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Sandy and Julie Nicholson

Oct 25, 2000, 3:00:00 AM10/25/00
Archive-name: music/performing/faq
Last-modified: 2 January 1999
Version: 2.1b

Frequently Asked Questions (and Answers)

* This is a monthly posting which attempts to address some of the
questions most frequently asked in
The term `FAQ' is used henceforth to refer to this posting.


1. What is
2. How do I post to
3. Some suggestions for combating performance anxiety
4. Over-use Syndrome (tendonitis, carpal tunnel syndrome etc.)

A. How to contribute to this FAQ

* The last update to this FAQ was dated 31 July 1996 (version 2.0).
On that occasion several sections were omitted as it was felt that
they were largely supplanted by better reference sources on the
world-wide web. I specifically referred readers to the WWW Virtual
Library at the URL .

As of this minor revision, I have renumbered the remaining sections
and made a small addendum to the section on over-use syndrome.


1. What is is a Usenet newsgroup intended for
people who are involved in or interested in the performance of
classical music (or closely-related genres), at any level and in
any capacity. (If you are unsure what the terms `Usenet' and
`newsgroup' mean, I suggest you read the articles in
news.announce.newusers before reading any further - ask someone
at your site if you have trouble finding this.) The fortnightly
posting `Welcome to!' includes a
more detailed charter for the newsgroup and it is strongly
suggested that you read that article before posting anything to
the group. There is also a fortnightly posting `Which Classical
Newsgroup? (FAQ)' which should help potential posters decide
which group best suits their requirements.


2. How do I post to

Posting to is accomplished as for
any other unmoderated newsgroup. It would be helpful if posters
would bear in mind the following guidelines:

- Always use an informative subject line; in particular, change
the subject line on a thread which is going off-topic to
something more appropriate.

- Keep cross-posting to a minimum; make judicious use of the
`Followup-To' field where cross-posting is necessary.

- Edit quoted material to a minimum but, at the same time, keep
articles as self-contained as possible.

- Perhaps most importantly, take time to prepare an article
before posting it to the net and ask yourself whether an email
message may be more appropriate when replying to a previous

These guidelines are generally applicable and part of standard
`netiquette' (for further advice on posting, see the group
news.announce.newusers.). Do not be discouraged from posting to!


3. Some suggestions for combating performance anxiety

[When the topic of performance anxiety was first raised in the
newsgroup, a significant number of responses appeared in which
various methods for overcoming stress were suggested. Only a few
of those are represented here - if anyone notices any glaring
omissions, please let me know. - SN]

If you do not suffer particularly from performance anxiety,
count yourself privileged. Anxiety in moderation can be a good
thing, helping you to focus all your energy on the task in hand.
Clearly, though, if you feel especially uncomfortable when
playing or singing (or conducting...) in front of an audience,
your performance will suffer.

There are countless ways of coping with the stress of performing,
some of which work better for some people than for others. Some
have suggested pre-performance exercises of various sorts, from
deep breathing to meditation to screaming (quietly if necessary!).
Also suggested were longer-term techniques such as the Alexander

Many people suggested (temporary) dietary changes as a means of
calming nerves prior to a performance. Indeed, one of the most
popular remedies would appear to be the humble banana. Eat a
couple of these before you perform and you'll have no problems
(or so we are told). [I have forgotten the other dietary advice
given in the original discussion - if anyone was taking notes,
I'd be very grateful... - SN]

Now for the serious stuff. A number of performers have advocated
the use of various drugs as surefire ways of reducing/avoiding
anxiety. While it is certainly true that drugs can be effective,
it is equally true that their misuse can be highly dangerous.
Never use anxiety reducing drugs unless medically directed.

Beta blockers, such as propranolol (Inderal in the US), block
the body's response (reaction) to adrenaline. Propranolol is
well recognized as effective in reducing performance anxiety.
It is one of the safest drugs ever developed, having been in
use for treatment of high blood pressure, angina pectoris, and
hyperthyroidism for more than 20 years. Unfortunately, beta
blockers have at least one potentially fatal side effect: they
will worsen the severity of asthma attacks and may precipitate
an attack in an otherwise well controlled asthmatic. Persons
with heart failure or mild degrees of heart block should usually
not take beta blockers, as they can worsen these problems.
Propranolol is supplied both in straight tablet form (taken
every 6 to 8 hours) and in a long acting (LA) formulation, so
be sure to find out from the prescribing physician how soon
before a performance to take the medication. "

Corticosteroids, such as Prednisone, work by reducing inflammation
through suppression of immune responses. A number of side-effects
have been attributed to use of such drugs, including thinning
of the skin and redistribution of fatty tissue. Short term use
of these drugs (a few days to a couple of weeks) will not usually
have such adverse effects, though, given the suppression of
immune response, corticosteroids should never be taken when
suffering from a bacterial or viral illness.

A book on the subject of performance anxiety which comes highly
recommended is `Stage Fright; its causes and cures, with special
reference to violin playing' by Kato Havas.


4. Over-use Syndrome (tendonitis, carpal tunnel syndrome etc.)

There have been several articles in the newsgroup from
people asking about dealing with pain during or after
playing their instruments. Here's a brief description of
some types of over-use syndrome and a few suggestions on
what to do if you have pain.

If you have pain while playing your instrument (or after
playing), it might be related to what doctors now call
`over-use syndrome.' This is caused by strain on muscles,
ligaments and tendons causing swelling, which induces pain.
One common type of `over-use syndrome' is tendonitis, caused
by a swelling of the blood-vessel sheath surrounding tendons.
For performers, this often occurs in your fingers, your
hand, or your arm, or your shoulder. Tendonitis is common
among musicians, typists, professional phone bank workers
and assembly-line workers; the common denominator is work
(or play) involving very repetitive motion in the fingers,
hands or arms.

Another, more specific, injury is carpal-tunnel syndrome
(CTS). The carpal tunnel is a wrist `tunnel' formed on
three sides by bone and the 4th side by a strong ligament
(the Transverse Carpal Ligament, to be technical). There
are nine tendons and the median nerve which travel through
this tunnel. Each tendon is surrounded by a lubricating
lining, called the synovium. CTS is caused by the compression
of these tendons in the carpal tunnel, either by swelling
of the synovium, injury to the bone or ligament, or by
fluid retention. CTS should be treated by a doctor. There
are several types of treatment for CTS, including surgery,
but surgery is the last resort and should never be done on
a musician without a second or third opinion.

If you think you have tendonitis, there are several things
you can do on your own to try to relieve it:

i. If possible, stop practising for a day or two. Also try
to avoid doing a lot of typing or other repetitive hand
activity. If the pain persists after a couple of days,
see a doctor.

ii. Before practising, warm up your hands, wrists, arms
with warm water or a heating pad on a low setting. Keep
the affected area from getting cold while playing (say,
from sitting under an air-conditioning duct).

iii. While practising, stop frequently, put the instrument
down (unless, obviously, you're a keyboard player) and
relax. A slow warm-up session with several short rest
periods can help relieve stress.

iv. You can use an anti-inflammatory medication (such as
Ibuprofen, also sold under such names as Nuprin, Advil,
and others). A doctor can prescribe stronger medication.
You may want to take Ibuprofen after eating to reduce
stomach upset. Aspirin is slightly less effective than
Ibuprofen, but works. Tylenol (acetaminophen) is not an
anti-inflammatory drug.

v. Right after playing, apply a cold pack or ice to the
affected area. An ice cube massage right after playing can
do wonders for tendonitis in the hand or fingers or arms.
I have a large cold pack I keep in the freezer which I used
to use for my shoulder. You can apply lots of cold for
short periods of time, but don't go overboard and get

vi. Sometimes a hand brace can help by immobilising the
hand, wrist, arm while not playing the instrument.

vii. If you type a lot, say while writing messages for, use a wrist rest for your
keyboard. They even make mouse wrist rests if you do a
lot of mousing at the computer. Avoid computer games that
call for a lot of typing or clicking.

viii. Again, though, if the pain continues, seek a doctor's
care. Cortisone shots, prescription anti-inflammatory
drugs, physical therapy and even surgery can be required.
There are special medical clinics for performing musicians.
[Andy Brandt has a list of such, a selection from which
could be added to the FAQ if there is sufficient demand. -SN]

ix. Tell your teacher. Perhaps there is a way to change
your technique to relieve stress on a particular muscle or
tendon. A doctor who is familiar with instrumental technique
can analyse what is causing the problem and suggest solutions.
Some doctors specialise in keyboard instruments, wind
instruments, string instruments, etc.

x. Try to stay in good general physical condition. Normal
exercise can do a lot to prevent over-use. Many musicians,
in school or later, often neglect their general physical
(and mental) well-being.

This information, based on personal research and experience,
is not professional medical advice. If you want professional
advice, seek a good physician.

[Andy Brandt disclaims any liability for the accuracy of
material contained in this article. Additional information
and corrections, if any, are always welcome. -SN]

Scott Van Hoven recommends the well-established `Alexander
Technique' (named after Frederick Matthias Alexander) whereby the
patient/student is trained to use his or her body appropriately
to avoid risk of injury. This can, for many people, be a useful
preventive and curative method. A search on the web should reveal
plenty of further information.


A. How to contribute to this FAQ

Contributions to this FAQ should be emailed to Sandy Nicholson
at the address given below, as should any corrections, suggestions
or queries directly related to this posting.

Many thanks to the following for their contributions:

Andrew Levin, Andy Brandt, Anita Thesen, Bjorn F Langoren, Cindi
Roden, Claudia Zornow, Dale Gold, Dan Breslau, Daniel Downey,
Denis L. Clason, Elizabeth L. Jones, Gene Ouye, Genevra Neumann,
Greg Baker, Greg Skinner, Hanspeter Schmid, Jason Tiller, John A.
Polito II, John Lewis, Jonathan Helton, Joris Geurts, Kailan
Rubinoff, Kathie Fry, Kip Bishofberger, Lawrence E. Mallette,
Lisa Argiris, Mark Bitter, Marko Hotti, Marlon Feld, Martin D.
Jenkins, Matthew Cable, Matthias Brixel, Michael Bersin, Nancy
Leinonen Howells, Nathan Kreitzer, Neil R. Corman, Nicole de
Beer, Peggy Lin, Phil J. Tompkins, Robert Levine, Robert Nelson,
Scott Van Hoven, Seth S. Katz, Stephen Birkett, Stephen Wilcox,
Terence T. Lung

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