Musicians' Health

El músico, profesional o estudiante, está expuesto a sufrir durante su carrera cierto tipo de lesiones asociadas a las características de su profesión. Las más frecuentes son las que afectan al sistema músculo-esquelético y causan pérdida de funcionalidad o incapacidad. Para abordar este tipo de lesiones (tendinitis, contracturas, distonías, etc.) la fisioterapia ofrece un tratamiento adecuado a cada patología, así como unas pautas de prevención que son el mejor modo de evitar lesiones.

The most frequently occurring performance-related health problems in musicians are musculoskeletal. Research on the performance-related health aspects of double bass playing, particularly musculoskeletal symptoms (MSS), is limited. Therefore, this literature synthesis aims to consolidate the existing research on the MSS experienced by double bassists. This article examines how the double bass has been represented in the musicians' health literature; explores the literature on double bass players' performance health; and investigates double bass pedagogical literature containing health-related information. Recent studies on double bassists' MSS provide a good foundation for further research. A promising amount of valuable health-related information can also be gleaned from non-academic sources such as double bass educational books. Double bassists experience MSS in the back, neck, and upper extremities, including shoulders, arms, wrists, hands and fingers. However, the exact prevalence and risk factors of these MSS cannot yet be conclusively determined due to the small number of studies focussing on the double bass, the small numbers of double bass participants in research on string players' MSS, and the grouping of the double bass together with other instruments in these studies. Further research ascertaining the types, frequency, severity and risk factors of double bassists' MSS, is necessary for the prevention and rehabilitation of double bassists' performance health problems, for enhancing performance, and for optimising pedagogy.

Musculoskeletal problems related to playing musical instruments have long been identified with adults, but little is known about their development during childhood. What evidence does exist has not adequately considered risk factors, in particular the effects of gender and age. A cross-sectional questionnaire study gathered data from 731 children enrolled in the instrumental music programs of government primary and secondary schools in Perth, Western Aus-tralia. This study, the first in a series investigating risk factors, established the prevalence of playing-related musculoskeletal problems, both symptoms (PRMS) and disorders (PRMD), and the association with gender and age. In this group, 67% of children reported ever experiencing PRMS, with 56% reporting symptoms at least monthly. Females were more likely (odds ratio [OR] 1.5, p = 0.03) to experience symptoms and older children were more likely to have ever experienced symptoms (p < 0.001). Thirty percent reported the experience of a PRMD, being unable to play their instrument as usual. Females (OR 1.5, p = 0.035) and older children (p = 0.001) again were more likely to report the experience of a disorder. For children having reported the experience of a PRMS within the last month, 5% took medication to relieve the problem and 4% visited a health professional to seek advice for the problem. Med Probl Perform Art 2008;23:178–185.

This research project assesses the factors, both on and away from the instrument, contributing to musculoskeletal pain among current tertiary drum kit players in Australia. Whilst performing arts medicine continues to grow as a research field, a lack of information and primary research exists for drum kit players wanting to take better care of their health and prevent playing-related injuries. Two new methods of data collection have been created, the Drummers’ Health and Pain Assessment Questionnaire and the Summary Index of Participants Self-Reported Pain, in order to assess the current state of health and injury prevention awareness within both drum kit majors and percussion majors who regularly play drum kit. Specifically, these methods generate new data concerning playing habits, the prevalence of PRMDs, injury history and treatment, most affected pain regions, internal/external pressures, general health, and stress levels.

Factor analysis has been undertaken along with a deconstruction of the questionnaire responses, and the researcher’s autoethnographic reflections geared towards optimal performance preparation in order to reveal emerging trends, patterns and overall findings. The outcomes of this study indicate that musculoskeletal problems are of concern to tertiary drum kit players and are exacerbated by contributing factors away from the instrument including performance anxiety, fatigue, stress, inconsistent warm up routines, lugging gear and a lack of muscular strength. My own experience of suffering a playing-related injury has sparked my interest in performing arts medicine and my desire to: 1) contribute new knowledge to the field; 2) provide new research data collection methods relevant to drum kit players; and 3) increase the awareness of injury risk factors and prevention for drummers, percussionists and educators of all levels.

"In seguito a gravissimi dolori alla schiena e alla quasi impossibilità di continuare la carriera strumentale ha avuto inizio un'ambiziosa ed incessante ricerca sulla postura del violoncellista.

Grazie anche all'aiuto del maestro Marcio Carneiro questa tesi illustra la storia della postura del violoncellista attraverso i secoli, i trattati e le evoluzioni organologiche dello strumento.

Si compone di un'introduzione storica, una parte autobiografica ed una parte descrittiva in cui vengono illustrate le possibili soluzioni ai numerosi problemi che una scorretta postura può causare.

Per ulteriori informazioni e per organizzare eventuali seminari in merito:
michelegalvagno@me.com

Per una versione con le immagini la potete trovare su Apple Books.
Grazie

The high prevalence of performance-related health problems (PRHPs) among musicians of diverse genres and cultures is well-documented, with lifetime prevalence rates showing that roughly 75% of musicians are affected, including tertiary and pretertiary student musicians, professionals and amateurs. Despite the well-established and multiple benefits of music for society, there are occupational risks, both
neuromusculoskeletal and psychological.
The literature underscores the need for a biopsychosocial perspective in the provision of musicians’ health education. Research on somatic educational practices demonstrates their suitability for addressing the postural, movement, musculoskeletal anatomy and proprioceptive training components. One of these practices, Body Mapping (BMg), focuses particularly on musicians’ needs and may be successfully
incorporated into a musician’s health course. However, BMg is a relative newcomer among the established somatic approaches and little research has been done on the incorporation of BMg principles into music education.
Due to the limited amount of research on the implementation and assessment of health education in tertiary musicians’ training, the purpose of this study is to focus on exploring the experiences of tertiary music students participating in an occupational health course, incorporating BMg as the somatic component. Interpretative
Phenomenological Analysis was chosen for the thematic analysis of the interviews conducted. The aims of the study were to gain an understanding of the participants’ experiences and perceptions of the course, any changes that occurred, and of BMg as the somatic education component. The data analysis revealed four super-ordinate themes: panorama, physical awareness, psychological awareness and musicianship, supported by a total of 20 subordinate themes.
Most importantly, the findings emphasise the reciprocal interactions of physiological, psychological, behavioural and musical aspects of music-making, and suggest that BMg may be highly effective in terms of the integrated teaching of musicians’ biopsychosocial and artistic requirements. The study underscores the need for musicians’ health education to be embedded in tertiary musicians’ training, the beneficial impacts of comprehensive musicians’ occupational health education, and the value of BMg as a somatic education component. The results provide information on essential course content, the advantages of interdisciplinary collaboration, the need for practical activities, the optimal duration, the value of peer learning and support, the importance of cooperation with music teachers, and the consideration of students’
motivation to attend and their readiness for change. The study also aims to raise awareness of the musicians’ health field in South Africa, and the critical need for further research, interdisciplinary collaboration, and the implementation of musicians’ occupational health education at tertiary institutions.
Keywords/Terms: performing arts health, performance-related musculoskeletal disorders, musicians’ occupational health, music performance, music education, performance psychology, Body Mapping, somatic education, Interpretative Phenomenological Analysis, musicians’ health promotion

ÖZET Nefesli Enstrüman icrası vücudun bir çok bölgesinin aynı anda ve yoğun olarak kullanılmasını gerektirmektedir. Bu enstrümanların performansı sırasında akciğerler, diyafram, karın bölgesi kasları, boğaz, yutak, dil, dudaklar, çeşitli yüz kasları, el ve parmaklar koordine şekilde kullanılmaktadır. Müzisyenlerin karşılaştıkları bazı sağlık sorunları performanslarını farklı oranlarda etkileyebilmektedir. Bu sorunların bazıları geçici ve tedavi edilebilir sorunlarken, bazıları kalıcı ve tedavi edilemez olmakla beraber, müzisyenlerin kariyerlerini ciddi anlamda tehdit eder niteliktedir. Müzisyenlerin kariyerleri boyunca karşılaşabilecekleri bu sağlık problemlerinin ortaya çıkma sebepleri, performanslarına olası etkileri ve varsa bunların tedavi yöntemleri ile ilgili bilgi sahibi olmaları ve konuyla ilgili bilinçlenmeleri, ortaya çıkabilecek olası bir sağlık sorunuyla başa çıkabilmeleri açısından büyük önem taşımaktadır. Bu sunumda nefesli enstrüman çalan müzisyenlerde ortaya çıkabilecek ve performanslarını etkileyebilecek çeşitli sağlık sorunları, bunların ortaya çıkma sebepleri, tedavi ve/veya başa çıkma yöntemleri ele alınacaktır. Bu yolla, nefesli enstrüman çalan müzisyenlerde konuyla ilgili farkındalık oluşması ve müzisyenlerin kariyerlerini tehdit edebilecek sağlık sorunlarının önüne geçebilmelerine veya bunları doğru bir şekilde ele alabilmelerine yardımcı olunması amaçlanmaktadır.
Anahtar Kelimeler: Nefesli Çalgılar; Müzik Eğitimi; Sağlık

This personal narrative traces the impact of performance-related injury on the author. Contextualising my own experiences alongside the testimonies of other musicians, I explore the non-clinical impact of injury: the social, the emotional, and psychological, including issues connecting music-making to identity and esteem. In chronicling my own subjective experiences as a layered account (Ronai, 1992), I hope to illuminate the complex and intimate relationship between musician and the act of music-making, thereby also revealing the multiplicity of factors involved in coping with a performance-related injury.

A long-standing taboo has likely contributed to a dearth of autoethnographic stories among research on musicians’ health. Here, I move away “from the gaze of the distanced and detached observer, toward the embrace of intimate involvement, engagement, and embodied participation" (Ellis & Bochner, 2006, pp. 433-434) and attempt to demonstrate the legitimacy and value of introducing the first-person voice into the growing body of work on health in the performing arts.

Warm-ups, stretching, taking breaks and resting are among common injury prevention methods practiced by musicians. However, it is not entirely clear if they are effective or not, or how musicians should employ these strategies in their practicing routine. This article investigates the studies available in order to conclude whether these practices are worth it or not and concludes that while warm-up routines, as well as taking breaks or rests during practice, can be efficient on injury prevention, the benefits of stretching before, during or after practice has yet to be validated.

A number of recent studies have responded to neoliberal understandings of entrepreneurship, creativity and innovation in the cultural and creative industries, and beyond. Although in recent years, the features of working life in this sector have been well-documented, little research seems to have looked at the psychosocial impact on the working lives of individuals.

Fantasy, Neoliberalism and Precariousness draws on the results of an original empirical study of independent musicians based in Brooklyn, San Francisco, Portland, Stockholm and Paris, and considers how experiences of precariousness and insecurity under conditions of neoliberalism threatens the well-being and self-realisation of aspiring musicians. Vachet examines anxiety, narcissism, recognition and self-esteem from a sociological perspective, considering them through the lens of social class and gender.

Contributing to debates within cultural studies, sociology and the political economy of communication about working lives in the cultural and creative industries, Vachet answers to-date unexplored questions around the psychosocial impact of precariousness and other problematic features of work in the cultural industries.

This paper interrogates two different perspectives on music and wellbeing. The first positions musical practice as being beneficial for emotional wellbeing and mental health, whilst the second positions musical workbuilding a career as a musicianas potentially detrimental. This apparent paradox matters because the clinical findings which establish a causal link between music and wellbeing are being disembedded from the contexts in which those links are manifesting by charities, social enterprises, advocacy organisations, educational institutions, governments and international bodies, and fuelling normative sociological prescriptions which encourage participation in music making. For those who go on to develop career ambitions, wellbeing outcomes are far less clear. Therefore, a more sophisticated appreciation of the uses of music and its impact on wellbeing is required. This paper provides a more balanced view of the connections between music, wellbeing and health and reflects on how this paradox might be resolved.

Objectives The aim of this retrospective, radiographic
study was to determine if there is a significant difference
between the most constricted area of the airway (MCA),
airway dimensions (length and volume) of the nasal cavity,
nasopharynx, oropharynx, maxillary sinuses, and prevertebral
soft tissue thickness of trumpeter players vs. controls
utilizing three-dimensional cone beam computed tomography
(3D-CBCT). The second aim was to determine significant
differences in the prevalence of airway pathologies
between trumpet players and controls.
Methods Following reliability studies, 3D-CBCTs of 66
Caucasian trumpeters were analyzed with 22 ethnic-matched
controls. Measurements of airway parameters and
pathology were compared between the two groups. An
analysis of covariance, with age and sex included as
covariates, was used to compare the airway measures.
Since there was a significant difference in gender and age,
comparisons between groups for the presence of airway
pathology was made using logistic regression including age
and sex as covariates. A 5 % significance level was used
for all comparisons.
Results The trumpet players had significantly smaller
nasal cavity volume (p\0.0001) and significantly greater
soft tissue thickness at CV2ia (p = 0.03) and CV3sa
(p = 0.005). No other airway measure demonstrated a
significant difference between the two groups. There was a
significant difference (p = 0.002) in airway pathology
between trumpeters (n = 33; 50 %) and the controls
(n = 4; 18 %).
Conclusion Trumpeter’s airways showed a decreased
nasal volume and greater oropharyngeal soft tissue thickness
compared with controls. Trumpeters were almost three
times as likely to exhibit some type of airway pathology
when compared to controls.

The discourse within Australian tertiary music institutions on playing-related injury is slowly developing. The high incidence of injury in students is gradually being acknowledged, and awareness of prevention strategies is increasing. In late 2005, a Queensland Conservatorium Griffith University presentation introduced staff, students, and the public to a project collaboratively undertaken by the Guildhall School of Music and Drama and ESMUC (Escola Superior de Música de Catalunya), Barcelona, aiming to dissolve taboos on playing-related injury among both music students and professionals. In one aspect, however, the current discourse is critically inadequate. In focusing on injury prevention and physiological management, it overlooks the psychological, emotional, social, and financial repercussions of injury. What impact can an injury have on a tertiary music student? What are the needs of students who suffer injuries? What systems are already in place within tertiary music institutions for those students, and what can be done to address the deficiencies? From the perspective of my own experience, this paper makes suggestions for strategies that address the needs of tertiary music students with a playing-related injury.

A response is needed to the numerous issues spurred by the expansion of the gig economy, where flexible patterns of employment prevail in contrast to permanent jobs. In this context of the exponential growth of the digital economy and underlying business models the largest nationwide study of its kind into the impact of the working conditions in the UK music industry ‘Can Music Make You Sick?’ has been conducted by MusicTank/University of Westminster.

This research suggests the need to consider the future of work not only from an economic or employment law perspective but from a mental health one too. What are the psychological implications of precarious work and how are factors such as financial instability, the feedback economy and personal relationships reflected in mental health outcomes or connected to the business relationships most musicians and other gig economy participants work under?

Authors Sally-Anne Gross, George Musgrave and Laima Janciute consider which policy measures may help or harm gig economy workers including the taxation of self-employed workers, a universal basic income, education around mental health issues and access to mental health support.

OBJECTIVES MATERIALS and METHODS Objectives: Music teachers contend that the arrangement of anterior teeth affects trumpet performance by influencing the embouchure. Since there is little quantitative data to support this claim, the purpose of this study was to determine whether trumpet performance skills are associated with malalignment of anterior teeth. Methods: Following IRB approval, 70 trumpet students (55M:15F; aged 20-38.9 yrs.) from 11 universities were consented to complete a survey concerning dental history and trumpet playing habits. The students were asked to play a scripted performance skill test (flexibility, range, endurance, and articulation exercises) on their instrument in a soundproof music practice room while being audio and video recorded. A three-dimensional (3D) cone beam computerized tomograph (CBCT) was taken of each student the same day as the skill test. Following reliability studies, overjet, overbite, and degree of anterior tooth irregularity (Little's Index) were measured on the 3D CBCT. Nonparametric correlations, accepting p<.05 as significant, were used to determine if there were significant associations between dental measures and any of the performance skills. Results: Intrarater reliability was excellent (Pearson correlations; r>0.9). Significant (p<0.05), but weak (r<0.30) associations were found only between Little's Index of the mandibular anterior dentition and the performance skills: flexibility (exercises a, c and avg) and articulation (double tongue). No other associations were significant. Conclusions: University trumpet students with mandibular anterior teeth that are smoothly aligned have significantly better performance skills than those with misaligned mandibular anterior teeth; however, the association is weak. Funding: IUPUI 3D Imaging Music teachers contend that the arrangement of anterior teeth affects trumpet performance by influencing the embouchure. Since there is little quantitative data to support this claim, the purpose of this study was to determine whether trumpet performance skills are associated with the malalignment of anterior teeth. SIGNIFICANCE If trumpet performance is affected by tooth alignment, young musicians should be referred for orthodontic treatment to enhance their performance. Design: In this prospective study, 70 trumpet students (55M:15F; aged 20-38.9 yrs.) from 11 universities were consented to complete a survey concerning dental history and trumpet playing habits. The students were asked to play a scripted performance skill test (flexibility, range, endurance, and articulation exercises) on their instrument in a soundproof music practice room while being audio and video recorded. A three-dimensional (3D) cone beam computerized tomograph (CBCT) was taken of each student the same day as the skill test. Following reliability studies, overjet, overbite, and degree of anterior tooth irregularity (Little's Index) were measured on the 3D CBCT. Statistics: Nonparametric correlations, accepting p<.05 as significant, were used to determine if there were significant associations between anterior dental measures and any of the performance skills. Skills Test Analysis Flexibility (Exercises A, B, C, avg.) Articulation (Single, Double, Triple, Flutter Tongue High Range) Range (High Range) Endurance RESULTS CONCLUSIONS FUNDING University trumpet students with mandibular anterior teeth that are smoothly aligned have significantly better performance skills than those with misaligned mandibular anterior teeth; however, the association is weak. Camcorder Microphone connected to the audio recorder Laptop running metronome application Sticks marking the 6" distance from bell Tuner & decibel meter Earphones connected to laptop with a splitter Recording of performance skills Table 1. Descriptive statistics of trumpet skills and anterior dental measures (n=70) Parameters Mean+SD Flexibility exercise A 113.0 + 43.6 Flexibility exercise B 94.9 + 22.9 Flexibility exercise C 122.2 + 31.8 Flexibility average score 110.0 + 29.9 Articulation exercise A 128.5 + 13.9 Articulation exercise B 193.7 + 41.6 Articulation exercise C 103.9 + 21.6 Articulation exerciseD high range 15.9 + 4.6 Range-high 21.3 + 2.7 Endurance 108.8 + 96.2 Little's Index-maxillary (mm) 3.3 + 4.3 Little's Index-mandibular (mm) 4.2 + 3.9

People working in the music industry report significantly higher levels of anxiety and depression than the general population, but to date, studies have not explored the differences between professional musicians and those who perform music primarily for recreation. In this study, 254 musicians from 13 countries completed measures of anxiety, depression, and wellbeing as well as answering questions about their professional status, level of success, and income. Across the whole sample, we found that over half had high levels of anxiety, and a third were experiencing depression. We showed that musicians who viewed music as their main career were more likely to have poor mental wellbeing and had significantly higher levels of clinical depression. Status as a solo or lead artist and perceived level of success also significantly predicted higher levels of anxiety and depression, and lower levels of positive wellbeing. We conclude that low mental wellbeing in musicians is the result of working as a professional musician, as opposed to being an inherent trait. Future work should explore underlying beliefs and perceptions of career musicians alongside other key factors, such as health behaviors and social support, with the aim of making specific recommendations to the music industries and educators.

Öz: Bu araştırma, özelde piyanistlerin genel olarak da enstrümanistlerin kariyer
süreçlerinde her an yaşayabilecekleri fiziksel sorunların/sakatlanmaların neler olduğuna ve bu sorunlarla nasıl mücadele etmeleri gerektiğine dair bilgiler sunmayı amaçlamaktadır. Araştırmanın verileri, piyanistlerde karşılaşılan fiziksel rahatsızlıklar konusunda çeşitli anahtar kelimeler kullanılarak Yükseköğretim Kurulu Ulusal Tez Merkezi ve Google Akademik veri tabanlarında yapılan taramalar sonucunda ulaşılan çalışmalardan elde edilmiştir. Elde edilen veriler müzik-piyano ve fizyoloji perspektifinden ele alınarak betimsel analize tabi tutulmuştur. Araştırma sonucunda, müzisyenlerin çok sayıda sağlık sorunlarına neden olabilecek birçok mesleki stres ve tehlikelere maruz kaldıkları ifade edilmiştir. Müzisyenlerin sağlık sorunları, performansla ilişkili risk faktörleri ve hastalıklar bireysel performans özelliklerine, yaptıkları müzik şekline ve çaldıkları özel enstrümanlara göre farklılıklar göstermektedir. Piyanistlerin sıklıkla karşılaşabildikleri sakatlıklar ise aşırı kullanım (Overuse) sendromu, tuzak nöropati ve fokal distoni olarak belirlenmiştir. Bunların yanında en çok yaşanılan bir diğer rahatsızlık da Karpal Tünel Sendromu olarak ortaya çıkmaktadır.

Abstract: This research aims to provide information about the physical problems/injuries that pianists in particular and instrumentalists, in general, can experience at any time in their career and how they should cope with these problems. The data of the research were obtained from the studies obtained as a result of the searches made in the Council of Higher Education National Thesis Center and Google Academic databases using various keywords about physical ailments encountered in pianists. The obtained data were determined from the perspectives of music-piano and physiology and subjected to descriptive analysis. As a result of the research, it was stated that musicians are exposed to many occupational stresses and dangers that can cause many health problems. Musicians' health problems, performance- related risk factors, and diseases differ according to their individual performance characteristics, the style of music they make, and the special instruments they play. The disabilities that pianists may encounter frequently are overuse syndrome, entrapment
neuropathy, and focal dystonia. In addition to these, another most common ailment occurs as Carpal Tunnel Syndrome.

This report presents an evaluation of the feedback by musicians from the
Rhythmix, Wishing Well programme, who are providing a live music-making
programme in healthcare settings in South East England. Evaluations that the musicians provided during their work at The Royal Alexandra Children’s hospital in 2015-2016 were summarised and analysed.

The results suggest that:
● this music-making programme has positive effects for patients, families and caregivers
● building and strengthening the relationships with staff seems helpful for these types of music-making programmes
● a balance is needed between welcoming staff’s assistance in prioritising which patients should take part in the music activities and allowing the musicians to use their expertise when approaching patients, in order to achieve the most positive outcome for patients
● opportunities for musicians to practice self-care are necessary in order to avoid ‘burn out’ and emotional trauma.

Introduction: The intense movement, awkward postures, concentration, and emotional communication required of musicians can place them at increased risk of music-related health conditions, such as musculoskeletal disorders and performance anxiety (Kenny & Ackermann, 2015). The development of music-related health conditions can be emotionally and financially devastating (Guptill, 2011). The role of occupational therapists in musician’s health has been previously discussed; however, no rigorous reviews of the scholarly literature have been conducted.

We have therefore undertaken a scoping review with the following research questions: 1) what is known about the role of occupational therapy in instrumental musicians’ health? 2) what is the potential role of occupational therapy in musicians’ health?

Objectives: Inform occupational therapists and scholars of the potential role of our profession in the care of musicians.

Methods: We registered our protocol with the Joanna Briggs Institute (JBI) Systematic Review register, and have followed the JBI and the PRISMA-ScR guidelines for conducting a scoping review. A preliminary search of Medline, CINAHL, SCOPUS and Web of Science was undertaken to determine the extent of the research on this topic, and to confirm that no other reviews have been conducted or are in progress.

Results: At this time, we have reviewed 54 abstracts and have proceeded to full review of 41 papers. We anticipate completing our scoping review by January 2020.

Conclusions: This results of this review will help musicians and health practitioners understand the potential benefit of occupational therapy to enable meaningful occupation for those with music-related health conditions.

Key words: Advocacy, Evidence-based practice

Numerous studies demonstrate the extraordinary vulnerability musicians have towards addiction, and this book attempts to examine all the facets that contribute to the problem and suggest ideas for addressing it. It takes the pilot article available from Academia (‘Musicians and Substance Abuse’) and expands the literature review in that article significantly, which becomes section 1. Section 2 presents personal insights from 30 contributors working in the Australian, US and UK music industries. This includes 12 excerpts from interviews and autobiographies of well known musicians, 12 specially commissioned recovery stories from musicians working across multiple genres, and a series of professional perspectives. The final section of the book examines the implications for individual musicians, organisations and the industry as a whole. The book potentially has relevance to visual artists, novelists, actors and other creative people. It will be published in June 2020, in paperback and eBook (Kindle and formatted eBook). See the companion website for further information: www.musicianaddiction.org