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ГАИ HEEL PROFILE By Joseph Baneth Allen Curing Sour Notes A unique program at the East Carolina University School of Medicine gives musicians a new shot at pain-free performance. Susan Paxton readies herself and herviolin fora performance — a performance capable of de¬ termining the future of her career as a musician. She raises the bow to the violin, al¬ ready balanced between her shoulder and cheek. Soreness and numbness grip her left arm and fingers, hamper¬ ing her ability to perform and threat¬ ening to turn her vibrant music into sour notes. Her audience. Drs. Nicholas A. Pa- tronc and Richard A. Hoppman, closely observe each move as she brings forth centuries-old melodies from Mozart’s Concerto in B. They are listening not to critique her perform¬ ance. however, but to cure her pain. As two of the few doctors in the coun¬ try specializing in music medicine, Patrone and Hoppman founded the Eastern Carolina Outpatient Clinic for Medical Problems of Performing Artists at the East Carolina Univer¬ sity School of Medicine in Greenville more than a year ago. The clinic, the only one of its kind in the Southeast, is intended to do for musicians, dancers, singers and other performing artists what sports medi¬ cine does for athletes. More than 100 performers have been treated there since it was was founded. “Just as athletes’ problems are being treated by sports medicine, the same is beginning to happen for per¬ forming artists," Patrone says. . Music and sports medicine are simi¬ lar in many ways. Each requires a complete medical history of the pa¬ tients. as well as their instruments or equipment and number of hours spent practicing and performing. “We need to get a detailed practice history in order to determine just how practice on an instrumentcan have an effect on a musician, whether through overuse, hypermobility or other problems." Hoppman says. Because Patrone and Hoppman are both rheumatologists and musicians, they are familiar with the muscle and bone stresses common in playing. Pa¬ trone is a member of the ECU Sym¬ phony. and plays the violin and viola. Hoppman plays the saxophone and percussion instruments. Both have felt the physical pain of practice and understand well the devotion of a mu¬ sician to performance. “Overuse is the most common prob¬ lem we see among musicians." Hoppman says. “Musicians can practice two, four, six. even up to eight hours a day," Pa¬ trone adds. Practice may make perfect, but it also can cause muscular and skeletal problems. Once a musician comes to the clinic for help, the doctors immedi¬ ately start looking for a solution, which can be simple or difficult. One common problem is “clarinet¬ ists thumb." “The weight of the clari¬ net places a fair amount of torque (pressure) on the thumb, which is used to balance the instrument." Hoppman says. While the fingers move rapidly over the keys, the thumb supports the weight of the clarinet. That can be painful to a musician who practices hours on end. The solution to clarinetist’s thumb is simple. Hoppman says. “Straps are attached to the clarinet, which dis¬ tributes the weight of the instrument evenly across the shoulders and back of the musician." he says. The thumb is freed from bearing the weight of the instrument, and the musician is free to concentrateon the music, instead of on the sore thumb. Susan Paxton's problem, however, could not be solved by attaching straps to her violin. She occasionally suffered from spontaneous disloca¬ tion of finger joints in her right hand. "I hadn’t heard about music medi¬ cine before I came to ECU." she says. But when she heard about the good reviews the clinic was getting from students and instructors in the music school, the 19-ycar-old undergradu¬ ate from Manassis. Virginia, sched- Drs. Richard Hoppman, left, and Nicholas Patrone watch Susan Paxton play herviolin. PbMo Jo-pMUmlhAllii the Statc/Scplembcr'89 36