Abstract
Playing a musical instrument at an elite level is a highly complex motor skill. The regular daily training loads resulting from practice, rehearsals and performances place great demands on the neuromusculoskeletal systems of the body. As a consequence, performance-related musculoskeletal disorders (PRMDs) are globally recognized as common phenomena amongst professional orchestral musicians. These disorders create a significant financial burden to individuals and orchestras as well as lead to serious consequences to the musicians’ performance and ultimately their career. Physical therapists are experts in treating musculoskeletal injuries and are ideally placed to apply their skills to manage PRMDs in this hyper-functioning population, but there is little available evidence to guide specific injury management approaches. An Australia-wide survey of professional orchestral musicians revealed that the musicians attributed excessively high or sudden increase in playing-load as major contributors to their PRMDs. Therefore, facilitating musicians to better manage these loads should be a cornerstone of physical therapy management. The Sound Practice orchestral musicians work health and safety project used formative and process evaluation approaches to develop evidence-informed and clinically applicable physical therapy interventions, ultimately resulting in favorable outcomes. After these methodologies were employed, the intervention studies were conducted with a national cohort of professional musicians including: health education, onsite injury management, cross-training exercise regimes, performance postural analysis, and music performance biomechanics feedback. The outcomes of all these interventions will be discussed alongside a focussed review on the existing literature of these management strategies. Finally, a framework for best-practice physical therapy management of PRMDs in musicians will be provided.
Highlights
Performing music at an elite level requires greatly developed and integrated sensorimotor and neuromuscular body systems
The purpose of this review is to inform physical therapists of evidence-based management strategies for performance-related musculoskeletal disorders (PRMDs) in the musician population that can be readily implemented in the clinic environment and introduced into music institutions and organizations
Since professional musicians often endure long rehearsals and performances that involve extremely repetitive activities, it is only sensible to educate them about potential risks to which they may be exposed; since these could lead to them sustaining a work-related injury (Pascarelli and Hsu, 2001; Baldwin, 2004; da Costa and Viera, 2010)
Summary
Performing music at an elite level requires greatly developed and integrated sensorimotor and neuromuscular body systems These are honed by long daily hours of practicing highly complex movements over many years of intensive training (Watson, 2006; Hyde et al, 2009; Krause et al, 2010; Hoenig et al, 2011). Shoulder problems are extremely common in swimmers, and knee and ankle problems frequently occur in soccer players (Pink and Tibone, 2000; Drawer and Fuller, 2001; Waivenhaus et al, 2012) Despite this similarity between the task-specific type of injury risks faced by musicians and athletes, there are clear differences in the provision of health education and injury management services. Throughout their training and professional life, musicians do not receive specialized health education and advice to aid in injury recovery www.frontiersin.org
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