Stephen L. Cash lives a double-life: Chief hand surgeon at Lankenau Hospital outside of Philadelphia and “George” in the Beatles tribute band “Liverpool Beat.” Dr. Cash graciously agreed to be interviewed by Music After 50 on aches and pains of older musicians.
What are some of the most common problems you see in middle-aged and older musicians (professional and amateur)?
Most problems fall into the broad category of “overuse” problems: too much practicing, especially in the younger players who haven’t learned to pace themselves. The older pros know how to do this, but their tolerance for the constant repetitive movement required diminishes over time, so they are at risk for muscle strains, cramping, and tendinitis.
The appearance of arthritis with aging also causes problems, when joints are no longer as flexible as they once were. Les Paul’s hands were riddled with arthritis, limiting his dexterity considerably. He has been in the news recently because of his recent passing, and in many of the photos you can clearly see the arthritic knobbiness of his fingers. Also, older players often have diminished capacities from awkward posturing.
Occasionally, there are actually instrument issues that contribute to musicians straining to play, such as the set up; the string gauges used by guitarists; poor practice techniques, and the like.
Is surgery a last resort for hand/arm problems or is it a common treatment for certain issues?
Surgery is always a last resort in musicians and non-musicians alike.
What types of operations do you mostly perform on musicians?
Typical operations include carpal tunnel surgery, trigger finger releases, and wrist tendinitis releases of various types.
Which preventive exercises or measures do you recommend for guitar and bass players, as well as other string players?
Finger and wrist stretching exercises are helpful for any string player. Relaxing exercises can also be helpful to reduce excessive muscle tension and cramping. Strengthening exercises are usually not needed, and in fact, they can be a problem, as they often exacerbate pain, stress, and tension. Pace yourself!
Which is better – heat or cold? Are stress balls/tennis balls good for strengthening the fingers? What about glucosamine and chondroitin for joint pain? How about rest?
Rest is definitely the best medicine. Heat helps some people, cold helps others. Glucosamine and chondroitin are unproven remedies for joint pain. Initially, there was some interest, but the weight of the actual scientific evidence to date has failed to show that this stuff actually does any good. Stress balls and tennis balls for strengthening are probably counter-productive, for the reasons I stated earlier; they can exacerbate the problem. On the other hand, a nerf ball, or other soft squeezable ball, may help with stiff joints, because these emphasize range of motion over strengthening.
Where did you grow up, and when did you first see or hear the Beatles?
I grew up in Syracuse, N.Y., saw the Beatles on Ed Sullivan when I was 12, and immediately dropped the trumpet and picked up a guitar. Much cooler! My interest in hands actually was unrelated to guitar playing, but I did appreciate all the fine delicate, dexterous things our hands allow us to do, like playing the guitar.
Did you ever consider becoming a professional musician?
I don’t think I ever seriously considered becoming a full-time professional musician, as it’s a difficult way to make a living except for a very tiny few. But I always knew music would be a big part of my life, even more so when the Beatles came into my life. I am still a huge fan, obviously, since I play in a Beatles tribute band Liverpool Beat. I’ve been with the band since it’s inception, about six or seven years now.
How did you come to be “George?”
Basically I answered an ad, met with a guy who wanted to form a twosome – John and Paul – playing with a backing track. But that didn’t seem too much fun. So, eventually, we found two other guys, and formed an actual band. I became George because I was the best guitar player and already knew all his parts. I liked Paul because he was a lefty, like me, but I liked George the best because he got to play all the cool guitar parts. So all in all, playing George is a good fit for me.
How often does “Liverpool Beat” play?
Currently, we play only every few months or so, although we were happily very busy over the summer. I play for the love of it, and a gig every 3 or 4 weeks would be ideal. I wouldn’t want it to become a “job,” an obligation.
But, there is nothing to compare with playing in front of a live audience, pretending you are the Beatles, and the audience pretending you are the Beatles, with everybody enjoying what is arguably the best music of the 20th century. I just love it, and will continue to play until they pry that guitar out of my cold, dead hands.
Article by Leah R. Garnett of the Music After 50 blog.
