Dr. John Chong: Occupational health issues for performing musicians

Dr. John Chong is medical director of the Musicians’ Clinics of Canada, which operates facilities in Toronto and Hamilton, Ont. He and his team specialize in the diagnosis and treatment of occupational injuries suffered by musicians and performers. John has been instrumental in many innovative strategies and techniques to prevent and treat music-related injuries. Clients have included members of the Hamilton Philharmonic, the Toronto Symphony, the National Arts Centre Orchestra, the Tragically Hip, Our Lady Peace and Blue Rodeo. For more information, you can visit the Clinics’ Website at www.musiciansclinics.com .

It’s all in the interface
Most music-related health problems derive from the interface between a musician and his or her instrument, or the musician and his environment. We analyze the ergonomics of that interface — too much force, too many repetitions, too much sound or volume. Playing music is very different from a dynamic occupation like a sport where the players are always moving. Musicians tend to be stuck in one place, often in one position, and repetitive strain injuries can develop from this static loading of movement. Faulty technique or accommodation can also contribute to problems.

Diet and workstyle
Diet is obviously critical to maintaining optimal health but when I prescribe a vegetarian diet with protein supplementation — which is the ideal — most musicians roll their eyes and say, “Sure, which truck stop has that on the menu?” That’s where problem solving comes in. I recommend stopping at 24-hour groceries to buy healthy foods that require minimal preparation, or buying healthy prepared entrées from the frozen food section and heating them up in the venue’s microwave. You don’t have to live on chicken wings and French fries. Many supermarkets stock freshly prepared salads in the produce section.

For muscle protein we recommend the supplement Creatine, because touring is hard work and your muscles can easily get burned out. I also recommend fruit juices, lots of whole fruit and vegetables. And LOTS of fluids, that’s critical. Try and keep the caffeine and alcohol to an acceptable minimum, which means having one or two beers, not three or four.

Smoking is obviously a no-no. Anybody working in a bar is getting way more than their personal limit of second-hand smoke to begin with, and that dries out the vocal chords, among other things. You should also stretch, and not just the muscles you use to play — full body stretching can make you feel so much better. These so-called workstyle changes will make a huge difference, not just in terms of your own life or death, but in terms of dramatically improving your personal performance.

Advice for singers
Hydrate! Water, water, water! And respect your vocal chords. The muscles in the throat are so delicate, they’re like onion skin. So the whole issue of keeping them moist is the first thing. The second is how hard you use these delicate structures. Breathing patterns, alignment and straining are all big issues. Many singers tend to jut their head and jaw forward and to push for intensity and volume. But those things can be counterproductive to long-term performance.

Advice for guitarists
Most pop guitarists are self-taught; they tend to pick up their licks from listening to CDs and mimicking Eric Clapton and Jeff Beck. Unfortunately they often learn those licks sitting around on a couch, which causes lots of bad posture and alignment problems. This is how injuries occur. Also, an electric guitar is heavy and if it’s strapped across a shoulder for hours on end, it’s going to cause nerve compression and blood vessel compression in the neck and shoulder

Advice for drummers
We see lots of posture and alignment problems in drummers who tend to play slumped over in the turtle position, sitting too low, with their cymbals mounted too high, and they’re slamming away as hard as they can. Now I’m not advocating that everybody go back to a softer style of drumming but you can accomplish a lot with a little pressure. It’s about finesse. Athletes like Mark McGuire and Tiger Woods, they’re actually exerting very little grip pressure, no more than you’d use to squeeze a tube of toothpaste.

Early diagnosis
If something is wrong, see your doctor. If your doctor doesn’t understand your work or your health problem, get a new doctor. Your injury or condition may seem minor, but even a small injury, if ignored and allowed to progress, could be career destroying. Early diagnostic analysis makes a huge difference in terms of the medical outcome. I consider careers in music to be occupational Darwinism, because it’s survival of the fittest in the truest sense. You don’t go on, you don’t get paid. Therefore, a musician’s goal must to be to perform with good health in mind.

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