In order to perform at a high level, most instrumental musicians must have full use of their musculoskeletal system, which includes the muscles, tendons, ligaments, and bones that carry out the brain's commands. While aches and pains in the arms and legs can happen to anyone, they can be a major problem for musicians if they interfere with the ability to practice and perform. In addition to everyday bumps and falls, the very act of practicing and performing can cause damage that impairs one's ability to perform. The goal of this fact sheet is to provide information that may help musicians avoid performance-related musculoskeletal injuries or allow them to seek help promptly before a chronic problem develops.
Performance-related problems of the arm and hand are fairly common among instrumentalists. Surveys of professional symphony orchestra musicians have found that over half are affected at any given time. Studies done at the Eastman School of Music have shown that about 10% of students develop a performance-related hand problem each year; a study from Houston showed that it was a common problem among performing-arts high-school students. Reports from Europe and Australia confirm the findings in North American studies, and the case histories of some famous soloists are well known. While most injured musicians recover within a few weeks, some are left with chronic pain and impairment.
The musculoskeletal system consists of muscles, tendons, bones, ligaments, and their blood vessels and nerves.
Our understanding of the causes of musicians' arm and hand problems is incomplete; however, we do know that:
Since most performance-related musculoskeletal problems are caused by overuse of the muscles and tendons in the arm and hand, prevention is both possible and preferred.
Some Common-Sense Guidelines:
In addition to listening to the music they are producing, musicians should also "listen" to their bodies. Aches and pains must not be ignored. The adage "no pain, no gain" probably has no place in the studio. Certainly any discomfort that lasts more than two or three days should be cause for concern. Keep in mind that other uses of the hands (typing, handwriting, waiting on tables, etc.) can contribute to an overuse problem. Pain related to overuse can start during the practice session or several hours later. Overuse problems may be especially likely to start during periods of increased stress.
Recovery from a performance-related musculoskeletal problem involves several steps, which you should take in conjunction with your teacher and your primary care provider.
Allow the overused muscles and/or tendons to heal. The cornerstone of this healing process is REST. If the problem is severe, complete rest of that limb for a short time may be necessary. On the other hand, a minor irritation of one particular muscle can heal if the specific action that precipitated the problem is temporarily avoided. If certain normal daily activities make the limb hurt, they should be avoided as well.
In addition to rest, anti-inflammatory medicines (aspirin, ibuprofen, and others) and the use of heat and cold are helpful. Physical therapy is another option, if needed. Your primary care provider can discuss the options with you.
Heat: Use heat to warm up and relax tight muscles and tendons when they have been resting.
Ice: Use ice to cool off muscles and tendons that have been working (and may be hurting).
Gradually resume a practice schedule in a way that avoids a recurrence of the problem. Your primary care provider and your teacher can recommend a practice schedule for you - sometimes beginning with only 10 to 20 minutes at a time, followed by at least 10 minutes of rest. At first you still may need to use ice and/or heat. Gradually you will return to your pre-injury level of practicing and performing.
Step 3 is the long-term approach to avoidance of repeat injury. You may need to take more frequent breaks (e.g., 5 minutes every 30 minutes) during practice sessions and be especially careful about extra heavy practice sessions before a big performance. Review the suggestions in the Prevention section of this brochure for additional ways to avoid second and third injuries.
Performance-related musculoskeletal problems are an occupational hazard of playing an instrument. Your teacher and the staff of the University Health Service have special expertise in helping you prevent and deal with these problems. You should have a low threshold for seeking their advice. "When in doubt, check it out."
Call 585-275-2662 to schedule an appointment at the University Health Service (UHS). UHS offers a full range of services. All visits to UHS are confidential.
The University Health Service has an office at the Eastman School of Music in Room 106 in the ESM Student Living Center. This office is open weekdays during the academic year, except during school vacations. Visits to the UHS Eastman School Office are by appointment. Call 585-275-2662 to schedule an appointment at the Eastman Office.
The main office of UHS is located on the River Campus in the UHS Building. This office is open all year. During the academic year, the office is open seven days a week, with evening hours Monday through Thursday. Students should call 585275-2662 to schedule an appointment in this office.