Performing Artists as Athletes: A New Perspective

Evan D. Collins, M.D.
Center for Orthopedic surgery
Houston Methodist Hospital
Houston, Texas

Introduction

1. Musculoskeletal injuries were reported by greater than 50% of the 264,000 employed Musicians in 2006

2. National survey of orchestral musicians 76% of the respondents had to take time off from performing because of injury during their career

3. Common injuries reported:

  • Persistent pain in the extremity
  • Loss of facility
  • Loss of endurance
  • Loss of strength

4. Common diagnosis:

  • Overuse syndrome
  • Repetitive stress
  • Myofascial pain
  • Tendonitis

5. Recent review of Playing-Related Musculoskeletal Disorders (PRMD) indicated a 35% prevalence of recurrent problems despite treatment

6. Approximately 1/3 of musicians require multiple visits to medical providers

7. No consensus on effective treatment

8. No outcome data regarding treatment modalities

9. Patient satisfaction

10. Questions:
Why is it so difficult to effectively treat?
What can we do differently to improve this problem for performing artists?

Approach

Traditional Medical dogma

  • People seek medical attention when something hurts
  • People seek medical attention when things don't work
  • Medical treatment applies scientific approach

    Assumes that identifying the change from normal, and then correcting it, will alleviate the problem

Introduction

1. Consider the type of problem the patient has

Categories

  • Mechanical - broken, torn or compressed
  • Biological - infections or disease

Mechanical

Examples: X-ray of broken humerus

Repair of torn biceps tendon

Biological

Rheumatoid arthritis, cancer, bone cyst

Additional Category

Capacity problem:

  • All constructs have a defined "capacity" to perform work
  • When you exceed the ability for a construct to perform work - "exceed capacity"
  • Result is break down

The majority fall into this category:

  • Repetitive stress
  • Over-use syndrome
  • Chronic Fatigue syndromes
  • Tendonitis
  • Bursitis

Science of Capacity

  • Musculoskeletal system principle material is collagen
  • Collagen cross linkage
  • Strength dependent on amount of cross-linkages
  • Stress increase cross linkage between collagen fibers decrease weakening the construct
  • Exceed capacity, failure occurs

Capacity

Lateral Epicondyltits (Tennis elbow)

  • Pathology - Tendon fails after repetitive use
  • Most people never played tennis
  • Occurs between ages adults 30-65

Treatments

  • Rest, injections, splinting, physical therapy
  • Surgery

Capacity
Considering these musculoskeletal problems as a lack of capacity, can we apply this in a more efficacious way for the performing artist?

How does this apply to athletes, and relate to the performing artist?

  • A Football play lasts on average 3.5 - 5.5 sec for sixty minutes
  • Time from a pitch to completed out is less then 6 sec repeated until 27 outs have been recorded
  • Soccer match has two 45 min halves
  • Opera - Some can last as long as 4 hours with one intermission
  • Ballet - Nutcracker
  • Symphony - Two hours with one intermission
  • Athletes train to achieve peak performance
  • Athletes train to prevent injuries
  • Athletes train to increase their capacity to do work

Performing artists

  • Musicians - PRACTICE
  • Ballet performers - REHEARSE

Energy used during a performance

  • Violinist can burn over 700 calories per hour equivalent to 40 minutes on a treadmill with average heart rate of 140 bpm
  • The athlete trains to increase his/her capacity
  • Why not a performing artist?

Treatment

Example:

  • Rule out biological and mechanical problems first
  • Identify capacity problems - Corrected with physical therapy, core strengthening, and training specific to that performer

Therapy Examples:

Prevention

  • Easier to prevent then to treat
  • Artist and their environment may have to change

Conclusion

  • Performing artist rehearse to perform
  • Performing artists should also train to perform
  • Doing both may decrease injuries, enhance recovery and prolong careers

Thank You

For more information
contact: 713-441-3535
or go to: www.drevancollinsm.com