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Upper Extremity Problems of the Mature Instrumentalist

William J. Dawson
From: Medical Problems of Performing Artists: Volume 14 Number 2: Page 87 (June 1999)

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Abstract: The author sought to study various details of epidemiology, etiology, and diagnosis of medical problems that affect musical performance in older instrumentalists, and to determine how this age group differs from populations of young musicians or musicians in general. The author reviewed his practice records of 433 musicians aged 50 and older, and 921 musicians under the age of 50 at the time of their first visits for new hand or upper-extremity problems. These patients were seen from 1983 to 1996. The oldest patient was 89; 38.3% of the group were male. Overuse-related conditions were diagnosed in 27.9% of the patients, traumatic problems in 31.9%, and arthritis (primarily osteoarthritis) in 16.4%. Other diagnoses were made in 23.8% of the patients. The principal overuse diagnoses were tendinitis/tenosynovitis in 67.4% and muscle-tendon strains in 26.4%; music was the cause of symptoms in 25.6% of this group. Common traumatic conditions included fractures in 37.3%, and sprains and strains in 25.4%. Sports caused 16.7% of traumatic problems; more than half of these were due to ball sports. Many other problems could be traced to aging changes such as cartilage erosion, tendon attrition and degeneration, and osteoporosis. Comparison of data for the mature population with that of the under-50 group showed expected differences in the frequency of arthritis (much greater) and trauma (much smaller). Music-related overuse was 1.5-5.0 times less common than in the young group. There are significant differences between older and younger musicians in the nature, cause, and frequency of hand problems. Treatment of the mature instrumentalist must take into consideration not only the conditions common to all age groups, but also those specifically related to the aging process.

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