Posts Tagged ‘Teaching’

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.

Injury Prevention at The Purcell School for Young Musicians

Thursday, June 8th, 2017

The Purcell School’s Specialist Physiotherapist, Sarah Upjohn, has had her pioneering work incorporated in the school’s new Playing-Related Musculoskeletal Injury Prevention Policy. While working at the school (and helping performers here at BAPAM), Sarah’s Doctoral work at the University of Cambridge has focused on preventing playing-related injuries in young musicians. Most of these problems, which musicians starting university and entering the profession frequently already suffer from, are preventable. The Purcell School’s strategy to identify risk factors and improve injury prevention awareness among pupils, staff, parents and all involved with the school, is exemplary in preparing young musicians for healthy and succesful careers.

Find out more and read the policy here.

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.

Foundations for Excellence Conference 2015

Thursday, September 17th, 2015

Meeting the Challenges of Excellence in Music and Dance

Mon 2 Nov, 10.00h-19.30h

Trinity Laban Conservatoire of Music and Dance

£75 including lunch / Limited student offer £30

Foundations for Excellence nurtures and supports talented young dancers, singers and musicians by sharing research, resources and best practice. Their next biennial conference aims to challenge existing pedagogical practices and propose innovative methods of nurturing excellence among young dancers and musicians.

Presentations, provocations, lectures and breakout sessions on Models of Teaching in Music and Dance, Formalising the Informal, Stress and Anxiety, and Self-Awareness are to be followed in the evening by dance and music performances and a reception.

Professor Roger Kneebone will make the Keynote address (attendees at BAPAM’s October 2014 Training Day will remember his fascinating presentation on simulation and education). Other speakers include Dr Terry Clark, Dario Cortese, Antony Dowson, Prof Jane Ginsborg, Dr Naomi Lefebvre Sell, Naomi Norton (BAPAM Student Advocate Scheme Manager), Dr Emma Redding, DJ Renegade, Penny Stirling, Paul Wilson and Dr Charlotte Woodcock.

Spaces are limited and advance booking is essential. The booking deadline is Fri 23 Oct 2015. For more information including programme details and contacts, click here.

BOOKING NOW OPEN via the Trinity Laban eshop