Archive for the ‘Playing Technique’ Category

Hand Surgeon and Professor of Piano joint BAPAM clinic

Wednesday, May 1st, 2019

There are intrinsic relationships between health and performance excellence, and educational and clinical expertise in the performing arts. In overcoming medical problems, specialist diagnostic and medical expertise can be complemented by performance technique and lifestyle and health-related guidance. In a new joint clinic at BAPAM, Mr Mark Phillips, Hand Surgeon, and Penelope Roskell, Professor of Piano at Trinity Laban, are exploring this opportunity for clinicians and educators to provide each other with unique insight and feedback. We asked them to tell us more about this innovative approach.

Could you explain the idea behind the joint clinic and why you decided to do it?

Mark Phillips: In my experience when treating musicians I found quite an overlap between the physician’s knowledge and the specialist physiotherapist/hand therapist’s knowledge, who’s an expert in musicians. But I soon realised there was a huge gap for the third element which is filled by the expert tutor on that instrument. I happen to be a trumpet player so as a musician I have some insight into the patient but that’s not enough when it comes to some of the issues they face. I can relate to some of the psychological performance issues, but the expectation patients have is of someone that can really understand how the technical demands of the instrument interface with the physiological problems they’re having and anatomical problems they may have and the outcome of the clinical assessment.

Penelope Roskell: The knowledge we have between us is enormous. My students have included musicians with injuries for 40 years, and so we fill in the gaps. Seeing musicians together in a joint clinic is very important because you can then see the whole picture and then decide on the best way forward. Sometimes it may be steroid injection and sometimes it may be surgery. But sometimes it may be that a tweak or a change of technique will solve that problem and reduce the need for further intervention. So, seeing them together we can get to the root cause, which we can’t always do if seeing them independently.

How do you decide if a patient would benefit from this dual approach? What can a patient expect at a typical joint session? How do you each approach the patient?

How do you prepare for a joint clinic session?

Mark Philips: Normally I will contact Penelope to say I’ve got a patient or she may say she has a student. We will both select patients for this clinic.

Penelope Roskell: Sometimes Mark will send me over a video of that person playing, so I’ll have a chance to look at it and pick out the obvious problems about what I think may be causing it. I’ll also have a clinic letter which will give some sort of background.

Mr Phillips: We then meet up for a coffee and chat about the patient. So then the patient comes in, and if it’s my patient I present it to Penelope and on one occasion Penelope presented the patient. And then we do the history in the normal way, present findings and run through it all. I then suggest what may be the anatomical or physiological problem and how that relates to this person’s technique. The technique may have worked well for a long time but now there’s a problem which is unique to them. Looking at the technique can help if I’m referring to Penelope. Or similarly if Penelope is referring to me is there a way that some of my interventions such as hand therapy or injections or my approach to examination would throw some light on the matter. It’s that overlap which is invaluable really.

Penelope Roskell: So for instance one of my students came to the last clinic and she had problems for the last year and had come to me for that reason. And Mark gave her quite a different diagnosis to what she had been given in the past, which then informed me. So now we are working slightly differently in the lessons that I have with her privately, having now had this intervention from Mark and he also suggested a steroid injection which we are waiting to see the results to. We can then see the whole picture about the ways forward, because there isn’t always one solution. A patient may need a steroid injection or piano playing adjustments to the technique.

Mark Phillips: It’s multi-faceted, there may be Alexander Technique, hand therapy and it may be someone looking at their posture. I learn so much by looking at Penelope tutoring at the piano in terms of elbow position, shoulder position and what impact that has in terms of the way the fingers lie on the key for example. Each presentation has its own unique cocktail of remedies really.

There are complex multi-faceted problems by the time they come here and it comes down to how we triage these patients essentially. I don’t bring every pianist to this clinic.

Penelope Roskell: It’s inevitably going to be someone with a piano related injury. If they’ve broken their wrist by falling down the stairs then they should go straight Mark. Whereas it’s different when it’s something like accumulated stress from years of playing with a technique which is a tiny bit off balance. They may be very experienced players and their technique has lasted them well, but there’s something that just tips it over.

Mark Phillips: What I see in my patients is that half of them have the same problem as everybody else and that may affect how they use their instrument. And the other half have instrument related problems and it may be a combination of the two. And say if someone broke their wrist a year ago and it may be throwing out their elbow, their shoulder or their posture and it may well be a good way down the line that it’ll come to me that a session with Penelope would be helpful. Because it may be to do with their elbow and shoulder which may be making some notes inaccessible and we can work around. They’re so unique each of these cases an each of them would have their own relative roles for the two of us sitting together and discussing the case. It would be good to extend this to guitar, violin and cello and get tutors to do a similar thing. And it’s pretty unique, I don’t think there’s anyone else out there in the world doing it.

What do you feel are the benefits of having an educator in a clinical setting?

Penelope Roskell: It is a very formal environment which is a positive thing and it focusses everything which is very important.

It is a sort of pilot, it’s the first of its kind and I think it is very valuable and let’s hope that other clinics may take the idea from this and develop that further.

What are the direct benefits for patients of having the educator and clinician in the same room in a clinical setting?

Mark Phillips: We often find that patients are often reticent about coming to these clinics. They really don’t want to look at their own techniques and I suppose they remember back to days when they were being tutored and they feel self-conscious. They have to want to come to this clinic and to be looked at. It isn’t like going for a piano lesson or being taught. We are looking to see whether there’s anything about their technique that may be in anyway connected to the clinical problem they have. So we’re not trying to look at the way they play from any other perspective than that. People play in lots of different ways. Also videos are really useful, anyone with a smartphone can record themselves. When we look at them we can slow them down, go back over a sequence, look at it carefully, look at it together and see how that relates to their clinical problem.

Penelope Roskell: There is something different about the joint clinics, because I’m there involved in the consultation I’m able to ask them questions from my own point of view so that I’m well informed as to how best to help them in the future. Because a piano teacher is not qualified to diagnose and that is absolutely number one and nor am I qualified to answer questions that students sometimes ask me, like should I have that steroid injection or that operation and it’s not for me to advise on that but in this situation between the three of us we can discuss the best way forward viewing it from all the different angles.

Any challenges you are finding with the joint approach?

Mark Phillips: It’s 30 minutes long, which is short. We are just getting into our flow by half an hour.

We haven’t had a chance to find out what patients think, especially how they feel about the added value of seeing us both together.

The four patients we have seen in this format have individually expressed to us they thought it was a good session and it stimulated a lot of discussion and ideas. It would be great in the future to include a hand therapist and do a proper multi-disciplinary clinic. Hand surgeons always work very closely with hand therapists. Because there are so many different joints in the hand and different diagnoses. In the hand you’ve got unique problems to one finger or there will be a combination of problems. So your hand therapy is always bespoke, it’s all tailor made to that patient so you have to discuss each patient individually and with musicians it’s even more so.

Certainly with the three most commonest instruments this is going to be a major area of growth in the next ten years and it’s very exciting.

During the half an hour the patients sense the trust we have with each other (Penelope: we work very well as a team, we both have a lot of respect for each other’s knowledge. So I think they go away feeling they’re whole picture has been seen and assessed and we are seeing them as an individual with a problem that can be resolved.)

All patients have been bought over by the end of the 30 minute sessions. You can see the reticence and slight nervousness at the start of the half an hour turning into trust and outpouring of confidence and sharing of the problem and by half an hour we are in to the nitty gritty aren’t we. The output of that is usually I will see them again or Penelope will see them again.

What they can do is continue seeing Penelope for a while and see me in the clinic two months later and see how things have been going on in the meantime. And because we know each other well we can send secure emails back and forth and stay in touch.

New Clinics in Liverpool and Belfast

Wednesday, April 17th, 2019

As part of our commitment to reach and support performers throughout the UK, we are pleased and excited to announce new regional clinics, this time in Liverpool and Belfast starting in May 2019. 

BAPAM are delighted to be working with the Royal Liverpool Philharmonic Orchestra, who will host the clinic at the Philharmonic Hall, and Dr Marie McKavanagh, a Performing Arts Medicine specialist GP (and musician).

Liverpool Philharmonic have pioneered an exemplary approach to developing and supporting performance excellence through providing specialist health and wellbeing services to orchestra musicians. The positive effects of this investment are proving that performer wellbeing and artistic excellence are interlinked. Taking care of both also makes good business sense. Performers are healthier, happier, take less time off sick and are better prepared for elite performance. Through their key support for the new BAPAM clinic, Liverpool Philharmonic are now helping to bring this approach to the whole performing arts community.

The first clinic will be held on Wednesday 1st May. 

Belfast

BAPAM are also delighted to be working with the Oh Yeah Centre, Belfast’s music hub, who will host the clinic, providing vital support for a healthy and vibrant performing arts community.

The clinic is led by Dr Christine Hunter, a BAPAM and  NHS GP and Medical Adviser to the Ulster Orchestra.

BAPAM’s Belfast Clinic will be held monthly from May 22

Who is the clinic for?

If you make a proportion of your living from, or study in the performing arts, and have a physical or psychological health problem related to your work, BAPAM can help you. BAPAM clinicians can provide an accurate diagnosis and information to help you overcome problems. The BAPAM team can identify the best sources of ongoing care, both in the NHS and from other specialists, and advise you about sources of financial support for people experiencing health problems affecting their ability to work or study.

Other regional clinics:

Glasgow: Friday 10th May, 7th June

Leeds: Thursday 2nd May

How to book a FREE confidential appointment?

Call 020 7404 8444 to register | Or email info@bapam.org.uk

Free Health and Wellbeing Webinar Series with ISM

Tuesday, February 5th, 2019

Tuesday 5th February to Tuesday 26th February

We have teamed up with the Incorporated Society of Musicians to present a series of free webinars looking at musicians’ health. Our performance health experts will lead the sessions, exploring solutions to problems frequently encountered in music careers. For more information on each session and how to book a free place click here.

Looking after yourself on tour: Tuesday 5th February
Health in the gig economy: Wednesday 13th February
Resilience and bullying in the workplace: Tuesday 19th February
Preventing playing related injury: Tuesday 26th February

 

INSIGHTS Day

Monday, November 23rd, 2015

BAPAM Healthy Performance Education Programme Launch

Our INSIGHTS Day aims to help performers, teachers, students, arts organisations, healthcare practitioners and employers optimise & inspire healthy performance practice. 

London, Saturday 5 March 2016 

Injury prevention
Networks
Stress management
Instrumental technique
Good practice
Health
Teaching
Success

Our growing network of performing arts medicine practitioners and trainers, and the expertise gained through our clinical work puts us in a unique position to share essential advice and techniques for healthy and successful careers throughout the performing arts community. Our INSIGHTS Day launches our education programme with a day of talks and workshops focusing on vital knowledge and skills. Early Bird tickets are now on sale for £45 (full price £85). Musicians’ Union members will always pay the lower rate. Sessions throughout the day will explore key topics including:

Drusilla Redman, Physiotherapist (BAPAM and Guildhall School of Music and Drama)  The performer’s body: Posture and musculoskeletal health, warm-up and cool-down routines.

Sarah Upjohn, Physiotherapist (BAPAM and Purcell School) Are you sitting comfortably? A workshop for instrumentalists who need to switch between sitting and standing positions. 

Paul Sogaard, Guitarist and Teacher  Ergonomics of the guitar. A holistic approach to practice and performance including advice on posture, left and right hand technique, Alexander Technique in guitar playing, and issues for acoustic and electric guitar players.

Penelope Roskell, Pianist and Teacher (Trinity College of Music). Piano performance advice and techniques.

Karen O’Connor, Performance Coach. Techniques for performance enhancement and performance anxiety management.

Giovanna Reitano, Trainer and Counsellor. An introduction to Autogenic Training for performing artists

Alison Loram, Violinist, Scientist, Alexander Technique Teacher. Realising potential in performance: An introduction to the Alexander Technique

Jenevora Williams, Vocal coach and singer. Vocal health for voice users: healthy voice functioning, and how things may go wrong. Some simple remedies and exercises will be explored, as well as ways of preventing future voice problems.

Jane Oakland, Music psychologist and singer. Managing the transition from performance student to professional performer. 

‘Ask the expert’ sessions with practitioners in this field.

The INSIGHTS Day will be held at the Musicians’ Union, 60 – 62 Clapham Road, SW9 0JJ London.

Advance booking is essential. Early bird tickets are available now at www.insightsday.eventbrite.co.uk

Early Bird tickets: £45 (available until 26 January)
Full price: £85
Students: £55

Lunch and materials are included in the ticket price.

Our ticket prices are designed to make BAPAM events accessible. Additional donations greatly help us to continue to provide our support services for performers.

We are grateful to the Musicians’ Union for supporting this event.

If you’d like to find out more about arranging a bespoke BAPAM training event for individuals or organisations, please take a look at our Education and Training Information and Enquiries Pack.

New and Updated Health Information Factsheets

Wednesday, January 21st, 2015

We know that a career in the performing arts can be physically and psychologically tough. Whether you’re on stage or behind the scenes, it takes a lot to keep the show on the road. BAPAM helps many people overcome health challenges that arise while they are working or studying in our industry.

Our free online Factsheets are designed to help you look after yourself and perform at your peak. They include advice about preparing for performance, from physical warm-ups to psychological self-care, coping with anxiety and challenging working conditions, caring for your voice, hearing, taking care of nutrition and alcohol consumption.

Click here for all of our Factsheets.

These materials are a developing resource, as we bring the expertise gained through our clinical practice and Trainer Network to focus on making key information available to all performing arts professionals and students. Look out for new BAPAM health resources throughout 2015 and please get in touch with Information Officer, Dan Hayhurst (dan@bapam.org.uk), with any comments and suggestions.

BAPAM Warm Ups Leaflet

Our Warm-up Exercises for Musicians pocket-sized leaflet is just one of our updated health resources

Havas New Approach – International Summer Academy for Strings in Oxford

Wednesday, April 30th, 2014

Kató Havas is a violinist and violin and viola teacher who developed the “New Approach to violin playing”, a method of releasing physical and mental tension, which could help prevent physical injuries and anxiety related to playing the violin or viola. A frequent presenter at European String Teachers’ Associaton events, Kató’s teachings are now continued by her assistant, concert violinist, Caroline Duffner.

The summer New Approach workshop to string playing is held in the beautiful setting of St Edmund’s Hall of the University of Oxford.

This year’s Summer Academy features a presentation by Candy Connolly, introducing South Indian violin playing with the New Approach.

This workshop is suitable for students and amateurs as well as performers and teachers.

Full details including booking information can be found here: carolineduffner.com/oxford-violin-workshop-2014

Please note that this event is not organised by BAPAM and we receive no revenue from it.

 

Study Days from the British Voice Association

Wednesday, July 31st, 2013

The BVA has a number of courses coming up through September to November.

For full information on the following events take a look here: http://www.britishvoiceassociation.org.uk/events.htm

Rock and pop day - flyer
Voice and the Brain

Rock and Pop Day

Voice Science for Choirs: cutting edge thinking for choral conductors

Weak, Wobbly or Working?

Voice Clinics Forum

The Perils of Percussion Playing | Alcohol and the Performing Arts

Friday, March 22nd, 2013

A British Association for Performing Arts Medicine Training Event: 

Saturday 18th May 2013
Main University Building, Cardiff University, Park Place, Cardiff, CF10 3AT 

 

Hand problems in musicians with an emphasis on percussionists
Practical percussion demonstration
Ergonomics
Assessment & treatment advice
Dystonia update
Alcohol and the performing arts

Click here for the full programme.

£80 – Full Day
£50 – Students

To book your place or for more information please return this registration form by post or email the Office and Clinics Manager, Clare Hicks, via clare@bapam.org.uk

BAPAM Training Days provide in-depth explorations of key areas of Performing Arts Medicine and unique insights into aspects of performers’ health and wellbeing. We present performers’ perspectives as well as the expertise of experienced medical practitioners.

Our events are also a great opportunity for all those interested in and engaged with Performing Arts Medicine to meet and network.

For those of you who are GPs, BAPAM training days should qualify for CPD credits under the RCGP CPD credits scheme (please check this with them directly).

The State of Play 2013 – Musical Instrument Day

Thursday, February 14th, 2013

Saturday 23rd March

10:00-17:00
(Registration from 09:30)
Saturday 23rd March

The Old Refectory, Wilkins Building, Main Quadrangle, University College London WC1E 6BT

A study day for performers, healthcare practitioners, music teachers, manufacturers and modifiers of musical instruments

Enhancing performance and facilitating healthier practice

Bespoke instrument modifications and manufacturing technology

Investigating tools for musicians’ rehabilitation from injury

Configuring the musical interface for healthy performance

Musical instrument ergonomics 

Sessions focusing on brass, strings and guitar

Full Day £75 Half Day £40

BAPAM Practitioner £65

Students £50

To reserve your place please email admin@bapam.org.uk and we’ll send you a booking form. 

More information: State of Play Instrument Day Programme

Photo: MFHiatt

Taubman Approach Symposium

Tuesday, February 5th, 2013

The Golandsky Institute present a symposium on the Taubman Approach, an instrumental playing technique that many musicians find useful in preventing playing related injuries and in overcoming problems if they do occur. The symposium will cover the application of the technique to both piano and violin.

The Symposium takes place at St John’s College, Cambridge, March 23rd and 24th 2013.

Further information and booking