Wellness for Flutists: Modifications, Mindfulness and Maintenance by Francesca Leo

Wellness for Flutists: Modifications, Mindfulness and Maintenance by Francesca Leo

Musicians are facing a unique set of challenges during this unprecedented time. Prior to this pandemic, we have collectively fallen accustomed to disregarding injury at the expense of taking professional auditions and advancing our careers. Our pedagogy as musicians has been largely based around the “no pain, no gain” mentality which is no longer a sustainable process. There also remains a stigma surrounding performance-related injuries, and although performing arts health has become a more prominent topic over the past few years, many musicians are still afraid to share their injuries with others in fear of losing potential employment or opportunities. I have a long personal history with a performance-related injury. I faced a nearly career-ending injury during my undergraduate studies and was forced to ask myself this question: am I going to continue allowing myself to become injured at the expense of my career or am I going to take viable action now to seek treatment? As a recent graduate of the Manhattan School of Music and the founder of www.playingwithoutpain.com, I have experienced how discouraging and terrifying performance-related injuries can be. I am committed to connecting musicians with resources to treat and prevent these injuries through this website and through my research. This period of prolonged rest has given me an opportunity to reflect on how we can all truly rely on each other to heal, grow and thrive.

Flutists possess a unique vulnerability to developing performance-related injuries due to the asymmetrical nature of our instruments. If we are not devoting enough time to taking care of our bodies after long hours of practicing in this asymmetrical position, injuries are likely to develop. Chronic anxiety, high stress levels and low self-esteem are also common experiences for musicians. We are not often taught how to properly cope with loss and rejection, only how to succeed in this competitive environment. When we fall short of this definition of success, we may experience feelings of failure and self-doubt. We tend to revert to negative self-talk in the practice room which begins to affect all aspects of our life. Multiple studies including my own [below] have demonstrated that there is a direct correlation between stress, anxiety and the development and severity of performance-related injuries. Musicians are constantly preparing for high-pressure auditions and competitions and we often do not have enough time to rest and recover in between.

Flute Modifications for Injuries

I am committed to discovering accessible and low-cost methods to treat and prevent performance-related injuries for musicians. As flutists, we have a variety of instrument modifications to provide additional comfort and ergonomically designed headjoints to navigate performance-related injuries that are triggered by the act of holding up the flute. I would like to start by discussing some basic modifications that you can purchase to add to your flute and increase comfort. If you have smaller hands or find yourself needing additional support, the addition of a Flute Thumbport Balance Aid or a Prima Thumb Rest can be extremely beneficial to allow more space for your right-hand fingers. This ergonomic design also allows for a healthier wrist position for the right hand and can improve technique. For your left hand, you can add a Flute Gel in between where your index finger rests on the flute for additional comfort and support. You can also add this product between the flute and your right hand thumb. Other left hand options include the Bo Pep Finger Saddle and the Bo Pep Finger Rest which are both great options. The finger saddle has a groove to place your finger in between to provide stability and the finger rest has a flat surface. Flute Specialists, Inc. also carries a variety of ergonomically designed headjoints. The Flute Lab headjoints allow you to hold and play the flute in a way that is gentle to your body and have been proven to allow flutists with serious injuries to return to playing. The Flute Lab Vertical headjoint allows you to hold and play your flute as you would a clarinet or saxophone. This can be paired with the Flute Lab vertical strap and each headjoint comes with a large thumb rest and a left hand support. The Flute Lab Swan Headjoint is an extremely popular product and comes with a thumb rest. In addition, Flute Specialists, Inc. also carries similar ergonomically designed headjoints by BT Bertrem including the Bertrem Vertical Headjoint and the Bertrem 30 Degree Headjoint. All of the above headjoints eliminate the asymmetrical element of holding the flute and can be sized to fit on most flute bodies.

Coping with Anxiety and Cultivating Healthy Lifestyle Habits

As musicians, we must take care of our bodies. If you are experiencing chronic performance-related injuries or pain, it is essential to seek professional medical attention. Prioritizing mental and physical health is essential in maintaining longevity in your musical career in addition to cultivating sustainable and efficient practice habits. It is so important to stay hydrated and well-nourished. Regular aerobic exercise is a great method of preventing performance-related injuries as well as conducting a physical warm-up directly before practicing. This can include jogging in place, large arm circles, shoulder shrugs and other methods of elevating your heart rate. Exercising regularly also helps to reduce symptoms of chronic anxiety and stress, especially in the days or weeks leading up to major performances and auditions. If you experience chronic anxiety, it can be helpful to be aware that it may be multi-layered and a symptom of unresolved past trauma. It may be beneficial to consult with a licensed therapist, as this may help to improve your overall mental health. You can also try the “box breathing” exercise when you are feeling anxious to slow your heart rate. Breathe in for four counts, hold your breath for four counts, breathe out for four counts, hold your exhale for four counts, and repeat until you start to feel more calm. It is important to engage in activities you enjoy each day and get outside as much as possible. Apps such as iRest or Headspace are wonderful tools to develop a regular meditation practice which can help to cultivate ease and mindfulness in your practicing and your daily life.

Developing Efficient Practicing Habits and Taking Care of Yourself

As you are planning your practice sessions, ask yourself a few questions: “what goals are realistic at this time? Am I asking too much of myself?” Developing attainable goals is a vital skill in maintaining an efficient practicing schedule. You can download my efficient practicing template as a guide to schedule one-hour blocks of practice and write attainable goals for each session. This template also includes healthy practicing reminders, schedules practice breaks and contains a physical warm-up routine.

As musicians, we are faced with many high pressure and anxiety-inducing situations. Whether we are preparing for a professional orchestral audition, a major solo performance or a competition, we must be sure to take care of our bodies and minds as much as we invest into practicing for these opportunities. We often translate “working hard” to physically working hard – we hold so much tension in our playing that we do not even realize, especially during these intensive preparation periods. There have been far too many occasions where I practiced for hours on end through intense pain while in preparation for an audition or competition. Practicing in pain contributes to high stress and high anxiety rates, which contribute to more physical tension and pain. This is a vicious cycle that many players often maintain for years as they are trying to win a job. This pain, stress and tension combined with the pressure only worsens performance-related injuries if left untreated. Try to set a timer every 15 minutes during your practice sessions, putting your instrument down once the timer goes off. Ask yourself if you are physically working too hard to play your instrument. See where you can invite more ease and notice if you are “gripping” your flute. Explore the minimum amount of pressure you can put on the flute to properly balance it and play. You will likely find that the amount of pressure you actually need is far less than what you are contributing. Enrolling in Body Mapping, Feldenkrais or Alexander Technique lessons are great ways to learn to cultivate a sense of ease in your playing and learn body awareness which is invaluable to musicians. Our bodies are integrated beings; if one part is not being taken care of, it will affect the whole body whether we realize it or not. Give yourself permission to check in with yourself mentally and physically each day and notice how much freedom and ease you are able to cultivate as a result.


Francesca Leo is a cutting edge flutist, educator and performing arts health advocate. She has appeared as a soloist with the Manhattan School of Music Chamber Sinfonia and the New Albany Symphony Orchestra and has performed internationally in Italy and France. Francesca is the founder of https://www.playingwithoutpain.com, an award-winning interactive website and social media platform committed to connecting musicians with resources to treat and prevent performance-related injuries. She has presented her research at various institutions and events including the Manhattan School of Music, West Virginia University, Ohio Northern University, the National Flute Association Convention, the Puerto Rico Flute Symposium, among others. Francesca has recently completed a certification in the Essentials of Performing Arts Medicine through the Performing Arts Medicine Association and is currently pursuing a certification as a Body Mapping Educator. She holds a masters degree in flute performance from the Manhattan School of Music and a bachelors degree from Bowling Green State University.

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