Student Resources

Instrumentalists and vocalists use both big and small movements of the musculoskeletal system, both inside and outside of the body. At times, the conscious positioning of the body into specific playing postures may seem unnatural and, if not properly executed, can induce injury over time.

Injuries and disorders to the muscular and neuromusculoskeletal system can vary, but generally fall into the following categories:

• Genetic or related to a pre-existing medical conditions
• Trauma or injury-related conditions
• Behavior-related conditions

In addition to the injuries listed below, special care must be observed by all musicians to avoid hearing loss from excessive exposure to loud noises.

• Plan ahead and be aware of any situation where you may be exposed to loud sounds of any kind
• Excessive exposure to sounds of 85 decibels or more will cause temporary or permanent hearing loss.

While all musicians are vulnerable to Noise-Induced Hearing Loss (NIHL), percussionists, winds, and brass players in: orchestras, wind ensembles, marching bands, and contemporary rock, pop, or jazz bands are particularly susceptible to damaged hearing from over exposure.

Average Decibel to Noise Comparisons

As a general rule, for every 3 dB above the 85 dB threshold, the intensity of a noise rises exponentially. For Example, a 100 dB noise or sound has 32 times the destructive power of an 85 dB sound or noise, even though it is less than 2 times as loud on a decibel scale.

• 30 dB – A Whisper
• 50 dB – Moderate Rain
• 60 dB – The Average Conversation
• 70 dB – Passing Freeway Traffic
• 80 dB – Alarm Clock 90 dB – Blender, Food Processor, Blow-Dryer, The Subway
• 100 dB – Mp3 Player at Full Volume; Lawnmower, Snowblower
• 110 dB – Rock Concerts and Sporting Events; Power Tools
• 120 dB – Jet Planes at takeoff
• 130 dB – Sirens, Race cars; Jackhammers
• 140 dB – Gun Shots; Fireworks

OSHA Maximum Daily Exposure Times to Continuous Noises without Protection

Notice that as the decibel level increases by only a few integers, the time it takes for daily exposure without protection to cause damage decreases significantly. An average instrumental ensemble in comfortable sized room (that is to say, not a concert hall or a room that is too small) can easily exceed the 85 dB threshold at numerous points throughout a given rehearsal.

The most important aspect of NIHL is that it is preventable. If you, your student, or your child will be in a situation of any kind where noise levels will exceed 85 dB for an extended period of time, please consider using protection such as noise-canceling earplugs. As hearing is vital to becoming accomplished performers and educators, we have an obligation to protect the hearing ability of not only ourselves but also those with whom we collaborate.

Volume and Maximum Exposure Time

• 85 dB – 16 hours
• 88 dB – 10.6 hours
• 91 dB – 7 hours
• 94 dB – 4.6 hours
• 97 dB – 3 hours
• 100 dB – 2 hours
• 110 dB – 30 minutes
• 120 dB – Almost Immediate Damage

Possible Injuries Associated with Musical Instrument Practice

• Inflammation of cartilage or tendons in hands or wrist (Tendonitis)
• Swelling, pain, or discomfort in neck, shoulders, arms, or wrist (Overuse Syndrome)
• Numbness and tingling in hand or arm caused by a pinched nerve in the wrist (Carpal tunnel syndrome)
• Involuntary, prolonged muscle contractions (Dystonia)
• Skin irritations such as erythema, scaling, cyst formation, scarring, or inflammatory papules where skin makes contact with instrument while playing (“Fiddlers Neck”)

Common Methods of Prevention for Instrumentalists

The first and most proactive measure is prevention

• Avoid overuse or misuse for extended periods of time, including excessive practicing.
• Always warm-up properly before extended periods of activity and perform any stretches as prescribed by private instructor if necessary.

Practicing and employing proper postural alignment

• Spinal positioning
• Weight distribution
• Adequate muscular support
• Proper balance

Rest if feeling fatigued or injured

• “No pain, no gain” is not applicable to playing your instrument. If you are feeling pain associated with playing your instrument either directly or from a secondary injury, you need to rest. You should consult your private instructor and, if deemed necessary, a medical professional.

Maintain healthy nutrition, hydration and sleeping habits

• Students should aim for 8 glasses of water each day, eat healthy and well-balanced meals to stay energized and focused, and maintain a sleep regimen of 8 hours each night.

Possible Vocal Injuries

• Inflammation of vocal folds and/or loss of voice from fatigue
• Calluses on the vocal fold (vocal cord nodules)
• Abnormal tissue growth on mucosal membrane (vocal cord polyp)
• Ruptured blood vessel in vocal folds (vocal cord hemorrhage)
• Formation of firm mass under the surface of the vocal fold (vocal cord cyst)

Common Methods of Prevention for Vocalists

The first and most proactive measure is injury prevention

• Avoiding overuse/misuse
• Avoid shouting or speaking over loud noises
• Avoid using voice for extended periods of time
• Includes excessive practicing/performing

Practicing and employing proper postural alignment

• Spinal positioning
• Weight distribution
• Muscular support
• Balance

Rest voice if feeling ill, pain, or fatigued

• Singing when tired or ill can exacerbate an underlying and sometimes unrelated condition.
• Singing when ill with a flu or cold can lead to laryngitis.
• “No pain, no gain” is not applicable to using your voice. If you are feeling pain associated with speaking or singing either directly or from a secondary injury, you need to rest. You should consult your private instructor and, if deemed necessary, a medical professional.

Maintain healthy nutrition, hydration and sleeping habits

• Limit or avoid entirely the consumption of caffeine, alcohol, and smoking, which dehydrate the vocal tract.
• Be mindful of singing while on medications that induce dryness or may induce vocal damage such as antihistamines and analgesics. When in doubt, consult a physician.
• Students should aim for 8 glasses of water each day, eat healthy and well-balanced meals to stay energized and focused, and maintain a sleep regimen of 8 hours each night.

Rehabilitation for Instrumentalists and Vocalists

In cases where prevention has either been lacking or found inadequate, injury may occur. In these instances, focus shifts from prevention of injury to rehabilitation. If any pain or lasting discomfort arises from your playing or singing, please raise concern with your private instructor and consider seeking guidance from a medical professional.

For more information, visit the Performing Arts Medicine Association website.

A dancer’s life is very much about training, developing and using the body. Our bodies must be as strong and powerful as a great athlete’s body, but also capable of delicacy, flexibility, suppleness, musicality. The physique must withstand all of these demands, and still retain a lightness and beauty of line and movement, which makes movement into art. AND, we must do all of this without any indication of effort or physical stress. We do not yell when we make a goal, or grimace when we exert ourselves. But the life of a dancer is full of the same aches and pains that accompany any athletic training.

We all experience and react to the demands of the training program in different ways. There is the expected tiredness at the end of the class. Sometimes we have sore muscles or some discomfort from the work we ask our bodies to do. Each day we push ourselves to try something new, hold a position longer, take a leg higher, stretch a little further… it is common sense to expect that the body will respond to these demands by complaining a bit! Most dancers who train and perform consistently for a number of years will have some experience with injuries, both acute and chronic. This is part of the process that the body goes through in order to reach its goals. But these difficulties can be minimized.

I’d like to speak about some of the things we can do to stay healthy and strong in three general categories:

• Prepare Properly
• Work & Train Properly
• Provide Proper Care & Recovery

Here are some examples of the things we can do in each category:

Prepare Properly

1. Stretch and limber-up regularly to insure that the body is prepared for the range of movement which will be required during classes;
2. Warm-up thoroughly before each and every class – come early enough to do whatever you need to do for your body! The barre exercise of the class is not designed to warm you up – it is designed to train your muscles;
3. Arrive on time to classes and rehearsals – latecomers will be asking their musculatures to take shortcuts, and this is always asking for trouble;
4. Try to review class material and corrections from the previous lesson before the new lesson time – the more quickly you absorb correct information, the more quickly your body will be doing the work in a clear, correct, and therefore healthy manner;
5. Prepare your uniform properly for each class – it is particularly important that your shoes fit correctly and fastened correctly (ribbons and/or elastic).

Work and Train Properly

1. Attend class regularly – material in the lesson is meant to be repeated and mastered through consistent practice. The work of the ballet class is too difficult to attempt on an inconsistent basis;
2. Apply all corrections to your work as clearly as you can. Most corrections are not just about pretty line or shaping – they are really about developing the musculature, the coordination of the body, the intellect and the artistic sensibilities of the dance student. The exercises of the ballet lesson are difficult and powerful – if we do not execute them carefully and correctly, we risk more than not achieving a positive result – we risk achieving the opposite! Our bodies learn whatever they experience, so we need to make sure that we practice correctly;
3. Work according to the teacher’s direction. Try to understand and follow her priorities for your work, even though it might sometimes seem to you that it is not so important. In other words, sometimes the teacher might ask you to keep working on something you do not enjoy very much. Do it anyway. As soon as you master it, she will stop asking you to work on it!
4. Work as consistently as you can. Your level of effort, your physical and intellectual exertion, and the attention you pay to your class work will produce the most impressive results. Working hard one day and relaxing the next day will not teach you the most important lesson of all – how to work hard to attain your goals.

Provide Proper Care and Recovery

1. Each class is a physical and mental effort. Cool down properly – move the body a bit, stretch lightly to make sure all the “kinks” are out, and make sure your respiration rate and heart rate have returned to normal before you jump into the car, onto the bike, or whatever…
2. Develop a routine of resting, feeding and hydrating your body which keeps you feeling alert, energetic and clear-headed. If you are tired, you aren’t getting enough rest! If your body is sluggish, consider more hydration, more rest, or experiment with eating, drinking and resting at different times of the day until you find the best solution for your training schedule. Pay attention to the information you learn about nutrition – your body is your “instrument,” and if it is “out of tune,” you will be unable to dance well.
3. Pay attention to the signals that your body sends you: stiffness, pain, soreness, imbalances between the two legs, feet, sides of the back, etc. It’s important to know your body and what affect the training program will have. If you have any concerns or questions, ask your teacher. It’s important for the instructor to have information from students about the class work, also. It helps us to gauge the level of work that is most appropriate for the class.
4. Do not hesitate to seek the advice and treatment from professional caregivers if you think that a problem is serious, or if you are advised to do so by your instructor. Sometimes a student experiences something new and different and it can be important to find out exactly what is happening.