This is an author-produced PDF of a paper accepted for publication Music in Australian tertiary institutions. The definitive publisher-authenticated version is available online at: http://www.nactmus.org.au/nactmus_2007.php . Complete citation information of the definitive publisherauthenticated version is: Grant, C. (2007). Beyond prevention: Addressing the needs of tertiary music st students with playing-related injury. In Music in Australian tertiary institutions: Issues for the 21 century. Proceedings of the National NACTMUS conference (July 2007; ed. C. Grant). Brisbane: Griffith University. Retrievable from http://www.nactmus.org.au/nactmus_2007.php.
Beyond prevention: Addressing the needs of tertiary music students with a playing-related injury. Catherine Grant Queensland Conservatorium Griffith University
[email protected]
Abstract The discourse within Australian tertiary music institutions on playing-related injury is slowly developing. The high incidence of injury in students is gradually being acknowledged, and awareness of prevention strategies is increasing. In late 2005, a Queensland Conservatorium Griffith University presentation introduced staff, students, and the public to a project collaboratively undertaken by the Guildhall School of Music and Drama and ESMUC (Escola Superior de Música de Catalunya), Barcelona, aiming to dissolve taboos on playing-related injury among both music students and professionals. A publication on the project is due for release in mid 2007. In one aspect, however, the current discourse is critically inadequate. In focusing on injury prevention and physiological management, it overlooks the psychological, emotional, social, and financial repercussions of injury. What impact can an injury have on a tertiary music student? What are the needs of students who suffer injuries? What systems are already in place within tertiary music institutions for those students, and what can be done to address the deficiencies? From the perspective of my own experience, this paper makes suggestions for strategies that address the needs of tertiary music students with a playing-related injury.
During the last week of August 1996, I developed a constant pain in my wrists. It was soon diagnosed as bilateral tenosynovitis (De Quervain's disease), an "inflammation of the tendons of the first dorsal compartment of the wrist" (Stedman, 2006). Medical advice was to discontinue playing until the pain subsided. My second semester as a Conservatorium student - with a recent track record as a concerto soloist, recitalist and finalist in a national competition - had just begun.
1
This paper is based on ten years of reflection on that experience and what followed. It tries to describe the impact of playing related injury 'beyond prevention', and outline pathways to deal with the realities of this type of injury in institutions for tertiary music education. To date, international research on playing-related injury has focused predominantly upon the aetiology, anatomy, prevention, and management of injuries. The titles of two prominent recent publications - The musician’s hand: A clinical guide (Winspur & Parry, 2006) and The percussionists' guide to injury treatment and prevention: The answer guide for drummers in pain (Workman, 2006) - indicate their pragmatic approach to injury. The most recent editions of the official journal of the Performing Arts Medical Association, Medical Problems of Performing Artists (ed. Mancester, 2006 & 2007), include no articles on the emotional-psychological repercussions of injury among performing artists, focusing rather on physiological-anatomical aspects such as “Three-Dimensional Analysis of Hand and Finger Movements during Piano Playing”; “Anterior Interosseous Neuropathy in Instrumental Musicians”; and “Prevalence and Causal Factors of Playing-Related Musculoskeletal Disorders of the Upper Extremity and Trunk among Japanese Pianists and Piano Students”.
Recent student dissertations from Australian music institutions display a similar slant. The focus on physiological aspects and preventative measures is exemplified in dissertation topics such as An investigation of the teaching and learning of injurypreventative principles to developing pianists (Collett, 2005) and Performancerelated musculoskeletal disorders in violinists (Ackermann, 2003). Similarly, one honours music student wrote a thesis on the causes and physiological management of playing-related injuries (Milanovic, 1997) and later researched the Taubman
2
Approach, a piano technique that has been successful in helping to overcome and prevent them (Milanovic, 2005).
While these research areas certainly indicate interest in the subject of injury, there is a lacuna with regard to the impact of playing-related injuries in musicians, beyond the physical. During his pioneer study of playing-related injury in Australian performing music schools, Fry found some degree of depression evident in all students with a Grade 3 severity injury or above, on a scale of 1 to 5 (Fry, 1986, p. 38). Despite his suggestion that “the depression found in overuse (injury) syndrome [sufferers] needs further investigation” (p. 39), no systematic research into the psychological or emotional impact of playing-related injury has been conducted in Australia. The understanding of how tertiary music students experience the impact of injury, and therefore the needs of those students, remains vague.
Personal experience When I first received the diagnosis of my condition, I was certain that with rest, healing would be fast. I had had no previous experience of playing-related pain or discomfort. I was aware, however, that playing through pain meant the risk of further damage. So after a first semester of straight high distinctions, and winning a Conservatorium-wide performance prize, I stopped, much as I enjoyed the hours I spent each day at my instrument.
The most immediate reaction instigated by the sudden necessity to stop playing was physical withdrawal symptoms, like those often experienced by injured dedicated runners (Morris, Steinberg, Sykes, & Salmon, 1990). I was anxious and irritable, and
3
at a loss to know how to fill the new and unwanted hours in the day. Upcoming performances and competitions loomed. It was impossible to entertain the prospect of a whole week, perhaps even two, away from my instrument. I wasn’t to know that for the next several years, my total time at the piano would be measurable in minutes rather than hours.
At first, I began medical treatment with expectation and hope. Physiotherapy, my first avenue, continued for several months, though improvement in my condition was minimal and reached a plateau after some weeks. I stopped treatment and began to look elsewhere. Local and interstate visits to sports medicine doctors, surgeons, and hand specialists were largely fruitless. In desperation, I began to diversify.
Over many months, I tried cortisone iontophoresis, internal and localised antiinflammatories, chiropractic treatment, massage and acupuncture. Some avenues gave minor or temporary relief, others none. I ended each with despondency, until I found the will and strength to try another. I took lessons in Alexander technique, Feldenkrais, and yoga. I attended a pain management clinic, a meditation course, tried acupuncture and physiotherapy a second time, homeopathy, kinesiology, Bowen therapy, neurolinguistic programming, and hypnotherapy. Over time, the interval between treatments lengthened, as I became discouraged and emotionally exhausted.
The sense of desperation I felt in my search for a solution to the problem of injury is reflected in accounts by other musicians. Over many years, Australian tertiary music student Milanovic explored a gamut of treatments for injury, including physiotherapy, injections, surgery, rehabilitative techniques, and various alternative therapies (2005,
4
pp. 13-19). Similarly, Walker describes ten years of an “aimless search” for a successful treatment when her performing and teaching career of thirty years was interrupted by injury, involving “some 25 doctors, therapists, teachers, and alternative health practitioners. The treatments employed included medications, rehabilitation therapies, injections, surgery, psychotherapy, playing technique modifications, alternative modalities, and self-help treatments” (2006, para. 2).
Although my injury meant that daily basic tasks – riding a bike, holding a book, cooking, writing an email – were constantly accompanied by pain, the physical aspect was nevertheless secondary in comparison to its psychological and emotional impact. Discussing the anatomy of my injury with a friend one day, I fainted. I lost my appetite, and lost weight. I slept as much and as often as I could, at times up to sixteen hours a day, to avoid the physical pain and the general wretchedness of being awake. I was constantly tired. I lost my willingness to be with my friends, almost all of them fellow Conservatorium students: their talk about repertoire, their lessons, and their upcoming performances was painful. Other people I dearly loved and respected stopped contact with me, the reason being - as I learnt many months later – a fear of upsetting me by talking about my injury.
By the end of 1996, I was emotionally and physically exhausted, and dreaded the thought of having to face another year. Months crept by. This was the most difficult period of my life. Retrospectively, I identify with the sentiments of pianist Leon Fleisher, one of the few performing musicians on the international arena to have talked publicly about the psychological impact of injury: As you can imagine, I felt desperate. If you spend your life training to do a certain kind of activity and suddenly it is no longer available to you, your life
5
seems to come to an end . . . I went into depression for a couple of years. I thank God that I also had to go on [with my teaching] or else I might have jumped off the Chesapeake Bay Bridge. (Montparker, 1986, p.9)
Throughout this period, I was acutely aware of a lack of directed support from the institution. In the initial stages of my injury my principal study teacher had provided me with constant emotional support, clearly out of personal concern rather than adherence to any institutional duty of care. In all other regards, I felt on my own. It was left to me to cancel several Conservatorium performance commitments and to inform my chamber music, accompaniment, and keyboard studies teachers of my injury. These tasks, as well as the deferment of the practical components of my course through student administration, were cumbersome and emotionally difficult processes. My other lecturers were left unaware of my injury, leading to an embarrassing situation during a lecture where I was asked to sight-read a score by way of demonstration. I was forced to decline, and explain the reason in front of 30 or 40 fellow students.
In mid 1997, twelve months after the onset of my injury and still unable to play, I reluctantly withdrew from my studies at the Conservatorium and began philosophy and religion majors in an arts degree at the University of Queensland, to pursue in an academic way my new awareness of pain, grief, and loss. I wrote a paper on the effect of meditation on pain, and another on the efficacy of music therapy in the management of grief. The physical pain of my injury continued throughout this time, and I was unable to use a computer or write at any length, which impeded my studies considerably.
6
Having now left the Queensland Conservatorium, I was no longer eligible to receive the Griffith University academic scholarship that had initially facilitated my move to Brisbane. My injury also prohibited me from taking on the piano accompanying work that had supplemented my scholarship. This dual loss of income, combined with the substantial outlay I made to follow the various avenues of treatment for my injury, meant significant financial pressure. I began a job at a CD store. The constant use of my hands in shelving CDs and using a cash register caused increased pain. After some weeks, I felt compelled to resign. Any job that was available to me required use of my hands in some capacity. Having lost my scholarship and lacking the means to support myself, I had little choice but to withdraw from university and return to my parents’ home, interstate, where I spent an unhappy next eighteen months.
Since the onset of my injury, I had been aware of and extremely grateful for a handful of people – certain friends, family, and my former piano teachers – who understood that for me, coping with playing-related injury meant far more than finding strategies to deal with chronic physical pain. They recognised that becoming injured can be emotionally devastating for a pianist. If a person’s thoughts, aspirations, and, perhaps, very livelihood center around the piano, then to be unable to play one’s best, unable to play without pain, perhaps unable to play at all, is a dreadful experience. Injured pianists often become deeply depressed and discouraged . . . An injured pianist desperately needs emotional support and understanding from friends, relatives, colleagues, and teachers. (Mark, 2003, p.149)
Nevertheless, I felt that it was – understandably – difficult even for these people to grasp the extent of the impact of my injury on my life. The grief I was experiencing was not only over the loss of my health and my ability to play the piano, but also over several highly significant consequential losses that were perhaps less apparent. These losses included:
my principal talent, with which I was essentially identified
7
my identity, and concomitant self-confidence and self-esteem
my principal source of joy and means of expression, as a reserved teenager who “off-loaded” by playing my instrument rather than talking
my social and support network of friends, teachers, and lecturers
my revenue (university scholarship), my job, and my ability to support myself financially
my residence in Brisbane; my independence
my ability to pursue tertiary studies, first in music, then in arts
the hopes and aspirations of my career as a pianist
and ultimately my sense of purpose and direction, and my very interest in life.
By late 1999 – over three years after the onset of my injury – I had resigned to the fact that a resumption of my music studies in the near future was unlikely. Lacking any direction, I escaped overseas. At the end of my first year abroad, still physically unready to resume piano studies, I saw little reason to return to Australia. I took a qualification in teaching English as a Second Language – one of the few jobs that required minimal use of my hands – and remained in Europe for a further two years.
During the years I spent overseas, I began the process of emotional recovery from my loss. Over time, I began to attend piano concerts and enjoy them again. I made new friends who were unaware of my past existence as a musician, and we talked of other things. I formed an identity that was not rooted in music. Renewed independence and the challenges that come with living overseas brought regained self-esteem. By this time, my condition had improved to the extent that I was able to play for a few minutes each day, though any longer still caused lasting pain.
8
I returned to Australia and spent two years working as an English teacher trainer. I still missed music greatly, and felt it absurd to continue through life in any other field. In mid 2005, after nine years of deferring music studies due to my injury, I enrolled in the non-practical honours year of the Bachelor of Music Studies at the Queensland Conservatorium. Researching musical representations of grief for my dissertation was a continuation of an ongoing curative process. In January this year, I began my current research assistant position at the Queensland Conservatorium Research Centre.
While the physical pain of my injury no longer steers my day-to-day life, it still prevents me from playing the piano at any length. I still hold the hope and intention of one day being able to play my instrument pain-free. As the above account indicates, however, the losses relating to the injury have already profoundly affected my life. I view neither this fact nor my experiences as tragic. The lessons I have learnt over the past decade are invaluable. I am fully aware of the importance of the role of music in my life. I have formed a sturdier identity that does not rely on my musical talents. Yoga and meditation, begun in an attempt to lessen the physical pain of the injury, continue to contribute to my quality of life. I am calmer and stronger, and have acquired a sharp awareness of the value of life.
The tertiary music environment Playing-related injuries in tertiary music students are not uncommon, and first-year students appear to be particularly at risk (Anderson, 2005, p. 62). Fry found the minimum prevalence of playing-related injury across seven Australian performing music schools to be 9.3%, and more controlled research within two of those institutions revealed figures of 13% and 21% (1987, p. 35). While no systematic
9
research on the incidence of playing-related injury across Australian tertiary music schools has been conducted since then, more recent studies confirm that the high incidence of musicians’ injuries persists, predominantly among instrumentalists (Zaza, 1998, p. 1019; Waters, 2005, p. 2). Tertiary music student Yang refers to a “nearepidemic” of injuries among piano students (2001, p. 12).
Taboo Despite the level of incidence, a culture of silence often exists within tertiary music institutions regarding playing-related injuries (Bragge, Bialocerkowski, & McMeeken, 2006). This culture is not necessarily due to apathy, or to ignorance of the impact of injury on students. One tertiary music student was advised by teachers not to publicise her injury as “it could be regarded as a pianistic deficiency” (Yang, 2001, p. 13). A common perception among musicians linking injury with technical insufficiency (Weltz, 2003, p. 253) gives credence to Yang’s suggestion that shame or fear of losing career status makes students reluctant to declare physical problems (Yang, p. 13). This was indeed one reason for my own disinclination to speak about my injury within the Conservatorium environment. During the first stages of physical pain, it was also the reason for my reluctance to cancel performances and competitions.
Speculatively, but not unrealistically, a fear – among students and teachers alike – of teachers being blamed for students’ injuries may also contribute to the general lack of discourse, both within and across institutions. In my own case, the potential repercussion of my injury for the reputation of my principal study teacher (whom I continued to highly respect) was another factor in my unwillingness to discuss my situation within the institution. Fry believed that the reported incidence of injury in
10
Australian performing music schools was lower than actual incidence, due to the likelihood that “some students did not wish to be ‘uncovered’ or they may have been afraid of losing the goodwill of their teacher” (1987, p. 36).
From a broader perspective, a high incidence of injury among student cohorts holds obvious implications not only for the reputation of individual teachers, but of the institution as a whole – another possible reason for institutions to remain tacit about the incidence of injury.
Whatever the reason for the taboo surrounding playing-related injury in tertiary music institutions, a serious implication is that the wellbeing of injured students also remains off the cards. Even if compassionate grounds are insufficient motivation for institutions to provide structured support for such students, their legal duty of care and risk of liability in an increasingly sue-happy society binds them to ensure as far as possible their students’ well-being.
Recommendations With particular regard to the emotional and psychological impact of injury, I suggest that the following seven practical initiatives could aid Australian tertiary music institutions to better address the needs of their students with a playing-related injury. At some institutions, some of these initiatives are already in place. Most are low-cost enterprises that might be organised and largely steered by students. Those students who have recovered from an injury may be particularly interested in helping to implement these strategies.
11
1. Establish protocol for when a student develops an injury. As well as streamlining administrative processes, this ensures that students are aware of available avenues of support. Given that one recent study identified a significant tendency among tertiary music students to turn to their principal study teacher for advice on both physical health and psychological well-being (Williamon & Thompson, 2006, p. 424), an example of a logical course of action is given in Figure 1.
Student reports to principal study teacher with injury
Teacher uses student’s regular lesson time - to provide basic information about managing the initial stages of injury (including via information brochure - see 2); - to inform student of support networks (see 3 and 4) and encourage him/her to seek support - to inform students of administration protocol (deferment of exams, courses etc) Student maintains contact with teacher and updates him/her on condition Student follows support avenues If student wishes: teacher informs student administration Administration informs the student’s lecturers and/or teachers of other practical courses
Figure 1. Example course of action when a tertiary music student develops an injury
2. Disseminate an information brochure or booklet developed specifically for students who have developed an injury. The brochure may include the following:
avenues of support within the institution (see 3 and 4 below)
protocol (see 1) including administrative matters such as the timeframe after onset of injury within which the student is required to formally
12
forego individual lesson time with the principal study teacher, or to withdraw from other practical subjects
contact details of local medical practitioners (doctors, physiotherapists, Alexander Technique and Feldenkrais practitioners, and other mainstream and alternative therapies), preferably those with experience in RSI (repetitive strain injury) or playing-related injury and rehabilitation
contact details of local counsellors, guidance officers, clinical psychologists, and similar
basic advice (compiled with the guidance of those professionals) on dealing with the initial stages of playing-related injury, both physiologically and psychologically
contact details of local RSI support groups, if any
support websites and online discussion forums (see “Selected Support Websites”)
useful resources available in the institution library (see 6).
Principal study teachers could distribute the brochure when a student first reports with an injury (see Figure 1), and additional copies be made available in student centres, support services, libraries, and on the institution website or online student portal as a download.
3. Ensure access to a support service whereby students with an injury can discuss its academic, emotional, psychological, social and financial impact and their general wellbeing with trained staff in a confidential environment.
Andrews believes that the lack of understanding often shown by general practitioners with regard to musicians’ problems leaves injured musicians no incentive to seek their help (2005, pp. 10-11). Given the specificity of issues faced by tertiary music students with a playing-related injury, there is a comparable risk of those students being disinclined to seek help from the general counselling service of the host university. If
13
the music institute does not provide its own counselling service, relying rather on that of the university, then at least one member of the support team needs to be provided training in the specific problems faced by music students with a playing-related injury.
In addition to a counselling service, there are two further support services that may be of practical use to students with a playing-related injury: a peer note-taking system for students who are unable to write; and easy access to a computer workstation with voice recognition software. With regard to the latter, an inability to use a computer without pain not only impedes course-related research and assignment-writing, but also may make students disinclined or unable to use the internet to gather information on their injury, to participate in web-based discussion forums relating to injury, or to maintain email contact with family and friends – all of which increase isolation and the impact of injury.
Although most universities already provide these support services, music students with a newly incurred injury may not have previously had the need to draw on them, and so may be unaware they exist. This reinforces the importance of protocol and a strategy for disseminating this information to students (#1 and #2).
4. Establish a support group for students with a playing-related injury. The aims of the group could be: to provide a platform for students to share information about their injury; to provide emotional support and decrease isolation; to share ideas about injury management and further prevention; to share knowledge of potential medical avenues; and to exchange ideas about minimising the academic, financial, social, and psychological impact of injury. The support group may be largely student-directed.
14
Students who have recovered from an injury may play an important supporting or mentoring role.
Friends, family, and teachers of students with an injury could also be invited to attend. This resonates with Ostwald’s recommendation of a team approach to supporting musicians with an injury: Emotional support is always necessary, not only for the musician patient, but also for those closest to him or her, for members of the family, for friends, for students and for teachers. (in Roehmann & Wilson, 1988, p. 248)
For this reason, information about the group should be made widely available on student web portals, noticeboards, and in institution libraries and cafes, as well as in the brochure distributed by principal study teachers to injured students (2).
A common format for international RSI support groups is a two-hour meeting every fortnight or month, at which a presentation by an invited speaker is followed by open discussion (eg. London RSI Support Group, 2001-2006). Examples of presentation topics include pain management; ergonomics; voice-activated computer software; basic medical treatments; alternative therapies; and emotional aspects to injury. In addition, the New England Conservatory’s injured musicians support group maintains a referral book with reviews on medical practitioners who have experience in treating playing-related injury (Marxhausen, n.d.).
I also suggest the creation of a web-based forum where Australian tertiary music students with an injury can discuss topics of interest or concern. This format for a support group has the advantage of enabling contributors to remain anonymous – a benefit while the taboo surrounding injury persists. Each institution may construct its
15
own forum, or the discussion may be extended nationally, in which case it is likely to be more vibrant and supportive. A national forum may be hosted by the website of one institution, or by that of an independent organisation such as NACTMUS. While there are already several well-established RSI-related discussion forums on the internet (see “Selected Support Websites”), few relate specifically to playing-related injury in musicians, and none are Australian-based. It is important to remember that difficulties with typing may prohibit some injured students from participating, hence the importance of face-to-face support group meetings.
5. Cultivate discourse among students, staff, and the community on playing-related injury. Two ground-breaking international prototypes for promoting discourse on the physical and psychological health of music students are the four-year educational initiative for first year students at the Royal College of Music, London, entitled “Healthy body, healthy mind, healthy musician” (Williamon & Thompson, 2006, p. 425-426), and the seminars and workshops on musicians’ physical and mental wellbeing held throughout Berlin’s music academies by the Kurt-Singer-Institute für Musikgesundheit (Institute for Musicians’ Health) (Weltz, 2003, p. 253). Initiatives such as these have two significant benefits beyond the intrinsic: firstly, they foster an environment that shifts the perception of musicians’ health and injury as taboo; and secondly, they potentially increase understanding of the impact of injury. Each of these in turn creates a more supportive environment for students with an injury, while also encouraging awareness of prevention.
Examples of current and potential discourse-promoting enterprises in Australian tertiary music schools include student workshops that address issues of prevention and
16
management, such as the Alexander Technique workshops offered during project weeks at Queensland Conservatorium; similar seminars on prevention and management for principal study teachers; encouragement of research interest in playing-related injury among RHD students and academics; and the collaborative Guildhall/ESMUC project mentioned in the abstract to this paper (Rosset i Llobet & Odam, 2007).
These initiatives promote a more vigorous national discourse on playing-related injury within tertiary music institutions. The dialogue may also extend into the community via groups such as the Friends of the Canberra School of Music or the Friends of the Western Australian Academy of Performing Arts. These groups provide a means for interested members of the public to support both the students and the objectives of the institutions (ANU, 2007; WAAPA, 2005). As such, they may engage in the discourse surrounding playing-related injury, for example through attending (or helping organise) workshops and seminars on the topic, or otherwise become involved in the implementation of support strategies for students such as those detailed in 2 to 4.
6. Maintain a comprehensive selection of resources on playing-related injury in the institution library. The resources need to be recent, readable, and address the emotional and psychological management of injury as well as issues of prevention, aetiology, and physiology. A flyer or simple brochure collating details of these sources and their location in the library could be made available at the library help desk or in other prominent library spaces.
17
7. Join the RSI and Overuse Injury Association of the ACT, the only major Australian organisation specifically providing for the needs of RSI sufferers. Professional membership by tertiary music institutions raises the profile of the association and supports its cause. The association website (www.rsi.org.au) may be publicised through the institution’s support services and materials (see 2 to 4); students may wish to receive the additional telephone support and referral service by becoming individual members of the association. The quarterly newsletter containing suggestions for prevention and treatment of injury could be made available for reference in the institution library. For non-ACT-based institutions, the listings of events and seminars in the newsletter may inform the possibility of organising similar local events through the institution’s injury support group (see 3).
Conclusion The goal to eliminate the incidence of playing-relating injuries in Australian tertiary music students, while ambitious, is both worthwhile and long overdue. The recent Queensland Conservatorium/Guildhall/ESMUC initiative indicates that promising steps are being taken towards this goal. The resulting publication, The musician’s body: A maintenance manual for peak performance (Rosset i Llobet & Odam, 2007), will become available in Australia in the next months, and its dissemination to tertiary music institutions across the country holds the potential to fuel a forward-looking and affirmative dialogue about playing-related injury, both inter- and intra-institutionally.
While a lively discourse on injury prevention is by all means to be encouraged, Australian tertiary music institutions need to be vigilant that those students who do suffer injuries are not forgotten. I strongly believe the challenges I faced, especially in
18
the first months after the development of my injury, would have been alleviated through basic institutional guidance and support. There is a pressing need to provide a supportive institutional environment for students experiencing the physical and emotional pain of injury.
In brief, it is certainly important for tertiary music institutions to continue the as-yet embryonic discourse on issues of injury prevention and management. Recognising, acknowledging and addressing the personal, human aspect to playing-related injury is equally imperative, and a matter of urgency.
Selected support websites RSI and Overuse Injury Association of the ACT http://www.rsi.org.au/ Self Care for RSI http://www.selfcare4rsi.com RSA Awareness http://www.rsi.org.uk/default.asp Dutch RSI Association http://www.rsi-vereniging.nl/english/ Sorehand An online community for people with repetitive strain injuries http://www.ucsf.edu/sorehand/ Musicians and injuries http://eeshop.unl.edu/music.html RSI-Relief Repetitive Strain support and recovery http://www.rsi-relief.com/rsi-links/rsi-community.html
References Ackermann, B. (2003). Performance-related musculoskeletal disorders in violinists. Unpublished doctoral dissertation, Sydney Conservatorium of Music. Andrews, E. (2005). Muscle management for musicians. Lanham, Maryland: Scarecrow Press. Anderson, J. (2005). “What problems fiddlers pose”. Postural approaches for violinists and postural awareness in young Australian violinists. Unpublished honours dissertation, Griffith University, Brisbane.
19
Australian National University (24 April, 2007). Friends of the Canberra School of Music. Retrieved 29 April, 2007, from http://www.anu.edu.au/music/about/friends.php. Bragge, P., Bialocerkowski, A., & McMeeken, J. (2006). Understanding playing-related musculoskeletal disorders in elite pianists: A grounded theory study. Medical Problems of Performing Artists, 21(2), 71-79. Retrieved 20 November, 2006, from http://www.sciandmed.com/mppa/. Collett, S. (2005). An investigation of the teaching and learning of injury-preventative principles to developing pianists. Unpublished honours dissertation, Sydney Conservatorium of Music. Fry, H. J. H. (1987). Prevalence of overuse (injury) syndrome in Australian Music Schools. British Journal of Industrial Medicine, 44, 35-40. London RSI Support Group. (2001-2006). Previous Central London RSI Support Group Meetings. Retrieved 29 April, 2007, from http://www.londonrsisupportgroup.org.uk/index/ page/meetings-previous. Manchester, R. A. (Ed.) (2006, September). Medical Problems of Performing Artists, 21(3). Retrieved 20 November, 2006, from http://www.sciandmed.com/mppa/. Manchester, R. A. (Ed.) (2007, March). Medical Problems of Performing Artists, 22(1). Retrieved 18 April, 2007, from http://www.sciandmed.com/mppa/. Mark, T. (2003). What every pianist needs to know about the body. Chicago: GIA Publications. Marxhausen, P. (n.d.). Support groups. In Musicians and injuries. Retrieved 29 April, 2007, from http://eeshop.unl.edu/supprsi.html. Milanovic, T. (1997). An overview of the primary causes and subsequent management of overuse injuries as incurred by musicians, with particular focus upon pianists. Unpublished honours dissertation, Griffith University, Brisbane. Milanovic, T. (2005). To play or not to play: An exploration of students’ experiences of the Taubman approach to piano. Unpublished masters dissertation, Griffith University, Brisbane. Montparker, C. (1986). The indomitable Leon Fleisher. Clavier, Oct 1986. Morris, M., Steinberg, H., Sykes, E. & Salmon, P. (1990). Effects of temporary withdrawal from regular running. Journal of Psychosomatic Medicine, 34(5), 493-500. Retrieved 14 November, 2006, from PubMed Services Journals Database. Roehmann, F.L. & Wilson, F.R. (Eds.). (1988). Music and Medicine. Panel discussion. In The Biology of Music-making. Proceedings of the 1984 Denver Conference, 242-267. St Louis, Missouri: MMB Music. Rosset i Llobet, J. & Odam, G. (2007). The Musician’s Body: A maintenance manual for peak performance. Oxgon, UK: Ashgate. Stedman, T. L. [electronic version]. (c2006). Tenosynovitis. In Stedman’s medical dictionary. (28th ed.). Baltimore, Md: Lippincott Williams & Wilkins. Walker, E. M. (2006). Personal case history: Playing-related injury, depression, and treatments. Poster presentation at The twenty-fourth annual symposium on medical problems of musicians and dancers, 22-25 June, 2006. Denver, Colorado: Performing Arts Medicine Association. Waters, M. (2005). Playing-related injury in violinists: Attitudes and priorities of South-East Queensland violin teachers toward beginner violinists aged 7-10. Unpublished honours dissertation, Griffith University, Brisbane. Weltz, K. (2003). Health Education. The Strad, 48(2), 250-253. Western Australian Academy of the Performing Arts (2005). Friends and sponsors: Friends of the Academy. Retrieved 29 April, 2007, from http://www.waapa.ecu.edu.au/support/friends.php. Williamon, A. & Thompson, S. (2006). Awareness and incidence of health problems among conservatoire students. Psychology of Music 34 (4), 411-430. Retrieved 1 May, 2007, from http://pom.sagepub.com/ Winspur, I., & Parry, C. B. W. (2006). The musician’s hand: A clinical guide. London: Taylor & Francis. Workman, D. (2006). The percussionists' guide to injury treatment and prevention: The answer guide for drummers in pain. New York: Routledge. Yang, K. C.-H. (2001). Pianists’ physical injuries: Strategies of treatment and prevention. Unpublished masters dissertation, Griffith University, Brisbane. Zaza, C. (1998). Playing-related musculoskeletal disorders in musicians: A systematic review of incidence and prevalence. Canadian Medical Association Journal, 158, 1019-1025.
Catherine Grant is a Research Assistant at the Queensland Conservatorium Research Centre, Griffith University. She is delighted to be working in the field of music. 20
