What can I do to minimize the risk of reinjury after recovery?

Returning to practicing and everyday activities after an injury marks a big step in your journey towards recovery. However, after an injury — no matter your state of health or physical wellbeing — your muscles and tendons will always be susceptible to reinjury because of the past damage to them. Over time, the risk of reinjuring yourself will decrease, but you must approach all musical and daily activities with care and diligence, especially in the early stages of recovery.

Return to play gradually

When injured musicians get cleared to begin playing again they often enthusiastically jump at the chance. Unfortunately, we sometimes do too much too soon, causing our improved condition to worsen, possibly setting us back many weeks. The most important step you can take to minimize the risk of reinjury is to return to play gradually. This will allow you to slowly strengthen your weakened muscles in a way that won’t overexert them.

If you have been working with a doctor or physical therapist, they will likely tell you when you can begin practicing again, ideally providing you with a structured “return-to-play” schedule. These schedules take place over many weeks or months and generally begin with very small amounts of playing and slowly increase each week until you are comfortable playing for multiple hours each day. If you have not been working with a doctor or physical therapist, talk to a peer who has, as well as your teacher, and try to create a return-to-play schedule that may work for you. It is always best to have proper medical advise when returning to normal activities following an injury. Make sure you continue to check in with your doctor, therapist and teacher regularly, as they will help make sure you are on track to a successful recovery.

Remember that the return-to-play process may be long and frustrating. You may experience the occasional setback: some days your injury may not bother you at all, and other days it may feel worse than normal. This “roller coaster of sensations” is part of the recovery process. Be patient and understanding with yourself and your body as you return to play, keep in touch with your doctor and therapist, and stay positive!

Take practice breaks

Every musician needs to take practice breaks, but they are especially important for musicians who have been injured. Since you have been injured once, your muscles and tendons will always have a higher potential for becoming injured again. Getting carried away in the practice room or skipping a break could aggravate your recovered or semi-recovered injury and result in a regression of the progress you have made.

No one should ever practice over an hour without a practice break. As an injured musician, you may want to consider never going over 45 or 30 minutes without a break. And remember that while practice breaks are important for you physically, they can also be helpful mentally, giving you time to clear your mind and rest from intense focus.

Taking one day off each week may be helpful because it can allow your body to recover from the previous week of practice and become rejuvenated for the week to come. Even if you don’t physically practice on a day off, that doesn’t mean that you can’t practice at all: you can score study, decide on phrases, and listen to recordings. There are many alternative methods of practicing you can do on your days off (see “Alternate forms of practice”).

(For more information on practice breaks, please see Practice Breaks under the section “What can I do to minimize the risk of an injury?”)

Exercising, strengthening and stretching

Since weak muscles will fatigue and damaged easier than strong muscles, preventing a reinjury requires maintaining a healthy and active body. Exercise may help you to improve your endurance, overall energy level, and can help keep your muscles strong. Low impact activities include things like swimming and running, but many other activities such as dance, or team sports like basketball (and others), can be great forms of exercise as well. Remember to work into your new exercise routine gradually, just as you would with practicing. While exercise is important, please make sure you have a doctor’s approval before you begin exercising regularly.

The main point of physical therapy is to strengthen your damaged muscles and to retrain your body on how to use those muscles more effectively. As you return to play, you must maintain your newfound strength and muscle awareness. If your doctor or physical therapist has given you an exercise or strengthening regiment, continue to do it until they tell you that it is OK to stop.

Stretching may also be useful in preventing reinjuries because it can help keep your muscles loose and flexible. If your doctor or therapist has given you any specific stretches, you can continue to do those. Stretching can be an effective tool, but you should have professional medical advice before beginning stretching. Improper stretching can cause more harm than good.

Remember that your therapist and doctor can continue to be a resource for you, even after recovery. It is not uncommon to have follow-up appointments after you have been approved to return to play, so if you have any questions or concerns you can feel free set up an appointment and ask.

Work with your teacher

As you gradually return to playing, you and your teacher can monitor your technique, make sure you are recovering without any setbacks, and map out a trajectory for how to make improvements in your playing. If you have any concerns about your technique or your instrument, now is the time to address it with your teacher.

While your teacher can be a great resource, keep in mind that he or she is not a medical doctor. They can offer suggestions and guidance for how to improve your playing but they cannot diagnose problems or prescribe forms of treatment. If you have any questions or concerns that your teacher cannot comfortably address, you should take them to your doctor or therapist, or to a medical professional.

Cultivate body awareness

All musicians need to be aware of what their body tells them, however it is arguably even more important for injured musicians. Since you have already been injured once it will be easier to injure yourself again. Failing to pay attention to what your body tells you could potentially result in reinjury.

Improving your body awareness should become a skill that you constantly work on. This skill may help you recognize potential problems in your playing, making it easier to implement improvements into your technique and possibly prevent future problems from happening.

Take moments while you are playing and while you are resting to notice what your body is telling you: Are you tensed or relaxed? Are you breathing properly, or you holding your breath? Do you feel discomfort or pain? How is your posture? In these moments, consider what physical motions or ideas may be causing you to do whatever it is that you are doing with your body.

Try to be aware of your body throughout the day, and not just during practice and rehearsals. Sometimes activities outside of music like typing and lifting heavy objects are the very things that can cause injuries in the first place.

If you ever have any concerns, consult with your teacher, doctor or therapist and experiment with how you can use your body differently to reduce any unnecessary tension, discomfort, or pain.

Introduce change gradually

Introducing change is important for every musician to keep in mind, but it is especially important for musicians who have dealt with injuries. Since you have been injured, your muscles and tendons may be susceptible to reinjury if you don’t monitor how you work and practice.

Increasing your practice time by large amounts over short periods of time could be detrimental to the progress you have made. You can increase your practice time gradually, being patient and aware of how you react to the increased time.

You should also phase new instruments or bows in to your playing gradually, as well as secondary instruments. Pay attention to how your body reacts to new instruments, get proper instruction from your teachers, and don’t overdo it when first working with instruments that you are not familiar with.

(For more information on how to introduce change gradually, please see Introduce change gradually under “What can I do to minimize the risk of an injury?”)

Taking care of yourself

If you aren’t taking proper care of yourself, your risk for developing an injury will probably be higher.

Physically, this means getting enough sleep each night. It means eating healthy, staying hydrated, and properly exercising each week. Taking care of yourself physically may help you feel stronger, more alert and more focused. In turn, feeling good physically can help you feel good emotionally.

Taking care of yourself emotionally means that when you get stressed you can take steps to minimize your anxiety (for instance, taking a break, talking to someone, or making a plan for yourself). It means staying on top of your work and saying “no” when you probably shouldn’t overcommit yourself. It also means finding time to do something for yourself like socializing, taking a walk, or doing something other than homework or practicing.

By taking good care of yourself, you will ideally be making sure that you stay happy, healthy, and are not overstretching yourself. This will hopefully help you prevent a reinjury.

Works Referenced

Horvath, Janet. Playing (Less) Hurt. Milwaukee, Wisconsin: Hal Leonard Corporation, 2010. Print.

Watson, Alan H. D. The Biology of Musical Performance and Performance-Related Injury. Lanham, Maryland: Scarecrow Press, Inc., 2009. Print.