How do you get to Carnegie Hall? Practice, practice, practice. But practice can land you in a different place altogether, as UConn music major Susan Barraco learned during her freshman year.

Barraco wound up at the Health Center's new musician's clinic, working with a team of health care professionals led by Martin Cherniack to cure arm pain that seriously interfered with her music and her career goal.

When she arrived at UConn two years ago to study music, Barraco pushed practice time from her high school schedule of two hours a day to five or six hours, trying to keep up with the ensemble, the marching band and private lessons of a freshman music student. "One Friday afternoon as I played my clarinet I felt a pain, almost like an electric shock, shoot up my arm. Then my hand started to feel tingly and numb," she says.

That started her on a months-long journey for an explanation of her ailment and a cure. It was a search that took her from the infirmary and a prescription for ibuprofen, to physical therapy to splints, cortisone shots, visits to a chiropractor and an orthopedic surgeon.

Earlier this year, she heard about Emil Pascarelli's work with injured musicians and discovered he had recently joined Cherniack at the Health Center.

"We're developing a unique team to care for musicians," says Cherniack, director of the Ergonomics Technology Center. The center has specialized in non-surgical management of upper extremity disorders suffered by computer keyboard users.

Part of the center's research program involves taking precise images of the techniques used by keyboarders and retraining them. "These techniques will work equally well in treating injuries suffered by musicians," Cherniack says.

"And we're bringing together physicians experienced in soft tissue diagnostics, occupational and physical therapists trained in direct manipulation, musicians with physical medicine backgrounds who can modify a player's technique and a skilled machinist who can modify musical instruments," he says.

"For musicians, the suffering is often the result of several factors," according to Pascarelli, former director of the Katherine and Gilbert Miller Institute for the Performing Arts in Manhattan, who has worked with musicians for years.

"The musical instrument should fit the person; all too often, the person struggles to fit the instrument," he says. "There is no tradition of physical conditioning among musicians. Music schools seldom have gyms and musicians too often look down on exercise," he adds. "And music teachers don't know biomechanics. They are hooked on tradition learned from their own maestro and often are unwilling to change techniques."

"If I had had this resource two years ago, it would have made a huge difference," says Barraco. "I've been through a lot of doctors. What I like about the musician's clinic is that I see a team of professionals, doctors and occupational therapists, and they understand what I'm talking about.".

With their help, she is working on her posture, her technique and undergoing occupational therapy.

Barraco, meanwhile, has temporarily given up the clarinet to give her arm a chance to heal. "I've switched to the French horn because there's a smaller role for my right arm. It just has to hold the bell," she says.

She's not giving up on her career goals, though. She still practices diligently and plans to apply to UConn's music education program next spring so she can be a music teacher.

"This has been really frustrating for me," says Barraco. "I know I can be a good teacher but it's been difficult working around this injury. I feel strongly, though, that it's important to talk about it because I know I'm not alone and that others can learn from me."

The Health Center musician's clinic will focus on clinical care, outreach and education, and research.

"Our outreach efforts will be particularly important for younger musicians," says Pascarelli.

"We hope to educate teachers on ways to prevent these injuries," he says. "It's really up to the next generation of musicians to be informed. That's what we're aiming for."

Kristina Goodnough