Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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Musculoskeletal pain from repetitive strain in musicians: insights into an alternative approach

Clair Davies
From: Medical Problems of Performing Artists: Volume 17 Number 1: Page 42 (March 2002)

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Abstract: In dealing with the symptoms of repetitive strain suffered by musicians, the focus has been primarily on assessing prevalence and developing means of prevention.1-6 While these are useful endeavors, the etiology of repetitive strain at the cellular level has not been well understood.7-9 As a consequence, the well-established forms of therapy'drugs, exercise, stretching, splinting, and rest'have gone largely unquestioned, even though they fail to solve the problems of many musicians.10 Chronic pain continues to ruin musical careers, in spite of everything the medical community has to offer.1 It may be worth questioning whether the medical community is overlooking something of value outside the boundaries of accepted practice. There is reason to believe that a significant proportion of the aches, pains, and other symptoms caused by repetitive strain are actually generated by myofascial trigger points, or small contraction knots, in the muscles of the body.11 12 This article is an effort to acquaint the readers of Medical Problems of Performing Artists with the basic tenets of myofascial trigger points and the work of Doctors Janet Travell and David Simons documented in their two-volume medical text, Myofascial Pain and Dysfunction: The Trigger Point Manual.13,14 Travell and Simons assert that trigger points are the primary cause of pain as much as 85% of the time and play some part in virtually every pain complaint.15 They consider trigger points to be a major cause of disability and loss of time in the workplace, in professional or amateur sports, or simply around home'anywhere people are apt to overdo some activity. One reason the medical profession has not given more attention to the study of trigger points may be because of confusion with acupressure points. Treatment with acupressure is alleged to affect the flows of energy throughout the body's "meridians." Although acupressure and other Eastern methods of healing sometimes seem to have a beneficial effect, in the absence of a sound physical explanation they are viewed by many physicians as quack medicine. If you don't know the facts about trigger points, they, too, sound like "quack" medicine. The reality of trigger points has been substantiated by Western medical research and clinical practice. Trigger points can be felt with the fingers. Their electrical emissions can be measured by electromyography. They have also been photographed in muscle tissue with the aid of the electron microscope and appear to be masses of sarcomeres that are unable to release from their contracted state.14,16,17 Trigger points can develop in any of the 200 pairs of muscles in the body, which gives them a wide territory for creating mischief. Trigger points can persist for life and can even survive in muscle tissue after death, detectible until rigor mortis sets in

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