Barrett L. Dorko, P.T.

          I was told that this young lady practices her violin five hours a day. On the phone her mother asked me several times if I wouldn't tell her to cut down on this, perhaps rest often and leave her instrument at home when they vacation next month. I told her that I simply wouldn't do this, that although she might think it was my job, I don't intend to try to stop her daughter's playing. Understandably, the mother is a little disappointed, and more than a little confused.

          How do you solve a problem like Maria?
          How do you catch a cloud and pin it down?

          When the patient arrived I saw a healthy and poised teenager carrying her violin case with a familiar ease. I couldn't help but think that my son would love to meet her.

          Although her referral says "right shoulder tendinitis," the patient told me she had a vague discomfort traveling across her upper back and into the region of the lateral deltoid. It's a bilateral discomfort and I can't see any sign that this is a tendonocity. She says her most painful movements are when she wakens.

          How do you solve a problem like Maria?
          How do you keep a wave upon the sand?

          Although I didn't actually ask, I presume that even this girl seldom plays her instrument while in bed. In fact, she says that playing doesn't hurt. Obviously, she gains something from it that nothing else can replace. She's brought the violin along in hopes that I can show her how to play more, not less.

          She tells me that her previous care had consisted of icing and stretching. A therapist wanted her to strengthen her abdominal muscles, and her mother is concerned about the possibility of permanent shoulder protraction. "Pull your shoulders back," is something she's heard more than a few times. None of this has helped, and I can't imagine the reasoning behind such an approach, given what I see before me.

          The signs of neural tension are both visible and palpable. The problem is perpetrated by a constant adduction of the hips and an inefficient, though cosmetic breathing pattern.

          Beyond what I can see, I sense a desire to play much more powerful than any advice I might offer. For this girl, expression through her music is not something she can choose, it has chosen her, and telling her to stop would be foolish. She needs the sound of music.

          I'm reminded of the familiar song in the musical The Sound of Music, the one sung by the nuns about a novice they cannot control. To them, Maria is a force of nature, and they have despaired of changing her. Instead they let her out into the world.

          This young woman appears not to have been made worse by her playing, but by the constant cultural admonitions to pose and posture, to look a particular way. Within moments of my allowing her to become physically authentic, she warms and softens and her pain decreases. Helpful movements emerge from her as effortlessly as the scales she plays each day, but now the music is spontaneous and uniquely expressive.

          I'm not going to tell her to stop playing. I'm going to show her how to bring a more pliable system into her life. The path toward this way of being is artistic in nature, so the lesson is easy for her to absorb.

          Her violin remained in the case because what she needs to change isn't in there, it's in her. She sensed this immediately and understod what to do.

          When her mother asked me to tell her to stop, something in my head began to stir. It was the final line of a song:

          How do you solve a problem like Maria?
          How do you hold a moonbeam in your hand?

Of related interest: "Gypsy Music" by Barrett L. Dorko, P.T.
Copies available from the author.