Professional Resources
Empowering Musicians:
Teaching, Performing, Living
Music In A Sound Body
A n alarming two-thirds of pro-
fessional musicians deal with
playing-related problems, and half
of musicians still in training (pre-pro-
fessionals) experience symptoms of
pain and other physical discomfort
related to playing. Established and
active musician health organiza-
tions—such as the Performing Arts
Medicine Association and the German
Association for Music Physiology
and Music Medicine (Deutsche
Gesellschaft für Musikphysiologie und
Musikermedizin)—suggest that the
ideal long-term solution to decreas-
ing rates of pain and injury is getting
music teachers involved and informed.1
For this reason, such organizations
embraced the promotion of a wide
variety of events providing informa-
tive speeches, courses and workshops
targeting music teachers. As music
teachers realized the relevance of the
topic, more and more music organiza-
Carina Joly
appears regularly
as a master class
artist, clinician,
guest speaker and
postural consultant
in international
conferences and
music educational institutions. She
currently develops neuropsychology
specialization studies and is
president-elect of the Musicians’
Health and Wellness Special Interest
Group at ISME.
AMERICAN MUSIC TEACHER 53
tions such as Music Teachers National
Association, College Music Society
and the International Society of Music
Education, have created committees
with the mission of providing music
educators with up-to-date information
on the prevention of playing-related
injuries and musicians’ health.2
As a professional who has been
actively involved with the promotion of
musicians’ health, it has been reward-
ing to observe the significant growth
of interest on the topic among music
teachers. After a lifelong passion for
the topic and the development of
specialization studies in the subject of
music physiology in Zurich, I started
to offer workshops on pedagogical
principles for the improvement of phys-
ical health among musicians. These
workshops provided a global view on
the most common health issues and
suggested strategies to improve the
overall posture through selected physi-
cal exercises especially tailored to musi-
cians.3 After more than 50 workshops
offered in a variety of music education
institutions and orchestras throughout
the Americas and Europe, I am pleased
to report that the topic raises interest
not only among individuals who are
familiar with pain and discomfort relat-
ed to their musical activities, but also
among individuals who have never per-
sonally experienced such physical issues.
Curiously enough, both very distinct
groups share the same fascination for
the results of physiologically oriented
training.
By Carina Joly
I recommend that the instructor
should experience how an activity
affects his/her own performance
before suggesting any physical activity
or exercise to a student. The self-ex-
posure to experiments with body
stabilization, postural alignment and
higher awareness can be an effective
first step toward establishing a solid
pedagogical foundation. The process
involves immersion into the analysis
of our own postural habits and may
or may not require some helpful input
from a health practitioner or an expert
on a preferred body therapy. The
Internet can be an endless source of
material on body stabilization and core
muscles development. Visiting various
body therapy courses is essential not
only to find a favorite fit, but also to
become aware of the variety of possi-
bilities to suggest to students.
A crucial part of the process is to
document posture and sound produc-
tion changes for further comparison.
The only way to fully analyze the
conditions in which we start and to
follow through with the developments
in our body and playing will be by
watching videos, looking into photos
and listening to recordings. The use of
cameras and audio recorders is essen-
tial because our brain will be too busy
trying to hold a new posture and this
overly attentive mental condition may
hinder our listening abilities. This will
not be different for our students, who
may be able to recognize changes only
after observing the images and analyz-
ing the recorded sound.
 After working with a variety of
musicians, I can certify the invaluable
advice from my music physiology
mentor, the Swiss physical therapist
Johanna Gutzwiller: “If you do not
know where to start, start from the
bottom.” To start from the bottom
means to bring the attention toward
how the connection between feet
and whole body is established. For
musicians who perform in standing
position, the quality of the contact
with the ground is essential. Exercises
that improve the awareness of the
foot-ground contact and that stimulate
the muscles responsible for the stabi-
lization of the standing position may
include standing on a balance plate,
standing on one foot while moving the
hanging leg toward various directions,
or trying the yoga pose known as the
Tree Pose (Vrksasana). My recommen-
dation is to practice standing exercises
while barefoot.
The pelvis directly affects the over-
all spinal alignment in both standing
and seating positions. Certain postural
patterns may be modified by the pel-
vic mobilization through exercises and
regular stretches. The iliopsoas muscle
group is involved in the stabilization of
the pelvis, and, when shortened, it may
limit the possibilities of holding a neu-
tral pelvic position while either standing
or seating.4 Stretching the iliopsoas
muscle group on a regular basis is the
first requirement to set our pelvis ready
for new postural possibilities.
For musicians who spend most of
the time seated, all sorts of pelvic
mobilization are welcome, if they do
not cause any discomfort or unusual
pain.5 One example of a highly effec-
tive pelvic mobilization involves imag-
ining that, while seated, our sitting
bones (ischial tuberosities) work as our
feet walking back and forth over the
54 FEBRUARY/MARCH 2018
whole seat surface. For higher ampli- hand exercise (Figures 1a and 1b) must
tude of the pelvic movement, each be done on a hard surface, where the
step should emphasize clear lifting of elbow and wrist should fully touch the
the sit bone away from the ground (as surface in perfect alignment (Figures
opposed to sliding). Another import- 2a, 2b and 2c). The pressure of the
ant exercise for the strengthening of fingers pulling against the surface
the pelvic floor muscles involves the should bring up the third knuckles
following procedure: while seated (metacarpophalangeal joints known as
almost at the edge of a stable chair the bridge of the hand) of all fingers
with hands over knees and both feet except for the thumb, while the wrist
flat on the ground, one foot will fully should remain in touch with the sur-
leave the ground to reach an imagi- face. To recruit the desired muscles,
nary slightly higher pedal (similar to the first and second knuckles must be
when playing the piano) and then extended, while only the third knuckle,
will return to the initial position. The responsible for the bridge, is flexed.
other foot follows the same movement I recommended up to 10 repetitions
sequence. While both feet alternate daily, holding the bridge for 3 to 10
the pedal reaching movement, special seconds and then relaxing, depending
attention should be directed to the on the hand strength. As this exercise
pelvis stabilization: any sideways wob- may cause fatigue, do a few repeti-
bling movement in the pelvis must be tions during the warm up, which will
avoided. The pelvic floor is strength- set the hand up for a balanced start.
ened as the pelvis seeks to stabilize The remaining repetitions should be
its position during this exercise. The done at the end of the practice ses-
muscles recruited are responsible for sion.7
the active support needed during long
hours of practicing or teaching in seat-
ed position. Once the pelvic muscles
have acquired a minimum of mobility
and strength, and it feels more natural
to hold the pelvis in a neutral position
(as opposed to flexed or extended),
it will be possible to experience their
direct influence in the upper body’s
overall alignment. A neutrally aligned
pelvis may minimize postural imbalanc- Figure 1a
es in the neck and shoulders while the
strengthening of pelvic muscles may
improve the breathing quality.6
A final example of an exercise that
is fundamental to musicians who use
finger action to produce sound has
the focus on the intrinsic muscles of
the hand (interossei and lumbricals).
The goal now is the balance of the
hand, which can be achieved by the
Figure 1b
strengthening of these muscles. The

Figure 2a: Incorrect alignment.
Figure 2b: Incorrect alignment.
Figure 2c: Correct alignment.
The adventure starts the moment
these exercises become a familiar
part of the practice routine and their
principles can be incorporated directly
into playing. In standing position, a
trombonist may experiment playing
with and without higher awareness of
the foot-ground contact. A pianist may
try to perform with and without the
active pelvic support learned from the
alternating feet exercise. The audio-vi-
sual analysis of these experiments may
bring the unexpected: this practice will
AMERICAN MUSIC TEACHER 55
not only promote a healthier approach
toward performance, but will also
bring further possibilities of sound pro-
duction and control. As a study real-
ized in Switzerland reported, besides
the health benefits, a new generation
of young musicians who were exposed
to physiologically oriented training
have confirmed improvement in areas
such as posture, breathing, freedom
of motion while performing, and con-
fidence on stage.8 Not only can phys-
iological training result in a healthier
approach to making music, but it can
also improve the quality of musical
performance. It is a win-win situation.
Notes
1. Claudia Spahn, Horst Hildebrandt
and Karin Seidenglanz, “Effectiveness
of a Prophylactic Course to Prevent
Playing-related Health Problems of
Music Students,” Medical Problems of
Performing Artists, 16/1 (2001): 24.
2. See the Musicians’ Health and
Wellness Special Interest Group (ISME),
the College of Music Society Webinars
and the MTNA Wellness Resources.
3. These exercises where taken
from various courses offered during
my specialization in music physiol-
ogy at the Zurich University of the
Arts (ZHdK https://www.zhdk.ch/
musikphysiologie). The required
courses were taught by Dr. Horst
Hildebrandt (a physician and violinist
specialized in Dispokinesis), the two
physical therapists Johanna Gutzwiller
and Irene Spirgi-Gantert (specialized
on the work with musicians), and
Marina Sommacal, a specialist in
Spiraldynamik; while elective course
offers included Alexander Technique,
Feldenkrais, Yoga, Tai Chi, Chi Gong,
among others.
4. The Internet is full of suggestions
for iliopsoas stretches. Some exercises
can be found in the following source:
https://uhs.princeton.edu/health-re-
sources/athletic-injuries. See especially
“Lumbar/Core Strength and Stability”
in this page. Also see Erik Andersson
et al., “The role of the psoas and ilia-
cus muscles for stability and movement
of the lumbar spine, pelvis and hip.”
Scandinavian Journal of Medicine and
Science in Sports 5 (1995): 10–16.
5. If any unbearable pain or dis-
comfort is detected while mobilizing
your body, it is important to consult a
health specialist to thoroughly investi-
gate the causes of the pain.
6. For recommended neck exercises,
see https://www.summitmedicalgroup
.com /library/adult_health/sma
_neck_strain_exercises/. For more on
breathing and the relation between
the diaphragm and the pelvic floor,
see Hankyu Park and Dongwook Han,
“The effect of the correlation between
the contraction of the pelvic floor mus-
cles and diaphragmatic motion during
breathing.” Journal of Physical Therapy
Science 27/7 (Jul 2015): 2113–2115.
7. This exercise is part of a series of
hand exercises suggested in Susanne
Klein-Vogelbach, Albrecht Lahme, and
Irene Spirgi-Gantert. Interpretación
Musical y Postura Corporal (Madrid:
Ediciones Akal S.A., 2010).
8. Claudia Spahn, Horst Hildebrandt
and Karin Seidenglanz, “Effectiveness
of a Prophylactic Course to Prevent
Playing-related Health Problems of
Music Students,” Medical Problems of
Performing Artists, 16/1 (2001): 30.
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