At the end of the 19th century hand diseases affected pianists so often that some musicians were forced to virtually review fundamentals of teaching methods. Nowadays this is still an urgent issue. Now we even have The Center for Musicians Medicine in Berlin, where occupational diseases of musicians, methods of prevention and treatment thereof are studied.
Prevailing types of occupational diseases manifestation among musicians can be referred to movement disorders in the form of abnormal state of motor system (impairment of normal, balanced functioning thereof during instrument playing, overexertion of muscular system of a kind). The above often results in involuntary muscle contractions, generally called convulsions, and neuralgic pains. Occupational neuralgias include, first of all, brachiplex neuralgias. The so-called neuromyalgia, neuromiositis, neurotendomyositis are also common.
A musician has to be able to operate his or her muscles, nerves and bones (locomotor and nervous systems) with great skill. Playing musical instruments requires controlled repeated movements and often implies staying in unnatural body position during many hours of rehearsals and performances. Such strains on the body may cause development of specific health disorders. Furthermore, poor working conditions: increased noise level, prolonged periods of play without breaks and preparation of a new complicated repertoire or use of new instruments can impact health of musicians regardless of their age and skill level.
Studies, conducted in the USA, Australia and Canada, have shown that approximately 60% of musicians get injuries, which can be detrimental for their profession, during the period of their professional activity. The studies have identified certain most common diseases: different overplay syndromes, including strain of muscles and connective tissues, controlling flexing and extending movements of hands. Such syndromes appear as a result of repeated strong movements of muscles and tendons. Pain in the back as a result of inconvenient position during the musical instrument playing is another widespread phenomenon among musicians. When playing the below-mentioned musical instruments, load is placed on nerves of the wrist and forearm, shoulders, arms and neck. Muscle spasms (focal dystonia) are also infrequent occupational disease of musicians. It may strike musicians in the prime of their career.
Bow instruments: violin, viola, cello, double bass, harp, classic guitar, electric guitar.
Health-related conditions of musicians, playing stringed instruments, are often subject to the way the musician holds the instrument and the way he or she sits or stands during the performance. E.g. most violin players or viola players put their instrument between the left shoulder and the chin. The musician often raises the left shoulder and lowers the left part of the chin and the jawbone so that the left arm could move freely along the neck. Simultaneous raising of one part of the body and lowering of the other part result in static muscle contracture condition, causing pain in the neck or the shoulder, temporomandibular disorders and thoracic outlet syndrome, when pain and numbness of the neck, shoulder and the upper chest are observed. Prolonged static sitting, in particular, in a bent position causes pain in the group of muscles, ensuring core stability. Playing the double bass, harp or classic guitar often requires static spine rotation. Heavy electric guitars often hang on a strap, worn over the shoulder at the left side of the neck. Therefore, there is a continuous pressure on the brachiplex, which may cause pain. Position-related problems are also one of the reasons of overexertion of wrist and fingers nerves and muscles as there appears a phenomenon of their pseudo-extending. E.g. the left wrist may be used for numerous repeated flexes, causing tension of extending wrist and fingers muscles and development of thoracic outlet syndrome. Pressure on nerves of the shoulder and the forearm can exacerbate disorders of the elbow, including the compression syndrome and neuropathology of the elbow bone.
Keyboard instruments: piano, organ, harpsichord, synthesizers and pianola.
Keyboard instruments playing requires a position similar to that of a typist. The head is often directed forward and down to see the keyboard and hands and repeated upward movements to see the score result in neurologic and muscle pain in the neck and back. A musician often rounds shoulders and raises his or her head up in addition to simultaneous shallow breathing. Continuous compression of nerves and blood vessels in the muscles of the neck, shoulders and ribs may result in development of a carpal tunnel syndrome. Moreover, tendency to flex wrists and bend fingers, keeping finger/wrist joints flat causes an excessive stress of wrist and finger muscles. Plus, due to continuous use of the thumb in the position lower than the hand, muscles overstrain, stretching and flexing fingers extensors. Efforts, undertaken to play large chords or octaves, may result in overexertion of the wrist joint capsule and ganglion development. This group of musicians frequently suffer from muscle spasms and focal dystonia. In this case sometimes it takes much time to learn correct hand positioning during neuromuscular training, which is needed to avoid further problems.
Wind and brass instruments: flute, clarinet, oboe, saxophone, bassoon, trumpet, French horn, trombone, bass horn and bagpipe.
A musician, playing one of this instruments, changes his or her position in such a way as to control the air flow as the position creates area for diaphragmal and intercostal breath blowing. Sound of the above-mentioned instruments depends on the way the mouthpiece (embouchure) is held, which is controlled by facial and throat muscles. The way the mouthpiece is held also influences sounds, generated by vibrating body or the mouthpiece. The position also influences the way a musician holds the instrument while sitting or standing and pressing the buttons of the instrument, controlling the pitch of the tones. Thus, French open hole flute requires stable position and bending (forward) of the left shoulder, stable position (backwards) of the right shoulder and slight turn of the head and the neck to the left. The left wrist is often held in an extremely bent position, while the arm is stretched so that to support the instrument by the crooked index finger and by two thumbs, balance is kept by the right little finger. This results in heightened tension of wrist muscles and muscles that flex and extend fingers. The habit to stretch the head out and breath shallowly increases the risk of thoracic outlet development.
Percussion instruments: drums, tympanum, hammer dulcimer, marimba, table and taiko.
Use of sticks, hammers and bare hands to tap the instruments results in hands and fingers injuries in no time. Pulse vibration, caused by taps on the instrument, is transmitted upwards via the arm and may cause injuries of tendons and peripheral nerves. Such biomechanical factors as the level of the applied force, repeated play and static load on muscles may also cause injuries. This group of musicians is frequently affected by the carpal tunnel syndrome and tendon nodules.
V.A. Guterman – the author of the book entitled Back to Creative Life. Occupational Hand Diseases, shares his interesting insights into causes of occupational diseases of musicians.
- Main Cause of Any Occupational Disease
The main cause of any occupational disease is loss of the integrity, unity, harmony of the performing musician’s motor system, essentially involving all of his/her body, from the finger tips to tips of the toes.
- Consequences of Performing Musician’s Motor System Integrity Loss
Natural balance of all components of the system is upset: it is infrequent that weak muscles and ligaments start to perform active, heavy work, while strong, large muscles are excluded from work and are inactive. The human body stops functioning as a well-differentiated whole, where all parts interact hierarchically and function harmonically, ensuring complete nerves conduction from periphery to the bran and back, and good blood flow.
- Contracture as a result of Natural Balance Upset
Upset of the motor system balance, impaired blood flow and nerves conduction in muscles of the music performer’s arms result in development of the root cause of all arm problems, the so called contracture: persistent contraction of a muscle, which becomes continuously cramped, mostly the shoulder muscle is affected by this condition. Paradoxically, pain occurs not in the contracture point, but in different parts of the arm – in the forearm, wrist, pain irradiates to the back, neck, etc. Contracture of the shoulder muscle is the reason of hygromas (bumps) on the wrist, peritenditis and other diseases.
As soon as the contracture is healed, several days later ganglions go away (the ganglions that are pressed out and surgically removed all over the world), pain stops, swelling subsides, flaccid, weak muscles liven up; auditory and muscle contact is restored. If the muscle is strained by contracture, tension of nerve fibers, wrapped around thereof (muscle spindle), decreases. There appears conductivity of nerve signals thereby from neural acoustic and emotional systems to fingers and of reverse signals from fingers to the brain. When contracture is healed, the musical performer’s arm becomes the speech organ again, the musician can freely express the imagery of the piece performed.
- Ilyashenko in her article Occupational Diseases of Guitar Players presents typical arms diseases of musicians in the form of a summary table.
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As is seen from the table, most arms diseases of musicians require long-term treatment, surgical treatment is often required.
Such diseases limit musicians’ working capacity and may require training for new occupation. The result is development of various reaction juxtapositions of neurotic character (asthenoneurotic syndrome, depression, etc.).
One of the serious problems a musician may face is possible hearing impairment.
Risk of hearing impairment as a result of exposure to noise of music depends on exposure intensity and duration. It is infrequent that the impact level reaches up to 100dB during quiet parts of orchestral music and up to 126dB peak values in the middle of the orchestra pit at the musician’s shoulder level. 110dB noise level is common for the place where a conductor stands or for a band performance. Noise level during performances of pop and rock musicians is much higher, it depends on stage or orchestra pit acoustics, amplifiers and microphones and other equipment layout. Average exposure time makes approximately 40 hours a week, however, many professional musicians may perform 60-80h a week. Hearing impairment is much more common among musicians than it might have been expected. 89% of professional musicians with osteomuscular traumas also have hearing impairments. Hearing diminishment in the range of 3-6KHz was found among them.
A musician’s work often implies concert tours. During such tours many musicians have to take long air flights which is very stressful. In addition to this a musician has no time for rest and relaxation as he or she has to spend a considerable amount of time rehearsing after arrival.
Jet lags, change of climate, etc. are additional stress factors. The organism does not have time to adjust to new living conditions.
Additional stress loads contribute to even greater upset of natural balance of all motor system components and also to development of various somatic diseases.
As is obvious from all of the above, prevention and treatment of occupational diseases of musicians have been highly relevant so far. It is very important to use safe methods with no side effects, the more so as prevention and even treatment is required as early as in childhood and at adolescence. Nowadays children and teenagers perform works, that not so long ago could be plaid by mature musicians only.
Currently recommended methods of occupational diseases of musicians treatment are not always efficient. If surgical methods of treatment have to be used in advanced cases of disease, there is a high level of disablement risk.
Matrix Trading Firm offers products, designed for contact Resonance Bio-Correction, which can be used as a method of occupational diseases of musicians treatment and prevention.
Resonance Bio-Correction method is based on coherent transformation (harmonization) of electromagnetic pulses, emitted by the human organism. The result is harmonization of life-sustaining systems of the organism and restoration of upset balance.
Since occupational diseases of musicians stem from upset of natural motor system balance, the Resonance Bio-Correction is a pathogenetically substantiated method of the above-mentioned impairments prevention and treatment.
Contact Resonance Bio-Correction method is carried out with the use of the products, including the topology design (fractal diffraction grating), created by AIRES New Medical Technologies Development Foundation. Upon interaction therewith electromagnetic radiation, emitted by the human organism is coherently transformed (based on passive resonance). As a result of passive interaction of electromagnetic radiation, emitted by cells, with intrinsic coherently transformed control field, there occurs stabilization of structural characteristics of physical fields, generated by organs and systems of the human organism.
Contact Resonance Bio-Correction method can be used for prevention and treatment of occupational diseases of musicians and for rehabilitation of musicians after past diseases.
The method is absolutely safe, non-toxic, environmentally friendly, it has virtually no side effects, is compatible with other proper treatment methods, can be applied at any age.
We recommend to use the following Health Matrix products to attenuate stress loads, restore natural balance of motor system:
- Aires Relax bandage with Aires Gold compound applicators helps to attenuate stress loads, and, consequently, to relieve muscle tension in the cervical area and to improve sleep. It is recommended to use the bandage during rehearsals, travels, it can also be used during sleep.
- Aires Gold neck bandage with compound applicators also helps to relieve stress tension (the neck is the stress area), to relieve muscle tension in the cranial area. The neck bandage can be used the same way as the Relax bandage.
- Health Matrix mat or the set of Aires seat covers can be used in the car, during flights, during rest (relaxation) and sleep. The mats help to relieve pain in the back.
- Ecostep matrix insoles for continuous use and Ortostep matrix insoles for flat footedness. Use of matrix insoles facilitates better blood flow in lower extremities, helps to reduce swelling, relieve fatigue, pain in legs.
Since musicians, like all other people in the world, are continuously exposed to electromagnetic background, generated by numerous sources of radiation, they are recommended to use AIRES gadgets for their personal protection:
- Aires Defender – can be used for protection against external electromagnetic radiation and as a resonance bio-corrector with a pronounced general harmonizing effect. It is particularly recommended to use the device during concert tours.
- Aires Shield neutralizer as a protection against radiation, emitted by smartphones, mobile phones, communicators.
Svetlana Pavlovna Lapina, MD, Ph.D (Medicine)