The athletic musician: A guide to playing without pain [Paperback]

Every musician who wants to avoid a playing injury or is recovering from such an injury should own this book. This is not a read-once book but a book to use and refer to until one has it memorized. It gives easy-to-follow instructions for safe warming up, exercises and stretches to do at home and even some for doing on stage, ways to avoid injury and means to stay healthy when one has recovered. The psycological and social aspects which confront injured musicians are sensitively dealt with in "The Athletic Musician". The title already tells us that this is a relevant approach to treating the subject of musician's health. Read it, it could save your career!

After a year of computer/instrument tendonitis, I FINALLY found this book, which really gave a lot of good, CURRENT information. Better yet, I made the pilgrimage to see Dr. Paull in Stouffville, Ontario. It was worth the 10-hour drive. She gave me a lot of important information that contradicted a lot of misinformation given to me by well-intentioned doctors, chiropractors, massage therapists, acupuncturists, pharmacists, etc. who seem to just perpetuate the status quo of repetitive strain injuries and rehabilitation without really researching new information about them. Read this book, consult Dr. Paull and start playing again. Christine Harrison, the musician who co-wrote the book, had a musician's horror story to tell and she is now playing professionally again after a FIVE YEAR UNNECESSARY hiatus. The book also has excellent information regarding stretches, posture, excercises and anatomy. READ THIS BOOK AND GET THE INFORMATION YOU NEED TO START PLAYING AGAIN! I did. I guarantee you can, too, if you follow Dr. Paull and Christine Harrison's advice. Good luck.

P.S. Doing hand strengthing excercises to get better? STOP NOW. You are probably hurting yourself. The only thing you should use to strengthen your hands is your instrument.

I was checking out this book and -- since I don't believe Amazon five-star reviews anymore (as often posted by authors/friends/publishers and other shills) -- I googled the net for info on this book in general. Here's one review that I thought is important to read before buying this book based on the hype in Amazon reviews above. It was written by Christine Zaza, a medical professional, and published in the Canadian Medical Association Journal -- a peer-reviewed medical publication (whereas the vague but five-stars Amazon reviews above come from someone "Skye Carman", non-real-name with only one review in his record (this one), and "A Customer" -- excuse me, but I don't believe these two reviews are real).

You can download the CMAJ review from [...](or google on title + Christine Zaza).
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The Athletic Musician: a Guide to Playing Without Pain
Barbara Paull, Christine Harrison. 175 pp. Illust. Scarecrow Press, Lanham, Md. 1997.
ISBN 0-8108-3356-5

Overall rating: Poor

Strengths:

- Addresses important subject
- Appropriate for the lay reader
- Warnings for musicians not to play in pain

Weaknesses:
- Information and recommendations reflect authors' opinions and experience rather than an evidence-based approach to injury prevention
- Many inaccurate or misleading statements not supported by research
- Though presented as a book for all musicians, the focus is on shoulder impingement syndrome and string players
- Many common playing-related injuries are either not clearly defined or not even mentioned
- Anatomy for brass players embouchure problems is not presented
- Lack of warnings for the reader (especially the injured reader) to consult a physician, or any health professional other than an orthopedic physiotherapist before engaging in the athletic protocol, which emphasizes neck and back extension stretches.

Audience: Musicians, especially string players with shoulder impingement syndrome

This book was written by a physiotherapist (Paull) and her violinist patient (Harrison), who began teaching injury prevention workshops after their experience with Harrison's shoulder problem. It addresses an important topic, anatomy is described clearly with simple diagrams, and the recommendations not to play in pain are appropriate. Although this book appears to be intended for all musicians, the focus is on one type of shoulder impingement syndrome. Few other playing related injuries are defined or even mentioned, and facial anatomy (applicable to woodwind and brass players) is not covered.

There are several inaccurate statements about musicians' injuries, and much of the research on risk factors for occupational musculoskeletal disorders is either ignored or misinterpreted.

The authors frequently make statements such as "study after study shows" without providing any references. No research support is provided for pronouncements such as "Never do sit-ups in any shape or form." Although the exercise protocol is presented as injury-prevention for musicians, research demonstrating its effectiveness is not evident.

Similarly, in promoting their "ergonomically designed playing chair" the authors offer testimonials and state: "All that remains to be done is to persuade healthy musicians to try this [chair] and learn how to use it as a strong dose of injury-prevention medicine." The authors provide no evaluation of the effectiveness of the chair.

The few research studies that are cited suggest a biased selection rather than a comprehensive literature review. For example, according to the best prevalence studies, playing-related injuries affect approximately 43% of professional musicians; however, the authors cite only studies reporting injury prevalence of 57% to 87%. By ignoring the methodological problems of the few cited studies as well as ignoring more rigorous studies, the authors misrepresent and overstate a problem that is significant even without exaggeration.

Similarly, the authors' warning against taking anti-inflammatory medications is accompanied by statistics on hospitalization and death that were reported at one conference presentation. Their cautions to "sit as seldom as possible" are based on one 1976 study.

The authors advise readers who are injured that this book does not replace their own orthopedic physiotherapist, and readers who experience pain while performing the recommended stretches or exercises are urged to consult an orthopedic physiotherapist. However, there areno cautions for the reader (injured or uninjured) to consult a physician (or any health professional other than an orthopedic physiotherapist) before engaging in the exercise protocol.

The lack of appropriate warnings and the authors' emphasis on back extension stretches are cause for concern. Although Harrison's detailed account of her injury experience illustrates some frustrations other musicians encounter when consulting health professionals, both she and Paull make several unnecessary derogatory comments regarding diagnostic tests and treatments used by health professionals other than orthopedic physiotherapists.

In sum, this book presents the authors' opinions and experience rather than a comprehensive evidence-based approach to injury prevention.

Christine Zaza, ARCT, BMus, MSc,
PhD
National Cancer Institute of Canada
Postdoctoral Fellow
University of Western Ontario
London, Ont.
Director, Canadian Network
for Health in the Arts

Reference
1. Zaza C. Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence. CMAJ 1998;158:1019-25

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