Musicians’ hands are vital to their musical performance. Rapid, complex and coordinated movements are required. Musicians frequently have to play in less than ideal postures and environments, usually without the support of a medical team and with poor facilities. Touring increases the hours of playing with reduced sleep. Noise, alcohol levels and pressure can be very high. In summary, musicians as well as other performing artists often have to perform to the limit of their abilities physically and emotionally. Thus, there is an increased risk of acquiring injuries that can lead to difficulties or an inability to play an instrument.
The vast majority of problems that musicians have are non-traumatic and highly related to posture. Some examples of clear-cut pathologies, in which a specific diagnosis can be made, are old injuries, tenosynovitis, joint hypermobility and focal hand dystonia; although in most cases few physical signs can be found and symptoms are seen as very general and due to poor posture or performance-related issues such as; incorrect practice or technique when playing an instrument.
Many performers are unaware of the stresses that poor posture puts on the body. Carrying the head forward will lead to increased tension in the neck muscles and upper back. Holding the shoulder and shoulder blades forward will overwork the muscles in the arms, which can eventually cause arm and wrist discomfort and pain. The muscles in the forearm are largely responsible for controlling movements in the hand, here, the importance of warming up, cooling down, and stretching these muscles, is crucial to increase the ease in performance and reduce pain levels.
Specialist assessment and rehabilitation techniques are required when dealing with musicians and any type of performing artist. An understanding of the instrument and the type of music played is imperative. Education is vital in the treatment of overuse syndromes and postural correction needs to be an essential part of the rehabilitation plan for Musicians.
Performing Arts Medicine (PAM) has been established for over 20 years now and it is a field devoted to the care and support of all performing artists. In the UK, there are two main organisations acting as advocates for this: The British Association for Performing Arts Medicine (BAPAM) for musicians and singers and Dance UK for dancers. At Trinity Laban Health we are proud to say that our physiotherapists are registered within this field so we can offer the best quality and a specialised service.
Isabel Artigues Cano
Physiotherapist at Trinity Laban Health