ST. PAUL, Minn. For decades, playing hurt was just part of the job for musicians, who learned to endure the pain in silence.
Now a cellist who once practiced to the point where she couldn't turn a doorknob is spreading a message that resonates with musicians around the country. Janet Horvath's seminars help prevent and treat injuries caused by overuse of muscles, harmful playing techniques and instruments that don't fit.
''These injuries really can be nipped in the bud,'' Horvath said. ''They can be very minor if you pay attention to what your body is trying to tell you right away.''
Horvath has been associate principal cellist with the Minnesota Orchestra for more than 20 years. In 1974, she was enrolled at the Indiana University School of Music, studying under renowned cellist Janos Starker.
Determined to be the best Starker student ever, Horvath practiced. And practiced. And practiced.
It was too much for her body to take. In one two-minute movement of the aria ''Why Do the Nations'' from Handel's ''Messiah,'' for example, Horvath's right arm moves back and forth 740 times during the 96-bar movement.
''Try brushing your teeth with 740 strokes,'' she said.
Horvath's left arm began to hurt. But she kept quiet, thinking the pain would disappear as she got in better shape as a cellist.
Instead, it got worse. She finally admitted her condition to Starker and put down her cello for three months. It took another nine months of working with Starker to adjust her posture and technique before Horvath was healed.
The experience sensitized Horvath to the pain all around her. Fellow musicians started asking for help with their problems muscle and tendon disorders, nerve damage, hearing loss, aching lips and jaws and teeth.
She began working not only with musicians, but with physicians, therapists, orchestra managers, college teachers and insurance carriers.
Today, some musicians use splints to brace their limbs and special supports for heavy instruments. They are experimenting with special chairs and modified instruments smaller piano keyboards for people with small hands, for example, and a viola that is stretched diagonally to help relieve a musician's elbow pain. Some musicians use Plexiglas shields to protect their hearing.
Performing arts medical clinics have sprung up, and there's a textbook for medical students who may want to specialize in the field.
In 2002, Horvath self-published a book, ''Playing (less) Hurt: An Injury Prevention Guide for Musicians.'' It has sold a healthy 3,000 copies.
Dr. Jennine Speier, a Twin Cities specialist in physical medicine rehabilitation who has worked closely with Horvath, said musicians are becoming more willing to talk about their injuries and seek treatment. And more doctors are becoming knowledgeable about the types of problems musicians experience and what specialists are best trained to evaluate and treat them, she said.
''It's a tremendously changed area, although we're still, I think, quite behind sports medicine,'' Horvath said. ''But we're getting there, and it's partly due to the rampant nature of overuse injuries, the repetitive strain injuries that are occurring in the workplace due to the computer.''
In May, the Indianapolis Symphony became the first major orchestra in the country to require its musicians to attend a two-day pain prevention workshop. Orchestra management brought in Horvath and used rehearsal time for her workshops.
Geoffry S. Lapin, a cellist with the symphony for 33 years, said injuries had been increasing and musicians were missing work. Horvath spent about an hour working with Lapin individually on his neck pain.
''I thought it was the way I was leaning my head back when I play,'' Lapin said. But when he played for Horvath, she determined he was scrunching his shoulders forward and putting pressure on neck nerves.
Because Lapin has very long legs, Horvath had him sit further back on his chair and pull out the end pin at the bottom of his cello another six inches, which opened up his shoulders.
''I am pain-free for the first time in years,'' Lapin said.
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