The physical problems of musicians, particularly injuries due to misuse of the body, have received considerable attention in recent years. Most of the interest has been focused on resolving injuries that already exist, rather than on preventing these injuries. A recent discussion with Shmuel Tatz – a rather remarkable Manhattan-based physical therapist and physical education specialist – provided some important perspectives on these subjects.
Tatz has worked with hundreds of musicians during his career, including such artists as Isaac Stern, Yehudi Menuhin and Vladimir Ashkenazy. He has also worked with countless ballet dancers, and with people who work in other fields. When asked how the average musician’s case compares to that of a dancer or a person who works outside the arts, Tatz pointed out that “everything we do in life can lead to physical problems. It’s just a question of when in life the problems begin. For a dancer, the problems usually start between the ages of 15 and 20; for a musician, between 20 and 30; for someone who has a desk job, between 30 and 40.”
Why this discrepancy? “Dancers have problems the soonest, because they demand so much from their bodies that they abuse themselves. Mussicians, on the other hand, are often taught early on to ignore their bodies. Frequently, when a teacher or parent discovers that a child is musically gifted, the child will be discouraged from engaging in normal physical activities, such as sports. This is very bad for physical development. It can prevent the child from acquiring the strength, flexibility and endurance that serious instrumental study and performance require. It may also set the stage for problems later on.”
A knowledgeable, attentive teacher should recommend that a student’s parents allow normal amounts of physical activities. In addition, teachers’ understanding and awareness of what may turn out to be physical misdevelopment in their students, coupled with referrals for physical therapy when required, can go a long way towards reducing these problems in childhood and afterwards.
“Unlike a ballet dancer, musicians generally require only normal strength and flexibility, to perform at a peak level,” Tatz said. “What is surprising is how many musicians don’t have even normal mobility. Often, the development is uneven – an arm is too flexible in one direction and stiff in the other, and therefore unstable.” Specific physical training is not the norm among musicians. “In fact, musicians are frequently taught to disregard the body, to be result-oriented – only the musical product matters, no matter what kind of physical deprivation or damage is required to achieve that end. In general, people are taught to see a health practitioner, such as a physician or physical therapist, only when they are already sick or injured. In my opinion, that is waiting too long. People need to seek out physical educators and medical doctors who are willing to help someone who is healthy to stay that way, so that certain avoidable problems can be prevented from ever occurring.”
What about adult musicians who are already suffering from physical problems? Tatz uses a unique approach called “Body Tuning” in his work as a physical therapist. “The body is an instrument that needs to be kept in tune, just like a violin or an automobile. When a musician comes to see me, I try to address not only the specific problem he is having, but also more general aspects of movement and posture.”
Tatz’s Body Tuning draws on a diverse combination of Eastern and Western disciplines. One component of his approach is “manual medicine” – hand-on physical therapy, a discipline to which he ascribes European and Australian origins. Manual medicine served as the focus of his studies in Israel. His earlier studies in Russia dealt with the use of “therapeutic modalities” such as laser therapy, microcurrents, ultrasound and magnetic therapy. “Russia is 15 to 20 years ahead of the West in these high-tech applications,” Tatz explains. “These approaches have caught on in the West only during the last ten years. In Russia, electrical modalities and magnetic therapy were already in use in the 1950s.”
Tatz also incorporates disciplines from the Far East, such as yoga, Tai Chi, energetic healing and acupuncture, as well as Western adaptations such as the Alexander and Feldenkrais techniques.
When working with a patient, Tatz begins by trying to establish a spiritual rapport. “I want a musician to feel that I understand what it means to be a professional musician, that I know how much energy and passion go into making music, and what the physical demands are. If a pianist, for example, knows that I understand his art and way of life, he will trust me to help him to take proper care of his body. This trust is the most critical aspect of my work with the patient.” After a personal connection has been made, Tatz begins by testing the mobility in the patient’s joints, the flexibility and strength of the muscles, and the condition of ligaments and tendons.
The second step is to help loosen tight joints or muscles through hands-on manipulation of parts of the body. Next, Tatz shows the patient exercises that can be done on one’s own to increase flexibility and strength in the areas that need improvement. “I start with the specific problem or injury, but in the back of my head I am always thinking of the patient’s general health. Once the particular problem is fixed, I go on to do a more general tuning, as a mechanic would tune up an automobile after replacing a defective part.
“Afterward, I might make some more general suggestions. These suggestions could deal with general physical health, including diet (in which case I have sometimes referred patients to a dietician)m and physical presentation on stage, which is extremely important for performers, but which teachers often neglect to address. The way in which a performer moves on stage is a crucial factor in establishing a connection with the audience.”
The last step in the process is finding out what kinds of physical activity the patient enjoys. According to Tatz, finding a physical activity that someone really enjoys is the best way to ensure that the patient will continue to exercise effectively. Continued exercise is critical, because it is “only when a musician can fully enjoy playing his instrument.” And that is, after all, the kind of enjoyment that musicians seek.
Allegro: Associated Musicians of Greater New York
By Richard L. Simon and Adam C. Fisher