Violist John Jake Kella was on holiday. The Metropolitan Opera season was over, the American Ballet Theatre season was over, and the chamber music groups he played with were taking a breather. Kella put his viola on the shelf and spent most of two months reading, writing and pursuing assorted projects.
When New York-based Kella, under contract with both the Met and ABT orchestras, took down his viola again for the current season, he assumed he could go back to playing with the same intensity he had before his vacation. "But my left shoulder said no. It wasn't ready."
In pain and unable to raise his arm for nearly a week, the 38-year-old musician packed his viola and headed to St. Luke's/Roosevelt Hospital Center where he performed a mini-recital for Dr. Patrick J. Fazzari, director of rehabilitation medicine. The physician "watched the way I moved, the intensity that I played with and spots where the injury was. (Then he explained) why it had occurred and what exercises I could do to prevent it happening again."
Diagnosed and treated for acute tendinitis of the rotator cuff, a group of muscles that surround the shoulder, Kella is one of a growing number of musicians, dancers, actors and others being treated at specialized arts medicine clinics in such cities as Cleveland, Chicago and New York. Summarizes Dr. Alice Brandfonbrener, editor of the new journal Medical Problems of Performing Artists, and founder of an annual conference on arts medicine in Aspen, Colo.: "There's a crescendo of interest."
San Francisco's Performing Artists Clinic opened at UC San Francisco in April, and discussions are under way to launch a similar clinic locally. Ear, nose and throat specialist Martin Hopp said that he and partner Dr. Robert Feder last summer approached a local medical center about incorporating such a facility there.
"There's a tremendous population and wide variety of performing artists located in the Los Angeles area," Hopp observed. "Individualistic problems associated with their profession often are not the routine medical problems taught in medical school."
In New York, for instance, the newly expanded Miller Health Care Institute for Performing Artists of St. Luke's has created a "performance evaluation" room complete with piano, mirrored walls, rehearsal barre, even a "sprung" floor to replicate the performer's professional environment. There is also video equipment so that doctor, performer and teacher can critique together what the performer is doing that might be contributing to the problem. Says institute medical director Dr. Emil Pascarelli: "We look at how violinists hold violins the same way (our colleagues) evaluate the golfer's swing and the batter's stance."
Majority in Pain
And many violinists are in pain, physicians say. Dr. Fadi Bejjani, director of the Orthopedic Center for the Arts at New York's Hospital for Joint Diseases, estimates that about 70% of professional musicians will be ailing at some point in their lives.
Consider the Los Angeles Philharmonic. Personnel manager Irving Bush figures that "at one time or another, just about everyone has a problem. Some just live through it, keep working and are comfortable enough to continue playing. Gradually it disappears or they play with some degree of pain throughout their careers."
Bush reports tendinitis, sore necks and shoulders, and neurological pain in the string section; hernias, dental and facial muscle problems in the brass section. Philharmonic trumpet player Boyde Hood adds that during summer's Hollywood Bowl sojourns, brass players breathing deeply "find ourselves coughing and getting chest pains. When the smog is bad, it really affects the way you play, and if you're downwind from the smoke during a fireworks concert, you have to be real careful breathing."
What they do for love. One local musician says he tends to scrape his cuticles raw on the steel strings of his electric guitar. Max Weinberg, the drummer in Bruce Springsteen's E Street Band, woke up the day after the band recorded "Born in the U.S.A." and couldn't move the fingers on his left hand; he later had surgery on each of seven injured fingers.
Dangers of Dancing
Medical journals almost routinely document the nutritional and skeletal problems of ballerinas. One article in the New England Journal of Medicine earlier this year, for instance, found that in a survey of 75 dancers from four professional ballet companies, the prevalence of scoliosis, a curvature of the spine, was 24%; the incidence of fractures was 61%.
Dancing can be dangerous. Orthopedic surgeon Dr. Dan Silver, for example, had to tape dancer Julie Janus' arm following her performance with the Joffrey Ballet here. "The choreography called for (Janus and another dancer) to interlock their arms. Apparently they missed their timing and his full body weight pulled against her frail arm, causing a partial tear of the muscle."
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