Research Review- Overuse Syndrome in Musicians
by Madeline Stewart July 13th, 2020
Overuse Syndrome in Musicians
Purpose of the research:
This review is a summary of the research article “Overuse Syndrome of the Hand and Wrist in Musicians: A systematic review”, presented by Betzl, Kraneburg, and Megerle (2020). This research article aimed to study overuse injuries in musicians and discover what current research says regarding prevalence, prevention, diagnosis, and treatment of overuse syndrome in musicians' hands and wrists.
Quality of the research:
According to Betzl, Kraneburg, and Megerle (2020), the literature on this topic is sparse, and the data quality varies greatly. The majority of the research surrounding musicians overuse injuries lacks original data and more often includes clinicians’ opinions and personal experience. This makes a systematic review and meta-analysis conducted using standard guidelines impossible.
Overview/summary of research topic:
Overuse syndrome is a diagnosis commonly given to musicians who present with non-specific symptoms and pain that cannot be attributed to structural alternations or specific conditions (Betzl et al., 2020). Even though this is a prevalent diagnosis, there is no universal definition for overuse syndrome, and there is little data published regarding this condition. According to Betzl et al. (2020), the prevalence of playing-related musculoskeletal disorders in musicians is between 30% and 47%, and the lifetime prevalence has been reported as being as high as 89%. Three of the four most affected body parts are the wrist at 43%, the forearms at 36%, and the fingers at 34% (Betzl et al., 2020). In addition, 35% of music students who report experiencing playing-related pain do not ask for outside help. Only 28% of those who seek treatment by a medical professional find their treatment satisfactory (Betzl et al., 2020).
Summary of research presented:
According to Betzl et al. (2020), there is a significant lack of quality research regarding this condition and its relation to musicians. In addition, there is currently no universal definition, diagnostic strategy, or treatment method. A more holistic approach to addressing overuse syndrome is essential. A holistic approach includes preventative measures, individualized treatment, and psychological support and considerations. According to Betzl et al. (2020), prevention is essential in the management of overuse syndrome. General prevention strategies should include increasing awareness among music students and musicians, promoting understanding by healthcare professionals regarding the physical and psychological demands of being a musician, and treatment protocols that include psychotherapeutic components and physical therapy.
Important/useful findings from this review
Risk Factors: (Things to be aware of).
A sudden increase in practice or playing time
Changes in teacher, conductor
Changes in psychological stress
Poor instrument fit
Prolonged muscular effort (holding the weight of your instrument)
Faulty technique
Joint laxity
Symptoms: (Stiffness, tingling, or abnormal sensations may proceed overuse syndrome).
Pain
Weakness
Stiffness
Loss of control during or shortly after playing
Pain at rest or at night
Pain when performing everyday tasks
Sensory changes
Swelling over painful areas
Unintended, uncontrollable finger movement (can also indicate focal dystonia)
Prevention: (Most effective way to prevent injury).
Practicing technique
General well-being
Warming up with exercises
Taking breaks during practice sessions
Balancing the hours of repetitive practicing
Physical conditioning-Poor physical health and conditioning have been linked to overuse syndrome in musicians. Specifically, instrumentalists with pain in their upper body joints were found to participate in significantly less physical activity than their colleagues without pain (Betzl et al., 2020).
Treatment options: (there is no standard treatment at this time)
Radical rest treatment-period of prolonged rest and avoidance of all pain-inducing activities. Then a slow reintroduction to playing accompanied by physiotherapy and occupational therapy. The results of this method are unconvincing in the research that has been conducted.
Individualized rehabilitation programs that incorporate physical conditioning (specifically of the back and upper limbs), and may include splinting, the use of technical support (straps etc.) and activity adaptations. This approach has demonstrated marked improvements.
Feldenkrais Method-no studies conducted
Alexander Technique- no studies conducted
References
Betzl, J., Kraneburg, U., & Megerle, K. (2020). Overuse syndrome of the hand and wrist in musicians: a systematic review. Journal of Hand Surgery (European Volume), 45(6), 636–642. https://doi.org/10.1177/1753193420912644.