Performer’s Perspective: The Two-Year Injury Saga that Nearly Ended All of My Activities

Laura Mertz

Violinist

Age at time of injury: 14-16 years old

Site of injury: shoulders and upper back

Laura is a performing arts medicine specialist and the owner of Behind the Scenes Medical Consulting. Her first experience with debilitating playing-related pain came as a 16-year-old violinist. Here, she details her injury and how she eventually overcame it – with the help of the friendly person working at KC Strings on the day she came in to correct her playing ergonomics.

During my time in high school, I was involved in a lot of activities, some of which included playing my violin. I was a member of the strolling strings, took private lessons, picked up the odd quartet gig here and there, and played in the musical pit orchestra. I also played volleyball in the fall and winter and softball in spring and summer.

The Beginning of the Injury

During the softball tryouts for my high school team my freshman year, I developed knots, pain, and tightness in my right rhomboids (the muscles that run between your spine and your shoulder blade; they pinch the shoulder blades together). With the help of my high school athletic trainer, I learned how to treat it and the problem went away.

Me (left) at a Strolling Strings gig after my freshman year

However, my freshman high school softball season brought me much more softball activity than I’d ever experienced in my life. The huge amount of practice and game time with very little rest took its toll as the season progressed. My fatigued shoulder-supporting muscles couldn’t stabilize my shoulder blade correctly, and my throwing mechanics went in the toilet. My body started making some huge muscular and mechanical compensations for my fatigued rhomboids, but I didn’t realize that this process had started until it was too late.

Ignoring a Disabling Problem

By the end of my freshman year, I could not throw anything (even something as light as a balled up piece of paper) with something even resembling correct mechanics without experiencing crippling pain throughout my right upper back, shoulder, and upper arm. More than that, though, I couldn’t pick up my backpack with my right arm or raise my arm above the height of my shoulder. Since my school softball season was almost over and I had several weeks before the start of my summer season, I decided to muddle through the last bit of the school season until I could rest my shoulder. (Please don’t follow my example – see a medical professional!!!!)

At this point, I was only experiencing minimal fatigue in my right upper back and shoulder while I was playing violin, and it wasn’t bad enough to be noticeably interfering with my playing ability. Looking back on it now, I realize that this fatigue that I wrote off as “not that bad” translated into modified posture and playing mechanics.

Like a Weed, You Must Get Rid of the Root (Cause) of an Injury

My pain and fatigue went away when my school softball season ended – I wasn’t throwing anymore and my playing time decreased significantly, so my problems ended. However, my throwing-related pain returned when I started throwing again during summer softball practices. Luckily, my dad was one of my coaches for that team, as he had been for my entire softball career. As a result, he was very familiar with what my “normal” throwing mechanics looked like. He recognized a mechanical problem I’d slipped into during the fatiguing high school season and we were able to correct it. With the corrected mechanics (and the resumption of my shoulder exercises that I’d received from the athletic trainer earlier that spring), the pain and weakness went away and stayed away for the whole summer.

Unfortunately, that fall, I started getting knots, tightness, and pain in my right rhomboids again. This time, they came during an extended serving drill at volleyball practice. Since I’d just addressed this problem a few months earlier, I was able to fix my mechanics and the pain seemingly went away. This time, I did not notice any big problems related to playing my violin. Occasionally, my upper back would seem to become fatigued earlier than it used to, but I dismissed it. My pain and fatigue did not return with any more of my softball and volleyball seasons for the rest of my time in high school.

The Injury Spreads

But by then, the damage had been done. While I was subconsciously (and, in some cases, consciously) compensating for my right shoulder pain and dysfunction at various points during that 1 ½ year period, I was also unknowingly altering the way I held and played my violin. This, combined with the fact that I already tended to use poor playing ergonomics – especially with respect to the music stand – overwhelmed the muscles in my upper back and shoulder. The pain in my right shoulder and the pain, weakness, and dysfunction in the muscles that are supposed to stabilize my right shoulder blade caused me to alter my playing mechanics in an effort to reduce the amount of motion and elevation of my bowing arm. These altered mechanics eventually led to fatigue, weakness, and pain in my left shoulder and surrounding muscles.

What started as an overuse/fatigue throwing injury to my right side during my freshman softball season turned into a crippling problem affecting my left shoulder and my entire upper back while playing my violin in the second half of my junior year.

My mechanics and technique were crumbling – and so was my sound. It got to the point that I could not even hold my violin with anything resembling good posture. Enough was enough! One day while struggling to use correct form and posture during a practice session, I resolved to figure out what was causing the problem and find a way to fix it.

The Path to Pain-Free Playing

I decided to start by getting a better – and taller – shoulder rest. My shoulder was having to work too hard to get the instrument and chin rest anywhere close to my jaw.

Me (left) & my shoulder rest during my senior year

Luckily, I lived less than 5 minutes away from KC Strings, an excellent resource for all string instrumentalists (I even passed it on my way to and from school every day!). So, I went to KC Strings and explained my problem. I told the poor guy behind the counter that I knew I wanted a new shoulder rest, but I didn’t know what exactly I was looking for (other than “not this,” in reference to the one I was using). Thankfully, he didn’t write me off. Instead, he said, “Well, we’ve got a bunch of them, why don’t you just start trying them on until we find one you want.” So, of course, the one I ended up getting was the second to last one in the stock that we tried – the stock of over 30 different kinds of shoulder rests!!!

As soon as I was able to rest my fatigued muscles, correct my posture (playing posture and standard posture), strengthen my shoulder stabilizing muscles, and then gradually return to playing while using the new shoulder rest, I could play without pain or fatigue again!

I went on to continue playing throughout the rest of my time in high school, without having to drop out of any of my playing-related activities. I continued playing after high school, including playing in the pit at Theatre in the Park and being a member of my college’s University Symphony Orchestra. Occasionally, I’d notice soreness in my upper back, but my shoulder and upper back pain never returned in the years after getting my new shoulder rest.

Lessons Learned

I just wish I’d have had the discipline to seek help to keep this from being a 2-year battle with pain and dysfunction! It’s so easy to give in to that part of your brain – the scared part – that tries to assure you that if you ignore the issue, it will just go away. Knowing what I know now, I wish I had forced myself to acknowledge the fact that my sports injury was more significant than I wanted to admit. I wish I’d realized what it was doing to my playing mechanics long before I couldn’t hold my violin correctly anymore. It sounds dumb to say it, but not being able to use any body part – especially your dominant arm – to its fullest extent is not normal! But too often, performers do exactly what I did: ignore the problem while telling yourself “reasons” why you don’t need to do anything about the injury, telling yourself it’ll go away.

Please take care of your body, listen to it, and seek professional help when it tells you to do so!