Musicians' Health

In 1986 the first issue of an American quarterly journal called "Medical Problems of Performing Artists" was printed. In it was an article by the pianist Gary Graffman entitled "Doctor, Can You Lend Me an Ear?" It described a serious hand problem which had forced him to give up his very successful performing career at the end of the 1970's, and discussed the lack of understanding he had experienced from all the doctors he had visited.

The article resulted in a deluge of letters to the press from musicians who were thankful that someone had finally come out of the closet and admitted to having a problem. As Graffman said "... instrumentalists' hand problems - somewhat like social diseases - were unmentionable. Understandably so: If a performer is still performing, or hopes to get back on the road soon, he'd be crazy to advertise his disabilities. Nobody wants a wounded pianist. There is an oversupply of healthy ones. Admitting difficulties is like jumping, bleeding, into piranha-filled waters."

The medical community were at last alerted to the problem and there are now an increasing number of Performing Arts Clinics worldwide.

Please email articles, accounts of medical treatment you have had (successful or unsuccessful) and addresses (URLs) of sites that you find helpful to this address or visit the Musicians' Health Forum below and leave a message

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Help 

• British Association of Performing Arts Medicine (BAPAM) An excellent organisation run by people who care about musicians. You can get a free assessment and expert help
  Helplines: Tel: +44 (0)20 7404 8444 (from London) +44 (0)845 602 0235 (from elsewhere)
  General enquiries: admin@bapam.org.uk
• BAPAM SCOTLAND: The Scottish branch of the above organisation
  Scottish musicians can contact Patrice Berque (tel: 0141 419 0571 or 07766 687578, email: patrice.berque@btinternet.com) who will make an assessment free of charge (reimbursed by BAPAM) and if necessary refer to a Scottish practitioner with specialist expertise — including general practice, physiotherapy, osteopathy, homeopathy, neurology, rheumatology and counselling. There are also a range of complementary therapies available, including yoga and Alexander Technique. Further treatment is provided at a reduced rate.
• Musicians' Health Scotland This is Patrice's new website and should be a first point of reference for musicians living in Scotland. Patrice brings together his work with the Musicians' Union and BAPAM, and also his own research and published papers. There are advice sheets to download and links to other relevant sites
• Edinburgh Physiotherapy Centre 36 Henderson Row, Edinburgh, Scotland. Tel: 0131 556 1116
  This is an excellent place which I can highly recommend from personal experience. It was established in 1992 by a physiotherapist who has a genuine interest in musicians' problems and who has assembled a group of dedicated therapists. Read an article by her here, and do have a look at their very helpful information sheets
• Performing Arts Medicine Association (USA) (PAMA)
  This site has excellent links, including one to the highly esteemed journal, “Medical Problems of Performing Artists”
• International Society for the Study of Tension in Performance (ISSTIP)
  Appointments: Tel: +44 (0) 171 373 7307 Fax: +44 (0) 171 274 6821
• MEDLINEplus
  A very large database of medical information. There are informative articles on nearly every subject
• Spine-health.com In-depth information to help patients understand, prevent, and research treatments for back pain and neck pain — written and peer reviewed by leading spine physicians
  These pages are particularly helpful: Reducing back pain while sitting in office chairs and Choosing the right ergonomic office chair — after all, musicians don't sit only on piano stools and orchestral chairs!
• Small Bone Innovations
  Makers of orthopaedic implants in the U.S. Go to "Products," scroll down the page and click on the "Avanta.org Surgical Techniques" link to get to the Avanta Orthopaedics site. Select "Products" to find info about their joint implants. To read about their thumb joint replacements, see Contributions From Visitors
• The Pulvertaft Hand Centre
  World famous hand centre in Derby, U.K.
• Anatomy Home Page
  Good hand anatomy site
  Become an online patient of Dr Eaton
• Musicians and Injuries
  A large and exhaustive site by Paul Marxhausen, who is an electronics engineer with wide interests
  Highly reccommended - Great links
• Musician's Health
  An excellent site run by chiropractor, Dr Tim Jameson, D.C.
  There is a good range of articles and a useful ‘Ask the Doctor’ section
• Hand Therapy Centre of Marin
  Larkspur (near San Francisco)
  Tel: 415.461.1333 Fax: 415.461.1450
  email: handtherapy@earthlink.net

Articles 

• NEW "Focal Dystonia - My History," by Michael Houstoun NEW Michael Houstoun is a top ranking professional pianist whose career was brought to a halt by the onset of focal dystonia. This brief account of his five years of persistence in working towards a cure makes fascinating reading. He has now returned successfully to a busy performing schedule
• David Leisner - Classical Guitarist and Composer Two very interesting interviews with David Leisner, who has found a way to cure himself of a hand problem which may have been a form of focal dystonia
• "A Ten Point Plan for Fitness to Play" By Alison Kelnar
  Alison Kelnar is a physiotherapist who works at the Arts Medicine Research Unit of the Western General Hospital, Edinburgh
• "Why is it that Musicians Suffer an Extraordinary Amount of Physical Discomfort?"
  A very clear explanation of the causes of muscle imbalance in musicians - from the Edinburgh Physiotherapy Centre
• CAFIMP (Campaign Against Fear In Musical Performance) Poster
  For PDF file click here (You will need to have Adobe Reader installed)
• Some thoughts on music competitions, by Richard Beauchamp
• "Playing the Piano: Playing with Fire?" By Jonas Sen (1991)
  This classic music medicine text makes fascinating reading and is still relevant. Sen's discussion of his personal experience of focal dystonia is thought provoking
• Report on ISSTIP course, March 1998, by Richard Beauchamp
• "Stress in Piano Playing" By Richard Beauchamp (1999)
  Notes of a talk prepared for a BAPAM conference in Edinburgh - aimed at physiotherapists and doctors

Self Help 

• The Complete Guide to the Alexander Technique
  A comprehensive guide to this method, including a page of resources for musicians
• The Alexander Technique
• Society of Teachers of the Alexander Technique (STAT)
  Tel: 0171 351 0828
• The Whole Guitarist
  This is a ‘must visit’ site for guitarists by Peter Inglis, a teacher who combines interests in ergonomics, Alexander Technique and dance. His book, “Guitar Playing and how it works” is very highly recommended. You can order a copy from the website. You can also hear sound bites of the author’s playing
• Pedro de Alcantara
  The website of the author of the wonderful book, "Indirect Procedures." Pedro de Alcantara studied cello with Aldo Parisot and William Pleeth and has taught Alexander Technique under the supervision of Dr Wilfred Barlow. (Tip - For an excellent introduction to the Alexander Technique, go straight to "Forward and Up")
• The Feldenkrais Movement Institute
  A very informative site which includes some useful articles
• Feldenkrais Guild UK
  PO Box 370, London N10 3XA
  This site includes a list of teachers in Britain
• Feldenkrais Guild of North America
  Find a practitioner in your area (inc. England)
• Feldenkrais Resources
• Feldenkreis Radio Show
  A light hearted and chatty introduction to Feldenkreis
• International Taoist Tai Chi Society
  Navigate to your nearest centre
• The Golandsky Institute
  Edna Golandsky continues the work of Dorothy Taubman who founded a school of healthy playing technique for pianists
  Find out how to attend courses
• Smaller keyboards
  A large proportion of injuries are suffered by people with smaller hands playing keyboards that are too large for them. The piano is designed for large Caucasian males. This site shows how you can have a 7/8 sized keyboard fitted to your own piano
• Health and Safety, Hearing Protection and Focal Dystonia
• More Self Help Links

Suggested Reading 

Elizabeth Andrews: "Healthy Practice for Musicians": Rhinegold Publishing Ltd: ISBN 0-946890-73-0

This is a book every musician - and teacher - should own. Elizabeth Andrews is an experienced viola/violinist (played in ensemble with Jaqueline du Pre) who has a BSc in chiropractic and psychology

Barbara Paull and Christine Harrison: "The Athletic Musician": Scarecrow Press, Inc: ISBN 0-8108-3356-5

Barbara Paull is a physiotherapist and Christine Harrison a freelance violinist and teacher who suffered from career-stopping shoulder pain. Together they have written a book which is very informative and readable and gives particularly good advice on how to take care of your shoulders and back

Ian Winspur and Christopher B Wynn Parry: "The Musician's Hand - A Clinical Guide": Martin Dunitz: ISBN 1-85317-492-0

This is an extremely useful book by two of the leading figures in musicians' health. It is aimed equally at musicians, surgeons and physiotherapists

Barry Green with W. Timothy Gallwey: "The Inner Game of Music": Pan: ISBN 0-330-30017-2

Very readable psychology for musicians

Peter Inglis: "Guitar Playing and how it works": Order it from the author’s website The Whole Guitarist

This highly recommended book is a much needed addition to guitar teaching literature, and deals with ergonomics (with reference to Alexander Technique and dance movement), sound production and a wide range of styles.

Pedro de Alcantara: "Indirect Procedures": Oxford: ISBN 0-19-816569-2

An extremely enlightened book, showing the application of Alexander Technique to musical performance. To quote Sir Colin Davis: "There is much wisdom here in this book, along with some great quotations, many photographs, and exhaustive analyses of the aims and applications of Alexander's discoveries." Visit Pedro de Alcantara's website

©Copyright Richard Beauchamp May, 2000 This page revised 12/03/2008 Disclaimer