Injuries in Performing Artists

Across performing artists, injury rates hover at 70% and above, with the type of injury reflecting performance-specific demands. Typically, it is a combination of multiple injury risk factors that the performer is exposed to that will cause them to suffer an injury. Mostly these occur in combination with over-training issues such as sudden workload increases and performing through fatigue. Due to intense competition, the “no pain, no gain” mindset is widespread and dangerous, and there is a tendency to try to hide injuries.

  • Extrinsic risks may include performance venue issues (floor/chair quality, acoustics, space, lighting and temperature), performance and rehearsal schedules, conductor/choreographer or director approaches, and work situations.

  • Intrinsic risks may include general health, lack of understanding of good health strategies and injury prevention, technical or positional flaws, high stress levels, other mental health issues such as performance anxiety, previous injuries, physical characteristics (flexibility, endurance, fitness), and poor posture.

  • Musicians should be taught that their physical body is part of the instrument and deserves and requires the same level of attention and care.

  • Musicians do not necessarily make regular exercise part of their daily routine, which may increase their risk of injury. 

  • Poor proximal strength, endurance, and stability result in poor posture, increased stress on distal muscles, and overuse injuries. 

  • The combination of poor and constrained postures, flawed practice habits, repetitive movements, poor physical conditioning, stressful work conditions, faulty ergonomics, and poor awareness are direct causes of injury.

How we can help

Prevention

Perry PT Solutions can help prepare performing artists to manage the demands of their jobs by targeted and specific physical and mental skills training programs that address their potential risks.

  • Video analysis of playing technique to address postural and biomechanical issues

  • Comprehensive  physical examination to assess posture, range of motion, and strength

 

  • Working with artists to develop:

    • safe and effective warm up and cool downn

    • more efficient practice schedule

    • individualized conditioning program for injury prevention

Assessment and Treatment

When performing artists seek care for a health concern that is affecting performance, a multidisciplinary approach is often indicated. We collaborate with doctors,  expert music instructors,  a psychotherapist, and a functional nutritionist. In general, we try to determine what precipitated the problem and eliminate it or change it. Rarely is total rest required. Once symptoms start to improve, the performer is guided through a gradual return to a reasonable practice schedule. 

Each musician is approached on the basis of professional and personal demands. A typical examination includes an assessment of pain, posture, strength, and range of motion. Musicians are asked to bring in their instrument and are assessed while playing the instrument. 

Posture

  • Musician's posture may not be that different from others, but the combination of deficient posture and playing an instrument can become problematic​

  • Musician's postures are evaluated with and without the musical instrument. It is important to realize that frequently the musical instrument has become an extension of the musician. 

  • The combination of awkward postures and repetitive motions has been shown to be particularly stressful and may contribute to muscle damage, tendonitis, or nerve damage.

Range of Motion​

  • Musicians may present with asymmetries in range of motion due to functional adaptation from playing their instrument. 

  • Some musicians need to be examined for localized or systemic hypermobility.

Ergonomics

  • ​Musical instruments were designed based on principles of physics rather than ergonomics, which may create specific challenges to play some instruments using good posture.

  • Key modifications may be indicated for players with relatively short fingers who may have difficulty reaching some of the keys of the instrument.

  • Certain musical instruments have specific characteristics that may predispose those musicians to injury. An evaluation of the musician both holding and playing his/her instrument can provide valuable information to this aspect.

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