Sports and performing arts medicineSports and performing arts medicine. 5. issues relating to musicians1
Section snippets
Educational activity: to discuss the unique aspects of the clinical approach in evaluation and management of 28-year-old conservatory violinist with forearm pain
MUSCULOSKELETAL SYMPTOMS IN musicians are common and have been reported in as many as 50% of musicians.1 Poor technique often plays a major role and must be thoroughly evaluated by observing the musician play. This observation may show a mismatch between the musician’s body and the instrument, thus perpetuating improper technique, as well as generating fatigue and pain. Musicians complaining of pain in the upper limb should have an evaluation of the whole body, focusing on stance, posture, and
Educational activity: what factors determine the musician’s return to play with full performance capability?
Once pain is controlled, the player may return gradually to full play. The approach to avoiding physically and emotionally distressing relapses is modeled on the occupational medicine approach for work return in the injured worker. The return-to-play schedule must be strategically developed to address duration of practice, playing time, tempo or speed of the music, and the technical difficulty of the repertoire. The plan must be modified to consider the instrument’s specific design and the site
Educational activity: a 52-year-old violist presents with left shoulder, upper back, and neck pain radiating to the left arm with pain and paresthesias. discuss the differential diagnosis, causative factors, ergonomic considerations, and treatment options for this pain
Upper-quarter pain is common in violists and violinists. In instrumentalists, upper-quarter pain is either caused by musculoskeletal overuse/injury (64%), peripheral nerve problems (20%), focal dystonias (8%), or other miscellaneous entities.4 The viola is particularly problematic because of its weight and size. It is comparatively larger than the violin. The viola is supported between the left trapezius and mandible during play. The viola’s thickness makes it impossible to completely fill the
Educational activity: to discuss the diagnosis and treatment of a 30-year-old concert pianist with a 3-month history of progressive, painless loss of coordination that is affecting her ability to perform with accuracy
Focal dystonia commonly affects instrumentalists and others who perform highly controlled, rapid movements over long periods of time. Painless loss of coordination is the hallmark of this condition and is a significant source of disability. Focal dystonia is seen in professional instrumentalists, predominantly in men, with average age of onset occurring at 38 years.4 Pain is a late feature and occurs as a result of muscular overexertion to compensate for the dystonic extremity. Eventually,
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