There are professional pains. No, not the irritating ways of managers, but physical stresses and strains unique to performing. Paul Colbert interviewed Osteopath Sue Farwell, a specialist in musicians complaints, to get the story.

A well known guitarist came to Sue Farwell complaining of serious neck pains. She examined the muscles around his back and shoulders, and found the strain there was bad enough to have been the result of a whiplash injury. But no, he hadn't been in any car accidents, and no, he'd not been dropped as a baby. He wracked his brains. He could think of nothing which could have caused it. So Sue went to one of his gigs.

"And part way through, his head started flying back and forth... enough to give himself minor whiplash," The headbanger just didn't realise what he was doing in the heat of the moment.

In fact musicians rarely do. Sue Farwell has been interested in their particular problems all through her four years of practice as an Osteopath, an interest which stemmed from her singing days in an orchestra. She used to collect backs.

"The London choir I was in sat behind the musicians and I could see their jackets stretched across their shoulders as they kept the same positions for several hours." She began to recognise violin player's wrist and double bassists back... all areas of concentrated muscle stress forced upon musicians by the instruments and techniques they use.

When she first went into practice it was mostly classical musicians that came for treatment. Now rock players bring a series of aches, brought on by the sustained, heavy and tightly focussed physical exercise that's part of their job. Osteopaths treat the whole body, using trained fingers to seek out tense and strained muscles, and examining the effect on ligaments, joints and other muscles further down the line. Gentle manipulation and massage should eventually relieve the stress and return the muscles to their relaxed norm, but it's up to the musician to keep them that way by re-examining their technique, or maybe their lifestyle. "A good Osteopath should help the patient identify what's wrong."

THE CAUSE

There are many contributory factors to muscle strain: "if you overuse a body that's underfed and under rested, or in generally poor health, that will encourage problems. Success or psychological pressure can also play a part. If you're body is developing a fatigue point then either your technique is wrong, or you're overtired and misusing yourself." In fact the proper application of correct technique — with no cheating — should keep troubles at bay.

But it can take some time before you realise you're doing it wrong. And your body will deceive you. "It's very good at helping itself out," says Sue, taking a guitarist's constantly strumming right hand as an example. "What will happen is that you'll start using the muscles in your forearm to help the tired ones in the wrist, then those in the biceps to relieve those in the forearm, then the rest of the shoulder will get involved..." The dull ache in your wrist never gets really bad, but after a couple of years, it could ache all the way up to your neck and shoulders. Then there are a lot of muscles to be treated which could have been spared if you'd taken your wrist in for an MOT earlier.

DANGER SIGNS

"Look out for anything that leaves you with a dull ache after the gig is finished, and gradually takes longer and longer to fade away after you've stopped playing." People often ignore such nags for three or four years. The bad news is — not surprisingly — that the older you get, the harder it may be to return stressed muscles to their blissfully relaxed original condition. Persistent, wilful ignorance can put the joints themselves at risk, Incidentally terror filled stories of Osteopaths popping bones with their knee in your back is highly exaggerated. Yes bones can make cracking noises as they settle back into relaxed positions, but it's no more painful then popping your knuckles. "You can hardly produce relaxation if your treatment is causing someone pain."

To identify trouble bones, Sue Farwell has asked musicians to bring their instrument in and play for her: "But they put on very proper performance, like they would for a music teacher, and that doesn't really show me what's happening." So trips to rehearsals and gigs have been necessary. "It's interesting... I can see them make the transition from playing with their heads to playing with their hearts." That's when the headbanging comes out.

KNOW YOUR BODY

There are a small number of musicians who stay aware of their bodies' condition, but most don't. Music Schools may send young students to Sue who can advise them on avoiding strain, But many of her patients will be people in the middle of their careers who have no time to rest the problem back to normal, and are to far advanced to rip their technique apart and start again.

Still: "musicians are better at taking advice than most," says Sue, weighing her words. "They do because it's important to them. Some people will come to maintain their fitness 100 per cent, there might be one small muscle in their wrist that is slightly stiff, but to a classical pianist that very small problem is enough to keep them off their peak." Initially, Sue admits, it may be difficult for and outsider to recognise that, especially when someone else in her waiting room is bent double with a back that has completely seized up.

Sue has a special interest in musicians' problems, and her Acton practice sees quite a few, but other Osteopaths will be able to help. The initials MRO (Member of the Register of Osteopaths) will assure you that they've completed the official four year training course. They're also taught to screen for problems which need to be seen by a Doctor, though frequently the referral will come from the other direction.