Posts Tagged ‘Performance’

Laryngeal Manual Therapy (LMT) and Head and Neck Massage: BAPAM Guidance

Tuesday, November 26th, 2019

In the light of recent press about a death following manipulation (www.bbc.co.uk/news/uk-england-york-north-yorkshire-50397867) and the publication of research last year on the dangers of head and neck massage if practised by improperly trained salon employees (“Crick” in Neck Followed by Massage Led to Stroke …), we at the British Association for Performing Arts Medicine, along with our clinical colleagues, thought it would be useful to provide guidance on Laryngeal Manual Therapy (LMT) and Head and Neck Massage, which is often used by professional voice users.

We recommend that manual therapy techniques applied to the head, neck and larynx should only be performed in clinical environments by the following registered professionals:

Physiotherapist – registered with the Chartered Society of Physiotherapists (CSP)

Osteopath – registered with the General Osteopathic Council (GOC)

Speech and Language Therapist – registered with the Royal College of Speech and Language Therapists (RCSLT)

Chiropractor – registered with the General Chiropractic Council (GCC)

Sports Therapist –registered with the Complementary and Natural Healthcare Council (CNHC), Federation of Holistic Therapists (FHT) or British Association of Sports Rehabilitators (BASRAT).

Massage Therapist –registered with the Complementary and Natural Healthcare Council (CNHC) or Federation of Holistic Therapists (FHT). Massage Therapists should be qualified to diploma level and registered with the CNHC or FHT, which are the only Registering bodies for Massage Therapy that are accredited by the UK Professional Standards Authority. While there are many organisations that provide training in massage, only some of them provide training at a level that provides a route to registration with CNHC or FHT.

Membership of a registering body accredited by the Professional Standards Authority is a guarantor of professional standards. It indicates that the practitioner operates within a structure that oversees qualifications, working practices, ethical behaviour etc. and can investigate complaints and impose sanctions on practitioners who fall short.

The BAPAM Directory also lists BAPAM-Registered Vocal Rehabilitation Coaches (VRCs). A VRC is a type of specialist voice coach who works as part of a multidisciplinary team that includes clinicians such as Speech and Language Therapists and Laryngologists. BAPAM-Registered VRCs have undertaken training to carry out palpation assessment. This is to assess tension only, and for onward referral, not to perform manipulations. Training in palpation assessment should be provided by a clinically qualified practitioner such as an Osteopath or Physiotherapist. Like clinical professionals, VRCs require clinical supervision from a Laryngologist, Speech and Language Therapist and sometimes a Psychotherapist.

January 2019 Newsletter

Tuesday, February 5th, 2019

Our January 2019 Performing Arts Medicine Newsletter is archived here

Contents:

New clinics

Healthy practice training for performing arts professionals and students

BAPAM and the Royal Society of Medicine Event: Occupational Health in the Performing Arts Industry: The Original Gig Economy

Trustee recruitment

Clinical Governance Toolkit

Free webinar series from BAPAM and ISM

Resources for healthy pianists

BAPAM Performance Environment Day

Tuesday, November 6th, 2018

What would an ideal performance environment look like? Is such a thing even possible when we work in such widely different spaces? How do our environments affect our health, our creativity, our social relationships? What can healthcare professionals, technicians, artists, support organisations and communities do to both support performing arts wellbeing and facilitate excellence in artistic practice?

Our Performance Environment Day explores these topics, from a healthcare perspective and including the experiences of other professionals including artists, technicians, educators and people working in arts support roles, some with additional needs due to illness, injury, difference or disability

You can now read the full programme.

The event takes place at Resource for London on November 17, 9.30 – 17.00.

Tickets are available here.

 


Presentations and Discussion

The Performance Environment: Challenges in the Performing Arts Industry
Sophie Lane, Specialist Performing Arts and Sport Physiotherapist

Saving Your Ears for the Music!
Gladys Akinseye and Jordon Thompson, Clinical Audiologists and Hearing Therapists

Preparing for Challenging Performance Careers
Arran Peck, Athletic Development and Conditioning Coach, National Centre for Circus Arts

Cognitive Function of Adult Amateur Pianists
Dr Marie McKavanagh, GP, MSc Performing Arts Medicine Shipley Rudge Award Winner

Anxiety and Psychological Support for Theatre Productions and Artists
Dr Anna Colton, Chartered Clinical Psychologist

Panel Discussion/Q&A

Do our performance environments facilitate or obstruct artistic practice? How can the ways in which we design, manage, use and share space be a positive factor in healthy practice? Collective support in creative communities, accessibility and participation.

Kris Halpin, Musician/Producer
Robin Townley, CEO Association of British Theatre Technicians
Lisa Tregale, Head of BSO Participate, Bournemouth Symphony Orchestra
Siân Willett, Co-creator of Wellbeing for the Arts

Dan Hayhurst, BAPAM Information Coordinator (Chair)

Listen to the experts on World Mental Health Day 2018

Wednesday, October 10th, 2018

At BAPAM we work with mental health specialists who have the knowledge and experience to help performing arts clients.

On 17th November, Clinical Psychologist Dr Anna Colton will be speaking at our training day about the Performance Environment, covering anxiety, how it affects performance, and how she works with adults and children in West End shows. You can listen to Anna discussing the challenges that arise for workers in this industry, her background and her wider work as a psychologist in our interview below, and you can book tickets for our Performance Environment Training Day here.

 

Surge in demand for backstage therapists due to pressures of social media

Thursday, September 13th, 2018

The pressures of performing in today’s social media culture means more and more therapists are working backstage to support performers in need according to an article in the Sunday Telegraph.

BAPAM registered psychotherapist Helen Brice who is featured in the article, says she is getting more requests for her services due to the fear of a blunder going viral within moments.

She says the emergency sessions which she gets called out for involve calming exercises to reduce a performer’s anxiety. According to her other factors affecting performers at the moment includes a demand to tour frequently, falling incomes and the need to stand out in a hugely competitive industry.

Helen has worked for more than twenty years in the music business in the areas of performance, production, publishing, artist management and classical music. She says over the last couple years people have started to become aware that the mistakes they make may be spotted and commented about on online within seconds. This possibility is becoming the source of more anxiety and is adding to the pressure to always say the right thing and avoid any thing that may be deemed inappropriate.

Her work backstage involves supporting clients with breathing exercises, using low energy techniques or more dynamic work depending on what the client needs the most at that time. The kinds of people Helen has helped includes musicians on the orchestral circuit as well as pop and classical artists and more recently, grime artists.

Vocal Health Workshop in Glasgow

Friday, September 7th, 2018

Top vocal and performance coach Lucy Heyman will be conducting an afternoon workshop for vocalists in Glasgow.

The BAPAM training session organised by the Musicians Union will take place at the Scottish Trades Union Centre in Glasgow on 13th September. It will cover essential skills for enhancing vocal performance with the aim of giving tools and skills needed to succeed and thrive in music careers.

As a manager Lucy Heyman has worked with a range of artists including some of the UK’s biggest names, so has a real understanding of the trials and tribulations a performer goes through.

The topics she will cover include vocal techniques and warm-ups, preparation for performance and psychological skills for optimal performance.

BAPAM’s healthy performance training sessions are designed to avoid health problems which are often encountered in the course of an arts career and are led by the experts in the field. To enquire about booking a BAPAM training session email info@bapam.org.uk

We also run free medical assessing clinics for performing artists in Glasgow every month. (Next one is 5th October) To register as a patient and book an appointment call our helpline on 0207 404 8444/5888

Alexander Technique Research Update

Tuesday, July 24th, 2018

If you’re interested in the ergonomics of musicianship then you may remember a previous post where we featured the research of Alison Loram. Alison is a violinist and BAPAM-registered Alexander Technique teacher working with performers. Alison is also a research scientist in the field of musicians health (and biodiversity in domestic gardens), and has published a number of papers.

Exploring the premise that musicians are subject to a wide range of medical and performance-related problems due to physical and psychological demands, Alison’s thesis for her masters in Performing Arts Medicine, which is now published and open access, looked into chronic profession-limiting problems in musicians: Underlying mechanisms and neuroplastic routes to recovery

A related presentation considers the scientific basis of the Alexander Technique, and presents results of experimental research into Alexander teaching methodology: Explaining the Alexander Technique to clinicians and scientists: Psycho-physical re-education – an introduction to cognitive-motor system-level causes of performance-related problems.

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.”

Psychosocial Practitioners Peer Supervision Group

Tuesday, December 5th, 2017

BAPAM is pleased to support the establishment of a new Peer Supervision Group for psychosocial practitioners who work with performing arts clients.

The group, whose inaugural meetings took place earlier this year, hope to open up the conversation between performing arts and psychological practice. The aim is to foster a network for counselling, coaching and psychology practitioners working frontline with performance artists for interactive exploration, mutual consultation and support on professional practice issues, and for reflection on what constitutes best practice in working with performers, as well as to share specialist expertise, guidance and information according to a professional framework of rigorous evidence-based practice and practice-based evidence in the field.

The next meeting is scheduled to take place on December 9th, and thereafter every two months on Saturdays from 12 to 1:30 pm at the London Natural Health Centre, 46 Theobalds Road, NW1 8NW.

Practitioners interested in finding out more or joining the group are invited to contact Dr Jane Oakland by email: jane.oakland@btinternet.com

Research: The Wellbeing of Musicians Across the Lifespan

Thursday, October 5th, 2017

Musicians sometimes spend a lot of time looking at what is wrong, which can give more energy to challenges and create a downward spiral. Positive psychology is influenced by the idea that in spending more time focusing on what’s right, we allow ourselves to consider what it looks like to do well, which can in turn lead to a more positive physical/mental/emotional outworking.

Marie El-Khazen is a researcher inviting musicians aged 60+ to take part in interviews which will help develop knowledge and understanding of musicians’ perception of wellbeing as a performer, throughout a lifelong professional career.

If you’d like to help with this study you need to be aged 60+, having earned the majority of your full time income from employment as a performing musician. Interviews lasting 60 – 90 minutes will be conducted face to face, or via Skype, and will be recorded (on a dictaphone). Participants will remain anonymous. To take part or to find out more, please contact Marie directly by emailing U1620023@uel.ac.uk. You can also find here a detailed participant invitation letter.

This research has been approved by the School of Psychology Research Ethics Committee, and follows the standard of research ethics set by the British Psychological Society.