Posts Tagged ‘Hypermobility’

Arts health practitioners in focus: Massage Therapy

Tuesday, March 27th, 2018

Arts professionals and students are unlikely spend much time thinking about their health until something goes wrong. Yet they work in a tough industry and often push themselves to the limit. Problems can accumulate over days and years spent practising and performing. Taking care over physical and mental health is essential to sustainable performance practice and a successful career.

Sometimes things go wrong. A health problem or injury starts to affect your performance and you need help to beat it.

If you are a student or professional in the performing arts, a call to BAPAM’s Helpline can provide advice about where to get help for work-related health problems. You can arrange a free assessment at BAPAM with a doctor or clinician who will understand the demands of your career. You should always talk to your NHS GP as well – often excellent services are accessible by GP referral.

What if you are looking for independent expertise from a physical or psychological therapist? It is easy to be confused with the number of different therapies available. How do you go about finding a practitioner with the right experience and expertise?

BAPAM’s Directory of Practitioners lists information about high quality and accessible performing arts healthcare provided by skilled professionals working in a variety of modalities. In this series of posts, we’ll look at how these different kinds of practitioners can help you stay fit, overcome problems, and give your best performance. In this post, we look at a sometimes overlooked section of our Directory, Massage Therapy.

Massage Therapists work with the soft tissues – muscles, tendons & ligaments to apply pressure, manipulate and stretch them. Often these clinicians are termed Sports Massage, Holistic Massage or Sports and Remedial Massage practitioners.

You should check Massage Therapists are properly registered with the regulatory body, the Complementary & Natural Healthcare Council, which means they are highly qualified. ITEC level 3 certificates are a good entry point into massage but for detailed knowledge of anatomy & physiology and more advanced methods of working, it is important that the therapist is qualified to diploma level or above.

We asked four BAPAM Registered Practitioners for their opinions on how arts specialist Massage Therapists can help you stay fit and give your best performance.

Rebekah Gilbert:

Rebekah Gilbert trained as a singer at the Royal Academy of Music and has sung as a concert soloist, recorded for EMI, BBC Radio, Classic FM and at Abbey Road Studios. She trained at the London School of Sports Massage and ITEC. She has a doctorate in coaching and is an Associate of Canterbury Christ Church University, working with Professor Stephen Clift on worldwide publications relating to singing and wellbeing.

“A good Massage Therapist will do a lot more than just ‘pummel’ you! First they will take a history of the issues you are consulting them on, your artistic practice and the time you put into it, lifestyle, exercise, the environments in which you work, and your medical history. If they discover anything that may need referral to another medical professional they will know when not to treat you.

Secondly, they will assess your posture as you stand and sit, the way a musician plays their instrument, and look at your walking gait. Is anything out of alignment? What are your posture habits and why? Might you need orthotics to improve how you stand and walk or just more supportive shoes?

Thirdly, they understand the difference between palpating well toned muscles and tense ones. Massage Therapists are good detectives, examining how you may have formed adhesions (knots), and can recommend changes necessary to reduce them in the future. The muscular skeletal system has an integral deep & superficial layer of facia running through it, which connects to every part of the body down to cellular level. Because of this, a Massage Therapist will know that a pain in one location may be triggered by problems in another and, within their toolkit of techniques, which will be most beneficial to apply.

Fourthly, they will have a long list of stretching exercises to give you as ‘homework’. However well a Massage Therapist can work in one hour, the time until your next appointment needs your input to make a difference. They may suggest other local practitioners such as Pilates, Feldenkrais, Yoga or Physical Training instructors to help you improve core strength and posture awareness. As a singer, I also know how beneficial optimal breathing techniques are in performance.”

Felicity Vincent:

Felicity Vincent is a professional cellist and a Pilates Instructor and Massage Therapist specialising in exercise for cellists. Felicity is an experienced active performing cellist and teacher with a deep understanding of how a player’s body might accumulate problems and how these might be solved. She has gone on to study Fascial Release with Anatomy Trains. Please check the BAPAM Directory for contact details. 

“Every string player knows their body isn’t just made up of levers (bones) and pulleys (muscles) but a controlled flow of circular and rotational movement. This is made possible by your fascia, the soft tissue of the body which is now known to be a strong, bouncy, stretchy, highly intelligent and trainable cell matrix which is everywhere, joining muscles to bones, allowing muscles to glide over each other, and through and over organs. But the fascial system is the site of countless numbers and types of nerve endings. These can respond to overuse and misuse which may be caused by imbalanced body use or holding onto emotions. Some degree of hypermobility can be an advantage in playing but is a double edged sword because stretchy tissue is particularly vulnerable to injury when overworked. On the massage couch your therapist will coax adhesions to dissolve and encourage held patterns to let go.

I see regular exercise as the principal key to health and wellbeing for every string player. I enjoy Pilates because it can be challenging and, particularly using the equipment, is a sophisticated way to balance the body and strengthen it. There are many schools of cello playing; the most important thing is that playing shouldn’t be destructive.”

Zoltan Zavody

As a musician (and martial artist) himself, Zoltan Zavody understands the range of injuries, impediments to joyful playing, and pain that can result from muscular imbalances.

“Anyone who trains their body intensively is more prone to soft tissue injuries – musicians sit in the same position for hours, make countless repetitive motions at speed, and then lug their instrument or box of scores to their next session. They are perfectionists who put themselves under intense scrutiny and thus stress. In the course of their careers, many musicians are likely to experience an injury requiring time off from performing.

The conditions sustained through the playing of music vary. Some seem relatively innocent, for example tightness and soreness in the left shoulder of a violin player. Others are more insidious, like the burning pain in the wrist of a guitarist. Still others are structural, like a lower back torsion in a pianist. Massage Therapy can generally help with all of these. And they can be interconnected.

Interestingly, through years of practise, it is not only the muscles that are habituated to playing. The connective tissue, the fascia that surround the muscles, also adapt. Research shows that this connective tissue morphs, slides, and grips according to habitual movements. So a musician may end up with managing to relax their ‘playing muscles’, but unless it is released, the tissue enveloping these muscles continues to pull their body and limbs into a specific posture, like a skewed bodysuit. The person is relaxed, yet they still feel a tightness, a pull, a misalignment. This is where a Massage Therapist can help with a range of myofascial techniques; softening, stretching, and pulling the connective tissues, the bodysuit, into comfortable alignment.

Myofascial work is not all about injury and problems! All of us inevitably have muscles and tissues that are a little stuck, whether from old injuries or emotional holding or underuse, and we don’t even notice. Take a singer for example, who has no complaints but wishes to improve the smoothness of their sound. By working fascially through the diaphragm and along the ribs, a Massage Therapist can help release these areas, leading to greater lung capacity and breath control, and an easier, more joyful singing experience. We have essentially freed up the bellows – and who wouldn’t want that?

If musicians were sportspeople, they would have ‘pitch-side’ Massage Therapists and coaches to help them fulfil their potential and make life a little bit easier.”

James Wellington

James Wellington is a specialist musculoskeletal physiotherapist and Sports Massage Therapist who works extensively with circus performers and other artists. He Lectures nationally and internationally in the fields of physiotherapy, injury prevention & performance enhancement and conducts research in evidence based practice.

“Using sports massage within clinical practice is hugely beneficial, as evidenced by the hundreds of satisfied performers that receive and rave about it. However, there are few well controlled studies into its clinical efficacy.

The speculated effects are biomechanical (improved joint range of motion, reduced stiffness and tissue adherence), physiological (reduced stress hormones, improved blood flow and parasympathetic activity), neurological (less pain and muscle tension), and psychological (reduced anxiety and improved relaxation).

Let’s be honest. It does feel therapeutic getting a sports massage (depending on the pressure being applied of course). It’s my conviction, however, that its benefits rely most heavily on therapist experience and their choice of technique.

If you’re lucky enough to find a sports massage therapist that has a broad set of massage skills, the ability to clinically reason and be able to justify every technique they use – you’re way more likely to see positive results. Personally, I find it hugely beneficial in improving joint range, reducing muscle tension, decreasing pain and decreasing injury-potential factors.

My top tips for performing artists thinking about getting a Sports Massage:

1. Think about the reason(s) you want to book a Sports Massage (post-training soreness / poor flexibility / repetitive strain injury / accumulated muscle tension / a pampering treat?) and communicate this to the therapist (this will assist in selecting appropriate depth of pressure and duration of treatment).

2. Tell the therapist if you specifically intend for the Sports Massage to improve your performance and/or recovery as this may also determine the type of techniques they use.

3. Timing of the massage is important. If in doubt, ask the therapist before booking what is the most appropriate.”

BIMM/SOMM Joint Winter Symposium

Thursday, October 1st, 2015

The British Institute of Musculoskeletal Medicine (BIMM) and the Society of Musculoskeletal Medicine (SOMM) is proud to announce a Combined Symposium: Challenging Joints: Management of laxity, instability and hypermobility, taking place in Birmingham on Saturday, the 14th of November 2015. A number of experts and highly reputed speakers will cover the medical, surgical, and therapeutic aspect of the condition. There will be a variety of interactive workshops providing an insight into the practical considerations of the condition. The day will also offer a great opportunity to network and exchange ideas and knowledge with other members of the professions.

For further information please take a look at the event page over at the BIMM website: Challenging Joints: Management of Laxity Instability and Hypermobility

Saturday 14th November 2015
Jury’s Inn, Birmingham City Centre

A great resource for anyone interested in musculoskeletal disorders, BIMM’s education programme of  short courses and workshops on various aspects of musculoskeletal medicine is ongoing. Forthcoming events include:

Soft Tissue Examination & Injection Roadshow: 4th November 2015

Chronic Pain Management: 21st – 23rd November 2015

BAPAM Journal Issue 2

Wednesday, July 23rd, 2014

Issue 2 of the BAPAM Journal, our free online resource and channel of communication for all those engaged with performing arts health, education and welfare, is now available to download here: BAPAM Journal Issue 2 – July 2014. Many thanks to all our contributors and those who have made a voluntary effort to assist with its production. Please consider supporting our work by becoming a Friend of BAPAM or making a one-off donation.

Contents include:

Interview with Professor Rodney Grahame on performing arts medicine and hypermobility

Work, Identity and Involuntary Musical Career Transition Jane Oakland

Playing-related Musculoskeletal Disorders in Flautists: A Pilot Study Investigating Risk Factors and Interventions that may Affect Outcomes
Dr Patricia Halliwell

The Impact of Hypermobility in the Finger Joints of Flautists Isobel Artigues-Cano

Biotensegrity and Cello-playing Felicity Vincent

The BAPAM Student Advocate Scheme: Reflections on a Health Promotion Initiative at the University of Leeds Naomi Norton

BAPAM Clinics: Learning from our Patients Deborah Charnock, Dan Hayhurst and Clare Hicks

Reflections on Contributing to the NICE Consultation Process on Developing the Guidelines for Social Anxiety Disorder Dr Carol Chapman

European Union Exchange Programme – An initiative to Encourage International Collaborations in Health Promotion Asmund Prytz

Book Review: The Alexander Technique for Musicians by Judith Kleinman and Peter Buckoke Alison Loram

Performing Arts Medicine MSc Student Hub

Student Advocate Scheme Update Naomi Norton

Previous Issues: 

BAPAM Journal Issue 1 June 2013

 

The Hypermobile Learner

Wednesday, May 28th, 2014

STOP PRESS! Last minute places have become available on the course. Contact Lesley McPherson for more details at info@classicalpilatesuk.com

Lesley McPherson, Director of Classical Pilates UK, and BAPAM’s Glasgow clinician, Dr Faith Gardener, are running a workshop for teachers and coaches involved in teaching movement and sport, looking at the hypermobile learner.

This event takes place on June 21st 2014 in Troon, Ayrshire

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

Anyone from adults, young dancers and athletes can be hypermobile and this presents unique challenges to the teacher and the student. This workshop will address not only the science and how to recognise hypermobility but will touch on the psychology of hypermobility and the application of exercise to strengthen the hypermobile student.

Attendance costs £140 including lunch. If you are interested in booking a place please email Lesley McPherson – info@classicalpilatesuk.com

The organisers have informed us that they are nearly full for this session and are therefore building up a waiting list. Enough interest will generate further dates so please let them know as soon as possible if you’d like to attend.

BAPAM Training Day at Leeds College of Music, May 17th

Tuesday, April 29th, 2014

Wind Instruments – Playing & Problems
Dance and Fitness – The Art & Science

We’re delighted to announce details of our forthcoming Training Day which takes place on Saturday May 17th 2014, 09:30 – 16:45, at Leeds College of Music.

The full programme can be viewed and downloaded here: BAPAM Training Day Programme 17 May 2014

BAPAM Training Days are designed for medics, health care practitioners, and all those concerned with performers’ wellbeing.

Our events 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.

The sessions are also a great opportunity to network with colleagues.

Venue: Leeds College of Music, 3 Quarry Hill, Leeds, LS2 7PD

£80 – Full Day
£50 – Students

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

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).

Understanding Hypermobility – a CPD day from Healthy Performers

Monday, October 14th, 2013

Osteopath and Performing Arts Medicine MSc lecturer, Jennie Morton, has organised this one-day CPD course for health practitioners & those involved in the care of performing artists.

Sunday November 3rd 2013
10.00am – 5.00pm
The Club Room
PARK CRESCENT CONFERENCE CENTRE,
229, Great Portland Street. London, W1W 5PN

Jennie and guest speaker, Professor Howard Bird (Rheumatologist, BAPAM clinician in Leeds) will cover topics including:

The spectrum of hypermobility syndromes – aetiology & medical management
Screening & practical measurement/ assessment tools
Hypermobility in performing arts & sports – advantages & disadvantages
Practical demonstrations & case studies of hypermobile subjects
Practical manual treatment techniques for the hypermobile patient

7 Hours CPD
Course Fee £120 (Students £95)

For further info or to request a booking form, please email info@healthyperformers.com

Note: this event is not organised by BAPAM

BBC News piece on hypermobility

Monday, November 2nd, 2009

Hypermobility affects many of the performers we see here at BAPAM. This BBC article features both Professor Howard Bird, Consultant Rheumatologist at our Leeds clinic, and famously hypermobile composer, Sergei Rachmaninov. Take a look here.