Hand disorders in musicians

Epidemiology of neuromuscular injuries in guitar players living in Portugal: Associated risk factors

BACKGROUND

Playing guitar involves several physical demands, most inclusive of which are long hours of practice, which can make musculoskeletal symptoms common.

OBJETIVE

To determine the epidemiology of neuromuscular injuries in guitar players residing in Portugal and risk factors.

METHODS

The sample consisted of 105 guitar players, being 103 (98.10%) men, aged between 30-75 years (29,83±10,23). The measurement instrument used was a digital survey, shared by email, on social networks and in person.

RESULTS

Fifty-six (53.30%) guitar players had injuries throughout their musical practice, totaling 132 injuries, 13 (12.40%) guitar players were injured at the time of assessment and 31 (29.5%) guitar players had injuries in the last 12 months, totaling 63 injuries. The value of injury proportion was 0.29 (CI 95% : 0.14-0.44) and the injury rate was 0.42 injuries per 1,000 hours of music practice. The most common types of injury were: tendinopathy (22; 34.92%) and low back pain (9; 14.29%). The most affected anatomical sites were: wrist (18; 28.57%) and lumbar spine (10; 15.87%). Repetitive movement was the injury mechanism most mentioned by guitar players (24; 35.29%) followed by maintaining postures for a prolonged period of time (15; 22.06%). Guitar players who did not warm up before practicing were 0.33 (CI: 0.13-0.79; p = 0.013) more likely to have an injury.

CONCLUSIONS

There was a high percentage of injuries in guitar players and failure to warm up was a risk factor for the development of injuries. This type of study can help in creating injury prevention strategies in this type of population.

Management of common conditions of the musician: a narrative review for plastic surgeons

Career-related injuries and disorders in professional musicians are prevalent across all their respective instruments and fields. They often endure long hours of intensive practice that demand high levels of precision, dexterity, and flexibility of their head, neck, hands, and upper extremities. Unlike the average patient, musicians are sensitive to even mild symptoms and deficits that can interfere with performance, which can potentially be career-threatening. Increasing attention to the care of musicians motivated performing arts medicine to tailor the practice to their individual and unique needs. Plastic surgeons are at the forefront of this practice; however, there are very limited reviews discussing plastic surgery management of the common injuries and disorders in musicians. This article reviews the most relevant literature of the past several decades regarding treatment modalities of the most common conditions endured by professional instrumentalists, with an emphasis on surgical considerations in the field of plastic surgery. A thorough literature search was performed for articles that encompass the interface between plastic surgery and musicians. We examined disorders of the head, ears, eyes, nose, throat, hands, and upper extremities including stress velopharyngeal incompetence, disruption of the embouchure, nerve entrapments, arthritis, traumatic injuries, focal dystonia, Linburg-Comstock syndrome, and overuse disorder. Overall, the goal of this review is to provide a summary of the existing and successful procedures performed to address prevalent musician conditions.

Fingertip Injuries in Athletes, Musicians, and Other Special Cases

Management of fingertip injuries in athletes is optimized by consideration of the sport, the playing position, the timing within the season, the level of competition, and the patient's goals. Mallet and jersey fingers are common injuries in athletes and may be treated in several different ways, based on the nature of the injury and the timing of presentation, as well as the athlete's demands. Management of fingertip injuries in musicians is optimized by consideration of how the musician handles his or her instrument and the specific requirements of the injured digit in the context of musical performance.

Overuse syndrome of the hand and wrist in musicians: a systematic review

We systematically searched medical publication databases for articles in English on upper extremity overuse syndrome in musicians. We focused on non-specific pain disorders, including diagnostic definitions, epidemiology, pathophysiology, risk factors, symptoms, treatment, and prevention. We included 42 out of 156 identified articles. The point prevalence of playing-related musculoskeletal disorders ranges from 37% to 47% in musicians with the hand and wrist among the most commonly affected areas, and the lifetime prevalence is reported as high as 89%. Leading symptoms are pain, weakness, stiffness, and loss of control. Intense repetitive use during practice, or before an audition or concert, recent changes in conductors or teachers, psychological stress, the effort of holding a weighty instrument, wrong technique, and joint laxity have all been identified as risk factors. The need for prevention is highlighted. Today's therapy is mostly based on individual rehabilitation programmes rather than on long-term rest. However, treatment remains predominantly based on beliefs rather than on evidence. The entire subject needs intensive future research.

Complex hand dexterity: a review of biomechanical methods for measuring musical performance

Complex hand dexterity is fundamental to our interactions with the physical, social, and cultural environment. Dexterity can be an expression of creativity and precision in a range of activities, including musical performance. Little is understood about complex hand dexterity or how virtuoso expertise is acquired, due to the versatility of movement combinations available to complete any given task. This has historically limited progress of the field because of difficulties in measuring movements of the hand. Recent developments in methods of motion capture and analysis mean it is now possible to explore the intricate movements of the hand and fingers. These methods allow us insights into the neurophysiological mechanisms underpinning complex hand dexterity and motor learning. They also allow investigation into the key factors that contribute to injury, recovery and functional compensation. The application of such analytical techniques within musical performance provides a multidisciplinary framework for purposeful investigation into the process of learning and skill acquisition in instrumental performance. These highly skilled manual and cognitive tasks present the ultimate achievement in complex hand dexterity. This paper will review methods of assessing instrumental performance in music, focusing specifically on biomechanical measurement and the associated technical challenges faced when measuring highly dexterous activities.