Pain Management

While strengthening, pacing, and other methods of bolstering will generally aid the hypermobile musician in managing potential challenges, pain flares are going to happen–learn how to develop a toolkit for pain management.

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Heat

Heat can be extremely soothing for muscle tension and soreness. This can be as simple as taking a hot shower or bath with epsom salts or magnesium flakes (the salts and delivery of magnesium is beneficial for aiding muscle soreness) if it can be tolerated (extreme heat can be triggering for thoses with dysautonomia or MCAS), or delivered via heating pad. While the research on red and infrared light therapy is still ongoing, an infrared heating pad and/or red light therapy device can be extremely beneficial for lowering inflammation, boosting blood flow and mitochondrial health, and aiding recovery.


Cold

Cold therapy can be useful when muscles feel like they are burning from lactic acid. Ice packs or ice rollers can be used for delivery. If it can be tolerated, cold exposure via cold showers or cold plunges can also be useful in stimulating muscle recovery as well as reducing inflammation and soreness (extreme cold can also be triggering for those with dysautonomia or MCAS).


Topicals

While many marketed topicals for pain relief can form more of a “distraction” sensation, it’s worth taking the time to find some that actually help with pain relief: topical analgesics are helpful for this, as are arnica, CBD balms, and salves that utilize herbs that target inflammation.


Rollers & Release Tools

Tools that help with releasing muscular and fascial tension can be extremely helpful when working out knots, aches, and pains. This can be as simple as using a lacrosse ball against a wall or utilizing your own body weight against the floor, a back buddy, a foam or textured roller for rolling out muscles, a TENS unit to block or change pain perception, or a gua sha tool for gentle muscle scraping (key word being gentle! This can cause bruising if done too enthusiastically). Massagers can also be very helpful, whether it is targeted for the shoulders or a free-standing massage gun that can be used on any muscle.

Getting a massage by a massage therapist can also be beneficial, but just as you would ideally try to find a massage therapist that is knowledgeable about how musicians use their bodies, you will want to try to find a therapist that is knowledgeable or open to learning about hypermobility and how it impacts you. For instance, over-massaging a muscle that is stabilizing a joint can result in subluxation if not managed properly. Always communicate openly and directly with your therapist during a massage, as you are the only one in your body to feel your limits.


Braces & Supports

While strengthening where possible is key, braces and other forms of support can be helpful tools in the interim, or more indefinitely depending on severity of symptoms. There are other braces and supports for nearly all aspects of anatomy, but these are perhaps most applicable to the hypermobile musician. Kinesiology tape is immensely helpful and versatile both for support as well as increasing proprioception. Ring splints and thumb braces can be very helpful to stabilize loose finger joints. For the hypermobile neck, particularly during traveling, a cervical collar is helpful for stabilization. Orthotics are a useful step towards learning to support hypermobile feet (particularly helpful for the standing musician). A coccyx cushion is particularly useful for not only supporting hypermobile hips and SI joints, but for correcting the angle of the average chair’s seat cushion (this is important for musicians who sit while playing).

An added waist strap to your instrument case (if it does not already come with one) can be very helpful in distributing its weight more ergonomically across the body. Additionally, adapting your instrumental set-up as needed with added supports can be extremely beneficial: for instance, if you are a violinist or violist, using drawer liner to outfit your shoulder rest or shoulder pad for a more custom fit, or if you are a bassist, utilizing yoga blocks to support your stance. For the traveling musician (or for more everyday use if dysautonomia symptoms are more pronounced), compression socks can be beneficial.


Medication

While you never want to solely medicate without addressing the root cause of pain, medication such as ibuprofen or NSAIDS can be helpful during an initial time-frame of experiencing pain to help lower inflammation and get out of the flare zone. Always consult your doctor prior to taking any medication.


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