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Musculoskeletal and Neuromuscular Conditions of Instrumental Musicians


Copyright 2024, Mark Alan Wade

Primary Author: Bejjani, F.
Journal Title: Archives of Physical Medicine and Rehabilitation
Date Published: Apr-96
Language: English
Category: Multiple Medical Disorders
Key Words: musculoskeletal neuromuscular instrumental musician physical
Full Citation: Bejjani, Fadi Joseph, Glann M. Kaye, and Melody Benham. Musculoskeletal and Neuromuscular Conditions of Instrumental Musicians. Archives of Physical Medicine and Rehabilitation 77, no. 4 (April 1996): 406-13.
Full Abstract: The earliest record of the diagnosis of musicians' disorders was in 1713 by Bernardino Ramazzini. Musicians are still susceptible to the same disorders today because of the demands of playing professional music. This can be attributed to personality traits and physical characteristics of playing instruments. Musicians are often perfectionistic and put their art before their own health and physical condition. Most musicians do not get paid unless they play, allowing little time for much needed rest. It stands to reason that they also do not have the luxury to take time off from work to recuperate and seek treatment. Depending on the instrument, many musicians' bodies can actually become deformed to better anatomically fit the instrument after years of playing. 4,025 musicians were surveyed from the International Conference of Symphony and Opera Musicians. Of the 2,122 respondents, 76% report at least one medical condition that negatively affects their performance. 36% reported having four different severe problems. The most common ailment among musicians is overuse syndrome with a prevalence of 50% among professional musicians. Although there is no objective test or diagnostic criteria for overuse syndrome, the chief symptom is pain. Brass instrumentalist are next to the least affected instrument family, followed by percussionists. Another common ailment is TMJ disorders. This is reportedly most prevalent among trumpet players, violinists, violists, and lower brass players. In the case of brass players, the TMJ disorder is caused by displacement of the mandible in forming the embouchure, disturbing the natural occlusion and related muscles. Studies show that trumpet players must bend their knees and straighten their lumbar lordosis to reach higher notes. This postural change is proportionate to the amount of upper jaw overbite. The overbite causes a lowered horn angle because the surfaces of the teeth of the upper and lower jaw are not even. Depending on the horn angle created by the player's anatomical structure, the trumpet player is required to compensate with posture changes to a greater or lesser degree.