The Clinic is staffed by Maureen, our office manager, Susan, our fitness appraiser and myself (Barbara Paull), with Christine joining in as our consultant whenever this is requested by a musician. If we need more clinical help, physiotherapists from the parent clinic, York County Physiotherapy & Sports Injuries Clinic, bring their considerable expertise.

The Stouffville Musicians' Injuries Clinic opened in 1991, and hurt musicians from all over North America and Europe have found their way to our door. Gradually, the staff is expanding, as other musicians who recover from their injuries and are interested in what they have learned offer their services as consultants for their own particular instruments. We have decided that this close partnership between a clinician and a musician who understands functional anatomy is the essential ingredient for successful results.

Much to my surprise, the fact that I am not a musician (but do appreciate music) has been a help rather than a hindrance. No one minds playing for me once they realize that I have no preconceived ideas about how they should play and will simply be watching what playing does to the body. Most musicians soon realize that their talent delights and amazes me, so they relax and give good demonstrations of their habitual playing postures and positions. Over the years they have also patiently taught me about their instruments and common problems.

Christine and I have discussed this gradual overlapping of our knowledge bases many times. Although we find each other's disciplines fascinating and continue to learn as much as possible from each other, when dealing with problems of injured musicians in the clinic, our roles remain distinct. Clients initially attend a one hour consultation with me. Violinists and violists may then, if they wish, spend another hour with Christine, experimenting with her growing collection of chin rests and shoulder rests and occasionally photographing or videotaping until we all are satisfied with the changes. The musician then goes off to try all the exercises, stretches and changes we have suggested. Some only need that one visit. A few need to return a few times until we all are satisfied with the results. Most will telephone us or respond to Maureen's “mother hen” calls to tell us how they are doing.

For a few who need a course of injury specific physiotherapy treatment, this can usually be arranged at a clinic close to home especially for students who generally need a government funded facility. So far we have been pleased with the results, but where do we go from here? Glancing back to the first chapter of this book with its alarming injury statistics, both collected and suspected, it seems obvious that we should be concentrating our energies upon “prevention” as well as “cure”. Injury prevention is an inherent component of physiotherapy and Christine is equally determined that musicians should be spared her miserable experiences. To address this, in 1992 we designed a one-day injury-prevention workshop for musicians, titled “Playing Without Pain”. During the workshop we impart much of the information contained in this book, and conduct practical sessions which include practicing many of the recommended stretches and exercises. Christine then demonstrates corrective ergonomics, using volunteers who are looking for ways to improve their playing postures.

We have presented the workshop to many groups of musicians and to some of their physiotherapists. (See Workshop.) Invariably, it has been received with enthusiasm and a sense of relief that “something can be done”. Group discussions usually continue right out into the parking lot or to a local restaurant.

We have also ventured outside of Canada, presenting papers at international medical conferences in Hong Kong, Australia, and England. Here we learned that the problems of musicians' injuries are indeed widespread. We also soon realized that the chief reason for the rather sparse help so far provided by orthodox medicine appears to be due to the fact that the majority of physicians and physiotherapists are unaware that there is a major problem.

Many of them are also musicians, with a genuine appreciation for music. Few of them, however, play sufficiently to induce overuse playing injuries as they are busy with their clinical practices, so they lack firsthand experiences to draw upon. And, as mentioned previously, few hurt musicians consult them. No wonder those who do specialize in this field feel rather alone.

In Australia, this led to discussions with local musicians and management groups, all actively searching for effective injury prevention and rehabilitation. Hopefully these medical and musical people will now get together and change the course of these injuries. In Canada, musicians continue to attend our workshops and the majority report that they can decrease their pain and manage their injuries when they have a better understanding of the underlying cause more successfully and simple preventive techniques.

Many music teachers who have participated have delighted us with their positive responses. Once they have been exposed to basic anatomy and athletic protocols, many can hardly wait to try out these new ideas with their pupils and to give us the benefit of their own experiences and experiments. Music teachers, in our opinion, are the main line of defense against playing injuries for the generations to come. If they are willing to incorporate our teaching into theirs, the Stouffville Musicians' Injuries Clinic should eventually run out of injured musicians to treat. Nothing would make us happier!