Dr. Raymond Wittstadt has a pretty good grip on the reasons why some musicians need his help to continue playing at an optimum level.
More often than not, their hands are either the source or the recipient of stiffness and pain. As such, the Glen Arm resident has has been an attending hand surgeon since 1994 at the MedStar Union Memorial Hospital's Curtis National Hand Center.
"Whenever a musician tells me where they hurt, it's usually (referred) pain from somewhere else," said Wittstadt, a guitarist in an all-physician, classic rock band, "the Stimulators," which performs for office parties and other small gatherings. "What I get involved with is learning their background and putting the big picture together" while attempting to diagnose the problem.
The Calvert Hall alumnus, who graduated from Johns Hopkins University and the University of Maryland School of Medicine, is the first practicing physician in Maryland to hold a credentialing certificate in performing arts medicine from the Performing Arts Medicine Association and the American College of Sports Medicine.
His interest in hand injuries stems from a seven-year career as a nurse at what was Baltimore City Hospital and is now Johns Hopkins Bayview Medical Center in East Baltimore, where injured steelworkers from Bethlehem Steel in Sparrows Point would come for treatment.
"I like to say I took the scenic route," Wittstadt, 64, said about the unusual nurse-to-physician path he followed. "I saw a lot of guys being treated there for hand injuries, and I thought, 'I can do that.'"
After completing his residency at the Curtis National Hand Center, Wittstadt stayed and is now one of 14 staff surgeons at the 23,000-square-foot facility in the north Baltimore hospital.
Patients and peers note his value to the hand center.
"We have a lot of subspecialty and super-specialty areas here," said Dr. James Higgins, chief of the Curtis National Hand Center. "Each of our surgeons has a specialty area, and Dr. Wittstadt's (specialty) is musicians. He's our go-to guy in that regard. It's a huge benefit to have him, especially because we are in a region rich with musicians. He treats all types, not just orchestral-level musicians. He holds a very important place for us here."
The Curtis National Hand Center has been repairing traumatic injuries and treating repetitive motion injuries, arthritic conditions and congenital problems since 1975 at the MedStar Union Memorial Hospital. With its state-of-the-art facilities, It was designated by Congress as the National Center for the Treatment of the Hand and Upper Extremity.
According to Karen Robinson, the care Wittstadt has given her now-18-year-old daughter, Natalie, since she was an eighth-grader has helped save her music career.
"He took extreme care to assess what was going on with her hand," Karen Robinson said. "For Natalie, it was one thing after another. He did six surgeries on her over six years, and was able to help her maintain a rigorous musical program at Barbara Ingram School for the Arts (in Hagerstown)."
Robinson said that Wittstadt's demeanor played a big part in her daughter's treatment.
"He's just so easygoing," she said. "It's like they speak the same language. Natalie liked Dr. Wittstadt so much that she invited him to her junior recital — and he came. She's even going to pursue a career in nursing at Towson University because of him."
Higgins said that Wittstadt is "unflappable" with his patients.
"He has the ability to take their anxieties and concerns and put them into perspective," Higgins said.
Wittstadt's work at a monthly musicians' clinic at the Curtis National Hand Center is a key way for him to make evaluations by observing musicians playing their instruments.
It's there that Wittstadt and his staff can see firsthand if a musician's problems arise from poor posture, awkward movements, improper hand placement or other contributing factors.
Patients are then counseled on injury-avoiding tactics, although corrective therapy and surgery are sometimes required.
At a recent session at the facility, Tim Houston attended the clinic to discover why his upper wrist was becoming bothersome.
The student jazz guitarist at Towson University played the instrument while Wittstadt observed his posture and playing style.
Houston, 22, said that he didn't feel much pain when plucking the guitar strings, but that he could "feel (a sensation) in my wrist" when playing certain chords.
"The biggest things is worrying about it," Houston said, noting that he wore a splint on his wrist to try to correct the problem. "When the splint didn't work, another student told me how Dr. Wittstadt had helped him."
After conferring with Lauren Valdata, a physical therapist and certified hand therapist at the Curtis center, Houston was given instructions on the best way to wear the splint to help alleviate pain from what was diagnosed as a ganglion cyst.
"It's a fairly typical problem, but when you're a musician it puts additional stress on the wrist," Wittstadt said. "It's a pretty straightforward condition, but because he's a musician who does many repetitions during practice, he becomes more symptomatic. String players are more prone to injury. But we're going to see if we can get him through the semester."
As for Wittstadt himself, while he has not sustained injuries from playing the guitar, he has suffered back and shoulder pain from carrying equipment to practices and gigs. "An overlooked stress of performing is from moving your equipment," he said.
Last summer, Wittstadt became the first physician in the state to earn a certification of expertise in the 40-year history of the Performing Arts Medicine Association (PAMA) from NewYork-Presbyterian Hospital and Weill Cornell Medical College.
According to Higgins, it was a "big deal" for Wittstadt to receive the certification, which required a five-day course and meetings in New York, plus an exam.
"It would have been easy for Dr. Wittstadt to just continue what he has been doing," Higgins said. "But he's always striving to improve his practice. He's the ideal practitioner."
Wittstadt noted that while previously physicians were able to claim PAMA membership, there was never any formal training available to them.
"It makes me even more proud of the hard work we do here at MedStar Union Memorial and the Curtis National Hand Center," he said. "And it helps the patients understand how dedicated we are to treat and care for them."