Chapter 4: Case Study - Week 1

It should be noted that not every asana or pranayama exercise was practised by every participant and in some cases participants chose to stick with one exercise per category to practise for the full first week. Whilst this establishes a proficient grounding in the particular exercise, not every participant's yoga routine looked the same so this can contribute to varying results. However, the experience of practising yoga should be very personal as everyone's body and capabilities are different. Therefore, a singular routine for every participant would not encourage the participants to practise body awareness. By creating their own routine they are cultivating their autonomy over their bodies and thinking critically on what is best for them and their experience, rather than blindly follow someone else’s routine. However, it is relevant to consider that therapeutic methods will not always feel comfortable and may feel counter-intuitive. In that sense it is important to identify what feels uncomfortable because it is difficult, and what feels uncomfortable because it is potentially harmful 

Participant Profiles:

The participants of this case study consist of seven brass musicians at a postgraduate level. The instrument division is two trumpet players, two trombone players, two french horn players and one tuba player. Two of the participants are in the process of receiving their master's degree and another has graduated from a masters. The group contains three male-identifying musicians and four female-identifying musicians. The gender ratio is balanced for each instrument except for trombone (two female participants) and the tuba participant (only one male participant). In the group, six of the seven participants had experience with yoga (Figure 2.0) however most reported irregular frequency of practice with only one reporting regular yoga practice “Have practiced yoga frequently for the past four years”. Four of the seven participants reported having experienced an injury or pain during practice of their instrument (Figure 2.1).

Practice Diary

Once the participants completed their first BodyMap survey, they were given a practice diary to record which yoga exercises were practised each day. The diary included a list of 16 asana poses and 4 pranayama (breathing) exercises with a link to a GIF demonstration embedded to each exercise. A description and explanation for why each exercise was chosen is included in the personal case study. The 16 asana poses were split into four colour-coded categories (Figure 2.6) to differentiate their execution: standing, bending, twisting and balance. A guideline of 5 - 6 poses a day was suggested with a requirement for at least one exercise from each category to be practised each day. Underneath the asanas are descriptions of how to practise each breathing exercise. Below are the results of the amount of times each exercise was practised during the first week which gives us an insight into the popularity of each exercise.



Pranayama Exercises

The last column of the practice diary left space for comments on how the yoga sequences have affected the participants throughout their week. Of the seven participants, six contributed to this section. The results include both positive and negative responses however the general reaction throughout the participants is that yoga assisted their practise rather than hindering it. With the recurrent benefits being general relaxation, relieved tension, increased breath control and heightened body awareness.

The most common benefit mentioned was a feeling of “increased relaxation” and a “calm mindset” which was referred to eight times across three of the participants. The relaxation felt by these three participants all were as a result of the breathing exercises with the alternate nostril breathing and Ujjayi breath being particularly popular:

The last common benefit felt throughout the group was a heightened body awareness which was mentioned twice across two of the participants:

Injury Prevention

Even after only a week of yoga, some of the participants began to see positive changes towards existing injuries/areas of tension. Out of the four participants that experience a pre-existing injury/area of tension, three specifically referenced positive change in their injury/area of tension (Figure 2.11):


The improvement seen particularly in Participant 3s progress emphasises the importance of working on our weaknesses. This is an attitude promoted through practice of yoga, “Often, the exercises or postures we don’t like end up being the ones we need the most.” (Olsen, M. 2009, p.xiv).

BodyMap

The “BodyMap'' section of the survey measures the physical impact of playing each instrument on the body throughout that week. The results of the ‘Brass BodyMap’ (Figure 2.4) shows that four of the participants experienced pre-existing pain/tension/discomfort when playing. The most frequent body part to be mentioned as a pre-existing area of pain/tension/discomfort were the shoulders which were highlighted by three participants in the comments section along with the lower back/back being mentioned by two participants. 

The participants were then asked how many hours a day they were playing on average throughout the week. The answers ranged from the highest being 5 - 6 hours a day and the lowest being 45 minutes. Next, they had to select any areas of the body where they felt pain/tension/discomfort during playing throughout the previous week. The 27 body parts were split into five categories (Figure 2.3):

Discussion

Participant Profile:

All participants involved in the case study have attained at least an undergraduate degree in music performance with two in the process of completing their masters and one having graduated from a masters. From this information we can determine that they are experienced musicians who have undergone intensive music education and playing schedules. Music performance graduates were chosen as they had gone through this rigorous playing schedule, and are more likely to have experienced either pain, tension or discomfort in their playing as opposed to a musician who only plays at an amateur level.  

 

Two musicians for each brass instrument were initially selected to participate including two tuba participants however one dropped out of the case study beforehand. If this study were to be repeated, an equal balance of instruments would be selected to offer balanced results. The gender ratio for each instrument was balanced with the exception of the trombone players. As I took part in a more detailed case study, I selected two female trombone players for balanced results. The tuba category initially had a male and female participant however the female participant cancelled, leaving male based results. Again, if this study were to be repeated, the gender ratio would be equal for each instrument.

 



BodyMap

The results of the first week's bodymap shows that the shoulders are the most selected body part in all three areas. They were selected by three participants as a pre-existing area of pain/tension/discomfort, six participants as a current area of pain/tension/discomfort and six as one of their three body-parts experiencing the most pain/tension/discomfort. These results align with existing research including a case study investigating “The high prevalence of playing-related musculoskeletal disorders (PRMDs) and its associated factors in amateur musicians playing in student orchestras: A cross-sectional study” (Kok et al., 2018). In this study 59 of the participants were brass players and similarly, the body part that was selected the most as an area of PRMD prevalence were the shoulders with 28.8% of the group experiencing a PRMD in that area. It is important to note that the musicians who took part in this study were amateur musicians as opposed to music students and the physical demands will be higher for the participants of my case study. 


Asana Exercises:

Comments Results and Analysis

Another common benefit amongst the participants was relieved tension in connection with the asana stretches and poses. This was referenced six times across three of the participants with the neck rolls being particularly popular:

The next most common benefit was the increased breath control and decreased tension in the breath. This was mentioned five times across four of the participants:

Figure 2.0

Figure 2.5

Figure 2.9

Figure 2.11

Figure 2.6

Figure 2.4

Practice Diary: Week 1

Figure 2.1

                                                 Increased Relaxation
  • “Alternate nostril breathing helped relieve general tension / feeling of physical stress when playing” Participant 1
  • “Forgot how much I enjoyed alternate nostril breathing – extremely relaxing” Participant 3

  • “Breathing helped to destress. Started to prefer Ujjayi breath”. Participant 6

  • “Enjoy destress effect in evening after practice” Participant 6

  • shorter session but enjoyed stretched and relaxing after a busy day” Participant 6
                                                Relieved Tension
  • “Loving the neck rolls still for easing shoulder tension” Participant 1

  • “The bending and standing poses definitely open up my breathing. And this in turn then eases tension when I play” Participant 1

  • “poses that stretch the arms such as overhead reach feel good on it” (in reference to elbow pain/tension) Participant 1

  • “I get tension especially in my left shoulder, and that felt a little less.” Participant 1

  • “lower back is starting to feel a bit looser than usual” Participant 3

  • “Stomach tension relieved throughout the week”. Participant 4
                                                Increased Breath Control
  • “backbend helped open up/relax my breathing” 1

  • “The bending and standing poses definitely open up my breathing” 1

  • “Breath of Fire nicely helps me feel the activity of the diaphragm that I need for playing” 2

  • “Breath control improved” 3

  • “breathing technique and conscious mindful breathing help chanel nerves for upcoming audition” 6
                                            Heightened Body Awareness
  • “I really felt how bad my shoulders are doing the crescent lunge” 3

  • “More present in ‘body awareness’ especially in a seated position and body pain” 6


Whilst heightened body awareness is ultimately a positive change, it is also a particularly complex one. Both quotes reference body awareness in relation to an awareness of pain or discomfort and looking further into the rest of participant 3’s comments we can see a trend of discomfort during practice of certain asanas. 


  • “Feel stiff after that little yoga session.” 3

  • “Did not enjoy doing the backbend especially in comparison to the forward fold – it didn’t seem to do as much.” 3

  • “Still feeling pretty stiff in my upper body, especially in my shoulders” 3


This could be due to a common consequence experienced at the beginning of your yoga practice which is to feel as though you are developing pain as a result of yoga. Often this is felt as a result of heightened body awareness that comes with regular yoga practice. You may begin to notice an area of pain/tension that you were not aware of. Just because you had not been aware of it before, does not mean that it did not previously exist. This resonates with my personal practice diary as heightened body awareness as a result of my personal yoga progress allowed me to notice other areas of held tension in the body which became the key to unlocking the recovery of my injury.


The participants who documented a positive change in relaxation were the participants who practised a variety of breathing exercises and were consistent with their practice. This could contribute to the additional benefit of increased relaxation. Participant 6 displayed significant benefits in this area and may be due to implementing the yoga after their practice as opposed to before. This further emphasises the importance of varying your routine to explore new benefits

This particular area displayed the only contradictory results with participants 1 and 3 experiencing conflicting feelings towards the back bend asanas.


Participant 1 wrote that:

  • “backbend helped open up/relax my breathing” Participant 1

  • “The bending and standing poses definitely open up my breathing” Participant 1

Whereas Participant 3 stated that: 

  • “Did not enjoy doing the backbend especially in comparison to the forward fold – it didn’t seem to do as much.” Participant 3 

This highlights the importance of allowing flexibility in the routines for each participant. What works for one person might not work for another.


From the results of the (Figure 2.4) we can see that the body parts most prone to injury were the left and right shoulders, both receiving 6 votes and the lower back placing third with 4 votes. This is then followed by the neck, upper back, wrist, jaw and lips with 2 votes. Body parts that did not experience pain/tension/discomfort from any of the participants were head, chest, pelvis, tricep, forearm, thigh, knee, shin, ankle, and forehead.

The participant who reported the highest number of body parts experiencing pain/tension/discomfort recorded 12 body parts. The participant who reported the lowest number of body parts experiencing pain/tension/discomfort recorded 2 body parts. The participant who reported the fewest number of body parts had no previous experience practising yoga. The participant who recorded the highest number of body parts described their previous experience with yoga as “Casual experience from online yoga lessons but I haven’t practised yoga in a while.”

The final question in the survey asked the participants to state the three body parts experiencing the most pain/tension/discomfort throughout the week of practice and playing (Figure 2.5). The body part most mentioned were the shoulders, receiving 6 mentions. When comparing the results of this question with the bodymap we can see that the shoulders are highlighted as a body part that experiences the most tension during playing in both frequency and severity with it being reported as an area experiencing pain/tension/discomfort by 6 participants and again selected as the body part experiencing the most tension by 6 participants.


Figure 2.8

Figure 2.7

Figure 2.10

Figure 2.3