Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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Common Problems of Wind Instrumentalists

William J. Dawson
From: Medical Problems of Performing Artists: Volume 12 Number 4: Page 107 (December 1997)

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Abstract: The early literature of performing arts medicine consisted primarily of case reports and other anecdotal writings. These dealt with specific physical problems, each of which could be attributed to the playing of, or other involvement with, a specific musical instrument. Conditions such as "English horn player's thumb,"1 "flutist's neuropathy,"2 "fiddler's neck,"3 "Satchmo's syndrome,"4 "gamba leg,"5 and "reed-maker's elbow"6 became part of our terminology and knowledge base, and the articles that described them have been quoted frequently in the bibliographies of subsequent publications. However, some of the medical diagnoses that were associated with these conditions later were found to occur also in players of other instruments, as well as in many nonmusicians. All of these difficulties were related in some way to overuse activities, which are known to occur in a wide variety of occupational groups. Further research has provided greater knowledge of the pathomechanics and etiologic complexities of performance-related problems,7-15 and our ability to make more precise and complete diagnoses has improved significantly. It is now apparent that only a very few conditions are truly pathognomonic of playing a specific instrument and that performers who play many instruments or instrument groups may experience the results of overuse or misuse activities in similar ways. t seems wise, therefore, to discuss the physical misadventures of wind musicians (and perhaps of all instrument groups) in relation to the specific physical activities involved in their performance, as well as in an instrument-specific fashion, where appropriate. This functionally- or mechanically-oriented approach is related to the postures, motions, and forces needed to make music, and both similarities and differences among the demands of various instruments should become apparent quite readily. This approach also may be useful in considering the pertinent and logically-related subjects of treatment and prevention. This article considers six major functional topics, applicable to all wind instruments: support, bodily posture, hand position and use, repetitive activities, embouchure, and muscle tension. These topics are followed by several shorter sections, each describing problems peculiar to a specific instrument or family of instruments, and finally by a few concluding statements.

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