The Free-Reed Journal
Articles and Essays Featuring Classical Free-Reed Instruments and Performers

The Accordion: A Back Breaker

Part Three: Oh, My Aching Neck and Back!!!

Preventing the Pain that Playing Can Cause. . .

by John Bonica, L.P.T., N.Z.R.P.

In the last issue I addressed the advisability and necessity of stretching and warming up the wrist, fingers, elbow and shoulders before practicing or playing, in order to maximize the length of your playing career and minimize the risk of inducing positional dysfunctional injuries common among many accordion players. This time I will deal in depth with perhaps the most crippling and painful condition which has prematurely ended many promising careers, and caused many accordion players to set their instrument aside permanently. I am of course referring to back pain.

Spinal pain and dysfunction has affected most of us at some time in our lives. Indeed statistics show that 86% of all men and women experience neck or back pain. As a Specialist in this field for nearly 30 years, I have met few of the fortunate remaining 14%, and have spent more than half of my life diagnosing and treating the cause and effects of spinal pain. Surprisingly musicians are high on the casualty list, along with sedentary occupations, cab drivers, and long haul truck drivers. All have one common denominator. They all must sit and perform repetitive tasks for a length of time. In my clinical experience it is much more difficult to relieve and rehabilitate a patient who predominantly sits down for a living, than a more physically active manual laborer.

As accordionists we are caught both ways. While we are able to stand or sit to play, the pressures generated on the discs in the lower spine (lumbar area) are subjected to phenomenal compressional forces while standing with a 25 - 30 pound instrument hanging from our shoulders. Studies show that a 30 pound weight held in front of the body will cause the lower spinal discs to be subjected to pressures of 1035 pounds per square inch. If a section of spine with its disc (the washer between the bones) is squeezed up in a vise, the bone will fracture at around 1045 pounds per square inch! Of course we have all lifted much heavier loads than our accordions without breaking bones or hurting our backs. Thanks to the wonderful design of our healthy discs and spinal column, the forces are dissipated by a hydraulic mechanism which absorbs the load and evenly distributes the pressure.

Note that I emphasized healthy disc. Unfortunately as we get older and subject our bodies to the traumas of life, gain weight and lose the flexibility and good abdominal muscle tone we had as youngsters, the disc spaces tend to narrow gradually, with a ''drying out'' of the disc commonly called degenerative disc disease. For those of you who have had this diagnosis pronounced upon you, whether it be in your neck or back, don't lose heart. Degenerative disc disease (or D.D.D.) is not an actual disease, but rather a natural aging process which occurs in the low back and lower neck areas from about the age of 26 and slowly diminishes the disc space and alters the weight bearing surfaces of some joints in the spine. Most often D.D.D. is not accompanied by pain but rather slight to moderate stiffness, which comes and goes according to activity levels.

Of course there are other pathological causes of back pain accompanied by severe pain, muscle spasm and occasionally numbness and tingling in the extremities. Pain is the body's way of alerting us that something is not right. Pay attention to your body and if symptoms persist for more than a few days consult your doctor.

The purpose of this article is not to address all the different types of spinal conditions, but to make you aware that much can be done to prevent the onset of back and neck pain which may start out as something just annoying but can escalate into distracting and debilitating pain which completely takes away the enjoyment we derive from playing the accordion.

Having mentioned the forces our spines are subjected to in everyday life, you can appreciate that anything we can do to minimize those forces will delay that day when inevitably we set the instrument aside because we experience too much discomfort to enjoy playing or practicing. For some, like Anthony Galla-Rini is his 87th year, that day will never come! I have observed the Maestro on many occasions recently, performing, teaching and demonstrating, and am always impressed with the great care and attention he gives to correct playing position and posture. He chooses a chair carefully. He uses a backstrap of the diagonal kind (which he designed himself) and he always takes a moment to compose himself and adjust his playing position.

On the other end of the scale I see atrocious examples of sloppy posture, poor choice of chair and improperly adjusted straps. In talking to these players, most complain of aches and pains, with many exhibiting more serious signs of numbness and weakness in the arms, fingers and frequently, severe headache.

I have said it before, but will repeat it. Prevention is worth a thousand cures! Most often the remedy is simple and inexpensive. For it lies in paying close attention to seemingly trivial little details, most of which I have previously addressed in an earlier '89 issue of Accordion World, ''How not to Hurt Yourself While Playing the Accordion''. Rather than repeat myself, I would like to make you aware of sound posture and positioning, which when you understand how to and why you should observe the basic concepts, you will more likely pay attention to your own playing position and be able to assist others to correct some of their bad habits too.

Firstly to minimize disc pressure in the low back, whether standing or sitting, it is essential to maintain a slight hollow in the lumbar spine (low back). Excessive hollow can be worse than no hollow at all. All spines are naturally curved especially in the lower neck and the lower back. The curve is called lordosis and the spine is shaped like a shallow S. (See diagram).

When we sit the lumbar (low back) curve flattens out if we slump. Try sitting in a straight backed chair or on a stool and put your hand in the small of your back. If you sit up straight and tall, you should feel a slight hollow. Now if you sag slightly forward at the waist the low back will flatten or become slightly rounded. Beware! This is a potentially injurious position. Many of us pick up our accordions from the floor in this position. This is perhaps the most common cause of back pain. Lifting without a hollow and particularly if we lift and twist slightly al the same time. Sound familiar?

So, try to develop the habit of playing while maintaining a hollow in your back. Sit up straight. Choose the right chair height - one that places your hips and knees at a 90 degree angle. (See photo).

Adjust that music stand height and get your music in good light.

For the neck and upper back (thoracic) area, it is essential not to sustain a flexed neck for long periods. Looking down causes the natural curve in the cervical (neck) spine to straighten out and stretch the muscles ligaments and joints posteriorly. Take a moment and place your finger tips centrally on the back of your neck just below your hair line. Try it sitting up with a nice hollow in your low back and head erect. Now tip your head forward and look down. Notice the increase in tension with even just a slight tip forward. More importantly still, with your fingers still in place on the back of your neck while looking down slightly, let your low back sag to lose the hollow. Did you notice the further increase of neck tension? Now put back the hollow in the low back. Feel neck tension decrease? Now regain your neck hollow. Notice how much softer the neck tissues feel? This very mechanism is one of the primary causes of occipital headache (headache that starts at the base of your skull and spreads over the top of your skull).

You can see by this small example that posture plays a big part in minimizing pressure and tension in tissues that will quite soon become painful and distracting if allowed to continue. Posture is a reflex. It is a learned habit Your posture reflects your moods and state of mind. Poor posture seldom means weak muscles, and can be corrected simply by being aware of that posture and consciously altering it. Bad habits can be broken in two to three weeks of diligent self awareness. Correction of poor playing posture often accompanies relief of nagging aches, headaches and other symptoms. Have your fellow accordionists check your position from a side view. Have someone take a before and after picture of you playing. Many of you will be quite shocked at what you see. Poor playing posture makes it impossible to control your instrument to get the best out of it. It follows that a better playing posture will enable you to become a better player (and it doesn't cost you anything!).

Obviously this subject has many themes and variations all of which cannot be addressed. If you have specific questions or related problems, write to me care of Accordion World and I'll do my best to give you pointers or steer you in an appropriate direction if professional help might be indicated.

Reprinted from Accordion World (Portland, Oregon: Spring 1991). Used with permission.

The Classical Free-Reed, Inc. staff gratefully acknowledges volunteer Terry Knight who assisted in the production of this article.

About the Author

John Bonica, L.P.T., N.Z.R.P., is the founder of Pacific Spinal and Orthopaedic Manual Therapy Clinic, a subsidiary of Rockwood Orthopaedic and Sports Physical Clinic, P.C., located in Portland, Oregon, USA.

Born in New Zealand in 1942 of Italian parents, he grew up in a musical family in which his grandfather played accordion. Mr. Bonica played drums, percussion, flugelhorn, bugle and string bass before turning to the accordion at age 15. He taught himself by ear and learned the Chopin "Minute Waltz" by listening to a recording by Charles Magnante.

After some time, he realized the limitations of playing only by ear, so he taught himself how to read music so he could enter competitions. He won the New Zealand Championship several years in the duet, trio and quartet divisions. He won second place at the New Zealand Open in 1978 in the solo division.

Mr. Bonica emigrated to the United States in 1980 to teach spinal specialists and continue his practice of spinal therapy. He has recorded four CDs of Italian and European folk music utilizing a MIDI orchestra ensemble. Other activities include writing and publishing (he was editor and publisher for Accordion World magazine from 1989 until 1994), sailing and photography.

Part Four: Is Your Wrist Slowing Down Your Fingers?
An Anatomical Discussion of the correct Wrist, Elbow and Shoulder Position for the Treble Keyboard

by John Bonica, L.P.T., N.Z.R.P.
Part Five: Oh, My Aching Neck and Shoulders!
An Exercise Program That May Help!

by John Bonica, L.P.T., N.Z.R.P.
Part Six: Special Instructions for Low Back Patients
by John Bonica, L.P.T., N.Z.R.P.
Part Seven: The Great Accordion Myth!
Is Lighter Really Better?

by John Bonica, L.P.T., N.Z.R.P.

Invitation to Contributors / Submission Guidelines
Back to The Free-Reed Journal Contents Page
Back to The Classical Free-Reed, Inc. Home Page