The first order of business is prevention.  There are three things you can do to protect yourself from injury—cardiovascular exercise, stretching, and strengthening.

Even though rocker and runner are not generally uttered in the same breath, the health benefits of cardio cannot be overstated.  Running, power walking, biking, and swimming (note: no gym membership required!) all enhance circulation of the blood and help to distribute oxygen, flush away metabolic waste, and deliver the bodies healing chemicals to sites of injury.  And you may be surprised at the strangely euphoric feeling the workout produces, not altogether different from that mid solo high.

Next up, stretching the upper back and arm musculature. Ideally this is done before and after playing.  Self-massage will enhance the effects of your stretching regimen.  Even better, for those who can, have at least one roadie certified as a massage therapist!

Finally, strengthening.  And though you might think that power chords can substitute for pushups, the mind-body disconnect so common when playing can easily push you beyond your physical limit and lead to injury.  Do your light free weights and crunches in the green room and then hit the stage.

But if you go down with pain, how to you know where to turn, which providers are best equipped to understand and treat?  Because these injuries are the result of over using muscles and joints, pushing them beyond their limits, causing micro tears, inflammation, and pain, seek a practitioner who deals with musculoskeletal problems daily.

Chiropractors work primarily with these types of injuries and can treat using joint manipulation, rehabilitative exercise and passive modalities such as ice, electrical stimulation, and ultrasound.  Acupuncture is another excellent choice.  Using fine needles and herbal medicines to stimulate healing, this ancient art can relieve pain and help to restore proper function. Just be sure the acupuncturist has a musculoskeletal injury specialty.

If these approaches do not resolve the problem, you may have to take the medical route.  Beyond the basic prescription of non-steroidal anti-inflammatories (advil/naprocin), muscle relaxers, and painkillers, a general MD may prescribe physical therapy which can be very helpful.  If those are not enough, an appropriate referral would be to a physiatrist, a medical doctor specializing in structural rehabilitation.  These doctors can perform anti-inflammatory injections into the tendons, muscles or joints themselves if necessary.

As a last resort, one may have to go surgical.  A carpal tunnel release could be the only effective treatment for that hand numbness.  Just be sure that the surgeon understands the unique needs and world of the musician.

We know that playing music is a great high, but we also know that it can be hard work.  And hard work can be rough on the body, causing pain and dysfunction. But also know that these injuries can be prevented.  Like Bruce, who pushed the E Street Band and himself into shape while on the road, we can all play well into our golden years. Just take care of your body like you would take care of that ’57 Tele and enjoy the musical ride in health.

Ricky Fishman, D.C. is a San Francisco based chiropractor who specializes in the treatment of performance and practice injuries.  Visit his website at www.rickyfishman.com click the Musicians Chiropractic Project for more information about his work.

People who have the most health care dollars to spend largely determine the direction of the health care market.  And where this money is spent is largely a function of the beliefs of these health care consumers. Over the past century, allopathic, or western medicine, has claimed this mantle of belief based upon its surgical and pharmaceutical power. Indeed, if a bone is broken, an infection raging, or an appendix bursting, an MD is the person to consult.  But the belief that allopathic medicine can cure all medical problems has not been borne out.

As long as allopathic medicine had minimal competition from other professions, patients had little choice but to submit to the powerful yet limited diagnoses and treatments of their MDs.  However, as more alternative methods become understood and available, the situation is changing. A 1993 study in the New England Journal of Medicine (and updated in 2003) revealed that, in the US, over thirteen billion dollars per year was spent on complementary, or alternative, medicine.  These therapies ranged from spinal manipulation and acupuncture to energy healing and massage therapy. Of this amount, over ten billion was spent out of pocket. That compares to approximately thirteen billion spent out of pocket for conventional medical treatment during the same period.  The study also showed that few patients—only 28%–told their family doctors about their alternative treatments. These numbers reflect a wide gap between allopathic and complementary medicine, both in theory and practice.

One reason for this gap is that the two philosophies of health and healing differ so dramatically. According to complementary medicine, health is defined as a state of wellbeing, an energetic balance of mind, body, and spirit.  It is not, as generally described in allopathy, simply the absence of disease. Complementary medicine holds that the cumulative effects of the stresses of life–mechanical, chemical, and emotional—cause imbalance, which in turn, create illness, or dis-ease.  Treatment is focused on restoring balance rather than the allopathic approach of attacking symptoms.

Allopathic medicine claims its practice is more legitimate than complementary medicine because it is based in science. This suggests that allopathic diagnoses and treatments have all been subjected to the rigors of laboratory testing and scientific methodology. While this assertion is subject to argument, it is true that the power wielded by the medical establishment has allowed it to conduct more extensive research than we have seen in the complementary medical fields. This has enabled proponents of allopathic medicine to dismiss complementary medicine as unscientific.

But patients have discovered that there are many conditions for which allopathy has little to offer and which respond positively to complementary care.  Chronic digestive and respiratory disorders, back pain, allergies, and headaches are often more responsive to Chinese medicine, chiropractic, or nutritional counseling than to drugs and/or surgery, frequently at lower cost, and almost always with fewer side effects. Still, patients sense that their primary MD’s don’t trust alternative medicine, ridicule it, or feel undermined by it, and so feel reluctant to bring it up, even though it is in the best interest of their health to do so.

Despite the gap in philosophies and resistance by the medical establishment, complementary medicine is moving from the fringes toward the center of an evolving medical paradigm. Driven by the proliferation of available information and the economics of patient demand, its worldview has infused and is slowly altering that of allopathic medicine.  Health insurance companies have been compelled to offer alternative services to their members. Advertisements for large medical centers promote wellness and prevention, healthy diet and exercise–all ideas that have emerged from complementary medicine.  We even hear definitions of health broadened, beyond the individual, to the environment, that a healthy body requires a healthy world so we must preserve and protect the environment of which we are all integral parts.

Based on a deep understanding of the philosophy of complementary and alternative medicine, more and more practitioners, including MDs, are creating innovative models that integrate technology and truly comprehensive practitioner networks, a holistic view of the body and the realities of the post-industrial workplace. With these models, patients, providers, employers, and insurers can together more effectively navigate the health care landscape of our twenty first century world.

Dr. Ricky Fishman has been a San Francisco based Chiropractor since 1986.  In addition to the treatment and prevention of back pain and other musculoskeletal injuries, he works as a consultant in the field of health and wellness with companies dedicated to the re-visioning of health care for the 21st century.

Hunkered over the big board and reaching to push one of those 48 sliders to get the mix just right, you feel your low back ache, reminding you that it is the end of another fourteen hour session.

Whether you are working in your home studio, or in a fully equipped professional control room, studio work today is mainly computer work and the ergonomic principles that apply to most high tech work stations are relevant for engineers, producers and players. Being seated in front of a computer screen for many hours, mesmerized by “Pro Tools”, is simply an unnatural act. The tendency to slump into the chair and round the low back and shoulders forces the head to be pulled in toward the monitor. This causes both low back and neck strain.Compounding the problem is that your love of the craft kills all sense of time.  Mind and body disconnect.

Start with your chair.  No need to purchase a $1000 Aeron.  Just head down to the local office supply store and find one with a nice padded seat that swivels, has good lumbar support, arm rests, and adjustments for height and back angle.  The test is comfort here.  Next is monitor placement.  Always in front of you, the center of the screen should be no more than 10 degrees up or down from your central line of sight. When working, your arms should be supported whether you are on the midi, the mouse, or the keyboard. Adjust the height of your desk so that your elbows are angled at approximately 90 degrees and keep your work as close to the desk edge as possible.  Arms suspended or reaching send damaging forces directly into the cervical and upper thoracic spine.

Take breaks. You can embed software that reminds you to stand up every 30-45 minutes. Roll your shoulders back ten times and then forward.  Take five deep breaths. Do ten standing back bends and every few hours go outside and take a walk.  Even five minutes of rapid movement will help to circulate your blood, wake you up, and loosen up your stiffening joints. Remember, pain and discomfort do not support the creative process.

Finally, be aware. Of posture and movement. Know that bending forward and twisting will, over time, cause low back pain, and slouching, neck pain. But maintaining proper posture requires internal musculoskeletal support.  This means exercise.  Without core strength, you will overstress your joints and although exercise is not generally associated with the rock and roll lifestyle, staying fit will prolong your working life and enhance its quality.  Basic stretching, cardio, and strengthening can even be done completely in studio.  A mini trampoline, a gym ball, a Styrofoam roller, and a floor are all you need.

There are few things as joyful as making music and the studio is a fantastic workshop for its creation. But we must be aware of its occupational hazards. As mechanical beings, we are designed to move and when we do not, our bodies break down. Fortunately, Rock and Roll is not a spectator sport. It is for neither the timid nor the meek. So stand up, breathe, dance, roll tape, and rock out.

Ricky Fishman, DC, a San Francisco based Chiropractor, blogs for both Line 6  and the National Association of Recording Arts and Sciences (The Grammies). He also runs the Musicians Chiropractic Project to support uninsured players.  See his website at www.rickyfishman.com

There were almost no tourists, partly due to Suu Kyi’s call for a travel ban as well as a generalized fear of the military.  Decades of isolation had left the country shabby, full of broken roads and drab hotels.  Yet at the same time, because of this isolation, Burmese traditions were intact.  Rows of barefoot monks walked the streets of Rangoon, carrying their bowls from house to house, collecting food for the day, before heading back to their monasteries for meditation and instruction. Men and women were dressed in traditional, non-Western clothing, and there was not a McDonalds or Kentucky Fried Chicken in sight.  It was a fascinating, powerful travel experience.

I have just returned from my fifth trip, this time leading a group of six. Close to our departure, I was bombarded with questions of concern by some of the group members.  “My aunts, friends, daughter just returned from travel to Burma and said that cameras and cell phones were confiscated at the airport and that there were armed military personnel everywhere.  Sounds very dangerous.  Can you check into this?” I did.  Calls to both the Embassy of Myanmar in Washington, D.C. and my local agents in Yangon, drew puzzled responses.  I assured everyone that I would not bring a group to a place where I felt they would be endangered, and that in fact, I believed Burma was a safer travel destination than the Upper West Side of Manhattan where several concerned members of the group resided.

Yet the “fear factor “ remained high right up until arrival at the airport in Yangon. A steamy, verdant colonial outpost, Yangon is full of old apartment buildings, grand colonial homes in disrepair, and streets crowded with bicycles, motorbikes, and bustling markets. We watched it all through the mini-bus windows and then, at our lovely hotel, the Governor’s Residence, we got to relax by the pool, drink Myanmar Beer, and recover from the jet lag and exhaustion of our 24 hour trips.

We began the next morning at the Great Reclining Buddha of Chaukhtatgyi, a beautiful, 230 foot long structure, and ended at Shwedegon Pagoda.  One of the Wonders of the World, Shwedegon’s gold plated stupa rises 322 feet, and is topped by a 120 karat diamond that reflects the days last sunlight. I walked barefoot on the cool marble tiles, amazed at the scene.  People pouring water on the heads of small Buddha statues, lighting candles, and chanting prayers, some of which were broadcast loudly through a crude speaker system.  And as gongs chimed and incense burned, I was swept up in a deep sensorial cloud, my head spinning with the sudden realization of how very far away from home I was.

But I was quickly brought down to Earth when I heard the news that one of our group members, Howard, had accidentally walked away from his camera bag filled with equipment and money and that it was now missing. Soon afterwards he found us and reported what had happened. When Howard realized his bag was gone, he and his partner found the Shwedegon Administrative Office.  After they walked in, and reported the lost camera bag, the two were met with excited applause.  His bag had been found and an announcement had already been made (in Burmese) over the loudspeaker system. The officials now guarding the lost goods insisted that Howard make sure the bags contents were intact.  After confirmation, the officials requested photos with Howard and his recovered property.  A happy ending to our first day in Burma and I could not help but wonder what might have happened to that camera bag were it found in the middle of Grand Central Station in New York City.

Our trip continued onto Mandalay, Burma’s second largest city.  A scruffier version of Yangon, Mandalay was the old capital and still is a major craft center. We visited the ancient wooden monastery of Kyaung Shwenandaw, the enormous Mahamuni Buddha, its body fat with decades of pressed gold leaf, and the neighborhoods devoted to woodworking, marble and bronze sculpture, and gold leaf production. On the morning of our departure, near the old palace moat, I saw people doing Tai Chi, monks on public elliptical machines, and jogging teenage girls and boys.  We eyed each other with curious smiles.

That afternoon, I spent hours on the deck of an elegant old Burmese river cruiser, gazing upon the great Irrawaddy.  The shores were lined with goatherds, fishermen, and villages of bamboo, and the river itself teemed with floating cargo, a great industrial highway through the heart of the country.  Huge rafts carrying teak downstream and vessels full of onions and tomatoes sweetened the desert air. And at days end, a blood red sunset over the distant Shan Hills.

When we came ashore in Pagan, we were assaulted by a barrage of men, women, and children, selling trinkets of every sort.  Plastic rubies, “ancient’ Buddha heads made the week before, and bootlegged copies of George Orwell’s “Burmese Days”.  “Hey Mister.  Where you from?  Oh America! America very good”. And when I finally got through the fray, I looked up to see dozens of glittering monuments lining the river and dotting the landscape beyond.

Different from abandoned ruins sites, Pagans temples are still active places of worship and meditation. Through the ruins, we rode bicycles along dirt roads to villages deep in the countryside, some without electricity or running water and watched girls and boys carrying buckets of water, over their shoulders, from a small river outcropping to their bamboo and jungle leaf homes.  The homes were simple–fire pits for cooking, sleeping mats, some pots and pans.  Outside, drying produce, a weaving loom.  The people were poor, but I didn’t feel poverty.  Children followed us down dusty paths, laughing as we gave them candy and played singing games. I saw no hunger, desperation, or begging, but rather, simple lives without grand aspirations and illusions, people born into villages from which they would not likely wander off.  I saw an old man smoking a cigar beside his family hut who knew that he would die in that hut, cared for until the end by his family.

It was the same at our final destination, Inle Lake–people living on the water as they have for centuries.  “Foot rowers”, paddling with their legs as they cast their pyramidal nets, bringing their catch onto narrow hand carved boats; farmers waiving to us from floating fields while their water buffalo trudged through the muddy shallows, pulling bundles of lake weed to fertilize the already rich soil.

Because Burma has been isolated for so many decades, it has been removed from our cultural imaginations.  Millions go to Thailand, and Cambodia, and Vietnam, all neighbors with common cultures, histories, geographies, and religions. Yet when telling someone that you are going to Burma, the response is often a stare and a “Why there?”

We Americans are not very adventurous travelers.  There are many reasons for this—short vacations, separation of the US from much of the world by two oceans, and the general absence of second language skills, to name just a few.  This has been compounded during the past decade by fear of  “the other” perpetuated by our own government since 9/11.  As a result, we have stayed close to home, our exploration of the outer world often done virtually, the powerful connectivity of the internet providing the illusion of travel. And if we want to venture into real space, we can chose safe imitations, fantasy reproductions of the foreign world.  We travel to Las Vegas and see the Pyramids, and Venice, and New York, New York.  We can go on an African Safari during the day and visit the Eiffel Tower at night, secure in knowing that later we can then find an inexpensive, international, buffet dinner.

Upon conclusion of the trip, the group agreed that Burma was “the opposite of dangerous” and that, while the brutality of the military regime is quite real,  the fears and misperceptions that people brought to Burma were unfounded.  And it left me wondering about the nature of perception and how we carry so much fear within us and how that prevents us from truly “seeing” the world.  And not just the world of foreign travel but the world in which we live every day.  I realized that our trip to Burma was a metaphor for how we live our lives, how we project our internalized fears onto everyone and everything around us so that after awhile we are living in bubbles, the world beyond a mirror of our fearful selves. Our hides thicken, until we feel nothing but our own internal gyrations.

To travel is to be challenged by unfamiliar surroundings and unexpected beauty, to push ourselves into realms that reveal not only new and different places, but new ways of being.  To travel is not only to see the world, but to see ourselves.

In a world of spectra and averages, we strive to fall within parameters established through the most current medical research; the closer we are to the mean, the more satisfied we are, and the healthier we believe ourselves to be. These numbers provide us with important information, guideposts that alert us to the presence or potential development of disease processes.  But they are approximations, reached through comparisons with idealized means, not true and accurate representations of who we are.

How do we establish these numbers, these “normals”? In her provocative book “Medicine and Culture”, Lynn Payer compares definitions of health and disease in four countries—The United States, England, France, and Germany.  One would think that among these modern, industrialized nations, diagnoses and treatment would be the same.  In fact, there are great variations, most of which can be attributed to historical, cultural, and political (e.g., health insurance system) differences.  Fundamentals such as “normal” blood pressure and the prevalence of particular diagnoses must be understood within socio-cultural frameworks. For example, in Germany, where there is a powerful romantic tradition, a blood pressure on the lower end of the spectrum, a reading of 90/60, one that would be celebrated by an American Doctor, might be of concern to a German MD who could feel that ones heart is not functioning properly, that it is weak, and perhaps an indicator of the need for love.  For a spinal condition, an American Doctor might recommend a surgical procedure while an English Doctor might opt for a more conservative physiotherapeutic approach.  The reason: in the US, where Doctors are reimbursed on a “fee for service” basis, the surgical procedure will pay very well, whereas the English Doctor, who is being paid a regular monthly salary, has no such financial incentive.

According to Payer, ideas about health and disease are strongly influenced by factors beyond “objective” medical research.  Medicine is an art and a science, a business and a cultural artifact. In my own practice I have had patents describe their chronic headaches as normal, to be expected in today’s stressful environment. “I am here for my back,” they tell me. “I can’t work because of the pain.  The headaches I can live with”.  So in the post-industrial American world, where people commonly work 40-50 hours per week in front of computer screens, headaches have become so typical that their significance has shifted from pathology to nuisance, less a diagnosis than a natural byproduct of modern living.  The norm gradually becomes normal.

To be fully assimilated, these ideas also require a narrative foundation upon which the world can be rationalized and constructed. Our contemporary socio-political narrative is largely rooted in a 19^th century philosophy called Positivism.  According to this very modern belief system, science has the answers to all questions worth asking and that it is only through scientific method that human problems will be solved.  This philosophy has become one of the pillars of modernity, supporting the framework through which we experience the world.  It has been the melding of science and technology within this positivistic embrace that has led us to rely on numbers and machines as arbiters of “truth”, including that of the “true” state of our bodies.  And out of this fertile ground has arisen our creation, “normal”.

However, these “normals” limit our understanding of health and disease. By definition, they tell us who we are as quantitative creatures, as averages, and to the extent that our bodily systems can be measured, categorized and compared, the pictures are accurate. But we quickly hit the limits of EMG’s, MRI’s, and C-T Scans.  How do we measure purpose and meaning?  How do we image the essential nature of our being? Yet our almost religious dedication to science and technology keeps us on this path.  So the Dalai Lama giddily sits in meditation, connected to sensitive laboratory monitors and a computer printout is produced that describes his deep meditative state. What are the Dalai Lama’s blood pressure, serotonin, and EEG readings and what do they tell us about “normal”? How do these readings skew the curve for the rest of us? And what does the computer screen reveal about the experience of meditation?

We bend under this oppressive weight of average, of norms and normals.  As we accept them with our health, we accept them in the rest of our lives. We internalize the cultural attempts to push us all into imaginary centers, whittling away our humanity in the interest of grand meta-truths.  We are taught to become obedient members of a society dedicated to the production of wealth, of goods and services, pressured daily to conform to the images of advertisers and other purveyors of popular and familial culture. We ignore our deepest hopes, suppress our creative energies, and dedicate ourselves to the accumulation of objects and indulgence in entertaining distractions, all opiate like substitutes to kill the pain of unfulfilled desires and forgotten dreams.  Through acceptance of the mediocrity embedded in these norms, we submit to their crushing power, and perpetuate the modern myths of reality. And by the way, how do we measure these?

It is true that low white blood cell counts can explain the exhaustion of a patient and can be an indicator of anemia, or worse.  And yes, a heart rate of 180, cholesterol of 240, and high blood pressure, is cause for concern and possible medical intervention.  There are dangerous numerical combinations. But reliance on numbers that fall within or at the edges of the normal range may tell us little or even give a false sense of wellness when, in fact, those numbers can be low or high for an individual and may actually point to latent illness.  Yet with unquestioning acceptance of our (non)diagnosis of “normal”, we surrender our personal power to mathematical authority. Norms and normals describe our averageness, our body fat indices, and our lives in a social constructed universe. And until we recognize the space between who we are and who we are made to be, we can never know the deepest parts of ourselves or even the true state of our health.

When I walked downstairs to get my second coffee, I glanced at a bulletin board near the counter.  I noticed a flyer that announced a ritual ceremony to be performed by a visiting Peruvian musician, Tito La Rosa. It described the “Ceremonia de Las Flores” as an ancient Andean sound healing ritual, and Tito, who had been on world tour with Kitaro, the renowned New Age musician, as a “Sound Healer”.

The synchronicity startled me.  I called the listed number right away and left a message.  Within minutes, my call was returned by a woman named Marty.  She described her organization, Kumpi Mayu, that was sponsoring the Ceremonia, as an NGO dedicated to developing clean water resources in a small village in the Peruvian Andes—Caruaz, Tito’s home. One of the ways they raised money for this cause was by producing concerts and ceremonies featuring Tito. When I asked what the Ceremonia de Las Flores was all about, she said, “I can’t explain it, but know that you should attend.  If it doesn’t transform you, I will return the (very modest) cost of the experience to you”. Clearly, an offer I could not refuse.

The ceremony would take place the evening before I left for Peru. Not ideal given my penchant for last minute preparations.  It would begin at 6.  I worked in my office in San Francisco until 4, rushed over the Bay Bridge, changed into some comfortable clothing, and arrived breathless, just in time.  I walked into the brown stucco house and entered a Peruvian fantasy world.  Tiled floors and walls, intricate tapestries draped over hand carved furniture, lit by “saint” candles.  The room was warmed by a wood burning fireplace and perfumed by metal bowls of rose pedals. There were instruments everywhere–drums of many sizes, wooden flutes, guitars with bodies made of gourds, and objects of unclear musical functionality. I was directed to an assigned space on the floor. There were eight participants, none of whom I knew, all of us seated on pillows around a woven altar covered in flowers, folded papers, and small stone and silver carvings. I closed my eyes and breathed deeply.

Tito entered the room.  About sixty years old, barefoot, and dressed completely in white, his long gray hair flowed as if blowing in his own private breeze. He picked up a long wooden flute, brought it to his nostrils (yes nostrils!) and played.  A pure, haunting sound filled the room and my head spun with the sounds of music and crackling firewood. Transfixed, I sunk into the pillows. He put down the flute and lifted a large drum, first playing slowly and lightly, then picking up the tempo, hitting the skins harder and harder until the room pulsed with its own heartbeat. And from what seemed to be a deep and ancient core came a chant, a sweet melodic sound of the Cordillera Blanca, Tito”s song to the high Andean Gods and the Four Directions of the Universe.  Then silence. Nothing but the soft falling of mesquite into ash.

Breaking the silence, Tito spoke about sound.  About sound as vibration, and of the world—the mountains, rivers, animals, and forests–as embodied manifestations of these vibrations.  He spoke of each one of us as vibratory beings, resonating in smooth harmony within the great cosmic field, or in frictional dissonance, futilely resisting the waves that wash over us. It is the dissonant, unconscious harmonic battle that creates disease and it is this disease that Tito’s sound medicine heals.

As Tito played, I slipped into a dream state, lost in a euphoric musical cloud. Startled by a hand on my shoulder, I looked up to see Dean, Tito’s apprentice, letting me know it was my time to receive the “medicine”. Tito stood over me, playing that lovely wooden flute. He placed its end on my chest and I felt its vibration, first on the surface of my skin, and then deeper. He tapped my sternum with the flute, over and over again, as if demanding entrance, pounding, refusing to stop until something opened. Tito then bent down, his mouth close to my ear.  As he spoke I felt wind on my face and the whooshing sound of a large bird passing closely by.  He was waving condor feathers, offering winged transport to the realm he would soon point me toward.

“You are a teacher, a healer, and a guide”, Tito whispered. “You are very lucky because you can live in accordance with lifes deepest principles every day in your work.  You can live in the service of unconditional love–Munay–and create harmony, abundance, and health for all things and all beings–Yankay.  You can live the sacred practice of teaching and learning, knowing that a person cannot do one without the other–Llanchay–so that all can live in the spirit of  absolute sharing, so no one is carrying too much or too little–Ayni.

“Truths surround us, waiting to be discovered.  They are beautiful things to find, but they are not like other “things”, objects that can be possessed.  You must hold them gently. Let them inside you. Allow them to penetrate your consciousness.  And once they have become part of your awareness, they can never be lost.  Forgotten yes, but lost, never. And if we become attached to those truths, they become something else, little more than clever ideas, things to sell, but without real value.  There will be people who will take from you and cause you harm, but the truth can never be stolen. So do not be afraid. Go into the world, give freely, and love.”

And so Tito sent me off and set me free with the knowledge that the deep pain in my heart was a pain borne of illusion, of a false understanding of the nature of truth and its knowing. And I understood that what I thought was stolen from me and had broken my heart was just a shadow, a dark reflection of ill intent. And I opened my eyes to the fire that warmed the room and burned in my heart and I forgave the thief of my dreams and illusions.

Ricky will be leading a trekking tour to Peru in April in which some  Andean rituals like the one described above will be explored.  For more information go to www.integralexpeditions.com

But my spirits shifted, lifting subtly as the taxi drove me into town. At eleven thousand feet, Cusco shimmered, its sea of tiled rooftops reflecting the light of a cloudless equatorial sky. After a brief rest, I ventured out of my hotel to wander the cobblestone streets, feeling the power and energy of the architecture, the mountains, and the confluence of great historical and cultural forces.

Feeling tired but relaxed, I sat down to drink a beer on the balcony of a café in the Bohemian neighborhood of San Blas, and looked down on the beige colonial cityscape that stretched into the valley below. And again, I waited for some sort of release, a transformation of the moment into a perfect, magical piece of “now”.  And waited. Until I understood that although a four thousand mile plane ride had taken me to a place four thousand miles away, a very different place for sure, I was still the same…un-different. Perhaps the “changed me” lay somewhere ahead.

I left Cusco the next day with a group of fellow travelers. We had all been invited by a local agency to experience a newly developed “Lodge to Lodge Trek” which the agency hoped we would soon be promoting to our own clients. En route we stopped in the town of Mollepata and visited textile and jam making collectives, both run by women and supported (in part) by the hosting company, Mountain Lodges of Peru. It was wonderful to see positive, sustainable tourism in action, especially when coupled with the empowerment of women who have long struggled under the thumb of a patriarchal agrarian system. The women, producing and selling their wares, were positively joyful.

From there we took off for the start of our trek, arriving at the first of a series of beautiful lodges and after settling into our lovely, traditionally furnished rooms, we sat down to a delicious Nouvelle Peruvian lunch. Fresh, organic vegetables, all grown nearby, and local river fish, beautifully prepared for presentation and taste. As I enjoyed our meal on the patio, taking in the spectacular mountain vistas that surrounded us, I felt the warm afternoon sun begin to soothe the subtle ache of travel, of crossed time zones and long flights, of strange beds and aloneness. The moment drew me to some of the questions I have asked myself since I was a seventeen year old hitching a ride from New York City to Colorado, the first of a lifetime of trips that would take me around the world many times. Why do we choose to leave home for the unknown?  Are we running away from something? Trying to feel, or perhaps find some particular thing? Why do we travel?

I thought about this as I walked up and down mountains for five and six hours each day. I crossed a fifteen thousand foot pass at the confluence of Salkantay and Huayantay glaciers, stunned by the beauty. I passed beneath the snowy abodes of Andean Gods and crossed the stony rivers fed by their melting ice fields. I rested in the thick grass of high sun baked pastures. And at the end of each day, tired and sore, our group would arrive at yet another beautiful lodge, perfectly set into the landscape. We were greeted by smiling Peruvian teenage boys and girls holding trays of rolled hot towels, gracious offerings for us to wipe the dust of the trail from our wind and sunburned faces. We were handed coca and mint tea and then we took hot showers in our simple, yet perfectly appointed rooms. Finally, we submerged ourselves in hot tubs set on the hotel lawns so we could enjoy the changing colors of the last light of day and feel the steely ache of our muscles and joints turn into rubbery pleasure. With our Peruvian Beer, Chilean wine, and Pisco Sours, our bodies soaked in the steaming mineral waters, and our eyes bathed in an ocean of early evening stars.

But it was not until the fifth day of that beautiful and difficult trek that I felt the deep release I had longed for. As I descended into a thick cloud forest above Machu Picchu, the ruins visible in the distance, I felt the tension in my body drain away. Each step on the soft compacted trail resonated in perfect rhythm with the lush foliage dancing in the breeze. Flush with a powerful blast of sweet jungle air, my mind cleared as my focus shifted from waterfall to river to the distant receding peaks. At that moment, the world revealed its perfection.

I walked out onto a rocky ledge, and in wonder, looked over a deep chasm. I sensed both the edge of terra firma and the boundary of my self and knew that this was why I had traveled four thousand miles and climbed mountain after mountain and left the soft comfort of my familiar bed. Because it is in the comforts and securities of our everyday lives that we lose that part of ourselves that sits in awe, that part of ourselves obscured by the tedious routines of every day life, the routines that reinforce the stories we tell ourselves over and over again, the narratives that define and limit our experience. To go out into the world demands a heightened awareness that we need to navigate unknown terrain and forces us to change those stories we know too well. I grasped that the anxiety one often feels on the road is psychic resistance, the friction of habit rubbing against the new. Its resolution…mindful surrender.  It was only in “non-trying”, that I was finally able to simply “be”.

I boarded the bus to Machu Picchu in the early morning darkness. It was a short ride up the mountain from Aguas Calientes. I walked toward the site and through the entrance gate and found a grassy area above a high Incan wall.  As I stood there, the sky became gray and the jagged mountains visible, towering above and around the ancient site. Below me were buildings of perfectly cut and piled stones, ritual areas that had oriented the inhabitants in space and time, energetic axes of the sacred and secular, the temporal and eternal. I stood on that promontory and watched the slowly rising sun burn through heavy clouds and joined in a collective sigh of the gathered crowd as the sky opened. The long abandoned plazas, temples, and houses filled with tropical light and the mountains burst neon green, vibrating, pure and perfect. Three alpaca grazed contentedly on a small field in the ruins and then scattered, graceful and quick. I was lost to myself, sucked into some kind of wave field that seemed to connect me to all that was. I felt the deep and healing power of that place between self and no-self, and sensed that this jungle city had been constructed to bless and support that realm, perhaps to guide us mortals in an embrace of the Great Cosmos of which we are such small yet integral parts, to embody the infinite. I remembered why I had come and knew why I would return.

Ricky Fishman is Director of Integral Expeditions, an educational travel company based in San Francisco, and will be leading this program to Peru in May, 2012. www.integralexpeditions.com

The low back pain we feel is most often the result of lumbar flexion—bending over at our waists. With twelve pounds of guitar or bass on our backs, our paraspinal muscles scream as they work to pull us above our pelvic centers, our discs bulging dangerously, their internal fibers tearing away from each other as inflammatory fluids rush in to control the damage.  Nerves compressed by the mechanical and biochemical pressure fire off, causing pain and spasm. Sometimes, when the damage is severe, we feel shooting pains down our legs.  Often debilitating–painful, numbing, and weak— it is hard to imagine relief.

Given the tough mechanical realities of the rock and roll life, we need to brace ourselves.  We need protection from these overwhelming stresses; protection rooted in core strength.  The abdominal and paraspinal musculature wrap around our trunk, connecting to create an internal lumbar support. As these muscles strengthen, they relieve pressure on the spinal joints by lifting their vertebral articulations and distributing balanced forces between the soft tissue structures—ligaments, tendons, and discs. With a strong core, a drummer lifting his or her 75 pound hardware case, will absorb (please have someone give you a hand here drummers!) the amplified (some knowledge of Newtonian mechanics required here) forces sharply concentrated deep in the low back but the damaging effects will be greatly minimized.

So what do we do? Join the gym? Get a trainer?  “But I’m a musician”, you say. “Trainers are not really in the budget. Bass strings and pedals, yes. Club One, no”! Well the good news is that all one needs to protect and preserve ones low back is a floor, a wall, the great outdoors, and one or two pieces of very simple, inexpensive equipment. First, start walking…quickly.  Increasing blood circulation provides biochemical nutrition to all the structures of the body, the nutrition needed for ongoing repair. Flushed with blood, our soft tissue remains soft.  Not weakly soft, but supple, poised for strengthening. In our culture, where we worship taut, buffed bodies, and equate softness with weakness, we seek a rippled effect.  But in fact, a tight muscle is a weak muscle, and a stiffened joint is a joint ready to break down.

After lubricating the musculoskeletal system with a sanguine cardio surge, it is time to stretch. Flush with fluids, one can more effectively nudge the muscles that connect to the pelvis.  The strong muscles of our upper legs—the hamstrings, quadriceps, adductors, the tensor fascia lata, and gluteals—all attach to the bony pelvic core and when there is too much tension in that musculature, motion is restricted and joint damage  becomes more likely.  All muscles can be specifically stretched on the floor and against the doorways of your apartment.  And when they are soft and stretched, they can then be strengthened.

From behind the Iron Curtain of Eastern Europe in the 1970’s and 80’s, emerged a new approach to the treatment of back pain.  While Medicine under Western Capitalism produced sophisticated and expensive methods of high tech diagnostics like C-T Scans and MRI’s, as well as surgical techniques to finely slice and reconstruct the human body, in the East, with minimal stores of cash, researchers discovered that functional evaluation and treatment which combined strength training and balance could be more effective than imaging and treating specific tears in soft tissue structures that might have nothing to do with a patients pain or dysfunction. Out of these Eastern European schools came the gymballs, styrofoam rollers, and balance discs we now see scattered around gym floors.  So to complete the home care program, get a balance ball, now available at every Costco and SportsMart.  Cheap! For abdominal and back muscle strengthening, all you need is the ball and the floor.  Minimalist exercise. Lying on that ball, face up, trunk below your neutral line, lift to neutral.  Then lie face down on the ball and do the reverse, lifting your trunk against gravity. Engaging, contracting the abdominals, upper, lower, and transverse, and your paraspinal erector spinae musculature you will feel your core when the workout is done. You may feel yourself standing immediately more upright, with less low back pain.  It is the miraculous nature of our deep centers when strong, the balanced confluence of the nervous, musculoskeletal, endocrine, and cardiovascular systems. Having this single piece of equipment at home completes your full gym requirements. Perfect for the musicians budget.  Find a Chiropractor, a Physical Therapist, or a good trainer to run through the basics described above and you will have gone a long way toward protecting your low back.

But this handles only the physical part of the problem. There are some other, more ethereal challenges. Like the show.  Hours of “let loose playing”, jamming, doing what we do for the reasons all players understand.  When we enter that “zone”, the space we all seek, where mind and body disconnect, and the self  disappears in a cloud of divine vibration, we feel no pain, transcending for the moment our burdensome bodies. But the body keeps working, mind detached or not.  And with that Telecaster hanging over your shoulder, that eight pounds of  hardwood country rock joy, you might jam out in ecstatic abandon, but the facet joints of your lumbosacral spine will still scream. And after the gig, you will feel your beaten body again.

So when on stage, lost in the music, maintain a thread of connection to your conscious mind. Cultivate a gentle, mindful, awareness of your mind-body totality.  Feel the music and your body simultaneously and visualize a space where it all comes together in some kind of harmonic balance.  And if you know that bending over is what will mess you up, then lean back.  Stand upright.  Do a few back bends.  The audience will dig your move.  The cool, bouncing lean back.  A new signature, perhaps. And for those longer shows, leave the Tele at home and bring the SG.  Hey, if it was good enough for Duane Allman…  And for the players stuck in the hot seat—keyboards and drums—stand up when you can.  After four or five songs, just get up and do ten back bends.  If the lead guitar guy can take five minutes and tell some quirky story about his life, you can stand and bend back.

Everything I have mentioned so far has been about prevention and maintenance.  But if you are lifting a large speaker cabinet and feel a sudden sharp low back pain accompanied by a searing leg burn…stop!  Get help and do not continue lifting. If you keep pushing, you may further damage structures already at serious risk.  Most often, the appropriate first aid is the application of ice, wrapped in a paper towel–ten minutes on and one hour off.  Then repeat. This, accompanied by some over the counter, non-steroidal anti-inflammatory drugs (NSAID’s such as ibuprofen*) will help to slow down the inflammatory process which is causing the irritating pain. If the pain does not quickly subside, see a health care practitioner who understands the diagnosis and treatment of these injuries.

Chiropractors specialize in the treatment of back problems.  Acupuncturists and Physical Therapists can also be very skilled in this realm, but in choosing any of the above practitioners, find ones who understand body mechanics and who complement their care with manual therapies such as spinal manipulation, stretching and exercise.  Although back pain is one of the most common complaints that presents in the Medical Office, the medical prescription is generally limited to pain killers, muscle relaxors, and anti-inflammatories.  After prescribing, a skilled MD should refer to a qualified manual therapist.

We play because we love to play, so we haul our equipment from home to car to studio or club and then back again, often enduring low back pain caused by the bend over, the grab, and the lift.  We overstress paraspinal muculature, lumbar discs, articular cartilage, and deep ligaments and tendons, all of which keep us stable and moving.  The damage results in microtears, generating inflammation, nerve irritation, and pain.  But we are not powerless to prevent and manage the natural wear and tear that comes with our chosen Rock and Roll lifestyles.  Exercise, stretching, ergonomic understanding, and mindful attention paid to posture and position will help preserve and protect our bodies so that we can enjoy the long musical lives we envisioned when we picked up our axes and were raised up by those first power chords.

*Please note that the material in this article should not be construed as Medical Advice, but merely represents general guidelines and principles for low back care.  Please consult your Physician before taking pharmaceuticals to be sure there are no contraindications such as allergies or internal sensitivities and if one experiences back pain accompanied by loss of bladder control, seek medical care immediately.

Dr. Ricky Fishman is a San Francisco Chiropractor and has been a performing electric bass player for over thirty years.  He runs the Musicians Chiropractic Project which specializes in the treatment of musicians injuries and offers special rates for uninsured players.

Over the past few years, as I’ve wandered the aisles of Guitar Center, I  began to notice some pleasant developments–heads with tube pre-amps that cut their weight down dramatically; lighter materials used in speaker and cabinet construction.  I also realized that for most gigs, a “2 by 10” cabinet was just fine.  Then I found  a “4 x 6”, even lighter.  At 32 pounds, it sounded great. My back cried with joy as I lifted that baby and dropped it into the trunk of my car.

But there was some personal business to attend to. It dawned on me that I had become attached to my equipment, not just materially, but psychologically, emotionally. Playing throughout the 70’s and 80’s, I worshiped at the “Alter of Analog and Tubes”. My identity had become rapped up in that SVT Classic, that stack of 10’s and 15’s.  It was gear as fetish. Shifting to lighter equipment required a kind of letting go, a detachment from that image of myself as some sort of Rock God standing before my heavenly wall of sound. But I did let go, and I am here to testify to the joy of liberation from bass rig hell.  As I watched my Aguilar disappear into another players car, I felt a weight (literally) lifting off my back. And when I slipped that 8 pound Mark Bass head into my back pack and then over my shoulder, picked up my little “4 x 6” cube, and headed off for my indie rock gig, it was with deep joy, satisfaction….and relief.  But make no mistake.  That little head can easily  power any “8 x 10” stack, no problem. And did I mention my new Danelectro bass.  Yes I know—made in China.  But for what it is and what it can do, I love it.  Those six pounds of punchy, utilitarian bass feel great in my gig bag. My ‘76 Fender P Bass and ’78 Stingray (where did they find that leaden wood in the 70’s?) can wait on their stands, ready to be lifted and plugged into the wall of speakers that sits unmoving in my home studio.  Of course, there is nothing like the vintage feel and sound of those historic axes and monster cabs and they do still come out with me…on special occasions.

I had a patient a few years ago who was playing guitar in the Abba Musical, “Mama Mia”. A serious player, he had toured with some of the top acts of the last thirty years.  After hobbling into my office, suffering from a flare-up of his 25 year old chronic low back condition, I treated him, did my Chiropractic thing–adjustments followed by a series of exercises and stretches that he needed to do so he could get back into the pit and stay out of my office.  And we talked—of Marshall Heads and Thunderbirds—of the heavy equipment of his profession. And he told me about the producer of Mama Mia, about how that producer told him which amp he would be using for the show. It was the “Line 6” digital modeling amplifier.  The player recoiled at the thought.  He, who had a studio full of classic guitar tube amps and cabinets back in New York, was being told to play through this “imitator”. His old school sensibilities were being offended.  But the player told me that when he plugged in, and flipped the dial to “60’s Vox AC30”, out came that sound, the one that brought back all those memories, tastes, and feelings.  Even better—every time he hit  “60’s Vox” the same sound came out.  No temperamental tubes reacting to the climate of the room.  No lag time while they warmed up, finally finding their sound.  That producer knew what he wanted.  He wanted predictable sound every night, every show.  And at a fraction of the weight of the real Vox, he had the added benefit of cutting down on costly work injuries.

There is no real substitute for the sound of a Les Paul plugged into a Mesa Boogie Rectifier or a J-Bass played through a Fender Bassman.  But we Middle Aged (and younger) players, whose roadies have long since left us, know that our bodies must be protected as well as our beloved equipment. And just as our forbears embraced the new technology of electric music back in the 1950’s, it is time for us to embrace the new wave of ergonomically friendly instruments and amplifiers. I was skeptical about an 8 pound amp providing the power I needed.  But when I stepped onto the stage in front of a full house at Biscuit and Blues in San Francisco, plugged in, lifted my Washburn acoustic, and heard that sweet bass sound coming through my little “4 by 6” and watched that crowd light up to the lovely sounds of the Bitter Mystics, I knew that there was no turning back.  At 54, I still have many years of playing left in me. Using this new light weight technology, those years will more likely be spent pain free, so I can just ride the deep bass waves with ease, into the sunset.

*For those who do not understand equipment lingo, reference to “4 by 6″ or “2 by 10″ cabinets refers to the number and size of the speakers in the cabinets, so that a “4 by 6″ refers to a cabinet that has four six inch speakers while a “2 by 10″ has two ten inch speakers.

Dr. Ricky Fishman is a San Francisco Chiropractor and has been a performing electric bass player for over thirty years.  He runs the Musicians Chiropractic Project which specializes in the treatment of musicians injuries and offers special rates for uninsured players.

Fundamentally, we are energetic beings, waves of electrical charges, cooled into embodiment; congealed organic structures; solid objects of nature. Our mind/bodies buzz as our internal energy systems resonate with the electrical fields beyond our physical limits in a great cosmic dance. Looking deeply within, we see cellular plasma, microscopic gunk. But deeper, at the nano level, we are mostly “No-thing”. Empty space, chaotic yet paradoxically patterned gatherings of vibratory forms.

While at ease, the wave flow is powerful and smooth, pulsing in sync with our natural rhythms, winding through imperceptible channels that give rise to healthy structures which then secrete biochemicals, generate electricity, and pump fluids that contain universally charged and ingested particles. When dis-eased, flow is uneven and weak, jammed up in some places, overexcited in others, creating a frictional drag on our systems. The difference between these two states is rooted in both the scarcity or abundance of available energy and the bodies ability to assimilate it.

One of the great expenders/depleters of this energy is the labor intensive work of “I Maintenance”. Bound through evolutionary determination to our senses of self, our “I-ness”, we navigate the world. From the vantage point of this self center of the cosmos we defend ourselves against dangers both real and imagined. And after constructing these defenses, we find ourselves alone, behind fortress walls, separated and distant from the world. Starved for connection and cut off from the bountiful energy that surrounds us, we feed on ourselves, cannibals drinking our own lifes blood, searching desperately for sources of sustenance. Alcohol, drugs, potato chips, television–all just empty calories and stimulants that create short term illusions of vitality, numbing the pain and suffering of self absorption, and almost always followed by a hangover.

So how do we free ourselves from this oppression, from the tyranny of the “I”. Where do we find the strength needed for this task? By opening ourselves to the power that surrounds us, an internal field is generated in which the “I” can merge with and finally dissolve into the “All”.

Creativity, arts engine, is a process whereby cortical consciousness connects with its deeper unconscious state, opening a conduit through which ideas and images flow. The work of art produced, through the hands, heart, and mind of the artist, then takes on its own vibrational pattern which exists independently of its creator. Great art is marked by its capacity to spontaneously awaken us by blowing holes through the psychic barriers that separate our inner and outer realms. The subsequent transmission and absorption of these powerful patterns then serves to replenish our depleted energetic stores.

In addition to the inherent energy of the art objects themselves is the power of the artistic process to enable both creator and observer to focus deeply, to effectively close out thought. Buried in the spaces between thoughts are modes of connection, intrapsychic bonds, that hold untapped potential. But we cannot access these sources because of the noisy chatter that obstructs our awareness. As the spaces of emptiness expand within us, the bonds between self and no-self are stretched, then shattered, releasing energies beyond the strength of will. Through the artistic silence of creation, appreciation, and focus we are able to harness the power necessary to “not be”.

So naturally, throughout time, our species has been drawn into this process. A vehicle of both transcendance and pleasure, art celebrates beauty and the immolation of self in an emptiness that human beings have sought since we awakened into consciousness.

So what heals us? Chiropractic adjustments, exercise, Acupuncture needles? Antibiotics and surgery? None really. Each modality opens a channel, clears the way so that the energy that swirls around and within us can move through us, lighting up our cells, resonating with our deepest frequencies, raising us. This is healing– the bathing of our bodies, minds, and souls in pure light, the energy of the cosmos. And the vehicles that open our energetic gates are the healing ways. But they are not the healing.

Every spiritual tradition utilizes some form of art—sound, movement, painting—to clear an opening for healing energy to flow. Gregorian chants, Church bells, Balinese dance, Tibetan Thanka painting. Even the repetetive, rhythmic focus of prayer and meditation generates musical vibrations. Why do people shout “I am healed” as the Gospel music pulses behind them, as they sway in ecstatic motion? Because they have opened themselves to the Universal (God to them) Force and it is this force that heals.

If we desire true healing, and want to address our illnesses at every level, we need to access the deep healing energy within us all. This is the medicine to be taken beside or instead of those traditional Allopathic remedies we are taught to depend upon. The activation of these energies through art allows and supports the healing of all of our bodily systems, connecting us to the great unity, and consecrating as holy the ground of our being.