Musicians and Injuries


[Books][Tapes/DVDs] [Links & On-Line Articles]

Maybe it's a nagging ache in your thumbs, every time you practice at the piano. Perhaps there have been long rehearsals for that crucial recital, and now you notice stabbing pains in your forearms. Or you find yourself struggling with hands that have become increasingly clumsy, or numb. It may be that you are even waking up at night with pain in your arms, or your back, or your neck. Well, it's just a part of being a serious musician, right? And after all, you can't stop practicing - there's too much at stake, and music is your very life!

Does this sound familiar?

Instrumental musicians are a special risk group for repetitive motion injuries. Sizable percentages of them develop physical problems related to playing their instruments; and if they are also computer users, their risks are compounded and complicated. My own computer-induced tendinitis was very much aggravated by my guitar and violin playing and did not begin to improve until I stopped all playing for several months.

Instrumental injuries often include the same conditions experienced from computer overuse : Carpal Tunnel Syndrome , Tendinitis, Bursitis , Tenosynovitis / DeQuervain's Syndrome , Tendinosis , Thoracic Outlet Syndrome, Myofascial Pain Syndrome, Cubital Tunnel Syndrome, and Trigger Finger/Thumb are particularly common among keyboardists, fretboardists, flute, and string players. But the particular demands of different instruments produce other problems as well, including hearing loss or TemporoMandibular Joints Disorder . (Additional TMJ leaflets: 1, 2, 3, 4, or this new site from the TMJ Association ). Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain, disability, and the end of careers.

But while these problems are unfortunately common, it's NOT an unavoidable part of being a musician. If we're willing to listen to what's being learned in the field of arts medicine, we may be able to escape the bullet of occupational injury and recover our ability to play.

What Can You Do?

I'll be putting more information here as I am able, but for now I highly recommend looking at some of the resources listed below. If you have pointers to similar literature, especially ergonomically oriented instrumental methods, or just have a tip or two of your own on safer techniques and injury prevention/recovery, drop a line so it can be added here. Please note that authorities in this area of study have differences of opinion about points of technique, treatment, or prevention: read as much as you can for the balanced view. Please note that several of the "reviews" below are written by persons other than myself: these have quotation marks and attributions to distinguish them. -Paul Marxhausen

[Books][Tapes/DVDs] [Links & On-Line Articles]

Books . . .

Books contain far more useful information than can be easily presented on-line. I strongly encourage you to read some of the following titles. The publishing information and Web links to the publisher or distributor are included where they are known. In addition, in association with Amazon.com Books you can purchase many of these titles on-line by clicking the Order from Amazon ... link after each listing, which will take you directly to that particular catalogue item. If you buy from Amazon, they will handle all billing, shipping, etc. and inquiries should be directed to them.

Too Many Titles?... I know it is an very long list of resources. One reason I just keep adding new titles as they are brought to my attention is that it increases the odds that you will be able to find some of these in your local public or institutional libraries, where you can read them for free. Always check there first!


Tapes and DVDs



Links & On-Line Articles

  • Performing Arts Medicine at Ithaca College - this school is taking a lead in this field and their Web site has good resources.

  • An important group concentrating on performing arts injuries is the Performing Arts Special Interest Group of the Orthopaedic Section of the American Physical Therapy Association. This site includes affiliated clinics that deal with performing arts injuries.

  • About Seats and Sitting for Cellists and Other Musicians by Victor Sazer is an excellent explanation of how sitting can give you back pain.

  • HANDS ON! ONLINE, the performance health newsletter for flutists. Great stuff!

  • SHAPE (Safety & Health in Arts Production and Entertainment) is the not-for-profit association dedicated to the promotion of workplace health and safety in the motion picture and performing arts industries in British Columbia, Canada. They provide health & safety information, education, and training for the performing arts and film industries. They have publications, posters, videos and access to professionals at the Workers' Compensation Board (WCB). In particular, download their publication PREVENTING MUSCULOSKELETAL INJURY (MSI) FOR MUSICIANS AND DANCERS

  • Dr. Joaquin Farias has posted the this site that discusses his treatment of musicians' injuries.

  • Hearing Problems are common among musicians, classical and rock alike. A good resource list is the Tinnitus Frequently Answered Questions Web site. Detailed information on protection, earplugs can be found from Aearo Company's technical support page, and definitely see HEARNET , the Web site for H.E.A.R. (TM) ( Hearing Education and Awareness for Rockers.)

    Also, read this thread on How Loud is Too Loud? , and Doug Yeo's article on Noise levels on stage/hearing .

  • More insights on musicians' hearing loss is found on Ken Laberteaux's "When It Hurts To Play: A Look Into Injuries Common Among Musicians"

  • Phil & Vivian Williams write on TENDINITIS PROBLEMS OF MUSICIANS - IDENTIFICATION, PREVENTION, TREATMENT

  • Andover Educators , "a network of teachers saving, securing and enhancing musical careers with accurate information about the body in movement", training aimed at preventing musicians' injuries. Includes an interesting and growing on-line book, At Last! Music Education on a Secure Somatic Foundation . Check it out, some interesting stuff here.

  • Six Golden Rules for Conquering Performance Anxiety by David Leisner.

  • Vox Cura , a Canadian voice care clinic, has useful information about taking care of your voice.

  • The Texas Center for Music & Medicine includes an interdisciplinary team of musicians, music educators, clinicians, and research scientists. The Center represents educational, medical and musical resources, brought together to study, treat, and prevent various medical problems associated with learning and performing music. Clinical resources are available for both students and non-students. Clinical care is provided through the Center for Performing Arts Medicine at the UNT Health Science Center in Fort Worth, the UNT Counseling and Testing Center, and the UNT Speech and Hearing Center. CALLING ALL ORGANISTS! All ages - all levels - whether you play concerts on trackers or polkas on fun machines. Please participate in the anonymous, international SURVEY OF MUSCULOSKELETAL PAIN OF ORGANISTS, a dissertation project. Your input is important!

  • The Classical music department of the WWW Virtual Library has excellent sections on Medical Issues for Performers , Coping With Performance Anxiety , and Medical Clinics for Performers (in the US and Canada) .

  • JAMES R. OESTREICH wrote this article discussing the impact of musicians' woes for the New York Times.

  • Musicians are also afflicted with Focal Dystonia, a baffling and controversial loss and distortion of muscular control. Read this first-hand account of this condition. The National Institute of Neurological Disorders and Stroke has a the NIH Dystonias Information Page and a Dystonias Fact Sheet. Also see the Dystonia Dialogue page from the Dystonia Medical Research Foundation, which includes a bulletin board for discussions of the disorder. I am told this board has more traffic than the alt.support.dystonia USENET newsgroup. Also: Read Constraint-induced movement therapy for focal hand dystonia in musicians in The Lancet . An excellent new dystonia resource and advocacy groupis Care4Dystonia, Inc.

    Some case studies and other information is on Andreas Kurth's Focal Dystonia in Musicians web page.

    Some possible insights on musician's dystonias are discussed in How To Resolve Dystonias: A Movement Perspective by Barbara Conable.

  • Dr. Tim Jameson, D.C. contributes articles on: Also see his new Musician's Health Web site for many more articles, suggestions, and stretches.

  • Another health clinic has some interesting articles, see the Performing Artists Health Center.

  • A forum for on-line discussions of musicians' injuries has been set up by PrivateLessons.com. Join in!

  • Andover Educators site promotes their What Every Musician Needs to Know about the Body course, also includes some on-line articles well worth reading.

  • Related information on computer injuries is on the RSI Page . . .

  • A list of performing arts clinics is included on the FindADoc list.

  • Many musicians report that The Feldenkrais Method and The Alexander Technique are helpful in learning non-injurious use of the body. A Feldenkrais practitioner has some good info on his Somatic Options page. Another Feldenkrais practitioner assisting musicians in particular is Aliza Stewart.

    Also there are many good reports on the effectiveness of Hellerwork , Trager Approach, Rolfing , and The Pilates Method in treatment of RSI. You may want to read Three Musicians Talk about the Alexander Technique. Music-oriented Alexander info is found at Alexander Technique for Musicians .

  • If Feldenkrais interests you, there is also a SANTA FE 2000 FELDENKRAIS TRAINING PROGRAM coming up soon.

  • John Link writes on The Feldenkrais Method for Singers (and Instrumentalists) Parts I and II . More resources and info from John are here.

  • GUITAR-SPECIFIC LINKS:

  • Paul Adams relates his experience with traumatic injury to his hand.

  • Health and Safety for Guitarists and Other Musicians, a good resource site with an emphasis on guitar.

  • Charlotte Adams has excellent articles and resources on her website. Well worth spending time with, whether or not you get the videotape.

  • PIANO-SPECIFIC LINKS:
  • Robert Burnson discusses his experience with piano-related injury and his success in using both John Sarno's approach to pain relief, and Dorothy Taubman's philosophy (explained in good detail) of effective and safe piano technique.

  • WIND INSTRUMENT SPECIFIC LINKS:

  • STUFF:
    Some ergonomic accessories for various instruments are appearing on the market. Here's some on the web. I don't endorse all of these, just passing them along. Such items may be very useful indeed, but don't go looking for a gadget to "fix" all your problems. If you are already injured, for CERTAIN don't be thinking you can get an accessory or new instrument and then go right back to full-speed, full-time playing with no other changes and with no visit to the doctor. It doesn't work like that!
  • Ton Kooiman designed and markets a number of woodwind thumb rests on his Woodwind Ergonomics website.

    Nitin Aurora is compiling a list of guitar supports on his website.

  • Hm, seems like an obvious idea: The Boom Stand . OTHER ERGONOMIC PRODUCTS: A whole lot of other ergonomic products, services, devices, etc. (mainly computer-oriented) are found on this Web page.


  • Discussions

    (Note: Most of the following articles are taken from discussions on USENET newsgroups and as such represent only the opinions of individuals. Also note that as of 1 January 1997 I will strip identifying names from the threads reproduced here to protect privacy.)

    Guitar Discussions


    Piano / Keyboard Discussions
    Percussion, Strings, Voice
    Winds
    Other . . .

    To find almost any other music-related site see the comprehensive Aardvark's Archive .


    Univ. of Nebraska-Lincoln / Music Injuries Web Page / Paul Marxhausen