Over the past 10 years of being involved in the management of patients with chronic pain I have treated a large number of professional and amateur musicians with pain problems related to their musical pursuits.
Many of the problems musicians have are also found in anyone whose job involves repetitive action and static loading of muscle groups — some of the most potent of causes of the current soft tissue injury explosion.
Posture and ergonomics The entry of ergonomic concepts into the field of industry was hastened by the ‘RSI Epidemic’ of the early 1980′s in Australia. Many of the solutions to the problems of ov-erusage in industry have application for teachers of music and voice.
Bernardino Ramazzini, a 17th Century Italian physician, was the first doctor to try and link the type of work performed with a range of illnesses in workers ranging from those who worked in mines, scribes, leather workers and those who worked in metals. In his 1700 work ‘Diseases of Workers’ Ramazzini wrote:
‘Various and manifold is the harvest of diseases reaped by certain workers from the crafts and trades that they pursue; all the profit that they get is fatal injury to their health. That crop germinates mostly, I think, from two causes. The first and most potent is the harmful character of the materials that they handle, for these emit noxious vapours and very fine particles inimical to human beings and induce particular diseases; the second cause I ascribe to certain violent and irregular motions and unnatural postures of the body, by reason of which the natural structure of the vital machine is so impaired that serious diseases develop therefrom.’
Although the first part of Ramazzini’s statement may not have relevance to repetitive action, the second certainly does.
If one cannot alter the basic position of wrist and fingers or the limbs in general, then it is likely the person performing the action will do so with undue muscular exertion and they may be statically loading their muscles more than they need to. In the case of music students, correction or prevention of these faults should be the responsibility of the teacher.
Static loading or isometric contraction of the muscles of the shoulder girdles and the upper back is one of the major contributing factors in the development of overusage symptoms of pain, stiffness, weakness and exhaustion in these areas.
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