Musicians' Medicine: Musculoskeletal Problems in String Players

Abstract

There is increasing attention to medical problems of musicians. Many studies find a high prevalence of work-related musculoskeletal disorders in musicians, ranging from 73.4% to 87.7%, and string players have the highest prevalence of musculoskeletal problems. This paper examines the various positions and movements of the upper extremities in string players: 1) basic postures for holding instruments, 2) movements of left upper extremity: fingering, forearm posture, high position and vibrato, 3) movements of right upper extremity: bowing, bow angles, pizzicato and other bowing techniques. These isotonic and isometric movements can lead to musculoskeletal problems in musicians. We reviewed orthopedic disorders that are specific to string players: overuse syndrome, muscle-tendon syndrome, focal dystonia, hypermobility syndrome, and compressive neuropathy. Symptoms, interrelationships with musical performances, diagnosis and treatment of these problems were then discussed.

Principais queixas osteomusculares em músicos da região do ABC paulista: um estudo de prevalência

“…Os movimentos que induzem o estresse podem ser classificados em dois tipos: movimentos isotônicos, que são movimentos mais sofisticados e rápidos, os que produzem sons; e movimentos isométricos, que servem para estabilizar e sustentar os instrumentos por grandes períodos 8 . Portanto, podemos observar que os locais que apresentam maior número de lesões em todo o Questionário Nórdico de Sintomas Osteomusculares foram os que realizam esses movimentos, como as mãos, que fazem os movimentos isotônicos, e os que fazem os movimentos isométricos, que são região da coluna dorsal e lombar, ombros e pescoço.…”

“…As exigências profissionais, que excedem o limite físico e demandam força excessiva, são outro fator que pode acarretar lesões causadas pelo superuso (overuse), sendo que os tecidos mais atingidos por esse excesso de carga são os músculos, os tendões, as articulações e os ligamentos 6 . O termo overuse é também conhecido como Lesão por Esforço Repetitivo (LER) ou desordem por trauma cumulativo e é usado quando o trabalho está relacionado aos sintomas de fraqueza, perda de controle ou velocidade 8 .…”

The Prevalence of Upper Limb Pain Among Veena Players: A Cross-Sectional Survey

“…Previous research has investigated the play-related musculoskeletal disorder and Upper Limb Pain among musician such as pianists, guitarists, violin, and string players 4,6 . However, to our knowledge there have not been enough studies to investigate the rate of musculoskeletal disorder or Upper Limb Pain among Veena players.…”

“…In recent years, medical issues among musicians have increased and have gained much attention as the industry has grown so much over the years 4 . According to Cebria et al 5 , the most common injury faced by musicians is the 'overuse syndrome'.…”

“…This term is normally used when the musician suffers from pain from which a diagnosis cannot be made and has been recognized as an occupational over use. Lee et al, (2013) reported that movements that increase the amount of stress on the musicians can be categorized into two groups. First is the isotonic movements whereby a musician does complicate and fast movements to produce sound eg; pianists.…”