| Literature DB >> 24634587 |
University woodwind students' experiences with playing-related injuries and their management: a pilot study.
Jessica Stanhope1, Steve Milanese2, Karen Grimmer1.
Abstract
BACKGROUND: This study aimed to determine the experiences of university classical woodwind students with playing-related injuries (PRIs), the impact of these PRIs, the management selected by students with PRIs, and the perceived effectiveness of this management.MATERIALS AND METHODS: All classical woodwind students enrolled in vocational education training or undergraduate courses at a university were sent an email with a link to an online survey. Only those aged 18 years and older were eligible. The survey obtained data regarding demographic information, details of PRI experienced (location, if they lasted for more than 3 months, and if they were current), and the impact of these, as well as the types of management strategies tried and their perceived effectiveness. Data were analyzed using descriptive statistics, and comments were reported descriptively.
RESULTS: Fourteen students returned the survey; however, one of these only completed the questions regarding demographics, and was therefore excluded. A total of 62% of participants reported having experienced a PRI. Common locations for PRI were the wrist/hand/fingers, lower back, and neck. Reducing practice time by half and missing playing commitments were the most commonly reported consequences of PRIs. Playing-related management strategies were most frequently trialed, with these and passive nonplaying-related strategies perceived to be the most effective.
CONCLUSION: PRIs are common in this population, with a range of consequences reported. While it is encouraging that students had tried and found effective playing-related management strategies, active nonplaying-related strategies should be encouraged, particularly in preference to passive nonplaying-related strategies. This was a small-scale study, and the results are only applicable to the institution investigated; therefore, similar larger-scale studies are recommended to determine the generalizability of these findings.
Entities:
Keywords: injury; management; musician; pain; prevalence; treatment; woodwind
Year: 2014 PMID： 24634587 PMCID： PMC3952899 DOI： 10.2147/JPR.S49620
Source DB: PubMed Journal: J Pain Res ISSN： 1178-7090 Impact factor: 3.133
Background
Table 1
Summary of the type of data published
| All woodwind | Flute | Clarinet | Saxophone | Oboe | Bassoon | |
|---|---|---|---|---|---|---|
| Lifetime prevalence anywhere/any duration | ||||||
| Pain | ||||||
| Injury | ||||||
| Musculoskeletal problem | ||||||
| Pain or injuries | ||||||
| Tingling | ||||||
| Weakness | ||||||
| Numbness | ||||||
| Duration prevalence – location-specific | ||||||
| Pain | ||||||
| Lifetime prevalence – location-specific | ||||||
| Problem | ||||||
| Pain | ||||||
| Point prevalence – location-specific | ||||||
| Pain whilst playing | ||||||
| Seeking treatment (during the university studies) | ||||||
Notes:
Ackermann et al;7
Brandfonbrener;8
Kreutz et al;12
Guptill et al;10
Cayea and Manchester;9
Pratt et al;13
Hartsell and Tata.11
Materials and methods
Ethics approval
Recruitment
Survey
Data analysis
Results
Table 2
Sample demographics
| Demographic | Number (% of respondents) |
|---|---|
| Sex | |
| Female | 10 (77) |
| Male | 3 (23) |
| Age (years) | |
| 18–19 | 6 (46) |
| 20–24 | 3 (23) |
| 25+ | 4 (31) |
| Program | |
| Certificate IV in Music (Classical performance) | 2 (15) |
| Bachelor of Music (Classical performance, first year) | 4 (31) |
| Bachelor of Music (Music education, second year) | 1 (8) |
| Bachelor of Music (Classical performance, third year) | 5 (38) |
| Honours Degree of Bachelor of Music (Classical performance) | 1 (8) |
| Major instrument | |
| Flute | 6 (46) |
| Clarinet | 2 (15) |
| Saxophone | 1 (8) |
| Oboe | 1 (8) |
| Bassoon | 1 (8) |
| Recorder | 2 (15) |
Table 3
Prevalence of playing-related injuries
| n (% of all participants)
| |||
|---|---|---|---|
| Ever | Longer than3 months | Current | |
| General | |||
| Neck/shoulder regions | 5 (38) | 1 (8) | 4 (31) |
| Back | 6 (46) | 3 (23) | 2 (15) |
| Upper limb | 6 (46) | 1 (8) | 4 (31) |
| Jaw | 1 (8) | 0 (0) | 0 (0) |
| Detailed | |||
| Neck (left side) | 2 (15) | 0 (0) | 2 (15) |
| Neck (right side) | 4 (31) | 1 (8) | 3 (23) |
| Upper back (left side) | 0 (0) | 0 (0) | 0 (0) |
| Upper back (right side) | 2 (15) | 1 (8) | 1 (8) |
| Middle back (left side) | 1 (8) | 0 (0) | 0 (0) |
| Middle back (right side) | 1 (8) | 0 (0) | 0 (0) |
| Lower back (left side) | 3 (23) | 2 (15) | 1 (8) |
| Lower back (right side) | 2 (15) | 1 (8) | 1 (8) |
| Shoulder (left) | 1 (8) | 0 (0) | 0 (0) |
| Shoulder (right) | 3 (23) | 1 (8) | 1 (8) |
| Arm (left) | 2 (15) | 1 (8) | 1 (8) |
| Arm (right) | 1 (8) | 1 (8) | 0 (0) |
| Wrist/hand/fingers (left) | 4 (31) | 1 (8) | 2 (15) |
| Wrist/hand/fingers (right) | 6 (46) | 1 (8) | 3 (23) |
| Jaw (left side) | 1 (8) | 0 (0) | 0 (0) |
| Jaw (right side) | 1 (8) | 0 (0) | 0 (0) |
Figure 1Management strategies tried.
Notes: ^Number of participants with a history of playing-related injury (n=8); *or increased discomfort.
Figure 2Perceived effectiveness of management strategies.
Notes: Circle, median; line, interquartile range; crosses, range; 1, no help; 5, extremely helpful.
Discussion
Limitations
Conclusion
Supplementary material
Systematic Search
Survey preliminary information
Table S1
Search terms
| Woodwind player | flute OR flutes OR flautist |
| University student | universit |
| Musculoskeletal symptoms | muscul |
| Prevalence/incidence | preval |
| Impact | consequen |
| Management | manag |
Note:
indicates a truncation symbol (the symbol may be replaced by any number of characters by the search engine).
| No chance | Extremely likely | ||||
|---|---|---|---|---|---|
| 6 months | □ | □ | □ | □ | □ |
| 12 months | □ | □ | □ | □ | □ |
| 5 years | □ | □ | □ | □ | □ |
| Ever | □ | □ | □ | □ | □ |
| No chance | Extremely likely | ||||
|---|---|---|---|---|---|
| Missed playing commitments | □ | □ | □ | □ | □ |
| A negative impact on your playing reputation | □ | □ | □ | □ | □ |
| A week off from playing | □ | □ | □ | □ | □ |
| Ending your career | □ | □ | □ | □ | □ |
| Reducing your playing time by half | □ | □ | □ | □ | □ |
| Financial problems | □ | □ | □ | □ | □ |
| Three months off from playing | □ | □ | □ | □ | □ |
| A month off from playing | □ | □ | □ | □ | □ |
| Social isolation | □ | □ | □ | □ | □ |
| Not at all | Extreme impact | ||||
|---|---|---|---|---|---|
| Not enough breaks when practicing | □ | □ | □ | □ | □ |
| Poor posture/hand position | □ | □ | □ | □ | □ |
| Sudden increase in playing intensity (eg, harder pieces) | □ | □ | □ | □ | □ |
| Sudden increase in playing time | □ | □ | □ | □ | □ |
| Carrying your instrument | □ | □ | □ | □ | □ |
| Overpracticing | □ | □ | □ | □ | □ |
| Playing with discomfort | □ | □ | □ | □ | □ |
| Insufficient warm up (eg, playing long notes, slow scales) | □ | □ | □ | □ | □ |
| Poor general physical fitness | □ | □ | □ | □ | □ |
| Cramped playing conditions | □ | □ | □ | □ | □ |
| Poor awareness of injury prevention | □ | □ | □ | □ | □ |
| Stress (eg, performance anxiety) | □ | □ | □ | □ | □ |
| Moving equipment (chairs, stands) | □ | □ | □ | □ | □ |
| Facilities (eg, chairs, temperature, lighting) | □ | □ | □ | □ | □ |
| Instrument setup (eg, thumb rests, reeds, neck straps, key height) | □ | □ | □ | □ | □ |
| No effect | Will completely prevent an injury | ||||
|---|---|---|---|---|---|
| Warm-up (eg, long tones, slow scales) | □ | □ | □ | □ | □ |
| Yoga | □ | □ | □ | □ | □ |
| Regular massage | □ | □ | □ | □ | □ |
| Stop playing as soon as you experience discomfort | □ | □ | □ | □ | □ |
| Pilates | □ | □ | □ | □ | □ |
| Aerobic exercise (eg, running, rowing) | □ | □ | □ | □ | □ |
| Stretching | □ | □ | □ | □ | □ |
| Muscle-resistance exercises (eg, weights, Thera-Band) | □ | □ | □ | □ | □ |
| Alexander technique | □ | □ | □ | □ | □ |
| Osteopath | □ | □ | □ | □ | □ |
| Bowen therapy | □ | □ | □ | □ | □ |
| Physiotherapy | □ | □ | □ | □ | □ |
| Relaxation techniques | □ | □ | □ | □ | □ |
| Feldenkrais | □ | □ | □ | □ | □ |
| Regular practice breaks | □ | □ | □ | □ | □ |
| Chiropractor | □ | □ | □ | □ | □ |
| Have done | Currently doing | |
|---|---|---|
| Pilates | □ | □ |
| Stop playing as soon as you experience discomfort | □ | □ |
| Alexander technique | □ | □ |
| Relaxation techniques | □ | □ |
| Stretching | □ | □ |
| Yoga | □ | □ |
| Feldenkrais | □ | □ |
| Aerobic exercise (eg, running, rowing) | □ | □ |
| Physiotherapy | □ | □ |
| Chiropractor | □ | □ |
| Osteopath | □ | □ |
| Warm-up (eg, long tones, slow scales) | □ | □ |
| Regular practice breaks | □ | □ |
| Muscle-resistance exercises (eg, weights, Thera-Band) | □ | □ |
| Bowen therapy | □ | □ |
| Regular massage | □ | □ |
| Has prompted a change | Would prompt a change | |
|---|---|---|
| Reading about injuries | □ | □ |
| Advice from a health/medical professional | □ | □ |
| Experiencing an injury that impacts on your playing | □ | □ |
| Starting to get symptoms (before they start impacting on your playing) | □ | □ |
| Having a class/workshop about injuries | □ | □ |
| Knowing someone who has experienced an injury | □ | □ |
| Advice from your teacher | □ | □ |
| Advice from other students/colleagues | □ | □ |
| Not at all important | Extremely important | ||||
|---|---|---|---|---|---|
| Have a ‘no pain, no gain’ attitude | □ | □ | □ | □ | □ |
| Understand the physical requirements of playing | □ | □ | □ | □ | □ |
| Have a good posture/hand position | □ | □ | □ | □ | □ |
| Understand injury prevention | □ | □ | □ | □ | □ |
| Carefully structure practice sessions | □ | □ | □ | □ | □ |
| Have good playing technique | □ | □ | □ | □ | □ |
| Do exercises (stretches and strengthening to reduce injuries) | □ | □ | □ | □ | □ |
| Completely disagree | Neutral | Completely agree | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Injury prevention is the responsibility of the teacher | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Injury prevention is the responsibility of the individual musician | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Injury prevention is the responsibility of the university | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Injuries can be prevented | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| If I had an injury, I would tell my teacher | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| If a musician has an injury, it reflects poorly on their teacher | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Musicians should understand injury prevention | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Discomfort is a normal part of playing | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Health professionals need a good musical understanding to advise and treat musicians | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| I would not tell another musician if I had an injury | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Musicians who have had an injury are at higher risk of future injury | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Musicians who have had an injury should not be professional musicians | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Musicians who have had to have time off because of an injury must not want to be musicians bad enough | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Teachers should teach injury prevention | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Injuries are an excuse for time off | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Completely disagree | Neutral | Completely agree | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Changing my posture/hand position would have a positive effect on my playing long term | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Learning more about good posture/hand position will make me a better teacher | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| It is too difficult to change my posture/hand position | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my practice structure will help improve my playing | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my posture/hand position will help prolong my career | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| The discomfort and fatigue from doing exercises will make it hard to practice afterwards | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Having a good posture/hand position will improve the way in which my performance is perceived, even if the sound is the same | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises will help decrease my injury risk | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises is embarrassing | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my practice structure will help decrease my injury risk | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises will improve my playing reputation | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| I need to practice for long durations to be able to perform for long durations | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my practice structure will help prolong my career | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| It is too difficult to change my practice structure | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises will help improve my posture | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises will improve my playing | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| If I found time to do exercises, I may as well practice | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| It would take too much time to change my posture/hand position | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my posture/hand position would affect my playing negatively in the short term | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Doing exercises will help prolong my career | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Changing my posture/hand position will help decrease my injury risk | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| There is not the space to do exercises at university | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| My duration of practice in one session is dictated by practice room availability | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| I don’t have the time to do exercises | □ | □ | □ | □ | □ | □ | □ | □ | □ |
| Ever experienced | Longer than 3 months at a time | Currently | |
|---|---|---|---|
| Neck (left side) | □ | □ | □ |
| Neck (right side) | □ | □ | □ |
| Upper back (left side) | □ | □ | □ |
| Upper back (right side) | □ | □ | □ |
| Middle back (left side) | □ | □ | □ |
| Middle back (right side) | □ | □ | □ |
| Lower back (left side) | □ | □ | □ |
| Lower back (right side) | □ | □ | □ |
| Left shoulder | □ | □ | □ |
| Right shoulder | □ | □ | □ |
| Left arm | □ | □ | □ |
| Right arm | □ | □ | □ |
| Left wrist/hand/fingers | □ | □ | □ |
| Right wrist/hand/fingers | □ | □ | □ |
| Jaw (left side) | □ | □ | □ |
| Jaw (right side) | □ | □ | □ |
| No help | Extremely helpful | ||||
|---|---|---|---|---|---|
| Relaxation techniques | □ | □ | □ | □ | □ |
| Massage | □ | □ | □ | □ | □ |
| Heat | □ | □ | □ | □ | □ |
| Cortisone injections | □ | □ | □ | □ | □ |
| Stretching | □ | □ | □ | □ | □ |
| Alexander technique | □ | □ | □ | □ | □ |
| Yoga | □ | □ | □ | □ | □ |
| Bowen therapy | □ | □ | □ | □ | □ |
| Pilates | □ | □ | □ | □ | □ |
| General body training | □ | □ | □ | □ | □ |
| Warm-up | □ | □ | □ | □ | □ |
| Stop playing as soon as you experience discomfort | □ | □ | □ | □ | □ |
| Regular practice breaks | □ | □ | □ | □ | □ |
| Time off from playing | □ | □ | □ | □ | □ |
| Medications | □ | □ | □ | □ | □ |
| Muscle resistance exercises (eg, weights, Thera-Band) | □ | □ | □ | □ | □ |
| Reduce playing hours | □ | □ | □ | □ | □ |
| Feldenkrais | □ | □ | □ | □ | □ |
| Chiropractor | □ | □ | □ | □ | □ |
| Physiotherapy | □ | □ | □ | □ | □ |
| Osteopath | □ | □ | □ | □ | □ |
| Ice | □ | □ | □ | □ | □ |
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