Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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Upper Extremity Overuse in Instrumentalists

William J. Dawson
From: Medical Problems of Performing Artists: Volume 16 Number 2: Page 66 (June 2001)

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Abstract: Upper extremity problems related to overuse continue to plague instrumentalists and remain a staple of performing arts medicine practices. The author reports his 15-year experience with these problems, both music-related and from other causes. The criteria for inclusion include adherence to a specific definition of overuse. The 329 patients reviewed for this series ranged in age from 9 to 89 years and included 48.6% males. Keyboard instruments and strings were the primary instruments of 79.6%. There were 63.7% who were professionals, conservatory or collegiate music students, or dedicated amateurs; these were described as high-level performers. Strains of the muscle-tendon unit and inflammatory conditions were the most common diagnoses made, each comprising about 43% of the total series. Neurologic diagnoses were made in only 6.8% of patients. Music was the cause of problems in 44.7% of the entire group; prevalence rates were higher in females, especially those from ages 10 to 13 years. Making music also was implicated in causing 62.9% of muscle strains, but only 26.3% of inflammatory diagnoses. Treatment generally followed conservative principles; only 10.3% of all overuse-related problems necessitated surgical care, mostly for release of inflamed tendons or compressed nerves in the hand and wrist. The demographics of this group reflect those of a typical hand surgical practice

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