Giving pain a name?

Often, a pianist walks into my studio with a complicated diagnosis, and proceeds to give me a thorough rundown as to exactly which muscles and / or tendons are irritated. Meanwhile, I am observing how they use their hands and arms as they speak, already making mental notes as to the underlying problems before they go anywhere near the instrument. Although the knowledge of anatomy is impressive, there are a number of problems here. 

Firstly, giving pain a name doesn’t solve the problem, nor identify what the person has to do to get rid of the pain. I often think of the story of Frederick Alexander (founder of the Alexander Technique) who angrily walked out of a meeting with anatomists with whom he’d been hoping to find common ground. The reason? They could name every single part of their body, but their use was absolutely terrible. He thought it was a waste of time to even talk to these “experts”. 

Secondly, a diagnosis itself can create even more stress. What was previously “just a pain”, is now a “condition” with a terrifying name. In the most difficult case I have  encountered, a musician who had dystonia,  I tried to avoid discussion of the diagnosis and the grim implications as much as possible at the beginning. In a sense, it didn’t matter or not whether it was officially dystonia, the hand was dysfunctional.  We just started work, making gradual improvements, and slowly establishing a comprehensive understanding of  “this incoordinate movement causes this result”, while incorporating healthy replacement movement. It was only when he was doing so much better that I felt I could be frank about what a bad place his hand had reached. There was simply no benefit in compounding an already demanding situation with (more) anxiety, fear, and  depression. Mrs. Taubman believed that one learns best when one is happy and relaxed, and she was absolutely right. A student who is teary, anxious and depressed cannot concentrate fully to the necessary information on board which will not only transform his experience of playing, but also his depressive state.

It never fails to impress me that healthy movement is that it actually eases pain, and helps heal the injury. While I have come to expect it, it is still such a buzz to see the shock on a student’s face as they realise that THROUGH playing, not resting, they can make changes to even significant levels of pain.  Sometimes there are just a few issues in a mostly healthy technique which are easily fixed. In other cases there are layers upon layers of habits and incoordinate movement, which is why training for Taubman teachers is so rigorous.

I would like to see less focus on naming pain conditions, and greater education amongst musicians and medical professionals regarding how to avoid getting into these situations in the first place. 

diaforlonfol

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