PERFORMING ARTS TIPS

OV E R U S E I N J U R I E S I N I N S T R U M E N T A L I S T S
There are basically two types of injuries: acute and overuse. Acute injuries
are usually the result of a single, traumatic event. Overuse injuries, on the
other hand, occur to tendons, muscles, joints, and other tissues as a result
of repetitive activity that creates small amounts of trauma over time. Common
examples include carpal tunnel syndrome, wrist tenosynovitis, and muscle/
fascia pain syndrome. Instrumentalists often sustain overuse injuries in the
hand, wrist, and arm muscles and tendons, as well as weakness and spasms
in the arm, shoulder, and upper back muscles.

WHY DO OVERUSE INJURIES OCCUR?

The human body has a tremendous capacity to adapt

to physical stress. We tend to think of stress in the
context of its negative effect on our emotional well-
being, but physical stress, such as exercise and activity,
is beneficial for our bones, muscles, tendons, and
ligaments, making them stronger and more functional.
This happens because of an internal process called
remodeling. The remodeling process involves both
the breakdown and buildup of tissue. There is a fine
balance between the two, and if breakdown occurs
more rapidly than build-up, an overuse injury occurs.

INSTRUMENTALISTS
S TOP S po r ts Inj ur i e s Keeping Kids in the Game for Life | www.STOPSportsInjuries.org
 WHY DO OVERUSE INJURIES OCCUR? Discuss appropriate, efficient music technique
including how it relates to the repertoirewith
Mechanical errors and too many hours of repetitive a qualified music teacher.
motion are the most common causes of overuse injuries.
Perform warm-up exercises before playing and cool-
Overuse injuries also happen in people who return to
down exercises afterward, especially for the shoulders,
their music practice after injury and try to make up for
elbows, hands, and upper back/neck.
lost time by pushing themselves to return to both their
previous repertoire and practice schedule they were Apply ice for 15 minutes after playing for minor aches
accustomed to before being injured. Proper technique and discomfort.
is critical in avoiding overuse injuries, as slight changes If symptoms persist, a sports medicine or performing arts
in technique may be the culprit. For this reason, music medicine specialist will be able to create a more detailed
teachers and parentsas well as healthcare professionals treatment plan for your specific condition. This may include
such as athletic trainers and physical therapists who a thorough review of your music training program and
have experience working with musiciansplay important an evaluation for predisposing factors associated with the
roles in preventing overuse injuries. problem. Athletic trainers, physical therapists, occupational
therapists, and hand therapists may also be helpful.
Imbalances between strength and flexibility around
certain joints predispose individuals to injury. Because
CAN OVERUSE INJURIES BE PREVENTED?
instrumental music requires a high level of repetitive
physical activity and a nearly constant use of the upper Most overuse injuries can be prevented with proper
back and upper extremities, these are areas where such training, common sense, and paying attention to warning
injuries are commonly seen. signs such as the onset of discomfort that leads to pain.
Many musicians have previous injuries, or injuries that are Learn to listen to your body. Remember that no pain,
incompletely healed, that can make further injury more no gain does not apply here.
likely. They also tend to play through pain. Sometimes Good posture is very important in playing an instrument,
pain is thought to be a normal part of playing a musical so a core training program is essential to preparing
instrument; however, this is definitely not true! Pain or the body for maintaining the required trunk and
musculoskeletal fatigue should be reported to the music upper extremity positions and executing the necessary
teacher, and advice should be sought from a healthcare movements of playing. Because the core, or trunk,
provider as soon as possible if pain is ongoing. of the body forms the foundation for movement, the
hours of rehearsal time needed for music means that
HOW ARE OVERUSE INJURIES DIAGNOSED? the core muscles must be well-trained for endurance.
The diagnosis of an overuse injury is made after a thorough Always remember to warm up and cool down properly
history and examination by a specialist skilled in working before and after playing your instrument. Increasing
with performers. The musicians instrumental technique; flexibility and incorporating muscle training will also help
practice, rehearsal, and performance schedule; and minimize overuse injuries. Since muscle endurance is very
activities that cause the symptoms should all be evaluated. important to good musicianship, using lighter weights
and more repetitions will help develop this.
Sports medicine or performing arts medicine specialists
with specific interest and knowledge of the demands of Seek the advice of a sports medicine or performing arts
performing arts will be very helpful in making an accurate medicine specialist when beginning an exercise program.
diagnosis and establishing a treatment plan. You can help Your exercise training can be modified to help you
your specialist by explaining the specific movements and maintain overall fitness even when you are injured. Overall,
demands of playing your instrument, including the types physical exercise will greatly improve your ability to play
and durations of your rehearsals, classes, and performances. your instrument while reducing the chance of injury.

WHAT IS THE TREATMENT FOR OVERUSE INJURIES? EXPERT CONSULTANT

Some tips for treating and preventing an overuse injury Jeffrey A. Russell, PhD, ATC
include: Performing Arts Tips provide general information only and are
not a substitute for your own good judgment or consultation with
Take short breaks during long practice sessions. a physician. To learn more about sports and performing arts injury
Adopt a practice or rehearsal schedule that allows prevention, please visit www.STOPSportsInjuries.org.
more intense playing to be interspersed with practice
that is less intense and varies the muscles being used.

Copyright 2016. American Orthopaedic Society for Sports Medicine. All rights reserved.

S TOP S po r ts Inj ur i e s Keeping Kids in the Game for Life | www.STOPSportsInjuries.org