A plethora of exercises can help flutists reduce playing-related pain or numbness. The chair of the Performance Health Care Committee describes a few of them.
by Angela McCuiston
One of the relatively few studies done on strength training and playing-related musculoskeletal pain, done in 2017, found that up to 93 percent of professional musicians experience playing-related pain. A recent 48-hour poll of flutists showed that out of 30 respondents, 28 reported playing-related pain or injury. Corrective exercises and strength training have been shown to reduce or prevent these.
Three of the most common areas of pain concern the shoulder, neck, and wrist. We are quick to stretch what feels tight, but often, the site of pain is not necessarily the source of pain. For example, pain in wrists or felt as carpal tunnel syndrome is actually often caused by chronically tight or overactive forearm muscles that bring swelling in the wrist region. Additionally the core, which ties everything together (and in this case we are talking about the transverse abdominus and glute, which provide deep stabilization) is frequently underactive, contributing to everything from back to hip to shoulder pain. Within my 10 years of training, I’ve seen this weakness in almost everyone, including flutists, who can sit—holding up a flute, sometimes a heavy one—for hours at a time.
From a veritable infinite list of possible exercises, I suggest these four “no equipment” options that can be done backstage or in the practice room. A general rule: Stretch first, then strengthen.
Chest Stretch
Put your arm in a doorway with your elbow at 90 degrees. Squeeze your shoulder blade back and down toward your low back and twist your body away from the door. If you don’t feel much, try bringing your arm up higher. Hold for 30 seconds.
Wrist Stretch
Facing a flat surface with your elbows straight, turn your fingers toward your body and lower your arms until the tops of your hands are flat on the table, if possible (If they don’t, do not force them; take them to maximum stretch and hold gently.) Touch your fingers and thumbs together; try to lift your knuckles off the table. This should not be possible. If you can do this, more than likely you are leaning too far forward or your elbows are bent. Hold the stretch for 20 seconds, rest 10 seconds, and hold 30 more seconds. Come out of the stretch gently.
The Upper Back/Shoulder
The “shoulder” can mean a lot of things, but most often when I hear of shoulder pain the area being referenced is on the inside of the shoulder blade, a muscle called the rhomboid, that brings the shoulders together towards the spine. Frequently, this muscle gets overstretched because the chest muscles (and neck, see bonus) are overtight, causing the rhomboids to yell in pain. If you press on this muscle and it doesn’t feel better, this may be because it needs to be strengthened. To do this stand with your feet hip width apart, knees slightly bent. Push your hips backwards keeping your spine neutral. Arms should be in front of your body with palms pointing forward. Raise your arms straight out to the side with thumbs pointing to the ceiling, keeping shoulders away from your ears and think about bringing the bottom of your shoulder blades together. Do 15 times.
The Core: Deadbugs
Lie on your back, with knees bent and feet flat. Pull your belly button toward your spine and mash your low back into the floor. Raise your arms overhead and drop them alternately behind your head. This is enough for some people, but if not, lift both legs to a 90-degree angle and drop one heel toward the ground at a time.
Bonus: The Neck/Shoulder
Flutists are unique in that to play the instrument, they not only turn the head to the left, they also somewhat tilt it forward and down to the right. Two muscles that tend to get overused in this situation and cause problems are the sternocleidomastoid (SCM) and the levator scapulae. The SCM is attaches to your collarbone near your sternum and inserts on the skull just behind your ear, turning the head and also flexing it forward. The levator scapulae muscle attaches to the upper part of the shoulder blade on the inside and goes up the neck, where it inserts on the C1–C4 vertebrae of the neck, where it helps shrug the shoulder upwards. In our forward-head-posture society, this muscle can become shortened while one SCM becomes tight and the other weak. They may cause headaches, pain in the back of the neck or pain on the inside of the shoulder blade (the rhomboid muscle). These two muscles, combined with tight chest muscles, can cause the rhomboids to become weak and overstretched, causing pain. Relaxing these and strengthening the rhomboids can be the trifecta to bring the upper body back into balance.
Disclaimer: This article is not intended to treat or diagnose, and its language been simplified.
BIOGRAPHY
Angela McCuiston is a NASM-CPT, CES, SFS and CETI-CES (Certified Personal Trainer and Corrective Exercise Specialist, Senior Fitness Specialist and Cancer Exercise Specialist) and owner of Music Strong, a business that specializes in personal fitness training for musicians.
Winner of the 2007 NFA Piccolo Master class, Angela received her Master of Music in Flute Performance from Florida State University and her Bachelor of Music in Flute Performance from Tennessee Technological University. An avid performer, Angela is Assistant Principal/Piccolo of Sinfonia Gulf Coast of Destin, Nashville Philharmonic, Columbus Symphony and Nashville Flute Choir. Joining the military soon after 9/11 she recently became a member of the 313th Army Band in Huntsville, AL, after completing a 16-year tenure in the 129th Army Band in Nashville, TN. In addition to her solo performances, she has performed with such celebrities as Kristen Chenowith, Pink Martini, Jamie Bernstein, Morgan James, Katherine Jolley, Nancy Griffith and Mary Wilson of the Supremes.
As a trainer, Angela maintains several training locations in Nashville and also travels to give her workshops and presentations, most notably presenting at the National Flute Association Conventions in Salt Lake City, UT; Las Vegas, NV, Washington, D.C. and Orlando, FL. Among her recent workshops, she has travelled to present at Arizona State University, Florida State University, Stephen F. Austin University, Ft. Lewis University and the University of Tennessee at Chattanooga among others.
Recently she was sought out by the Old Guard, Army Fife and Drum Corps as a special consultant to prevent playing related injuries. She has since taken up residence on the faculty of the Stetson University flute camp and has been sought out for numerous other positions including her recent appointment Fall of 2018 as Chair of the National Flute Association Performance Health Committee.
In February 2019 she published her first book: The Musician’s Essential Exercises, with plans to branch out into instrument-specific volumes in the near future.
When she is not performing or training, Angela can be found teaching private flute lessons in the middle Tennessee area or riding her Trek road bike as many hours as there are sunshine. She recently completed her 4th century ride (100+ miles) and has a goal to ride between 5-12 centuries in 2019 and log 5,000 miles.
Angela is constantly on the search for new research and her studies include Alexander Technique, Barbara Conable’s “What Every Musician Needs to Know About the Body” Body Mapping Class and Eva Amsler’s classes in Dynamic Integration in addition to live workshops with NASM, most recently traveling to Ottawa, Ontario, Canada to complete coursework in Neurokinetic Therapy and plans to have her level 1 certification Spring 2020.
So what do you do? And do I need to be a musician to benefit? People from ALL walks of life benefit from Angela’s specialized training. Each client gets a unique plan, totally tailored to their goals, lifestyle and movement abilities. She focuses on creating tailored workouts that incorporate corrective exercises to correct each client’s muscle imbalances be they due to life, work or play and those are integrated into a full body workout so that the body is left feeling whole, balanced and centered. She specializes in preventing injury from overuse, helping those who are preparing for surgery or who have just left PT, overcoming osteoporosis, muscle imbalances, weaknesses and compensations. If you think you’re beyond hope, Angela is your goal. Musicians are a unique group with demands that leave them more prone to injury than any profession. As a musician herself, Angela understands those demands and will design a workout program that not only prevents the inevitable pain from overuse syndrome but will keep musicians, strong, healthy and balanced so they can have a long, pain-free career!
“Three things I love to do: perform, teach and train. All involve sharing myself. It is my strongest desire that my clients walk away healthy and pain free, stronger and more functional than they thought possible, that my students are inspired to be their best and find their passion and my audience leave feeling uplifted and joyful.
As a trainer, my goal is that each client become the healthiest, strongest, and most balanced person they can become. I seek to empower each client with knowledge about how their bodies function and move and understand the warning signs of overuse and more importantly, what to do about it. I want all my clients to have the longest, pain-free careers possible”