Prevention of musculoskeletal injuries in performing artists

Editor's Notes

• #3 Overuse: Average performing artist rehearses hours a day. More so when learning a new piece. Accidents: In other words, acute injuries. Much less likely but still possible Improper form: There are various schools of thought to the play of each instrument and in how to hold onesself singing. Form that causes pain is an indication of something not working right. Alexander Technique: unconscious change – directed by teacher through physical biofeedback conscious change: - awareness of a habit - inhibition – thought and action stopping (not changing just not doing) - conscious control – directing appropriate change Feldenkrais Method: break down movement into its learned components if technique is not producing or is causing pain, see where they skipped in learning process and recreate no “right and wrong” Physicals: Specific for musicians Proposed by Neward and Weinstien in ‘95 include specific history: practice schedule exercises – wu, cd, specific to instrument, other activities training / education level Previous treatments: including Feldenkrais and Alexander Musculoskeletal – include posture with and without instrument hypermobility identified other muscle specific changes (fasciculations, atrophy, strength imbalances)
• #4 ROM – need to make sure full ROM is achieved bilaterally to limber muscles that will be called upon during play and prevent imbalances Speed and Tempo need to be eased into Range of sound, especially vocal, need to be eased into Standard – Scales Preparatory – shortened version of piece to reherse/play or known piece that can gradually increase range and speed
• #5 Use cool down to counteract imbalances during play and to reestabilish full bilateral range of motion
• #6 Rehearsal begins with warm up. Need to factor in any performance times occuring on same day Need to factor in any individual lessens on same day Difficulty of piece can cause overuse and abuse issues Multiple technique changes can cause stress
• #7 Standing general posture – forward head tilt pelvic tilt affects balance and body recovery Seated at instrument – pelvic tilt head tilt lumbar/thoracic Hypermobility – some may be needed ain’t broke don’t fix it…unless there is some underlying pathologies Ergonomic aids – multiple aids out there to adjust for mobility issues with various instruments braces to encourage proper posture – neck, back, shoulder, elbow, wrist
• #8 Hand size Arm length Playing posture – rounding of shoulders lead to nerve entrapment Mouthpieces – in addition to standard issues of mouth, also position of head when in contact with mouth piece Hand placement – neutral wrist, pressure through finger tips whenever possible.