How to reduce the risk of injury as a musician

As a guitar teacher, few are as experienced as ICMP’s Tolis Zavaliaris.

With a love for sports and fitness, alongside his instrument, Tolis has been undertaking extensive research into what musicians can do protect themselves from injury from playing and practice.

He presented some of his findings at our first Research and Development Conference back in June so we tracked him down for an extensive interview on his tips to prevent injury… check out his advice below…

What inspired this line of research into reducing the risk of injury as a musician? 

Over the years, I have heard many complaints from my students about pains in their fingers, hands and other areas of their body when practicing. Many of them develop strain injuries which interfere with their development and studies. They visit their GPs, who direct them straight to medication, but this method doesn’t cure the problem.

GPs are not specialists in this field and are often not well informed. So I feel it is my responsibility to help, protect and educate my students about possible injuries and how to avoid them.

Many years ago, I was faced with one of the biggest dilemmas of my life. I was a full-time musician and at the same time, a professional Muay Thai boxer. Unfortunately, I dislocated my right shoulder and couldn’t fully use my arm. Obviously, such an injury is difficult to heal completely and it is something I have had to live with.

It was then when I started investigating and observing which parts of my body are involved and various treatments such as Osteopathy and the Alexander Technique.

What are the most common injuries musicians sustain from playing/performing? 

Instrumental musicians are a special risk group for repetitive motion injuries. A good number of them develop physical problems related to playing their instruments.

Common injuries include:

• RSI - Repetitive Strain Injury
• tendonitis
• carpal tunnel syndrome
• tennis elbow​
• myofascial pain syndrome
• arthritis
• back pain
• neck pain
• shoulder pain

What can new musicians do to reduce their risk of injury? Have you any tips? 

Learning guitar or any instrument in general, demands a lot of practice, which involves both body and brain. This is a life-time event, as musicians always struggle to keep up technically with their instrument.

Having a good technique helps instrumentalists battle with all the performing difficulties and demands. Therefore, maintaining and improving technique is essential. You need accurate posture, stretching, hydrating and regular breaks." 

Here are some tips:

• Relax
• take breaks while practicing/playing
• stretch
• observe your body
• check out posture
• check out instrument position
• practice in front of a mirror 
• keep your shoulders straight
• use the correct muscles and parts of your body
• drink a lot of water

For guitarists, which parts of the body are most at risk? 

Mostly the back and upper body, especially the neck and shoulder. However, I have developed approaches to avoid tension on the upper body and focus mostly around the fingers, wrists and arms. Many guitarists also suffer from pains around the arms, fingers and wrists, but these pains are not always bad.

If it is a muscle pain then this is good, because you are working on the muscle that will support your technique. If it is around the areas that there are joints and tendons, then perhaps will need attention and rest."  

Practicing the guitar will bring pain, but there is good pain and bad pain. Our body has a language and tells us when there is something wrong. Therefore, we all need to learn to listen to our body and observe. Everybody is different so the experiences of pain vary. Remember though, no pain no gain!

How can thinking about reducing the risk of injury inform/improve technique? Can it make you a better player? 

Absolutely! We weren’t born with the guitar in our hands, right? So, the instrument is an external introduction to our body and it must feel naturally as part of it. When you are on tour, gigging and traveling every day there is a lot of physical involvement, tension, lacking rest and sleep.

Having a strong technique reduces the risk for injuries and supports you against these bad conditions and challenges. As far as being a player, it helps you improve your tone, speed and many other components of your playing." 

Are there any changes coming to the industry or any industry bodies musicians should be aware of who exist to help them if they do succumb to injury? Is there any support out there? 

BAPAM (British Association for Performing Arts Medicine) offers specialist health support to performing artists. Through their website you can find practitioners that can help you with your injury. Unfortunately, GPs are not specialists in this field so I encourage all students/musicians to register with the Musicians' Union, which provides discounted, or in some cases, free services for BAPAM.

Jennie Morton’s book'The Authentic Performer: Wearing A Mask & The Effect on Health', is great and is based on her personal experiences and expertise being a performing artist. Jennie is a dear friend of mine and I have also been her patient for many years now. She is a professional singer and actress, as well as a trained osteopath specialised in injuries for musicians. During our sessions, she has helped me with my injury and showed me ways to maintain a healthy body. She has taught me a lot of techniques about posture, body ergonomics, as well as stretching and pain relief exercises. In many of our sessions, I had to bring my guitar and play for her, so she could examine the way I played and how I involve my body and treat me accordingly to my habits. I have learned a lot from her and I will use some of her wisdom and approach in my intervention.

Also, Ron Brown’s 'Authorized Summaries of F.M.Alexander's Four Books'  is an excellent book and a good starter when it comes to the Alexander Technique... 

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