Amid all of the behind-the-scenes aspects of the music industry, those who help musicians stay healthy are often forgotten. Physical therapists are among those unsung heroes — which is why MusiCares is excited to highlight Certified Hand Therapist (CHT) Noelle Austin and Certified Orthopedic Manual Therapist (COMT) Sandy Murphy of STAR Physical Therapy in Nashville, Tennessee.
Both Austin and Murphy have dedicated their careers to helping musicians overcome the physical demands of their professions. From their early inspirations, to pioneering the Musician Rehabilitation Program at STAR, they've blended passion with expertise to keep the music playing.
Austin and Murphy were first introduced to MusiCares during the COVID-19 pandemic, and have been offering specialized care to the music community since. They're a partner for MusiCares' Music Pros As Athletes clinics, which take place each April and October with a variety of body movement and injury prevention specialists.
Below, Austin and Murphy share some insight into their individual journeys, the unique challenges musicians face, and the innovative approaches they employ to treat and prevent injuries for those in the music community.
Can you tell us about your respective journeys to physical therapy?
Austin: When I was a young teenager, I volunteered at a hospital in the summer, and they assigned me to the Physical Therapy (PT) department. I loved the experience — helping and serving people, making a difference in their lives. That really resonated with me, and I decided that was what I wanted to do with my life.
In college I was truly in awe at the complexity of hand anatomy during class, and then when I was just out of school I worked in a clinic that exposed me to both hand therapy and hand surgery — I loved it so much! These experiences solidified my decision to pursue my career in the specialization of hand therapy and I have now been a Certified Hand Therapist (CHT) for over 30 years.
Murphy: I started to think about my career in high school. Having grown up on a farm and always been around animals, my first thought was to be a veterinarian. My dad thought I should hang around with the vet the next time she was on the farm. After experiencing helping to dehorn cattle, check cows to see when they would have their calves — realizing I was not going to be able to pet dogs all day — I pivoted.
I have always had a love affair with water and was on the swim team as a child. So, animals in the water right? Marine biology. Found out [it was] not swimming with dolphins all day, but lots and lots of research. So I went to college with no clue.
I met a fellow student that was taking pre-physical therapy courses. I knew nothing of the field. I went home and volunteered at a local hospital and fell in love. It was a perfect mix of service, daily learning and activity — mind, body and spirit — that I needed and desired. The past 25 years in the field have been very good to me. It has seen me through moves across the country and allowed me to continue to serve, be creative and learn.
What inspired you to start the Musician Rehabilitation Program at STAR?
Austin: My love for music started at a young age — singing, playing piano, and various other instruments. I have always enjoyed treating musicians over the years, and when I relocated to Music City in 2019, I realized there was such a great need to address this unique population with PT. I was surprised to learn there was no PT clinic with a dedicated program to address musician's unique issues.
Ultimately, I decided to blend my love for music and hand therapy by helping to create a comprehensive Musician Rehabilitation Program specific to meet the needs of those working in the music industry. I am excited to collaborate with Sandy on this unique program at STAR Physical Therapy in East Nashville, and look forward to making a positive impact on this amazing creative community.
Murphy: I was involved in music starting at an early age. I grew up listening to my great-grandfather play banjo. In elementary school through high school, I was involved in the school band. This showed exactly how much training and practice it takes to not only participate but be successful.
Once I moved to Nashville, I started to work with more patients in the music industry. I quickly became aware of the significant time, attention to detail, posture, and travel required to be successful in this field. I also started to realize the void in terms of expertise care for performing artists. I began to research and develop the Musician Rehabilitation Program at STAR to help fill the void in physical therapy for performing arts athletes. I enjoy working with Noelle in continuing to refine this unique offering for the Nashville musician community.
What are some common physical challenges that musicians face that you frequently treat?
Murphy: Overuse injuries, poor posture for sustained periods of time, poor self care (lack of sleep, poor nutrition). I see more neck/upper quarter pain/tightness as well as headaches.
Austin: Musicians commonly suffer from a range of ailments related to their craft. We are experts at conducting a thorough examination to pinpoint the root cause of any symptoms — not just reactively treat the symptoms. Our comprehensive knowledge of rehabilitation principles, and the unique demands placed on a musician's body, allows us to develop a personalized treatment plan tailored to address each musician's specific needs.
We commonly treat the following conditions related to instrument use:
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Neck/back strain
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Rotator cuff tendonitis/bursitis
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Numbness/tingling in arms/hands
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Lateral/medial epicondylitis
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Trigger finger and DeQuervain's tenosynovitis
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Cubital/carpal tunnel syndrome
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Arthritis in the spine/hands
Do you have any specialized techniques or approaches you use specifically for treating musicians?
Austin: Components of our one-of-a-kind rehabilitation program include: comprehensive assessment, education on modifications of activities/ergonomics at instrument/computer/phone, manual therapy, instrument specific exercises, postural correction, strength/conditioning as well as pain management techniques.
In addition to working with musicians to overcome an existing injury, this program has also been highly effective in educating musicians about injury prevention. Understanding the principles surrounding being a healthy musician include education on the importance of lifestyle habits — for example, exercise, nutrition, sleeping, to name a few. We also spend a great deal of time discussing healthy practice and performance routines with the ultimate goal of career longevity.
Why is it important for musicians to consider physical therapy?
Murphy: PT can keep you going, limit time off and prolong the longevity of your career. Learn tips, tricks to protect your body. In our program, musicians also get connected with other healthcare providers of a variety of disciplines that have the same mindset. Ultimate goal: keep you playing!
How and when did you first get involved with MusiCares?
Austin & Murphy: As we were researching organizations in Nashville committed to serving the music community, we came across MusiCares. We started creating this program specific to the STAR East Nashville location just prior to COVID, which obviously stalled our efforts when the music stopped. We used that time to plan and create a program as well as establish connections within the local music community — those like-minded providers who want to serve the musicians.
We initially met Stefanie Curtiss via Zoom during COVID, and she was amazing! So open to our ideas and willing to let us jump in and get involved with their clients. We are so grateful to have made that connection.
We are finishing up our second round of Music Pros As Athletes Clinic for MusiCares clients, and have found this experience to be so enlightening. We feel so fortunate to have become involved in these clinics. We are learning from every client we work with!
Serving this music community is a priority in our East Nashville clinic — we are so thankful to have the opportunity to make a positive impact on these patients and help them return to creating the wonderful music that Nashville is known for!
Are there any personal experiences or patient stories that have been particularly impactful in your career, whether with a MusiCares client or someone who has come through the STAR office?
Austin: There is a theme that has emerged over the past years. Multiple times I have personally seen how the support MusiCares offers their clients can make a big difference in the musician's day to day lives. By offering grants to assist with payment of therapy services, MusiCares takes away some of the financial burden and therefore relieves major stress, allowing the musician to focus on what is most important — getting better and back to their creative profession.
Murphy: I will never forget as long as I live the songwriter that came in and sang "Happy Birthday" to another musician in the clinic. So powerful. Still gives me goosebumps.
Also, a MusiCares client came in and was telling me how he was sharing what he learned here [last] October with other musicians, and they were all noting improvements with sight changes. And that is the power of education. It reaches way beyond us here in these four walls.