Go to any rock concert and you'll feel it. The sensory overload of the flashing lights and the blending of the audience shouting and singing along with the lead singer's vocals throughout each song. You'll hear the music's wave of sound and energy amplified to make your ears ring. And dominating the inundation of your senses, you'll feel it in your bones...THE BEAT. The thunderous power of the drums as they guide the tempo and pulse of each song and provide a defining energy and intensity for the band and the crowd.
The rock drummer plays an important role in steering the rhythm, intensity and power of a band's sound. Their physical exertion, depending on their style of drumming, approaches that of a pro athlete. For example, the Basher style of drummer hits the drums very hard, producing a loud, powerful sound. But just as hard as this drummer hits the drums, being a basher is as hard on the body, especially the feet, arms, legs and wrists.
A Basher-style drummer applies about 450 pounds of kick force with their feet for each hit on the kick drum. As comparison, kicking a soccer ball as hard as possible exerts about 300–450 pounds and a trained boxer exerts about 250–400 pounds for a straight punch. But the main difference is that a Basher-style drummer is doing this hundreds, if not thousands, of times during a concert.
"I reached a point where the pain while drumming became too much to deal with," said Cartellone
Michael Cartellone is a Basher-style drummer. He started drumming at the age of nine, became a professional drummer at the age of eleven playing in bars and, in his 50+ years of drumming, he has performed with a who's who list of some of the greatest artists and bands in rock-n-roll history. He has worked with John Fogerty, Peter Frampton and Freddie Mercury; was the drummer for German heavy metal band Accept, was a founding member of the multi-platinum selling bad, Damn Yankees (known for their hits, "High Enough" and "Coming of Age"); and since 1999 he has been the full-time drummer for the classic southern rock band, Lynyrd Skynyrd ("Free Bird," "Sweet Home Alabama" and many others). And in addition to his illustrious music career, Cartellone has simultaneously had a successful career as a visual artist with his artwork having been displayed in galleries across the United States ("I was actually painting before I was drumming [art school at age 4, drumming lessons at age 9]," mused Cartellone).
Despite his style of drumming, and the wear and tear of decades of playing, Cartellone had never had an injury to his feet until 2023. It was then that he began experiencing pain in his right big toe (on his kick drum foot). The pain only occurred when he was drumming, but as it progressed he found himself having to limp off the stage by the end of a concert. "I reached a point where the pain while drumming became too much to deal with…and I realized I needed to do something about it," he said.
Cartellone initially saw an orthopedic doctor who told him that he had a broken toe, a bone chip and a lot of arthritis. The doctor suggested a surgical procedure that would have involved inserting a steel rod into his toe. He was told this surgery, which would prohibit his toe from ever bending again, was the only way to completely address the pain.
"I never considered the ortho’s plan for a second," he said. "The idea of putting a steel rod into my toe, so it would never bend again and not cause me further pain, sounded ridiculous." Instead, he opted for a cortisone injection, which provided only short-term relief.
During Lynyrd Skynyrd's 2024 tour, Cartellone's intense pain returned
Knowing he wasn't going to have the suggested surgery, but needing to address the pain, Cartellone began experimenting with different solutions. He tried adjusting the position of his foot on the pedal, he reduced the impact his foot was absorbing and began wearing steel tennis shoes to protect his big toe. "Those changes enabled me to continue to play a little easier through the pain...temporarily," he said. After Lynyrd Skynyrd had begun their 2024 tour, the intense pain returned and he knew he had to do something about it now or he'd be risking his drumming career permanently.
As luck (or fate?) would have it, a friend of Cartellone told him about a successful foot surgery she had with Stony Brook Surgery's Doctor Bernard Martin, DPM, of the Division of Podiatric Surgery. While Dr. Martin had not treated any professional drummers during his 40-year career practicing podiatric medicine and surgery, he had previously helped many professional and college athletes with a variety of foot and ankle injuries during time spent working with the New York Knicks, St. John's University and Long Island University sports teams. Based on his friend's strong recommendation, and Dr. Martin's experience, Cartellone soon had an appointment booked.
"During the first meeting with Michael, we had an extensive conversation about the discomfort that he was having [due to hallux rigidus, a medical term meaning lack of motion through the big toe joint with arthritic changes] and the likely propensity for this to continue due to the nature of his drumming profession," said Dr. Martin. After examining Cartellone, Dr. Martin discussed options to address the injury (these included conservative non-surgical approaches and also surgical options).
Dr. Martin explained the Keller procedure as a surgical option for Cartellone's injured toe
According to Dr. Martin, he told Cartellone that there were basically two surgical options. The first would be to fuse his toe to the metatarsal, which would likely limit his drumming ability due to lack of motion in the toe but still allow him to perform. "[Michael] was told that if we went ahead and fused the joint, and it did not give him the results that he wanted, there was no other option except to take down the fusion and try to utilize an artificial joint (which does not have a high satisfactory rate)," said Dr. Martin.
Dr. Martin then told him about another option: the Keller procedure (named for Colonel William L. Keller, MD, who first described it in 1904). This procedure entails the joint being resected of all the arthritic pathology and a small connective-tissue-like membrane being placed in the joint. He advised Cartellone that, in his experience, the Keller procedure seemed to work fairly well for most people, but if it didn't help him they could always go back to try the fusion procedure. "A critical factor of foot treatment is truthful extensive conversation with the patient so they know what they can expect and most important is expectations they have being realistic," said Dr. Martin.
When Cartellone and his wife (actress, Nancy Meyer) returned for another visit a few days later, they opted to go with the Keller procedure. "My initial reaction [to the description of the Keller procedure] was it sounded ideal...and we immediately scheduled the surgery," said Cartellone.
Seeing the damage in Cartellone's toe during surgery, Dr. Martin was surprised he could walk, let alone drum
During the surgery, Dr. Martin discovered Cartellone's big toe injury was worse than the x-rays had shown. Cartellone had only about 10% cartilage remaining in the toe, multiple fractures, multiple bone chips and a hematoma that Dr. Martin drained. Dr. Martin later told Cartellone that with all of that, plus bone-on-bone rubbing and jagged edges in the joint, he was amazed that he could walk, let alone drum for hours at a rock concert.
After the successful surgery, the groggy Cartellone was visited by Dr. Martin who explained the previously unseen extent of the injuries he discovered and described how the procedure went. Cartellone explained to Dr. Martin that life in the music business had helped him develop a high threshold for pain. He also stated that he "...was very happy having a cup of coffee and some outstanding cinnamon toast" in post-op (a popular choice in the Stony Brook recovery room).
The next step for Cartellone was a four-month rehabilitation and follow-up visits with Dr. Martin. His therapy consisted of stretches and walking aimed at preventing scar tissue and regaining flexibility. Soon he was given the okay to resume drumming. Carefully, with a bit of hesitance, he began playing again. "Even though I barely tapped the bass drum pedal that first day at home, it was terrifying," said Cartellone. "I was afraid I would do something to ruin all the healing my foot had done. Thankfully, that did not happen." Gradually, despite a few aches and cramps, his strength and confidence returned.
"Over the six months of follow up visits with [Dr. Martin], I truly feel like he and I have become buddies," said Cartellone
Six weeks later, Lynyrd Skynyrd was playing their first show of a new tour. Cartellone's hard work at rehab and drumming practice paid off. Quickly overcoming any anxiety that may have remained, he and the band had a perfect gig. "I am significantly satisfied that I was able to help Michael go back and continue to be the world-renowned drummer that he is," said Dr. Martin. "Every time he performs, he will give a phenomenal performance with the assistance of the motion we gave him in his toe." The band has played several concerts since then and Cartellone is still drumming pain free.
Over the period since Cartellone's surgery, this unlikely relationship--rock drummer and veteran podiatric surgeon--has blossomed into a friendship. "...Over the six months of follow up visits with [Dr. Martin], I truly feel like he and I have become buddies," said Cartellone. "I also have made friends with the wonderful people in his office." Dr. Martin shared a similar feeling, "We definitely have become buddies, and both he and Nancy were told that anytime I can do anything for them I will gladly do so," he said. "[They] have my numbers and I will gladly speak to them, and do anything I can, to keep him as healthy and exceedingly skilled as he is. I do hope that we stay in contact as friends and, if necessary, a physician."
"Quite simply, my experience with Stony Brook Surgery has been absolutely fantastic," said Cartellone.
Reflecting on his decision to choose the Keller procedure, Cartellone said, "Dr. Bernard Martin saved my career. I am not just saying that. He saved my career. I will be eternally grateful to him for doing so." Further beating the drum, he continued, "Quite simply, my experience with Stony Brook Surgery has been absolutely fantastic."
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