By Brian Wise | From the July-August 2021 issue of Strings magazine

With the return to live performance, musicians may also experience heightened levels of stress, anxiety and repetitive strain injuries if they haven’t been keeping a regular playing schedule. Here’s how to combat that comeback anxiety and stress.

When Patrick Miller, a Cleveland-based violist, attended his first rehearsals with the Columbus Symphony Orchestra after a seven-month hiatus last October, he found that his ensemble skills and technique were intact. But there was one unexpected concern: “I was exhausted,” he says. At the Columbus Symphony, rehearsals were shortened by an hour, to 90 minutes, following COVID-19 safety protocols. The ensemble also avoided too much unfamiliar music. “But even with standard repertoire it was tough to stay strong throughout the entire week,” the 27-year-old Miller adds. “Stamina was a big concern.”

Miller is not alone in grappling with the challenges of re-immersion into concert life.

Li Li, a violist in the Indianapolis Symphony Orchestra, is thinking more about the psychological jolt of returning to the stage this fall than any rustiness on her instrument. “I don’t think I will be shocked physically,” she says. “It will probably be like riding a bike. Mentally, though, yes. Sometimes I have been having these horrible concert dreams, like one where I forgot my viola.”

As COVID-19 vaccinations continue, so do plans to get full orchestras and chamber ensembles back in halls before in-person audiences. But performance coaches, teachers, and psychologists see the comeback concerts as potential breeding grounds for repetitive strain injuries and festering anxieties, particularly after a year so characterized by stress and social isolation. Even veteran performers aren’t all ready.

“When there isn’t something to practice for, whether a concert or an audition, it’s very difficult to maintain consistent practicing habits,” says Janet Horvath, a cellist and author of Playing (Less) Hurt: An Injury Prevention Guide for Musicians. “I know of many colleagues who are concerned that they’ve been losing their chops, simply because it’s really hard to stay motivated when you are by yourself, not playing with anyone, and not preparing for anything,” she says. “So I wouldn’t say that it’s a given that people are in shape enough to start back into a full orchestra schedule.”


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Compared with the quietly analytic habit of practicing at home, rehearsing under a conductor can exact far more stress on a body. There are cues for extreme dynamics, sudden pauses, held notes, and abrupt tempo shifts. Bowings can become jerkier and attacks more sudden.

“There’s a lot of muscle control and evaluation involved in practice,” says Noa Kageyama, a performance psychologist on the faculties of the Juilliard School and the New World Symphony. “This is what musicians have been limited to doing for the most part this past year. But when you are performing effectively [in public], you’re doing almost none of that. You are not critiquing, evaluating, analyzing, problem solving, or consciously controlling your muscles. You’re just playing.”

Kageyama recalls a 2015 study in which German and Japanese neuroscientists compared the abilities of musicians to follow a conductor with those who followed a metronome. The study, published in Frontiers in Human Neuroscience, found that orchestra musicians develop an advanced ability to predict a conductor’s next action from the gestures—a skill (and region of the brain) that doesn’t correlate with metronome-based practicing.

“There’s a skill of being able to watch the conductor, watch the principal ahead of you, and listen across the stage, whether it’s your own section or the winds, brass, or percussion,” says Miller, the violist. “You are constantly having to keep track of a lot of different things. When you don’t do that for seven months, it definitely takes some getting used to again.”

How to Handle Judgment from Colleagues

As musicians return, they may also fear that colleagues will notice that their skills have deteriorated. “There’s a lot of stuff that doesn’t get talked about openly because of a machismo culture, but should” says Drew McManus, an orchestra consultant who writes the blog Adaptistration. “Traditionally, this is the stuff that gets you thrown under the bus by your colleagues.”

Even in a supportive work culture, orchestras could face the need to lure back hesitant audiences, and in turn program splashier and more taxing repertoire. McManus advises ensembles to place a moratorium on performance reviews and probationary periods for new members until musicians can acclimate.


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In one unusual move, the Phoenix Symphony, in Phoenix, Arizona, plans to hold a paid two-week retreat for its musicians and music director, Tito Muñoz, before onstage concerts resume this fall. Not unlike spring training in baseball, the gathering will take place offsite. “This retreat is truly a time for Tito and the orchestra to reconnect as they hone their skills both as musicians and as partners in music making,” says Phoenix Symphony president and CEO Suzanne Wilson in an e-mail.

The spring training analogy only extends so far, however. Athletes generally have more opportunities to compete and readjust over the course of a season. For this reason, Horvath advises inching back into shape slowly. “If musicians haven’t been playing for a month or two, they should begin consistently building up, starting with ten minutes at a time,” she says. Gradually, one can add more intervals throughout the day of just ten minutes per hour, allowing muscles time to recover. Only after a baseline endurance is achieved should one add to the length of sessions.

How to Manage Stress

Just as homebound office workers have developed a hunched “pandemic posture” from working on the couch or in bed over many months, similar habits in practicing can lead to carpal tunnel syndrome and other strain injuries. “Many of my colleagues are spending many hours on the computer teaching on Zoom and then practicing themselves,” Horvath notes. “That cumulative effect can cause fatigue. The first sign is burning and tingling, because you were taxing the muscles for a long period of time. If you can avoid doing that by alternating your position and alternating repertoire, it’s always a good idea.”

When it comes to the mental stress of returning to live concerts, some researchers advise meditation, deep breathing exercises, or muscle relaxation techniques. Memory slips may be contained by preparing “safety zones” in the score where one can turn to recover and continue. “The pandemic has exacerbated the anxieties that were already there,” says Julie Jaffee Nagel, a psychologist, pianist, and author of Managing Stage Fright: A Guide for Musicians and Music Teachers. “If you have a slip, you can know the score so well that you can jump to a safety spot and pick up. You have a way to get through it that’s not freaking out.”

Juilliard’s Kageyama says that while he’s seeing an uptick in musicians preparing for auditions, he expects some to be “kind of thrown” by what things feel like initially. “But,” he adds, “I think a lot of the positive aspects of being able to play with other people again and feel the energy of live audiences is going to certainly outweigh the initial surprises that might happen.”

Dianna Joiner is a violinist in the Indianapolis Chamber Orchestra. She recalls a rush of emotions when the ensemble gave its first pandemic-era concert in November, a live-streamed performance of Beethoven’s Fourth Symphony. “I remember practicing two days before like crazy,” she said. “I was practicing with recordings and I was so excited to be able to play a symphony again. It was an out-of-body experience to just start the Beethoven after not being able to practice a symphony for months.”