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  • Understanding Overuse Injuries: Causes and Preventions for Percussionists by Ryan Bond

    by Rhythm Scene Staff | Sep 21, 2022

    Careers can come to a sudden halt for athletes, industrial workers, and musicians due to overuse injuries. Percussionists are some of the most highly injury-susceptible musicians due to the physical demand of the instruments. Understanding and recognizing early signs and identifying methods of recovery are key to prevention of overuse injuries and minimizing their impact.

    Overuse injuries are also called soft-tissue injuries. They occur when the soft tissues — ligaments, tendons, cartilage, and muscles — become damaged. Soft tissues have biomechanical characteristics that help to determine their vulnerability to injury, phases of healing, varying prescribed exercises for each healing stage, and how to minimize a risk or injury. In all cases, if you recognize any risk-related injuries, it is important to consult with a licensed medical professional.

    Two common types of risk factors contribute to overuse injuries, either alone or in combination: intrinsic and extrinsic. Intrinsic risk factors are biomechanical characteristics unique to each person, including malalignment, muscle imbalance, inflexibility, hypermobility, muscle weakness, instability, and excess weight. Extrinsic risk factors include training errors (excessive or repeated forces), equipment, environment, and technique. Outside factors that may contribute to an injury include changes in duration, intensity, or frequency of activity (too much or too little), or too little rest. Overuse injuries are likely to happen during transitions from preseason to competition, aggressive preparation for recitals, heavy gig seasons, change of technique, or sometimes with the simplest of physical changes such as a new pair of shoes.

    The two most common overuse injuries in percussionists are in the primary muscles used in flexing the wrist: tennis elbow/golfer’s elbow and carpal tunnel syndrome. 

    Tennis elbow/golfers elbow occurs from gripping or squeezing something in the hand with repetitive elbow or finger movements. This injury can occur from day-to-day activities such as typing on a keyboard, playing piano or percussion, or sports. 

    Carpel Tunnel BondsCarpal tunnel syndrome is caused by the entrapment of the median nerve in the wrist as it passes through the carpal tunnel. This syndrome may cause pain, aching, and numbness in the affected hand. Other symptoms include numbness in the fingers, pain in gripping, tingling in the hand, decreased grip strength, and reduced object control precision (or combinations). This condition is caused by physical activities that require tightly gripping objects such as a golf club, bat, tennis racket, etc. Carpal tunnel syndrome is also aggravated by repetitive motions such as typing on a keyboard. Combine repetitive use and tightly grabbing mallets/sticks when playing percussion, and the likelihood of carpal tunnel syndrome increases drastically. This condition can become even more complicated due to additional external factors, causing further problems and increasing the time needed to recover.

    Percussionists are prone to injuries like tennis elbow/golfers’ elbow or carpal tunnel syndrome for several reasons. First, holding a stick or mallet is unnatural. The tendency for beginners is to grip the sticks and mallets too tightly while playing. Nerves in early practice and performance contribute a lack of steady breathing and additional tension in the arms, hands, wrists, and fingers. Playing at loud dynamics and intense speed also increases the likelihood of injury. Exhaustion to the muscles, such as practicing for extended periods, make the body more susceptible to overuse injuries.

    Percussionists should apply a consistent routine to aid in injury prevention. Daily warmups and cool downs can help percussionists check in with their body and address technique issues. Taking lessons with a percussion instructor allows for an additional professional point of view that may address technique concerns and improve practice strategies. Stretching exercises help ease some of the pain that percussionists might experience. Lifting weights can help strengthen muscles and areas around the tendons. Diet and rest also play a significant role in keeping the body healthy and functioning at its best. Slowly adjust (increase or decrease) the time and intensity of practice sessions. Work up to any goal slowly and consistently with time and using as little tension as possible are critical components to prevention.

    STRETCHES
    Exercise 1 Bond WellnessWrist and Finger Extensors Stretch: Put your right arm out in front of you with your elbow straight, wrist and fingers flexed as far as possible, lengthening the right wrist (and finger) extensors to their pain-free end range. Fully flex your wrist first, curl the thumb to the palm, and then curl your fingers around the thumb as far as possible. Your primary goal is to maximize wrist flexion. 

    Next, wrap your left hand around your right (providing resistance), then start trying to extend your wrist and fingers, including the thumb, slowly. Isometrically contract your extensors for six seconds. After the isometric push, maintain your wrist and fingers in the starting position. Relax and breathe. As you exhale, contract the right wrist and finger flexors, deepening the stretch on the extensors. Repeat two to three times or as needed. Switch hands and repeat

    Exercise 2 Bond WellnessForearm Supinator Stretch: Bend at your waist and rest your forearms on your thighs. Bend your left elbow and rotate your left forearm, so your palm faces down. Wrap your right hand over your left so that the fingers of your right hand can hold the little-finger side of your left-hand wrist. From this starting position, begin slowly trying to rotate your forearm as if turning your palm to face up, isometrically contracting your supinator for six seconds. After the contraction, relax and breathe in. As you exhale, rotate your forearm, turning your palm down to deepen the stretch on the supinator. Repeat two to three times or as needed. Switch hands and repeat.

    Bond Wellness Exercise 3Forearm Pronators Stretch: Bend at your waist and rest your forearms on your thighs. Bend your left elbow and rotate your left forearm to the left, so your palm faces up. Wrap your right hand under your left so that the fingers of your right hand can hold the thumb side of your left hand and wrist. Begin slowly trying to rotate your forearm back to the left (pronation), isometrically contracting your pronators for six seconds. After the contraction, relax and breathe in. As you exhale, contract your supinators by rotating your forearm to the left to deepen the stretch on the pronators. Repeat two to three times or as needed. Switch hands and repeat.

    Ryan BondRyan Bond is a percussionist who is completing a Doctor of Musical Arts degree at the University of Nevada, Las Vegas (UNLV) under the mentorship of Dr. Dean Gronemeier and Dr. Timothy Jones. Prior to completing a Master of Music degree at UNLV, he completed his Bachelor of Music degree at Snow College in Ephraim, Utah with an emphasis in commercial music. Bond has performed and given clinics in Finland, Norway, and Sweden. He has performed with Opera Las Vegas, Vegas City Opera, Southern Nevada Chamber Orchestra, and the Grammy-nominated UNLV Wind Orchestra, serving as principal percussionist under the direction of Thomas G. Leslie. Notable artists he has worked alongside include John Patitucci, Eric Marienthal, and Bernie Dressel. Bond is a member of the PAS Health and Wellness committee. Bond actively clinics and teaches privately in the Vegas and Utah valleys. For more information about Ryan, visit his profile at https://orcid.org/0000-0002-1727-1769.

  • An Introduction to Active Isolated Stretching with Phil Warton by Nathaniel Gworek

    by Rhythm Scene Staff | Jul 20, 2022

    Repetitive stress injuries are extremely common in musicians, and one of the best ways to avoid them is through basic stretching. Stretching has been scientifically proven to be an important part in preparing for and recovering from physical activity, but it is also important as a daily health care routine. Continued research has shown that stretching is not just preventative, but it also helps cure muscle injuries. Although there are many methods, from yoga to passive or ballistic stretching, it is commonly agreed that everybody should be stretching on a daily basis.

    Active Isolated Stretching (AIS) was developed by Aaron Mattes and Jim and Phil Wharton. As physical trainers, each has worked with professional athletes worldwide, from football players to Olympic gold medalists. The method of AIS has not only aided in muscle recovery and injury prevention, but is also effective in improving physical performance of top-level athletes. The Whartons have over 25 years of experience in AIS and muscle-injury treatment and prevention. They have appeared on national television, including Dateline NBC and the Discovery channel, and continue to share their work in publications such as the Wall Street Journal and their own podcasts.  This article will focus on Whartons' stretch method and will end with an interview with Phil Whaton.

    Active Isolated Stretching is not a new method, but perhaps isn’t as popular as yoga or tai chi, which tend to take place in studios with large group classes. In fact, the simplicity and do-it-yourself nature of AIS is one of the main draws; you can do it anywhere and with any amount of time. The theory is that by focusing on a single muscle in each stretch, you can both strengthen and relax the muscles. When you do this with all the muscles in a chain (lifting an object takes all the muscles up the arm), the whole-body mechanism becomes stronger and more flexible. AIS also uses 8–10 repetitions of short, small stretches — hence, the “active” element. AIS posits that isolated muscular stretching and strengthening will lead to greater flexibility and physical performance of the body as a whole. The method behind Active Isolated Stretching is deceptively simple. The instructions provided by the Whartons are as follows:

    “Prepare to stretch one isolated muscle at a time. Actively contract the muscle that is opposite the isolated muscle. The isolated muscle then will relax in preparation for its stretch. Stretch it gently and quickly; hold the stretch for no more than two seconds. Release the stretch before the muscle reacts to being stretched (by going into its protective contraction). Do it again.”

    As Wharton mentions, it’s “remarkably simple.” I have illustrated a single stretch in the figures provided. Note that in Figure 1.1, I am starting the stretch with just the strength of my right hand. Figure 1.2 shows me gently assisting the stretch with my left hand (on the palm, not the fingers) and holding it until the point at which I feel the stretch reflex, after which I will release. Note that the assisted stretch is not that far away from how far I can stretch independent of any assistance. You then repeat this 10 times and move onto the next stretch. Figure 2.1 and 2.2 demonstrate this with a rotational stretch.

    Gworek Examples

       

    A scientific principle behind the advantages of Active Isolated Stretching is avoiding the “myotatic response”: the involuntary reaction of a muscle to tighten when it is stretched. Because of this response, when you do things like static stretching (getting into a stretch position and holding it for 30 or more seconds), your body is working against itself; while you are trying to stretch, your body is automatically tensing the muscles you are stretching. The same response occurs in ballistic stretching, which uses short, sharp bursts of movement to stretch. Our body naturally considers this a danger to itself and the muscles tighten in defense, rather than achieving the end result of relaxing and stretching.

    One of the main principles of stretching is that it is not only restorative, but also preventative. Wharton makes a point to discuss the mental state one must have to stick to a stretching routine. He issues a 21-day guarantee, saying that you will experience a profound change in your physicality and flexibility if you commit yourself to stretching every day for three weeks straight. As we know from our musical practice, we are only as good as our drive to practice and hone our craft. This applies to almost every aspect of physical health, including the practice of AIS. You have to commit yourself mentally to the idea of making a routine for stretching to see the benefits. The person most affected by your habits and your routine, both positively and negatively, is yourself.

    INTERVIEW WITH PHIL WHARTON

    Nathaniel Gworek: Why do we need to stretch?
    Phil Warton: Sometimes we don’t realize how contracted we get just from daily life. Gravity is a force that is always there. And when we exercise with intensity and duration, after a while, the system isn’t posturally aligned and has a limited range of motion because it’s going through these limited motions repetitively. On the other hand, we have compression from sitting. Musicians get both of those; sometimes they have to do repetitive motions and sit at the same time. So, there’s spinal compression and also repetitive stress through the median nerve and the carpal tunnel. Simply put, muscle fibers come together at random when they’re overworked, overused, hyperextended, and there are adhesions of the muscles that limit blood flow to these muscle fibers. Stretching helps break these adhesions and restore blood flow to restore those muscles.

    Gworek: What does AIS do differently than conventional stretching?
    Warton: Just to back up and give an overview, early stretching in the 1920s, ’30s, and ’40s was a lot of ballistic work. There was a lot of bouncing and tearing of muscle fibers. Then in the ’60s, ’70s, and ’80s, we took the stretching principle from yoga and increased the intensity; they took out the mental aspect and tried to push the stretches even farther. Then people started to do static stretching where you hold a stretch for 30 seconds to a minute. Only later would the research show that this stretching triggered the myotatic response, your muscles’ defense against overstretching, which actually weakens the muscle at the tendons and ligaments. So instead of going against that myotatic response or thinking it will let go, we do a non-hold and release those stretches before receptors kick in. We’re moving within our normal range of motion, into that point where you feel that stretch, that’s when the myotatic response kicks in, and then we go back to start position. In the books we say one to two seconds, but you’re never really holding a stretch, that’s really the time it takes to move within that dynamic range. There’s a sophisticated simplicity behind the motion since it’s all based on doable stimulus.

    Gworek: If someone wanted to start AIS, where would they begin?
    Warton: The books and the videos [links below] walk you through the process. It does depend on what area you want to target. In the book, we break it down into five zones. When we work with people, we start at the hips and trunk because a lot of pain comes from the spine. The shoulders are another great place to start, and you can do it while you’re seated, working, or on an airplane or something. There’s about a 10-minute routine for the hands and fingers, which is what musicians might really want to work on. As long as nothing is fractured, you can start anywhere you have pain. Your body signals you with pain; you get this biofeedback telling you to try to decompress these injured areas. 

    Gworek: What would you say to people who feel nervous about a new type of stretching?
    Warton: A lot of us are reluctant to move; the intuitive thing to do is stabilize. We need to use the idea of moderation for these stretches. If you’re in severe pain, more is not better. You have to listen to your body, try a couple of repetitions, and ask yourself if it feels worse. When you’re in pain, you need to test your range of motion. With repetitive motion injury, we used to think RICE was the answer: Rest, Ice, Compression, and Elevation. But we’ve started to see that it’s more powerful to move instead of rest. Movement is life; we’ve got to try to get the circulatory response. The key is the blood flow — getting new nutrients in there to break down the adhesions or the microfiber reductions. The idea of elevating your legs on an exercise ball or a couch to return blood flow from your lower extremities to the rest of the body is powerful. The simple things are the best.

    Gworek: What are some of the most common stretch mistakes you see?
    Warton: I think the mistakes are going too hard, too fast. Trying to get it all in one repetition or two. We’re already in such a fast-paced Western lifestyle. It’s also about the breath — getting that airflow to the blood. We need to isolate some things and restore our bodies before going into these complex movements. It’s not that the movement is too much, it’s just too much right now, like putting the cart before the horse. We always come back to basics. We need to allow our body to be functioning before we go into being functional. Another mistake is focusing only on the painful area. If it’s the right hand, they’ll only treat the right side. We need to focus on the whole body, being bilateral and getting both sides. Sometimes the pain can be a compensation in the way you hold your instrument or the way you set yourself up to play. 

    Gworek: How do you feel about other care activities such as yoga or chiropractic treatments?
    Warton: I love them. Vinyasa yoga is a great practice; it is movement based rather than holding positions. Chiropractic can be a great adjunct, but we don’t want to get reliant on it. We need to not just be releasing muscles and fibers, we also need to support and strengthen them. So, the ultimate is, we have those adjunct therapies that we can utilize, but we’re coming to the table with the self-care of AIS. Yoga, chiropractic, massage therapy, and pilates are all great adjuncts, but we want to start with the basics. We see the basics work and they help heal because that’s how the body works. We’re just looking at how the body is supposed to function and trying to get back to that function of the body mechanics so you can be more efficient in your biomechanical action, whatever you may do. 

    Gworek: Have you worked with people who have movement disabilities or frozen motion? 
    Warton: Definitely. That’s what’s great about the work, it’s basic kinesiology. In the study of muscles there are modifications for everything. I’ve worked with a patient — the mother of Georg Wadenius, who played guitar for Steely Dan — and doctors were considering surgery on her. Her arthritis was so bad and there was serious calcification in every joint. We worked with her for three days and she was able to play a piece with her son. She was on medications that weren’t working because the simple range of motion and strength hadn’t been restored. We can’t reverse serious arthritis, Parkinson’s, and MS, but when things come, there are strategies where you can restore. So, this kind of work is great for a lot of movement disorders and conditions. It’s almost a suspension of disbelief; it’s so simple, but you have to try the active work to believe it. And we need to try the good things, because we’re so inundated with the bad things — the time wasters — so it’s really nice when we can develop some healthy routines, and this can be a good part of that.

    Phil Wharton has generously donated free memberships to his subscription channel. Visit https://vimeo.com/ondemand/whartonhealth and use promo code Rhythm22 for a month of free access. This offer is good until October 31, 2022.

    BOOKS
    Mattes, Aaron L. Active Isolated Stretching: The Mattes Method. A.L. Mattes, 1995.

    Wharton, Jim, and Phil Wharton. The Whartons' Stretch Book: Featuring the Breakthrough Method of Active-Isolated Stretching. Random House, 1996.

    Nathaniel GworekNathaniel Gworek is an Assistant Professor at Point University, where he is the Assistant Band Director and Percussion Instructor. He works with the percussion community commissioning new music and performing recitals and clinics in the area. He is a member of the PAS Health and Wellness Committee, vice-president of the Georgia PAS chapter, and has previously served on the Board of Directors for the Women Composers Festival of Hartford. He has played with the Tuscaloosa Symphony Orchestra, Finger Lakes Symphony Orchestra, UConn Opera Company, and the Hartford City Singers, and has toured the Northeast with percussion ensembles, orchestras, wind ensembles, rock and jazz bands, Mexican and African music groups, and a Renaissance music ensemble.


  • From Music School to the Olympics: An Interview with Liz Hinley by Tyler Tolles

    by Rhythm Scene Staff | Jun 22, 2022

    Liz Hinley“Much of her success in learning the various aspects of rowing she dedicates to her background in triathlon and her talents as a musician. Being a percussionist afforded her a great sense of rhythm and body awareness that transfers into the necessary skills to become a competitive rower.” —U.S. National Rowing High Performance Center

    In this audio interview, recorded over Zoom on March 20, 2022, Liz discusses interdisciplinary transfer between sport and music, physical and mental health, performance anxiety, and her path from music school to joining the United States National Rowing Team and, one day, the Olympics.

     

     

    A few highlights include:

    [On performance anxiety] “What do [I] want to feel like before [I] perform? … I have come to use the term 'neutral' — not too hyped, not too sleepy, I'm just living in the moment; I'm chill.”

    [On years of experience] “I don't [care] how many years of experience you have, I care about how many experiences you've had within a number of years. That's how I see maturity … My favorite thing is how many people I have shocked who say: 'Wow, you're on the National Team already, you must have been rowing for 15 years!' [I respond] No, I've been rowing for three … and within those three years look at what I've done.”

    [On mental health] “Don't lock yourself in that room for hours on end. Take those breaks; it not only resets your mind, it resets your body. You are able to retain what you just practiced much better.”

    Tyler TollesDr. Tyler N. Tolles is an active performer and educator based in Annapolis, Maryland. He performs as a percussionist with the United States Naval Academy Band and maintains an adjunct professorship at the University of North Alabama.

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