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The following are discussions I've had regarding playing with pain in the
last couple of months.
Tim Janof
Anyway, I'm a highschool student that has been playing the cello for about 11
years, and have had different arm/hand pains, but recently, my right hand has
been bothering me very very much.  I play with a straight thumb and I've
tried changing it, but it hasn't changed.  Also, I notice that my hand creeps
up a lot on the bow. Anyway, my hand hurts immensely at the base of the thumb
and on the top and bottom of my wrist.  Another thing that happens is that
when my hand starts to hurt, it follows with the thumb slipping through and I
lose all control.  This used to only happen when I would play Bach Suites,
particularly the Preludes.  Recently, it hampered my playing a lot at a
competition and performance of the Dvorak Concerto.  I'm worried now, because
it happens really badly when I'm playing the Shostokovich and by the second to last page,
my hand feels ready to fall off.  I have too play the piece soon and in a recent
rehearsal, I couldn't finish a run through because it hurt to much.  I would
appreciate any help!  S. K.
Of course, It is difficult if not impossible to diagnose Sarah Koo's
problem completely, sight unseen. However, it is obvious that she plays in
a way that generates a great deal of tension. I believe that the first step
in solving her problem is to evaluate the way she uses her body when she
plays. She needs to learn more about her body's natural impulses, so that
she can adapt her technique to these impulses, rather than forcing her body
into unhealthy patterns.
Most pain is related to poor body balance. Faulty alignment, immobility and
pressing are the main causes of such imbalance. Body imbalances create
muscle tension which can accumulate layer upon layer, leading to the kind
of pain and loss of control that Sarah Koo is experiencing. Clearly, she
clutches and presses her bow, but I would guess that this is just the tip
of the iceberg. If your body is out of balance and/or any part of your body
holds tension, you tend to clutch and press.
One of the most fundamental causes of tension and pain among cellists, is
faulty sitting. (This is why cellists have the  highest incidence of back
problems of any group of musicians.) Many pain problems that appear in the
hand, arm, shoulder, etc. are not initiated at the site of the pain, but
are the result of a chain-reaction related to the way cellists sit and hold
their instruments. A solid, mobile and balanced base of support is
essential to healthy and efficient playing. For further information on
seating problems of musicians, see http://home.earthlink.net/~vsazer/seating.html.
Anyone can Increase awareness of their body's natural impulses. It is not a
difficult task. If you are alive and can breathe an feel, you have all of
the equipment you need. The next step is to ask your body a few questions.
Your body will give you the right answers if you ask the right questions. I
suggest checking out "New Directions in Cello Playing" for examples of some
right questions. Your body's answers will provide the tools which will
enable you to identify the sources of your tension. I have worked with many
musicians who were able to overcome problems similar to Sarah's with this
approach. Naturally, it would be helpful if Sarah could find a teacher who
could guide her though this process.
Best regards,
Victor Sazer
With all due respect to Victor Sazer, who has many good things to say, I
would STRONGLY urge Sarah to get to the nearest music medicine clinic for
evaluation and a treatment program tailored specifically for her.  Time is of
the essence here, since the tissue damage can become irreversible in time,
and this had been going on a LONG time.
Jack Winberg, M.D.
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