The tuba, disability, and back problems.

[tubanews]

I remember when I first started playing the baritone in elementary school. It was alot of fun and led to the tuba years later. One thing I remember in particular was having to somehow manage getting the hardcase on the bus.

Later in middle school, I walked to school every day, and I remember carrying the thing (switching hands) a mile and a half or so each way every day.

My next memory of pain of suffering was the first day I played a sousaphone in the marching band in HS. We had to stand at attention with our instruments for an hour which seemed like an eternity. My shoulder and I were in severe distress.

Then when I stopped participating in that before college and only played tuba indoors and sitting down, I discovered the "gig bag". This seemed like possibly the greatest solution of all time for tuba transport. I for many years carried my instrument all over major cities, up and down tiny alleys in 3rd world countries.

And then by the time I was 35 I had a slipped disc in my back. (They have a fancier name for it now). Im ok, Ill "live".

Sam Pilafian used to talk about this a bit. About having a lighter tuba and carrying the thing on your back all the time. When your a teenager, you dont listen to stuff like that much.

But I wonder if we could do better at moving our stuff. Rolling stock? I dont know, its one of those things that creeps up on you. And by the time you realize it it may be too late.

[matt g]

Disc herniation actually has little correlation to back pain:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464797/

Further, disc herniation is very difficult to pinpoint in terms of cause. It’s effectively ever-present in the human population.

Most sousaphone-induced problems can be handled with physical training. Strengthening the back along with the general posterior chain can avoid most fatigue-induced injuries associated with an asymmetric load.

In other words, most kids need to get eat some food, do some physical training, get some muscle, and simply get a bit stronger before saddling them with a sousaphone. And then when they are using one, directors should be mindful of how long they’ve been holding them, specifically brass ones.

For those of us that have had “back pain” (this happens to almost everyone by age 40 or so), getting stronger usually helps there as well. There are movements in modern medicine advocating resistance training for both muscular hypertrophy and bone density in populations over 40 for these reasons.

[tubanh84]

By about 10th grade, I was diagnosed with scoliosis, having one shoulder significantly higher than the other. Not unsurprisingly I had been playing a contra in marching band, and I carried a tuba in a gig back, but only one one shoulder.

Once I got to college, I wasn't playing in marching band anymore, and my carrying my horn in my gig back reduced significantly (to a practice room, back to the locker, to the car parked right outside the music school, etc...). Unsurprisingly, I no longer had a scoliosis diagnosis. To this day, though, I have lingering back issues.

Fast forward *mumbles* years, and I'm yet again talking about back issues, this time with my lute teacher. He said he spent some time with a physical therapist and finally came to the conclusion that it was not possible for him to play effectively while also playing in a posture that ensured his back stayed healthy. The result was a series of exercises to do after each practice/performance.

I'm not a doctor, I don't play one on tv, nor did I stay at a Holiday Inn Express last night. But that's as good as I've ever done for a solution to instrument-related back issues.

[hrender]

For those of us that have had “back pain” (this happens to almost everyone by age 40 or so), getting stronger usually helps there as well. There are movements in modern medicine advocating resistance training for both muscular hypertrophy and bone density in populations over 40 for these reasons.

This. I've had back problems, shoulder problems, knee problems, etc. In most cases, physical therapy (mostly focused stretching and strengthening exercises) have corrected the problems. In the few where significant injury or wear-and-tear have occurred, there's been surgery then PT. When experiencing any kind of pain it's okay to wait a while to see if it will correct itself, but after a few weeks, I'd always recommend getting a professional diagnosis and looking into PT.

[matt g]

@tubanh84, that brings up a good point in regards to “occupational therapy” as an aspect of PT. The thing you’re doing might be some weird biomechanical compromise. In theory, by getting stronger in a position of good posture, it should lower risk when we have to endure periods of poor posture.

[Shawn]

One piece of advice re PT/OT: if you're doing physiotherapy/contemplating it, bring your instrument to the assessment session(s). Physios are very goal oriented. Some of them can't tell a tuba from an oboe, but if you say 'I need to be able to do [X] with this instrument' they can focus on building an exercise plan to give you a shot at it. X can be anything from an arthritic finger to needing to march with a BAT. Maybe you'll never get there, but they'll certainly know/explain the road you need to take to try.

I can go on about this all day, I'm a physio lifer, but I'll spare you all my ailments unless you're curious. I do want to stress that the goal-approach really is the way to go with physio/occupational therapy, and that maybe for once, I actually know what I'm talking about.

[bort2.0]

Every year in college marching band, I remember about 3 or 4 days that really sucked at the beginning of the season... And then everything was fine after that.

As compared to people who played those awful marching baritone things... They never got used to holding them up the extreme top heaviness caused by them.

My bigger ergonomic issue is when playing, what are your arms and shoulders doing. If they are relaxed, and your hand is at a natural angle, then all is well. If you are not relaxed and are trying to do something your body doesn't naturally want to do... Forget it, it's not going to get better.

[jtm]

A high school director that makes the bass players keep horns on their playing shoulders for an hour without any break has misplaced priorities.