Tag Archives: musician health

Proper Playing Position Is Key to Comfort and Injury Prevention in Strings

by Claire Stefani

Playing any instrument means moving a lot. Musicians make a number of physical adjustments to play, often at the expense of optimal body mechanics. Given the asymmetric position of playing a violin or viola, properly fitted ergonomic solutions are critical to a healthy body and optimized posture. It is important to find the appropriate equipment for your body and periodically check that it’s still the best solution for you. Here are some tips from a chinrest fitting expert. 

Head Balance—Keeping the head balanced and free to move is critical. Chinrest height should permit the head to rest in a neutral position at the low point of nodding “yes,” but free to move laterally (shaking the head “no”). Some chinrests provide ergonomic benefits such as additional height or left/right tilt. Some custom models allow musicians to lower their instrument and rest it partly on the collarbone in a neutral head position.

Arm Balance—If not supported by the torso muscles, arms will hang and pull the instrument downward. If a musician is not keenly aware of back and shoulder muscles, especially in the development of arm support, any attempt to adjust the chin/shoulder rest setup to counterbalance this downward weight will only put more stress on the head and left shoulder. Also, work at allowing the shoulder blade to immediately follow the humerus while shifting and bowing—similar to how the femur swings freely from the hip joint when walking.

Instrument Position—Up or down, in or out, is an individual preference. The chinrests or shoulder rests should not dictate instrument position. By allowing the instrument to lean on the collarbone, instead of only on the left shoulder, you are less likely to clench, and will have more freedom in the left shoulder, as well as in the bow arm.

Shoulder Rests—Once the head is balanced, muscular work is redistributed throughout the torso to better support arm weight, and the left shoulder is relieved from its static role, you can determine what equipment, if any, to use under the instrument. A shoulder rest can result in overall stiffening of the entire left shoulder, but playing without one can lead to distress throughout the upper body. Changes may need to be progressive. Keep in mind:

  • If a shoulder rest is too squishy, it may encourage clenching.
  • Models designed to lean just below the contour of the collarbone prevent downward pressure over the left shoulder.
  • Anti-slip surfaces may add to comfort, especially when shifting to and from high positions.

Seating—Much of your playing is likely done sitting. Wedges, pads, and stools mounted on a convex base allow a slight pelvic tilt resulting in psoas muscle release. This pelvic tilt will improve awareness of balance around your lumbar core and address lower back pain linked to postural issues or ill-fitted chinrest/shoulder rest setups.

Listen to Your Body—Pain or fatigue often come from muscle tension. It is important to identify any postural imbalance in playing position (versus neutral position)—leading muscles to sustain a static position, instead of contributing to movement. Say “No!” to the mantra “no pain, no gain.” Pain only leads to injury!

Claire Stefani is a fitter for the Frisch and Denig chinrest line, she has helped more than 400 musicians with their setup. She is founder of Volute Service International and amateur chamber music violist and violinist in New York City, an affiliate Andover trainee, and an active member of the Performing Arts Medicine Association.

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


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.

Tips for Saving Money on Health Care in 2015

While the Affordable Care Act (ACA) has given more Americans access to health insurance, many of the plans come with high deductibles. The percentage of insured workers who face a deductible of $1,000 or more grew from 6% in 2006 to 32% in 2014. Today, consumers need to approach medical care as they do other purchases—shopping for both quality and price. Unfortunately, our health care system is not set up for easy comparison shopping. Here are some tips for saving money on health care in 2015.

Check Your Bills and Statements

Know your insurance policy and what it covers before you need to use it. Read the fine print to find out about preapprovals, emergency room visits, copays for doctor visits, and coinsurance for procedures, as well as “wellness” benefits like preventative care screening, gym membership, and weight loss programs.

Always ask for itemized bills and check them, as well as insurance company statements for errors. Was the same procedure covered for one member of your family and not another? Was it covered last time and not this time? Don’t be shy about asking your doctor’s billing office to resubmit a bill to your insurance company for an item you believe should have been covered.

The same goes for calling the insurance company to question why certain items were not covered. Even those with the best insurance policies often get bills for procedures that should be covered. A mistake in coding can mean a difference of hundreds of dollars.

Prescription Medications

Check prescription medications to see if any of them have gone off patent. For medications that are off patent there may be cheaper generic equivalents. Consult your prescribing physician before switching. When a doctor prescribes a new drug, ask if there are less expensive alternatives.

Many pharmacies extend special offers on certain prescription drugs. Shop around for the best discounts. Search web pharmacies and mail order pharmacies for even deeper discounts. Check the website GoodRX.com, which gives price comparisons based on your location.

Live Healthy

Probably the best way to be proactive about health care savings is to be proactive about your health. Eat well, exercise, and steer clear of unhealthy habits like smoking and excessive drinking. According to the Center for Disease Control and Prevention (CDC) it costs 18% more to insure a smoker. Medical costs for people who are obese are also significantly higher.

Many insurance companies now offer good health incentives to clients to maintain or improve their healthy lifestyles. Sometimes they will provide a percentage off the cost of gym membership or weight loss programs.

Preventive care is another key to keeping health care costs down over time. Annual checkups give your doctor an opportunity to recommend screenings, provide medical advice, and identify health concerns before they become major issues. By law, ACA-compliant insurance plans offer a number of screenings with no copays. When possible, also take advantage of free screenings provided at health fairs.

Shop Around and Plan Ahead

If you need to see a doctor after hours, don’t visit an ER unless the condition is truly life-threatening. Consider an urgent care center or convenience-care clinic. You can save hundreds of dollars for relatively minor issues like stitches for minor cuts, a sprained ankle, or routine x-rays. Investigate the facilities near you before you need them so you can make the right choice when you do.

Items like flu shots, physicals, and cholesterol and blood tests may be cheaper at walk-in retail clinics. Blood can sometimes be drawn at a clinical laboratory service. Instead of paying for 20 sessions of physical therapy, pay for one and learn exercises to do at home. Get copies of all your medical test results and records. Bringing them to consultations can cut the number of tests and office visits required.

Be sure to compare prices. Don’t be afraid to ask about prices and discounts for cash payment and express the fact that cost is a concern to you. Ask a lot of questions: Is this test really necessary? Are there less expensive alternatives to this treatment? Is it possible to wait and see if the issue resolves before ordering an expensive test?

Nailing down a price is difficult because there are multiple players involved in most procedures. One clinic’s fee may include the surgeon, anesthesiologist, and facility, while another may bill separately for each. Find out the specifics, make sure they’re all part of your insurance plan, and then compare prices.

Reassess Your Coverage

Hold onto all of your out of pocket health care receipts for the entire year. This includes all medications, deductibles, eyeglasses, and dental care. If you are the primary caregiver for an older relative keep receipts for those expenses as well. A tax preparer or accountant can advise you on possible deductions.

As the year winds to a close and the next open season arrives, it’s time to examine how your insurance policy is working for you. The coverage you selected last year may no longer be the best option. Information online can be incomplete or outdated, so call the your doctors to make sure they’re still participating in plans you’re considering.