Drumming should not cause you pain. If it does, something is amiss. Generally stated, beginner drummers (1 day to 3 years) especially, tend to play too hard, too stiff and often have bad posture. For beginners, I do not recommend playing hard and I DO believe in good posture. This is the beginning for good technique. Sit at the front edge of your chair for starters.
The concept at work here is that beginners hear the teacher (or other source), playing beautiful musical sound and try to duplicate that sound. But, there's one thing missing, technique. Correct hand and arm technique and even proper breathing can take years to get 'right'.
So a smarter move for beginners who may be prone to overdoing it due to excitement inherent in drumming, is please be careful. You WILL hurt yourself if you play too hard when you don't know how to play. It is our job, the teachers, to help show you the way to good sounds, speed and musicianship. It is your job to realize that this takes time. My master teacher Famoudou Konaté says it takes a lifetime to learn the djembe. So do many others. So do I. Actually, I say maybe two lifetimes.
Take your time and relax and remember to play from a place of love, peace and total relaxation. It is not easy to learn all of that. Take your time. If you feel pain, you are probably doing something wrong. Stop!
Ask us for advice right away and we can help you decide if you need to stop, modify a position or tensioning, use a device to aid in playing for a while, many possibilities. We know. And just to mention, if you do need to go to a doctor of PT, OT or physiatrist, and you tell them you are drumming, they don't know what that is. You MUST, no matter how weird this seems, use the top-side of their desk and show them the motion and about how hard you are doing that motion and tell them for how long you do that. Then they can start to understand what 'drumming' is for you. And if you play the dunun, with a stick and a bell stick, show them that too. If you are timid to demonstrate this, at least show a YouTube video of someone hand drumming correctly or not correctly on a djembe or dunun.
Below is just the beginning of how to deal with some common drumming hurts. This is a work in progress and I welcome your feedback. Email me.
•By Luga Podesta, M.D.
•Originally published in the April 2007 issue of DRUM! Magazine
Arm pain is a common complaint among drummers. Pain in the upper arm can originate from a number of locations in the upper extremity, including the neck, shoulder, and elbow. However, one of the more common sources of arm pain in drummers is from the biceps tendon (i.e., biceps tendonitis).
A tendon is a band of connective tissue that attaches muscle to bone. The biceps muscle is located in the front of the upper arm and attaches to two locations in the shoulder and at the elbow. The biceps muscle functions to rotate and bend the elbow and assists in elevating the shoulder.
Biceps tendonitis is a quasi inflammatory process in the tendon that causes pain in the front part of the shoulder and upper arm. Actually tears, or micro-tears of the tendon is more correct than inflammation. Biceps tendonitis occurs from overuse of the arm and shoulder or from a direct injury to the biceps tendon. Repetitively riding cymbals that are set high and reaching for drums or cymbals behind and to the sides can predispose drummers to bicep tendon injuries.
Pain develops in the upper arm with movement of the shoulder, particularly when the arm is moved forward and over shoulder height. Pain is also present when you apply direct pressure over the front of the shoulder. These types of injuries are diagnosed by clinical examination by a physician and more advanced imaging studies such as an MRI of the shoulder.
Biceps tendonitis can be a very annoying injury and an extremely difficult problem to treat. The initial treatment will include the use of ice packs over the front of the shoulder for 15 minutes every two to three hours. The use of oral non-steroidal anti-inflammatory medications initially for two to three weeks can also be useful. Occasionally a corticosteroid injection around the tendon can reduce severe inflammation and pain.
Physical therapy has also been beneficial in reducing symptoms and improving function.
Resting the shoulder by limiting the activities that caused the problem is also helpful. If not cared for properly, surgery may become necessary to relieve pain and repair the damaged tendon.
Performing proper warm-up exercises and stretches prior to activity and properly cooling down afterward can prevent biceps tendonitis from occurring.
Tennis elbow is a form of tendonitis that causes pain over the bony prominence called the lateral epicondyle on the outside of the elbow. It is often referred to as lateral epicondylitis. They are responsible for extending or bending back the wrist and fingers. The tendons are fibrous bands that connect the muscles to the bone, in this case the lateral epicondyle.
If too much stress is placed on these muscles and tendons, micro tears can occur at the site where the tendons attach to the lateral epicondyle(see drawing). These micro tears cause pain that is usually localized at the lateral epicondyle but the pain can occasionally radiate down the forearm. Aging appears to make these tendons more prone to breakdown. Therefore, lateral epicondylitis is more common once we get in our fourth decade of life and beyond.
For more excellent info on Elbow Pain, please click here.
And for even more excellent info on Elbow Pain, please click here.
Personal Notes on Pain of the Shoulder Capsule and Arm
I will repeat myself here: Drumming should not hurt you. If you push yourself you run the risk of pain. Do not ignore the pain.
I would like to share some thoughts and things that have helped me and other more notable drummers who often, due to privacy, don't talk about this stuff. Yes, even the famous dudes and ladies out there.
The more you learn about drumming and the better you get, that's when you are the most prone to getting some inflammation of an arm or joint area - be it the fingers, wrist, elbow, shoulder or neck. If your drum is not tall enough you may experience low back pain. There are drum risers available or you can get a taller drum. We like the drum supported by the ground and not held between the legs, unless you are standing with your drum in a good padded drum strap or your drum is in a djembe stand.
(yes I have been a crash-test dummy for all of the below)
• Ice - I use a product called ActiveWrap Shoulder Heat/Ice Wrap. It is the best one out there; black, easy to get on and off when in pain and made extremely well. Chose the correct size for your body. At about $68.- I keep one at work and one at home. Extra ice pacs are a good idea. Do NOT apply ice directly to the skin unless you are moving it constantly, like in a dixie cup of solid ice would be okay. Wipe off any wetness on the ice pacs's sleeve (it needs to be in a sleeve) before putting it on your skin or you may ice burn yourself.
Also, I have found that playing with the ice ON while drumming worked for me quite often. I understand that some people might not approve, but I found that this technique DID help me when I HAD to play in pain.
• Rest - This doesn't mean to stop all use of an arm necessarily. Complete rest is usually not a good idea as it can cause frozen shoulder. Rest, to me, means, to play smarter, keeping elbows down and using the weight of your arm as opposed to striking the drum. It takes a lot of practice but you can do this! It also means to try to use your other arm to do some of the work. I can work with you to help you avoid this problem or help you get better.
Caution - As I stated above, use your other arm BUT be careful of overcompensating where the other arm may get inflamed or fatigued and prone to injury.
• Heat - I have found that sometimes heat is a good compliment to the ice. While heat doesn't stop inflammation, it can help you feel better. It can also guide any medicine you may take to that area where it is most needed as it increases blood flow.
• Medication - There is a lot of information about anti-inflammatories out there, as you may know. I like taking 800mg of Ibuprofen (Advil) 2x a day and then switch to Naproxen (Aleve) 500mg 2x a day for a few days. Treatment is for as long as you are experiencing pain. Common medical advice from top doctors of the shoulder say to take Naporsyn 500mg 2x a day for 30 days. Include the above steps and reevaluate in 30 days. If pain has not improved, seek more medical advice. But keep in mind, you want the tendons to heal and, in fact, tendonitis is not really an inflammatory disease. However, it may make you feel better.
• No Medication - My understanding is the healing of tendons especially, is a natural occurrence as long as the tendon is in touch with the bone and enough blood enters the area and considerable healing time is allowed. (There's not much blood in a tendon) I have heard that medications that stop inflammation may also cause the area to take longer to heal. Some people choose to not use much if any anti-inflammatories for this reason. You may heal faster if you stay away from anti-imflamatories.
• Iontophoresis - a therapeutic modality often used by physical therapists. It is a type of electrical stimulation that is used to administer medication into your body through your skin. I have found this very helpful especially for the elbow where the nerves are very close to the skin.
• Nitroglycerin Patch - The questions surrounding whether nitroglycerin is truly beneficial and how to properly deliver it are still unanswered. It is currently in use in the US and endorsed as a good adjunctive treatment for tendonitis in addition to a standard physical therapy rehab program. (They always throw that in.) You only use 1/4 patch directly on the skin over the exact point of pain. 12 hours on 12 hours off. You must be evaluated and prescribed this patch and guided for this use. Personally I get a mild headache with it many times which goes away when I remove the patch. So sometimes I do 8 hours on and 16 hours off and get great relief. Tendons don't heal fast as they don't get enough blood. This takes blood from other parts of your body and brings it right to the tendon. Recommended!
• Massage - Very helpful to focus on the shoulder capsule and the supporting muscles (actually part of the rotator cuff). For tendon health, massage is essential. Some you can do yourself by possibly using balls or hard foam tubes to massage alone. Not as good as going to a massage therapist but cheaper. There is a tool called The Stick Travel Stick, 17-Inch for about $25 at Amazon. It can be used to break up tissues in your inner forearm where drummers muscles get really tight. If we don't get those relaxed, the tightness can 'travel' up the arm to the shoulder.
• Chiropractic - My shoulder has been under the care of a chiropractor who helps me stay in the game. I like full manipulation. She stretches the shoulder capsule and it gives me great relief and helps me heal.
• Ultrasound - This therapy can be very helpful to assist the healing process. I am a fan! Recommended!
• EMS - Electro Muscle Stim - A simple unit can be purchased for under $50.- these days. Be careful to use a gentle setting for the shoulder or arm. Stim is NOT to be used on the upper neck area, careful. You may wish to use EMS on the surrounding tissue to the injured tissue OR directly on it or both. Don't overdue it!
• Acupuncture - For years I have heard this was a 'cure' for tendonitis. Many friends have said it is THE way to heal your tendonosis as do many in the medical profession. Recently, I decided to give it a try and it has been really helpful. The long term results await but I have received a lot of relief with acupuncture. If you have little money, try Acupuncture Together on Mass Ave in Cambridge, MA for treatment. Recommended!
• Steroidal Injections - These can be very helpful in making you feel better and can actually stop one from developing frozen shoulder as you will use your arm more since it will not hurt. In Boston, there is a doctor at NEB Hospital who basically only shoots shoulders and he promised me and delivered on getting rid of my frozen shoulder in 3 days! It was an injection with a viewing screen called an arthrogram. Highly recommended depending on the condition and doctors expertise.
• Topical Anti-Inflammatory - Voltaren Gel - (prescription) Basically Naproxin in a gel form that is applied to the specific area. It works very well for me. DO not combine the topical gel and ingesting systemic Naproxin.
• Physical Therapy - Sometimes PT is necessary. I found the ice and heat and EMS part to be especially helpful. I really can't say that I found the exercises, strengthening and stretching to help me. Of course while at PT you meet a lot of people just out of shoulder surgery and we all talk. You can learn a lot! Very few (out of maybe 35 people I spoke with at PT) felt they were getting anywhere with PT, yet, it is the first thing that many doctors recommend.
I DO think that a few sessions can help you feel better and give you ideas on how you can best help yourself. And the massage techniques they may do should certainly help. If in the Boston area, I highly recommend ProSports Physical Therapy, Cambridge or Waltham, MA where the Boston Celtics train.
Always take care of yourself when you play. Use musicians earplugs, sit up very straight, shoulders back, head back. Sit at the very front edge of your chair so your back will be straight with the side benefit that you will have improved sounds coming out of your drum! Nice!
If you feel fatigued, stop immediately! One common drumming situation I want to mention is.... When the rhythm gets faster, many, many people play harder and louder. DON’T DO THAT. Please, do the opposite. Because, for one thing, playing louder and faster will slow you down as you will get fatigued almost immediately. And you can get hurt that way. It is a natural thing to do but - YOU need to take care of you! If the teacher or facilitator is not telling you to back off, you may hurt yourself. Again, this usually happens early on in drumming when you don't necessarily have the ability to be aware of what you are doing all of the time.
For now, faster should mean even more relaxed, a tad quieter and a softer approach. Use earplugs. DrumConnection is endorsed by and carries products by the Hearing Institute and by Etymotic Research. $20/pr in a case. In our shop we have been trained to fit you to personal earplugs for musicians for $39.95 a pair. We also always have foam earplugs on hand. When you play with them for a while you can actually get them to give you a decent experience but only for emergencies.
If you have any comments or suggestions, please email me.
American Academy of Orthopaedic Surgeons http://www.aaos.org