, what you do, how you feel, what you believe, how you relate to others, and many other aspects of your total being. The concept seems rather esoteric at first, until you see how you fit into it. You cannot appreciate the role of music in everyday life, and your role as a musician, until you understand the meaning of the whole person. Once you grasp that concept it will be amazing how much easier it is to communicate with others and allow your music to touch the lives of others.

Adapted from Managing Your Head and Body So You Can Become a Good Musician, by Dr. Richard H. Cox, Colorado School of Professional Psychology Press, Colorado Springs, CO, 2006.