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Playing Flute with Scoliosis?

In Corrective Exercise, Fitness, Flute, Pedagogy and Teaching by musicstrongLeave a Comment

A little while back, I received this email from a teacher concerned for her student with scoliosis:

“I have a student that has scoliosis. She has been told by her doctor that she is going to have to stop playing flute due to the severity. I know that if she is sitting correctly, and using complete correct posture this really shouldn’t be a problem. I need expert advice from a professional to make sure she is doing all that she can in terms of posture to keep her playing. She loves playing is upset about the report from the doctor. What advice or strategies do you have?”

As chair of the Performance Health Committee for the National Flute Association, I sent this query out to my committee members and the advisory panel. Our advisory panel is made up of licensed medical professionals and the committee is made up of flutists with an interst and/or specialized background in health/wellness/fitness. These are their answers and hope they give some insight for those who may wonder about this question.

Disclaimer: this is not medical advice or a prescription, merely optionion and speculation based on the fact that none of those polled have actually seen, treated, tested, etc. the child in question. We are going on the limited knowledge we have at face value and this is not in any way to disregard the treating clinician.

Dr. Steve Mitchell, ENT

I am confused why this child’s doctor feels she has to stop flute playing. Granted deep breathing and tidal volume would likely be less than her peers, but so what? Just add more breath marks. Quite frankly, anything that helps the child with deep breathing exercises is usually encouraged. A flute is much more fun than a respiratory blow bottle.

Dr. Michael Treister, MD: during my orthopaedic career I treated lots of people with scoliosis. I cannot specifically relate scoliosis directly to flute playing in terms of specific recommendations. Pulmonary function is probably the main overall issue: breath capacity is often reduced in individuals with scoliosis. Taking additional breaths in the right place is appropriate in this case. Additionally, if standing causes back pain, you just have to perform sitting. As long as their upper extremity function is not affected they should be able to play the flute just fine.

My suggestions: avoid marching band (perhaps) and if there is back pain, perform sitting. If anything, flute playing should be therapeutic and not harmful in scoliotic patients as I see it. If there are therapeutic recommendations they should come from an orthopaedic expert who primarily treats children with scoliosis. Scoliosis is not a contra-indication to playing the flute.

Dr. Michael Weinstein, MD

Here is a link to the Mayo Clinic’s page on scoliosis:
https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716

I agree with the other MDs that it is a curiosity that this person was told not to play flute.
A variety of interventions, from breathing technique modification, to improved seating, use of a flute stand, etc…Could be useful.

Dr. Chip Shelton, DDS: The treating doctor would likely endorse a practice regimen consisting of 60% end blown flute and 40% transverse flute, ergonomically-postured as suggested. I presented at NFA Orlando on end-blown flutes (article on NFA committee page).  Ergonomically re-designed flutes seem to all have significant learning curves, particularly the one I write about in my synopsis. However the limitations are surmountable and well worth the resultant benefits. Here is a link to an audio example:

Susan Mayer and Kristen Gygi

In addition to the MD comments, there is support for people with scoliosis in yoga therapy, massage therapy, personal training and Alexander Technique. 

Lisa Garner-Santa

My guess would be that scoliosis, which already creates some imbalance due to misalignment, could exacerbate the assymetry required to play the flute for extended periods of time. I agree with Michael that it would be impossible to give a “one size fits all” prescription since each individual’s case of scoliosis would be unique.

As a yoga teacher I’ve had numerous clients who come to yoga as a part of their therapuetic plan to alleviate pain due to scoliosis.  I’m guessing that flute student might benefit from something similar? In all honesty, some of my best yoga students are the ones with scoliosis.

I’m sure there are also strength training activities that might support a diagnosis of scoliosis.

Angela McCuiston, NASM-CPT, CES

My first thought, having trained several people with scoliosis, is that while strength training cannot fix the problem, we can at least strengthen the muscles in the opposite direction of the rotations while incorporating more overall core strength, as well as bilaterally and unilaterally.   I wonder if 1) the student is in marching band, which, we know, can contribute to poor posture choices due to the straight nature of the instrument, rotational compensations must be made and if in the opposite direction of her scoliosis could contribute to pain or if in the same direction as her scoliosis could make the problem worse or 2) the student rotates her upper body due to being cramped in the section, or just naturally over rotates causing the above concerns?

In either case, body awareness of posture would go a long way in addition to strength training and the all the other suggestions made.


In summary, the overwhelming response is confusion as to why this doctor would tell the child to stop playing. A suspicion is that this doctor has no idea about playing a musical instrument and is giving a standard “stop playing” answer. This is all said without knowing any particulars about the student or her situation, which leaves out a lot.  But overall, we see no reason scoliosis should hinder her from playing.

Summary  

  • If playing is affected by not being able to breathe well, add more breath marks, but continuing to play should actually help this problem.
  • Playing the flute is actually beneficial to increasing volume of breath and tidal volume
  • if due to postural distortion, is it because of unreasonable demands in marching band, natural over rotation in her posture, cramping in the flute section, etc? If so, those are easy modifications to be made.
  • If it is more of a postural distortion problem, body awareness techniques, Alexander Technique, yoga and strength training in the opposite direction of the rotation, improving overall core strength, etc. could be VERY beneficial. 

Have you had experience with this? We would love to hear your thoughts and experiences! You can find the official page for the PHC Here and the unofficial Facebook page here. Love to hear if you have more questions!

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Workshop At Belmont University School of Music

In Entrepreneurship, Pedagogy and Teaching, Travel, Workshops by musicstrongLeave a Comment

Recently, we were delighted to be asked to present at the Belmont University School of Music on our workshop of injury prevention for musicians. We have workshops in 1-2-3 hour increments. This was the two hour workshop and the students came excited and eager, enthusiastic and engaged and not only did we have a lot of fun, we learned a lot.

Currently I’m in Phoenix at the NASM OPTIMA conference: a 3 day advanced continuing education conference for fitness professionals. I’ll be learning everything from the latest in neck rehab to helping those with joint replacements, to low impact high intensity cardio! It’s a HUGE recharge to my fitness career batteries, as it reminds me how much I love to help people, musicians especially, and being around so many passionate, like minded, humble and SMART trainers and professionals is just the thing I need to keep me going. We’re a small but dedicated bunch and I’m glad to see it growing!

Immediately after this, I’m headed to Durango, Colorado to be the artist in residence at Ft. Lewis College! I’ll be giving my 3 hour workshop on Becoming Music Strong, a flute masterclass and a flute recital. All my workshops help meet the National Association of Schools of Music requirement for accredidation, and I am taking requests for 2020, so drop me a line! Here are some pictures from Belmont, hope you enjoy!

setting up the PowerPoint

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Welcome New Brand Ambassadors!

In Entrepreneurship, Motivation and Success, Resources, Special Thanks, Travel by musicstrongLeave a Comment

Are you sold out on what we do? That musicians can be strong and that strength training is actually a good thing for musicians? Do you believe in our mission to empower musicians with knowledge about how to take care of themselves so they can live their longest, healthiest, pain-free lives and careers? Do you want swag? Do you want to travel? Are you good at social media, conversing with others or just have a big mouth or a platform? 🙂

Well, WE WANT YOU.

We have been putting out the word on social media and we’re proud to welcome these new brand ambassadors to Music Strong! Please give them a like and a follow and if you’re interested in being a brand ambassador for us we’d love to hear from you!

Welcome New Brand Ambassadors!

David Cartolano – “The Conditioned Musician” “I’m a musician, personal trainer, exercise physiologist, and student doctor of physical therapy. I truly believe in the power of exercise to help not only shape someone’s body, but their mindset and their ability to cope with challenges in life. Better muscles, better mindset, better music is my slogan.” You can catch him on Insta at @theconditionedmusician and definitely check out his podcasts for the latest musicians crushing it on the fitness scene.

Valerie Speights – violist with an incredible bounce back story: “Having recovered from being over 70% disabled due to playing-induced chronic pain, I’m passionate about injury prevention, conditioning, and passing on what I’ve learned to others. ” Instagram: @whatisvaleridoing

David Margulis – Opera singer and Crossfit athlete/coach with a passion for heavy lifts and high notes. Instagram: @dmtenor25 Really…..does any more need to be said?????

You can submit your application here: Become a Brand Ambassador for Music Strong.

What do Brand Ambassadors do?

  • Promote Music Strong any way they can! Through Social Media, hashtags, picutres, videos, blog posts, word of mouth, advocation in schools, being a go-between, sharing YOUR story, etc.
  • Tag us in everything! Let’s see you wearing your swag (we send it to you!) talking it up, in short, what it means to you and how it helped you and others!
  • Join us at events, trade shows, etc. We are in need of excited, passionate people who believe in what we do to join us at various trade shows conferences, etc. We have one coming up in Nashville on Oct 24, so if you’re local, reach out! And for sure one in Dallas, TX in August 2020, so holla at us!

Wondering what you get? Well, it’s not all work and no reward! See the initial benefits below!

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Corpsonore

In Uncategorized by musicstrongLeave a Comment

In the last 6 months or so, the musician’s wellness movement has seemed to explode! Whether these people have always been there or things are just now starting to catch fire I don’t know, but I can tell you I am super happy to see this FINALLY happening. When I first got injured….nay, all three times I was injured, performance injuries were not talked about and you were expected to figure out how to take care of your body in silence lest you be perceived as an inferior musician. Admit you hurt and your injury was viewed as negligence, a mistake, practically a mark on your character and with the classical music world as incredibly cut throat as it is – someone who DIDN’T have any injuries or problems (or didn’t talk about them) was more than willing to take your place.

That being said – there was little to no guidance given in the realm of physical preparation, conditioning, etc. when it comes to the musician. Somehow, you’re just supposed to know how to stay healthy, and if you get injured, well, you shouldn’t have done that – why didn’t you stick to “running” or “yoga” since those are “safe” for musicians.

WHAT??? No…
WTF…..

In what other profession is this the norm? Expected to hone your craft, on a physical level, to an elite status, hours a day, decades at a time WITH NO GUIDANCE and if you mess up you’re NOT GOOD AT WHAT YOU DO?????

Does that mentality make anyone else want to pull their hair out???

Thankfully, enough of us realized the sheer lunacy of this mentality and are taking our careers and our health back, determined to be a resource.

Meet Corpsonore: Madeline Stewart and Hannah Murray, two musicians who decided to branch out from their classical roots and pair up to bring helpful healthy resources to the musical community. You can read their bios here.

They found me on Instagram and asked if I would like to not only write a guest article for them, but to be on their podcast? Of course I said yes! The article is out but the podcast might be a bit since Madeline is about to have a baby!

You can read my article here where I talk about Debunking Weightlifting Myths for the Musician (ANOTHER soap box) , but I urge you to take a look around their website and see what all the offer. A quick run-down of new musician resources follows, but posts on each are forthcoming.

Big things are in the works here at Music Strong, and your support including so many people seeking me out just confirms: This is NEEDED. Stay tuned for more good things!

Recent podcasts: their info on the left, link to our podcast on the right
The Rock Doctor : Lifting Up the Music World with Music Strong
The Conditioned Musician : The Musician’s Trainer
The Fit Musician: Podcast interview out around Oct. 6 – subscribe/download here

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Debunking Weightlifting Myths

In Fitness by musicstrongLeave a Comment

I remember back when I was in school for music, going to the gym to lift wasn’t a very popular thing and to be honest, sometimes it was even discouraged.  I frequently was cautioned against lifting because I could hurt myself, “what if you crush a finger?” was something I heard on the regular.  Most musicians I knew just ran if they did any exercise at all or maybe an aerobics class because those were “safer options”.  Well, there’s risk with everything, including those two activities. You can get an overuse injury from muscle imbalances that arise with only running, or not having enough core strength or even improper running form, never mind twisting an ankle, or falling.  Aerobics? Well, you could always twist and ankle, fall off a step, or what if you aren’t aerobically prepared for the intensity of the class?  I think being in a car carries much more risk and we don’t think anything about it. 

Thankfully we’re coming out of the dark ages and musician’s fitness is becoming more and more common place, but lifting programs geared directly towards musicians are still a rarity and going to lift without a plan is a dangerous place to be.  Group fitness like CrossFit and Orange Theory provide structure, but are they always appropriate?  A structured training plan that can correct muscle imbalances brought on by playing your instrument as well as increase muscular endurance can actually be hugely beneficial.  Still concerned? Let me address some common concerns and misconceptions that will give you more confidence to get your lift on.

If I train with weights I’ll get “bulky”. If I add too much mass in shoulder/chest area it will get in the way of being able to play


When it comes to strength training: lifting heavy does not automatically equal size.  If you want to train for size, you have to work within a certain overload principle: training at higher and higher volume, consistently over time.  There are different muscle fibers and these need to be trained in specific ways to get specific results.  Truth: Building strength in weak muscles can prevent injury and building overall strength can give you better balance, overall strength and endurance. It does not automatically mean you’ll get jacked or be the most swole person in the music building.

As for mass in the shoulder/chest area, that can be a valid concern, especially with some instruments (though I have several musician friends that are classically trained and perform on a regular basis in the studio and with orchestras that are powerlifters – if you’ve seen these people, they can be huge – and they train to be that way on purpose, but it can also be a by-product of the type of lifting they’re doing. That being said, ask them, and they’ll tell you in no way does the size of their chests/shoulders hinder their playing.  Caveat – these are brass players, string players for sure have a different viable concern here, however you can still train for strength and even for size (if you want) without going for mass that will impede your playing.  You just have to train within those certain parameters to get the results you want, AND you have to be consistent. Just like practicing, if you don’t practice consistently, you won’t become the great musician you want to be, same thing in the gym: if you don’t train with consistency and intent, you won’t get any specific results.  To get huge, you have to train specifically for it.

But let’s talk about Olympic lifting and CrossFit for a minute. Olympic lifting refers to a series of whole-body movements involving a barbell: clean and jerk, snatch, deadlift, etc.  CrossFit does a lot of those.  Difference? Intent. CrossFit focuses on volume, people who usually do Olympic lifts, either as part of a regularly scheduled strength training program, or as a power lifter, do so at lower repetitions. I can talk all day about training variations, and you don’t want me to go down that rabbit hole, so just let me stress again: a certain modality, be it Oly lifting, strength training, just doing some deadlifts or bench presses, etc. does not inherently equal size/mass. They are tools to be utilized within a program that fits YOUR needs. They can be utilized for size building (hypertrophy/bodybuilding/powerlifting) or strength/fat loss ((not synonymously related btw) (CrossFit, within a traditional strength training program, etc.).  The key is 1) how you train 2) What your training goals are and the big one 3) consistency.  You can train for anything but without consistency you won’t get there. Whether you want to be a world class runner, a bodybuilder or just be able to play your instrument without pain for decades, you HAVE to have consistency in your training.  To that end, remember, when it comes to your body and how you use it, there is no maintenance: you are either going forward or backwards, you’re never still. Are you getting better every day or slowly declining? Are you building strength and endurance or on a path towards an overuse injury?


Sorry, rabbit hole folks. There’s a LOT that goes into programming a proper strength training workout depending on your goals and the other half of that depends on you and what you do with it.  Suffice it to say, just because you pick up something heavy, even on a regular basis, doesn’t mean you’re going to get swole and huge.

If I focus on my grip strength, I’ll lose dexterity in my fingers


There are two types of muscle fibers in the body: fast twitch and slow twitch.  They work together but if you train one more frequently you won’t automatically lose strength, mobility, dexterity, etc.  in the other.  Additionally, focusing on one doesn’t automatically cancel out the other.  If you’re continually practicing, you’re reinforcing those fine motor skills. When you work on grip strength, you actually could be reinforcing joint health/strength, especially elbow/shoulder areas which are HUGE areas of concern for musicians.  The key is to do both and if you’re really concerned about it, use lifting hooks.

If I pick up heavy things in the weight room, I might develop calluses that can interfere with my playing

That seems like a valid concern, especially for string players.  Some calluses come in handy (ever seen the end of a harpists fingers?) but think about how you hold your instrument – you usually don’t grip it.  Most instruments are held with the fingers with the palm of the hand not coming into direct contact with the instrument. The calluses you may develop would be at the base of the fingers/top of palm, they form from the friction of where you grip the weight/implement, and not at the end of your fingers.  However, if you’re still concerned, you can always wear weightlifting gloves – I have many clients who wear them specifically because they don’t want to develop calluses or because they want to protect their hands.

Lifting weights is dangerous, what if I crush my fingers or drop a weight on my toe?

There is danger in every situation – driving a car, chopping vegetables and mowing the lawn are all dangerous skills but because you have practiced them you become more comfortable. The real danger lies in two aspects:

  1. Not knowing correct weight lifting form
  2. Becoming too complacent


This can really be applied to any are in life – anything that is unfamiliar is scary, and of course when it comes to your body, your FIRST instrument, you want to take care of it more than most. The chances of you having the above accidents are way higher if you’re 1) not sure what you’re doing 2) are too caught up in how you look in the mirror and to those around you to focus on good form or your surroundings (watch out for those errant dumbbells folks! I just plowed my foot last week into a 25 pounder that should have been racked….trainers are guilty of leaving their toys around too #rackyourweights) or 3) are picking up something too heavy either because you want to look like you know what you’re doing and impress someone or because you don’t have a spotter.

The thing is, you go to the gym to train your body, not your ego.  Yes, looking better is a byproduct, but NEVER at the expense of good form.  Sadly, there are a LOT of bad trainers out there, which gives those of us who care and who pay good money to continually educate ourselves and are the ones constantly coaching you without a phone in sight…. a bad name.  Please, don’t lump us all together.  Find someone who really cares, who can answer your question of “why are we doing this? Why do I need this?” with an actual answer, and if they can’t, be very, very wary.  Pick a trainer not necessarily only on how they look but can they tell you what continuing education credits they have? How are they continually bettering themselves, continuing to learn? Tell them you are a musician and these are your concerns….do they give you a movement assessment or just walk you around from machine to machine with a clipboard counting reps?  Just like you need to demand more from your doctors (if it hurts just stop playing…. not an answer) you need to demand more from your trainers. Interview them like you would an instrument repair tech.


After all, your body is your first instrument.

Podcast Interview with The Conditioned Musician

In Entrepreneurship, Fitness, Motivation and Success by musicstrongLeave a Comment

I found David on Instagram and knew instantly he would be an amazing resource. He’s a musician, ACSM certified personal trainer AND getting his doctorate in physical therapy because he wants to be a personal trainer for musicians. I’m happy to have him as a brand ambassador for Music Strong and really wish he lived closer so we could cross refer (strength training and PT go REALLY well together!). He started a podcast recently where he interviews all kinds of musicians who are also in the health field, including a body building opera singer, an MMA fighting/weightlifting multi-instrumentalist, and Crossfitting/Yoga teacher flutist (Practice Room Yoga if you haven’t seen her yet!)

I was honored to be interviewed on his podcast the other day and I talk about how I got started in music and also how Music Strong was born. Give him a follow on IG and subscribe to his podcast if you haven’t yet!

You can hear the entire episode below!

Listen here on Spotify!
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Interview on News Channel 5 Nashville

In Entrepreneurship, Fitness, Motivation and Success, Resources by musicstrongLeave a Comment

If you didn’t happen to be watching the news in Nashville yesterday at 6 AM, you missed a story done on us that the news anchor called “the most “Nashville story she’s ever heard” 🙂

Never fear, here’s the video so you can say you didn’t miss it and I explain

  • How Music Strong came to be
  • What is “Fitness Training for Musicians”
  • Who we help
  • How we can help