Tightness, discomfort, pain, numbness and limited range of motion are the typical symptoms. The following scale can be helpful in assessing degree of disorder and appropriate treatment:

Level	Severity
1	Symptoms appear after practicing or performing intensely, but performance is not diminished and symptoms go away on their own.
2	Symptoms appear during performance, but performance is not diminished and symptoms eventually go away on their own.
3	Symptoms appear during performance and quality or duration of performance is diminished. Symptoms reappear occasionally while not playing instrument.
4	Symptoms appear immediately when one begins to play and performance is no longer possible. Symptoms reappear frequently while not playing instrument.
5	Symptoms persist during all regular activities. Playing the instrument is impossible and quality of life is compromised.

In addition to this scale, there is also the more anecdotal self-assessment that clients share, such as not "feeling right" or suspecting that their performance could improve if they were looser or had greater range of motion when they play. We explore these issues through looking at questions such as these:

• Are you comfortable when playing, even at peak levels of performance?
• Are there situations in which you're more or less comfortable when playing? How does this manifest in your body?
• How aware of your body are you when performing?
• Do you have habits of posture and movement that only appear when playing and are not part of your typical patterns?
• How do you take care of yourself when you're practicing and performing intensely?

There are also areas of pain or discomfort that appear for musicians that might not seem related to playing the instrument. Trouble in the feet or legs, headaches, or any of the garden variety aches and pains may in fact be related to postural habits while playing. The body is interconnected in wonderful but sometimes puzzling ways which can be disentangled and treated.

I consider all these possiblities when creating a treatment plan. I also tailor a program of movement and stretching to help clients help themselves stay symptom free.