JAVS Fall 2023

difference between a stretch and pain. Stretch is good; pain is not good. Many people have a “no pain no gain” mentality, which has been falsely implanted in us by popular culture, instructors, or any one of a number of hopefully well-meaning people who were just wrong . Pain is telling you that something is wrong and needs to be addressed or fixed. Listen to it and make the necessary adjustments. When discussing the viola from a playing and technique perspective, it is impossible to separate it from its ubiquitous cousin, the violin, with which it shares many similarities but also very distinct differences. These distinctions must be considered when approaching the viola from a playing perspective and therefore from an injury prevention standpoint. Generally speaking, string instrumentalists are most susceptible to musculoskeletal problems, such as tendonitis. Tendonitis is the most common repetitive stress injury—which refers to inflammation of a tendon—which connects muscle to bone, and which can lead to pain and discomfort in the area concerned, for our purposes commonly in the shoulder, wrist, elbow, and forearm. This is not so hard to understand, given the tasks required to play the instrument, performing repetitive motions requiring precision and dexterity at high rates of speed. This is increased by the additional physicality required to play the viola due to its size which can affect one’s ability to easily navigate the instrument. To see where we can go wrong—or right—from an injury prevention perspective, we need to start at the beginning, which starts with selecting an instrument that fits properly size-wise. Many injury patterns start with a child or a beginner who is fit with an instrument that is too large, causing shoulder pain and/or problems that will become habitual as they grow, maintaining an instrument they have outgrown with similar bad results. Speaking specifically about the viola, the size and weight of the instrument alone makes it harder to play than the violin, and more difficult to achieve one’s desired tone. This means the player must work harder, often producing extra and unnecessary tension in the body.

Players need to be careful to avoid overly flexing either wrist, and when forced to do so for the sake of technique or in service to the music, must remember to go back to as neutral a position as possible whenever possible. For example: when holding the bow, some players drop the elbow which requires the wrist to flex, or bend, too far, which can cause problems if this becomes a habit. For those with shorter fingers and hands, placing the pinky or little finger on the fingerboard before the other fingers, such as the index finger which is commonly placed first, will lessen strain on the hand and allow the rest of the fingers to lie in a more natural feeling position. With the viola, one should be careful to avoid excessively raising or lowering the elbow. Raising the elbow too high will cause the shoulder to rise, producing shoulder and upper back tightness; while dropping the elbow too far can cause excess flexion in the wrist as previously addressed. When faced with an injury, as earlier stated many times, it will be a repetitive motion-type injury. When this occurs, it is best to address it as quickly as possible; it will be easier to manage the earlier it is diagnosed and treated. If imaging is required for the diagnosis, your provider will order it, and if the problem requires treatment, many times acupuncture, chiropractic, or physical therapy—my areas of expertise— can help to relax musculature, reduce any inflammation, and restore proper motion. Always tell your provider or therapist if something is painful, whether the therapy is assisted or directed, as this will help them to make sure the treatment is progressing properly. This goes for any treatment by any provider. Additionally, if the therapy consists of strengthening, consider that if a problem is not resolved or is still painful or limiting in some way, strengthening can, rather than help one to avoid pain, reinforce the problem that is still there, so this should be discussed with the therapist to avoid prolonged injury. When going to see a provider or therapist for the first time, let them know ahead of time you will be bringing your instrument with you, so they can see what you do and how you do it, which can help with finding the source of the issue and inform on what to do about it.

56

Journal of the American Viola Society / Vol. 39, No. 2, Fall 2023