Tuesday, September 15, 2009

Wilco Drummer Glenn Kotche-Video of the Week

So I'm interrupting my three part series on joint pain and musicians to bring you this weeks "Video of the Week". I know, I know...I skipped last weeks video...sorry. I was on the road and just didn't have time to post one...but this weeks will make up for it....I PROMISE!!!

Glenn Kotche is the drummer for the band Wilco. He's doing a TON to expand the idea of the drumkit as a solo and compositional instrument. This isn't your run-of-the-mill drum solo with fast doubles and stick twirls. This is strictly focusing on creating a piece of real music using the drumkit augmented by other percussive instruments. He's trying to creat a mood...I didn't see a thing in this solo that was aimed at impressing you with what a fast or technical player he is. Glenn is always seeking to serve the music and stretch the instrument...and his reward is a status as one of todays top drummers.

So open up your mind, clear out any pre-conceptions you may have, close your eyes and soak up this inspirational piece.

Thursday, September 10, 2009

Is It Carpal Tunnel?

So in my post yesterday I gave you the skinny on wrist pain, the possibility that it might NOT be Carpal Tunnel, and what Active Release Technique is. Today I want to tell you about my experience with it...

I've been playing since 14...all types of gigs, sometimes 10 hours a day on stage, sometimes equally as long practice sessions, and lots and lots of lessons with quality professionals. Even though I had learned the proper technique for my hands and feet, about two years ago I started having a dull ache in both of my wrists.

I ignored it for a bit...shuffed it off as overuse. Backed off of my practicing a little, thought that would do the trick. And it did...but as soon as I would pick up the sticks and start playing again, it would come back. I had no clue what to do. I was scared to death of visiting a doctor about it, knowing the only option was to cut my wrists open...yikes!

This went on for months...thought I might have to stop playing altogether. Then one evening, as I was lying in bed, I remembered an article from a Modern Drummer magazine I had gotten in the mail while in college. I couldn't remember the content of the article, but I remembered the title..."Wrist Pain...It May Not Be Carpal Tunnel". Then I went to sleep and forgot about it.

Fast foward a couple of weeks...I was looking for some reading material to occupy me as "nature did her thing" and I grabbed an old Modern Drummer out of a stack of about fifty. And what to my suprise?! It was the edition with that same article in it! Talk about a God send!

I devoured the whole article in about two minutes and by the end of it I was convinced that I had to meet with the doctor (Dr. Preston Wakefield) that had been interviewed...it didn't matter how far I had to drive. Then to my suprise, I read the small print at the bottom of the article...HE WAS RIGHT HERE IN MY OWN TOWN!!! RIGHT HERE IN NASHVEGAS!!!

Fast foward another two seconds and I was on the phone scheduling an appointment with him. It took them about a week to work me in, but work me in they did. Dr. Wakefield works part time with the Titans (pro American football team) and part time with the Predators (pro hockey team)...and the other part of his time is spent working on musicians...lots of them.

I walked in to a dark office with some moody music playing...um, ok. It threw me off a bit...definitely not your normal, run of the mill doctor. Dr. Preston is a soft spoken guy with somewhat of a "hippie" vibe to him...very nice and very cool. He took my wrist, flipped it over and began to feel around with his fingers.

"Ah, there's your problem" he said.


"Right there..here feel this..."

"Um, I got nothin'...don't feel a thing..."

"Yea, we can fix this."

WHAT?!?! No surgeries? No long recovery time? No living with the pain? That was it? "We can fix this?" As if he saw a stain in the carpet and he knew all it needed was some cleaning and it would be fine.

I couldn't believe it. Dr. Preston explained to me exactly what you read yesterday...that my problem wasn't at all with my carpal tunnel. He explained that repetitive motions in the same position over prolonged periods of time have the same result that happens immediately when an athlete gets tackled hard or in the wrong way (hence the reason he also is in high demand with pro teams.)

He worked on my arm for roughly half an hour...he would knead my arm, ask where the pain was (it was moving when he was massaging it...amazing!), then knead some more.

We scheduled another appointment.

The pain got worse. Suck. I couldn't believe it. Here I was thinking that I had found my miracle man and it turned out to be all smoke and mirrors.

When I went back to him the second time I informed him that it had gotten worse.




He stared at my arm for a minute and then went to work. I went to pay him at the end of the visit and he wouldn't take my money. "You can pay me when I stop messing up your arm." (Although he used a bit more colorful language than that!) Now I knew this guy was the real thing! I had never had a doctor refuse my payment for failing to make me better! This guy was great.

Long and the short of it...I went to Dr. Wakefield three times and haven't had pain since. He taught me a series of stretches (which I'll post on later) and informed me on how to avoid the problem again.

So here I am, two years later, playing with no pain and telling everyone I know that's going to get checked out for Carpal Tunnel Syndrome to stop and go see my doctor. Insurance won't cover the visit (his techniques are relatively new and the insurance companies usually don't accept the visits) but it's only $70 a visit. His goal is to see you once and never see you again. Mine was a pretty bad case, so it required a little more attention.

So if you've got wrist or joint pain, don't get freaked out. Look up an Active Release Technician (A.R.T.) that is close to you and get the problem seen about.

My next post is gonna be on how to avoid the problem altogether, so keep checkin in!

Wednesday, September 9, 2009

Musicians, Wrist Pain, and Carpal Tunnel...

...And joint pain...and ankle pain...

There are certain dangers to watch out for when playing any musical instrument, but especially drums. It's an instrument that requires alot from your joints in both the arms and legs. The constant impact with hard and varied sources isn't exactly a walk in the park for your body...add to that the repetitive motions that are required in long practice sessions and you have the recipe for potential injury.

I don't care how good your technique is, injuries can still happen...and all too often do. The problem is that way to many people are quick to point to Carpal Tunnel as being the culprit, when in many cases it's not.

The reason I wanted to take some time and talk about this is because about 2 years ago I thought I was going to have to stop playing. My wrist pain was getting pretty bad. Here I was a very schooled drummer, had spent years studying under some of the best hand technique guru's...and my wrists were killing me. Expensive doctors visits and surgery images flashed before my minds eye. Then I remembered an article I had read in Modern Drummer about wrist pain...I looked it up and there was my answer!

I'll be talking on this topic in three different posts...one will be an article and interview with one of the doctors (the one I went to), one will be my experience with the problem, and the last will be on how to avoid the problem altogether.

Below is a re-post of an article by Jennie Hoeft...you can find it here, or you can just keep reading...



Stiff hands? Tingling fingers? Burning or numbness in the thumb and first three fingers?
Loss of speed, strength, or control?

You might…or might not…have carpal tunnel syndrome.

“Anyone who does a repeated motion long enough, without proper warm-up, stretching, and rest, will have a balance problem at some point. This imbalance has been fearfully named carpal tunnel syndrome,” says Dr Preston Wakefield. “ It has become the new melting pot diagnosis for all repetitive motion injuries from the fingertips to the shoulder.”
Preston (he prefers it to Dr.) claims that 90% of the carpal-claimers are incorrect in their diagnosis, that they actually have a very curable form of tendinitis/peripheral nerve entrapment.
And he cures them in 2-5 visits. Did you hear that? No more pain, no restricted movements, no drugs, no incisions, no braces…no way.

One year ago, George Lawrence, the drummer for Jo Dee Messina, couldn’t lift his suitcase. He couldn’t reach to the upper cupboard and lift down two dinner plates. His tingling arms kept him from sleeping, and the numbness and pain in his hands nearly cut his career in half. He came to Preston Wakefield as a last resort. He explains that his arm pain had been happening on and off for years, and then it became constant…not when he was playing, but when he went to lift anything, open a door, lift the trashcan…it was debilitating to his entire life. “I wore a brace for six months religiously, and nothing changed. Surgery was recommended, and I knew I had to investigate this new, non-invasive technique, before I looked for a new career”. After two visits, and daily homework of stretching and performing a couple of exercises, George is cured. “I sometimes feel a sense of tingle in my elbow, and it reminds me that I haven’t been doing my stretches.”

Trey Gray, the drummer for Faith Hill, known for his huge overhead left-hand back-beat, woke up one morning unable to raise his left arm. He had heard about Preston’s technique and now had no choice but to call him. Trey had relief within a few hours, but knows that his crazy style is the cause of his shoulder trauma, and that he if he doesn’t re-evaluate his motion, he will always have this potential for trouble.

Ron Ganaway, a serious session and touring drummer with Steve Wariner, took a few months off the road and then returned to an extra loud, extra long, extra demanding series of shows. For the first time in his lengthy recording/touring career, Ron felt a tingling in his forearms, and pain that would not go away. Ron thinks this tendinitis is about a lot of things… “The music is louder, the sticks are bigger, and the tours are fewer…so when I did go out, it was full out! Every drummer wants to kick the band, be the foundation, but there has to be finesse and control. If I could make one change in my past, present, and future playing, it would be to play relaxed…if the drummer doesn’t, no one else in the band will…and your body will suffer”. Ron sends every ailing musician he knows to Dr. Wakefield…“he freed all of that stuff up, and has given me an awareness of how to take care of my body before and after a show”.

What do these three professional, touring, recording, fabulous drummers have in common?

All three guys had pain, tingling, aching and numbness in their shoulders, arms, or hands.
All three guys thought they had carpal tunnel syndrome.
All three are clients of Dr. Preston Wakefield.
All three are playing pain-free, surgery-free, and drug-free


Dr. Preston Wakefield, a chiropractor and trained A.R.T.â therapist, has an office at The Club at Green Hills in Nashville, and is one of the only practitioners of Active Release Techniques âin the city. In thirty minutes, Dr. Wakefield observes what movement causes the pain, puts you on his table, and then puts the particular muscle through its’ range of motion. He is applying tension with his fingers, searching for the spots where the muscles are sticking together. Relief is immediate and lasting, if you do your homework. He is a forerunner in the healing industry as he focuses on the cause of the pain, not on masking the pain.

Dr. Wakefield grew up playing guitar and new first-hand about the possibility of repetitive motion injuries. He has transferred his love for music into an art of healing that does just that…heals.

A cure for carpal tunnel syndrome? Well, A.R.T. â is curing many of the same symptoms that are associated with CTS. As a working drummer myself, I was sensitive and curious about this new technique. As a personal trainer, I knew of the body’s natural ability to heal itself. I had to talk to Preston about this cutting edge approach to wellness, and his miraculous curing of Nashville’s finest drummers.
Jennie: You’re passionate about your work? Please describe it, and why…

Preston: I was watching people fail all around me. They had to give up careers even after surgery and physical therapy. I knew there was a physical solution to these problems without knives and drugs and surgery…

Jennie: What kind of problems?

Preston: Repetitive injuries…like the strumming arm of a guitar player, the hat side of a drummer, the arms/hands of a keyboard player, anyone who does a motion over and over again. Our bodies are not designed to do this type of motion, and when we do, the muscles tend to stick to one another. Muscles rub on muscles, and build up this resistance to stretching.

Jennie: Because the muscles are swollen?

Preston: Not necessarily. Swelling can occur at the later stages of the syndrome, but the real culprit is the adhesions that form between the muscle groups. These adhesions limit the ability of a muscle to slide over adjacent muscles, ligaments and nerves. They create a tug-a-war in the muscles involved. The weird thing is that you might not know it is happening until you feel pain or tightness. This process can manifest over 20 years, but the predisposition has been there all along.

Jennie: Is this process inevitable?

Preston: I can’t say that every person who overuses a limb will get injured, but the probability greatly increases without some type of preventative measures. If you don’t do any maintenance on your car, over the years, it will break down. The same holds true for the human body.

Jennie: So…you wanted to find a non-invasive way to balance these injured muscles, and help the body heal itself?

Preston: Yes. In 1992, I was in chiropractor school, and read a paper in a sports chiropractic journal by Michael Leahy, D.C., an aeronautical engineer and chiropractor who was working with the Olympic athletes in Colorado Springs. He had developed a technique that helped these athletes with exertion and over-use injuries. The paper focused on repetitive injuries like carpal tunnel syndrome, why they happen, and how he was treating them. I knew I had found my healing technique. I called him immediately after reading the article, bought the tapes and began learning the Active Release Techniquesâ.

Jennie: What do Olympic athletes have to do with drummers?

Preston: Well, the similarities are more a function of how the human body heals soft tissue injuries. Athletes over-exert and damage muscles with a sudden force, like a muscle strain; musicians injure themselves over a longer period of time with repetitive motions. The body heals both of these injuries by forming scar tissue.

Jennie: So this over-use injury is not carpal tunnel syndrome?

Preston: 9 times out of 10…no.

Jennie: Then can you please explain what carpal tunnel syndrome is and why we are mistaken?

Preston: (smile). Yes. Carpal Tunnel Syndrome is inflammation and entrapment of the medial nerve in the carpal tunnel, (the tunnel formed by the carpal bone at the base of the hand). This medial nerve controls the thumb, index finger, and middle finger on the palm side of the hand. Numbness in these three fingers, or in the nerves leading to these fingers, could be caused by swelling and entrapment of that nerve in the carpal tunnel. Now, like a garden hose that is kinked, the block could be anywhere along the length of the hose. There are nine prime spots along the arm that may be causing this entrapment, and it is so much easier for insurance companies, surgeons and electro-diagnostic studies to all conclude that because there is no “water coming out of the hose” we better widen the tip. So, the surgeons then cut the carpal tunnel open to make room for the entrapped nerves.

Jennie: But they start at the base of the hand searching for the kink, and work their way up the arm, loosening and freeing the house of the medial nerve.

Preston: Right. Electro-diagnostic testing is performed to determine the time it takes for an impulse to travel down the nerve. If it takes longer than expected, the assumption of carpal tunnel syndrome is made. And then they work on “widening the tip”. When I was taking gross anatomy, and I knew I was going to be working on this injury, I did a lot of upper-extremity dissections, and there wasn’t a case that I had, (I know this is dead tissue), that I couldn’t fit three probes the size of pencils in the carpal tunnel, and still not touch the tendons and nerves. There is plenty of room in there! Plenty of room for all that stuff to move around…

Jennie: Unless the tendons or nerves are swollen?

Preston: Yes, unless they are swollen a little bit…but swelling goes down over time. But they want to go in and cut it! Here’s what we are finding out…that after five years, about 80% of the persons that have the surgery, have recurring symptoms, and they think that the tingling and pain are just a fact of life and go on...because they had the surgery. But most of the cases with these symptoms that I see, the entrapment is somewhere other than the carpal tunnel.

Jennie: And that is peripheral nerve entrapment?

Preston: Right. That is what is creating the numbness and tingling. But, the condition I see most often in musicians is tendinitis.

Jennie: Tell me what tendinitis is.

Preston: Tendinitis…inflammation of the tendon…and it is due to the muscles adhering to one another, and when you move the muscle, there is actually some adverse tension placed upon the tendon at the insertion onto the bone. You move this muscle, it tightens up, and it pulls on the tendon. Under normal conditions, the muscle is acting like a resilient, flexible elastic tube. When the muscle gets too tight, it develops a ropey texture, which increases the tension on the tendon, when the muscle is contracted

Jennie: And why are the muscles too tight? Over-use, not warmed up?

Preston: …and not stretched…this can take over 20 years to develop…scar tissue takes time to develop, and we don’t listen to our bodies, unless it is hurting. So the problem may be there for a while…we may have every excuse in the book… “I’ll play through it”, “It’ll go away”, “I don’t have any money”, or the biggest one… “I’m scared”.

Jennie: It IS scary!

Preston: Damn right...so don’t ignore it! This injury needs attention and awareness to heal.

Jennie: So you can tell by touching, whether the injury is carpal tunnel syndrome, or tendinitis?

Preston: Yes. No MRI’s, no x-rays, just some simple muscle testing and palpations of the injury, and I can get an accurate read on where the scar tissue has formed and is blocking the natural, easy flow of the movement.

Jennie: So, out of all the drummers you have seen here in Nashville, complaining of hand/arm dysfunction, how many of them have Carpal Tunnel Syndrome? (Preston has seen over 40 drummers in the last 3 years).

Preston: None.

Jennie: Some of your patients had already gone through the CTS surgery, even though they didn’t have Carpal Tunnel Syndrome?

Preston: Yes. I treated them after the surgery, when they still had symptoms. They are all right now. They didn’t have CTS in the first place.

Jennie: Yikes. These drummers that come to you, are complaining of what exactly?

Preston: Well, it is a general weird feeling in the hands or forearms…a tingling, and ache, sharp pains, maybe dull pains, throbbing, numbness, and lack of strength and gripping power.

Jennie: And describe a first visit please.

Preston: First… “Let me watch you play… bring a practice pad”, I’m concerned with what kind of grip you use…how much movement is generated in your forearms, hands and fingers when you hit, can you maintain that tempo for a long period of time, can you control the movements as your arms begin to fatigue, do you develop cramps in your thumbs? I’m not a drummer, but I do know about balance and efficiency of movement.

Jennie: And what are you learning about your patients?

Preston: They are using way too much effort to get a really loud sound, and they don’t have an efficient way of getting it! I suggest they visit an instructor who can help them with technique. I give them advice on how to treat their injury off the kit…stretching regimes, icing, and exercise…If the person responds to the treatment I am giving them, in two or three visits, the diagnosis is accurate. I’m not going to suggest spending big money on a bunch of tests if two or three of my treatments may cure the problem.

Jennie: So you watch them play, you feel the scar tissue in the injured arm, and then you use Active Release Techniquesâ to eliminate the problem.

Preston: Correct. I usually find that when using this technique, the problems go away.

Jennie: Say that again??!!!!

Preston: I believe the problems can be fixed!! I start at the origin of the pain, use A.R.T. â on the prime moving muscle, and then I release the antagonistic muscle, which is working just as hard. Then, if all else fails, we will trace the pain to the spine, and do some spinal manipulation…but I don’t usually need to.

Jennie: What else does the treatment include?

Preston: Ice, sometimes…stretching…absolutely…and some basic exercises for the rest of your dang life. You have a predisposition for this problem, and if you continue to do the same thing you did to bring this problem on, and not change anything…you are insane…doing the same thing and expecting different results…insane.

Jennie: Does anything else effect tendinitis?

Preston: Yes…things like cigarette smoking, too much alcohol, little or no aerobic activity, lack of sleep…all of these factors can contribute to a flare up.

Jennie: And stress?

Preston: Sure. The body’s natural response to stress is to tighten up, and the artioles (the blood carriers) do the same thing. So, not only are we demanding more work out of a muscle, we are asking it to work with less blood…that can lead to a compromising position. Stress is a major factor in developing tendinitis.

Jennie: So out of those 40 drummers, how many are healed?

Preston: 90% are okay, playing pain free. Some come by for a tune up every 6 weeks to 6 months, depending on how frequently they play and how often the stretch. I cannot emphasize the importance of daily and sometimes hourly stretching.

Jennie: And the other 10%?

Preston: They don’t stretch, or I should say, they don’t invest the mental energy it takes to develop necessary, preventative habits. So they stay within the box, wondering when they will get better. OR, the other 10% might need surgery or may have diabetes, hypothyroidism or some other disease that effects muscle and nerves. Active Release Techniquesâ is a great place to start but there is no one- treatment protocol that can cure every problem of muscle, tendons and nerves. Health problems are as unique as the people who have them. The important thing is to get checked out. My goal for every patient is to see me once…the body has a natural ability to heal itself and I am here to help align the muscles and the tendons to facilitate the healing. Then it is up to the patient to stretch, strengthen and retrain their muscles to move without strain or pain.


Jerry Kroon, Nashville’s legendary session drummer, is a new client of Prestons’. He tells a story of a professional pitching coach… “in life, we are blessed with a limited amount of pitches. It is our job to learn the proper technique that will most efficiently perform the throw.” Jerry noticed his arms tightening as the music in the studio changed from traditional country (stick in left hand, brush in right), to harder, rockin’ country, almost 70’s rock-n-roll… “we were self taught to get a sound, a feel…and we just didn’t develop the relaxed technique to pitch forever.” Jerry Kroon, master session drummer on over 30 gold and platinum records, can’t emphasize enough…IF YOU FEEL PAIN, TENSION, TINGLING, NUMBNESS…CHECK IT OUT RIGHT AWAY!!! You can change your posture, your technique, your kit set up…you can’t change your arms. “I hope Preston works for me…I’m going to give it my best.”


Musicians have a naturally high tolerance for pain. The nature of playing, (sometimes 8-10 hours a day, just to be competitive), can be a breeding ground for repetitive motion injuries. First, we hate that we are hurting (someone is right behind us who isn’t), we have egos that convince us that we can heal ourselves,
(we can, but an objective, learned pro may figure out the cause much quicker), and money and insurance are luxuries of more legit professions. Musicians have a dilemma…no sick days, no paid vacations, and a long line of hungry players willing and able to work. Injuries happen to all players, at all levels. It is important to address the tension, the tingling, the numbness, the aching, and the loss of speed or power immediately…take care of your body, and it will take care of you.

You can learn more about A.R.T. âor find a practitioner in your area, by checking out: http://www.activerelease.com/

Or contact Dr. Preston Wakefield at 3820 Cleghorn Ave. Nashville, TN 37215. http://www.prestonwakefield.com/

Thursday, September 3, 2009

Playing Soft

Your mom was right...you play to loud. I know, hard to admit your parents might be onto something. Seriously though, you play too loud, you play too hard...

A real simple way to change things up when practicing is to play soft. You may not even know you're playing loud...and maybe you aren't. Not the point. The point is that whatever volume you're comfortably playing the drums at right now is too loud and you should practice playing softer. You can always play softer.

We're creatures of habit, we get it naturally, that's the way we were created. It's our job to consistently break those habits, even if they're not bad habits, for the sheer sake of growth.

Try this...sit down at the drums and start playing. Whatever volume you started at is your new definition of loud. Spend a whole practice session concentrating on playing at about half that volume. "But I play a dinner gig every week and I'm already playing at my softest." No you're not...I promise, you can play softer...you just don't want to put the effort into it. It's not easy.

I play a ton of rock, pop, and country at his point in my career....alot of outdoor venues, big venues, loud venues...and I have to beat the tar out of the drums. I stopped paying attention to practicing at a softer volume because all of my gigs required me to play at Mach 9. I slowly started to notice some of my finesse slipping away. Keeping yourself accustomed to playing at low volumes translates into loud situations. It gives your grooves depth, feeling...they're 3D instead of flat. It's the difference between looking at the Tennessee mountains and looking out over the Arizona desert...you don't wanna be a desert.

For a week or so, bring the volume down. It's frustrating...you feel like you're having to re-learn old material, but in the end your groove deepens and you have the confidence of being able to go into any situation and play at any volume needed.

So take a detour and go to the mountains...

Wednesday, September 2, 2009

Planned Practice

Practice isn't an accident. It doesn't just happen. You don't just stumble into a 3hour practice session.

Practice is a deliberate act. It's a focused, committed, and planned occurence. If you plan your whole day out and don't plan out a specific time and length for a practice session, chances are it won't happen. And if it does, it won't happen in a structured or planned fashion, thereby stunting its effectiveness.

Here's the big point...WHEN YOU PLAN YOUR DAY, SCHEDULE YOUR PRACTICE SESSION IN THE SAME WAY YOU SCHEDULE A DOCTOR'S APPOINTMENT, A COLLEGE COURSE, OR A HOT DATE. This means getting out your calendar, or Blackberry, or iPhone, or the back of your hand or whatever and blocking out a period of time devoted solely to practicing your craft. My relationship with my wife didn't happen by accident...it happened through me purposefully planning time with her...getting out my calendar and writing her in.

This is how a sample day looked in college for me...

5:30am-Wake up and shower
6:00am-Breakfast and devotions
6:30-9:30-Practice Snare and Drumset
1:00pm-Jazz Band
2:00pm-Practice Mallet and Keyboard Instruments
4:00-6:00pm-Practice Drumset or attend Ensemble Class

Practice was never an accident and it very rarely took me by suprise. I very rarely FELT like practicing at 6:30 in the morning...but it was a time that I was up and no one else would bother me. While we're here, let me say a bit about FEELING like practicing. I don't care if you feel like it or not...just do it. Practice is work. Monotonous work. Yes, sometimes it's a blast...and alot of times it's not. You don't need to be inspired to practice. It's a decision. I planned a practice session and I'm going to attend said practice session and work through my practice outline for that day. The payoff is that when you get on the gig, things will flow smoothly and effortlessly...and this is the time to really enjoy your playing. I love my practice times too...but I'd be lying if I said I enjoyed the process of banging my head against the wall, constantly pushing myself to play things I'm not able to....like I said, alot of times it's just plain work.

I think the biggest question is "Do you love playing this instrument?" Anything worth loving is worth working for...and working hard.

Planning and attending a purposeful practice time consistently is the only way to improve on any kind of measurable level.