Musician Health and Wellness

The Bob Jones University Division of Music seeks to support the University’s educational mission by promoting the health and wellness of our music students, faculty, and staff. Because overwhelming evidence points to the prevalence of musculoskeletal, vocal, and auditory injuries among both college and vocational musicians (Ackermann et al., 2012; Huttunen et al., 2011; Rosety-Rodriguez et al., 2003), we seek to educate and advise our students on injury prevention, recovery, and post-recovery self-care. We believe we are “fearfully and wonderfully made” (Psalms 139:14) and that God’s intelligent design of the body and its maintenance should be integral to the education of musicians committed to stewarding their gifts for redemptive artistry (Romans 12:1-2; Ephesians 2:10).  

The National Association of Schools of Music (NASM) supports this endeavor with standards and guidelines for addressing these issues and provides resources for musicians’ health and wellness. In addition to resources provided on this webpage, the Division of Music provides periodic lectures, workshops and library resources on musicians’ health as well as individual help for those experiencing physical pain and discomfort.

Neuromusculoskeletal Injuries

Musicians must be proactive about any physical discomfort they may feel related to music-making. Neuromusculoskeletal injuries involve muscles, ligaments, tendons, nerves, and joints and can have symptoms of discomfort such as pain, weakness, redness, swelling, stiffness, cramping, tingling, and numbness. Symptoms of vocal injury include hoarseness, pain, loss of vocal range, and loss of breath/vocal control. Ignoring such symptoms with a “no pain, no gain” attitude can allow things to get worse, performance ability can be altered, and recovery can be prolonged. Steps to injury prevention include the following:

1. Ensure healthy water intake, diet, and sleep (7+ hours daily).
2. Pay attention to good posture and alignment throughout the day and during music-making.
3. Make time for full-body exercise such as swimming, walking, running, aerobics, etc., three to four times a week.
4. Refrain from activities that put you at risk for injury to your physical instrument, such as rock climbing, heavy weightlifting, cheerleading (vocalist), etc.
5. Sufficiently warm-up the body before intense and prolonged practice and performance.
6. Train your kinesthetic awareness during music-making, focusing not only on sound but also physical feel.
7. Avoid sudden increases in practice or excessive repetition in practice. Plan ahead to avoid “cramming” for performances, tests, juries, auditions, etc.
8. Choose balanced repertoire programs for moments of physical/emotional repose as well as physical/emotional intensity.

If you are a BJU student, faculty, or staff member experiencing music-making-related pain and/or discomfort, refer to the steps below to begin addressing the issues:

• Immediately consult a teacher or instrument expert to determine if physical technique is at issue. The teacher can also determine modifications to practice and performance to prevent further injury.
• Consult a medical professional to rule out underlying health issues as well as to prescribe treatment.
• Consult the BJU Division of Music resident musicians’ injury advisor for additional actions to take. This advisor will meet with students individually and communicate with teachers, ensemble directors and administration about injury management options and recovery progress.
• Consider chiropractic care and deep tissue massage to address misalignments and muscle tightness throughout the body.
• Education about the body and the biomechanics of music-making is beneficial to any musician; your body is your instrument. Persons experiencing pain and discomfort related to music-making are especially benefited by self-education.
• Evaluate water consumption and diet to reduce sensitivities and/or inflammation.
• Evaluate changes in the instrument, performance literature and style, environment, current health issues and levels of anxiety that might be contributing to the physical discomfort.

Hearing Health

Most musicians experience decibel levels in both ensemble, solo practice, and in leisure listening that could eventually damage their hearing. Decibel levels 85 dB and above for prolonged periods of time can eventually cause damage to hearing; levels 124 dB and above can cause immediate harm to the ears. If a musician anticipates an environment that regularly exceeds safe dB levels for prolonged periods of time, then ear plugs are recommended. Take advantage of free decibel level apps that inform of the level of noise exposure throughout the day. There are also specially designed ear plugs that allow for hearing the instrument, quality of its tone, as well fellow ensemble members while reducing the dB impact (Niquette, 2006).

Below are sound comparisons, decibel levels and exposure levels recommended by the National Institute for Occupational Safety and Health (NIOSH):

*https://medicine.uiowa.edu/iowaprotocols/music-and-hearing-loss/music-induced-hearing-loss/music-induced-hearing-loss-pages-audiologists-0

Conclusion

As Christians serving the Lord with our musical talents, attending to bodily care as well as healthy performing technique will help prevent injury and allow for a lifetime of music-making and service. The Division of Music at Bob Jones University is dedicated to training our students to use their instruments properly and wisely. The following resources will help students, faculty, and staff educate and protect themselves from injuries related to music-making.

Suggested Links

Ear Protection: https://www.etymotic.com/wp-content/uploads/2021/05/erl-0105-2006.pdf

Ear Health—Calculating Exposure Effects: https://medicine.uiowa.edu/iowaprotocols/music-and-hearing-loss/music-induced-hearing-loss/music-induced-hearing-loss-pages-audiologists-0  

NASM Hearing, Neuromusculoskeletal & Vocal Health Resources

Ear Health: Hearing Protection NASM-PAMA Student Guide 

Neuromusculoskeletal & Vocal Health: Neuromusculoskeletal_and_Vocal_Health_NASM-PAMA_Student_Guide

References

Ackermann, B., Driscoll, T., & Kenny, D. (2012) Musculoskeletal pain and injury in professional orchestral musicians in Australia. Medical Problems of Performing Artists, 27(4):181-7. PMID: 23247873

Huttunen, K. H., Sivonen, V. P., & Pöykkö, V. T. (2011). Symphony orchestra musicians' use of hearing protection and attenuation of custom-made hearing protectors as measured with two different real-ear attenuation at threshold methods. Noise Health, 13(51), 176-188. https://doi: 10.4103/1463-1741.77210.

Niquette, P. (2006). Hearing protection for musicians. Musicians need to hear well, and safely, when they play. Hearing Review,13(3), 52-58. https://hearingreview.com/hearing-products/hearing-protection-for-musicians

Rosety-Rodriguez, M., Ordóñez, F., Farias, J., Rosety, M., Carrasco, C., Ribelles, A., Rosety, J., & Gómez del Valle, M. (2003). The influence of the active range of movement of pianists' wrists on repetitive strain injury. European Journal of Anatomy, 7(2): 75-77. https://eurjanat.com/data/pdf/eja.03020075.pdf

University of Iowa (2022, January 12). Iowa Head and Neck Protocols. University of Iowa Health Care. Retrieved April 25, 2023, from https://medicine.uiowa.edu/iowaprotocols/music-and-hearing-loss/music-induced-hearing-loss/music-induced-hearing-loss-pages-audiologists-0

Special thanks to Dr. Lorri Turcios, associate professor in keyboard studies, for preparing this resource. As an undergraduate pedagogy major, Lorri began studying musicians’ wellness with an emphasis on ergonomic technique and injury prevention. Her wellness studies have included courses and private lessons with Barbara Conable (Body Mapping) and Sheila Paige (Taubman Technique and biomechanics), as well as observation of Alexander Technique and Taubman lessons. She is the resident advisor for musicians’ injuries in the Division of Music, presenting lectures and actively counseling musicians with pain and technical issues from both BJU and the surrounding area.