Lifetime Prevalence of Upper-body Musculoskeletal Problems in a Professional-level Symphony Orchestra: Age, Gender, and Instrument-specific Results

Abstract

Instrumentalists are at risk to develop upper-body musculoskeletal problems (MSKPs). Identified risk factors include age, gender, instrument played, joint laxity, and poor technique or posture. In this study, we established the prevalence of MSKPs that affect the ability to play an instrument in the population of a professional-level symphonic orchestra and the relation of these problems to gender, age, and instrument. The members of the Puerto Rico Symphony Orchestra were recruited voluntarily. A questionnaire was used to obtain information on demographics, instrument played, and history of MSKP severe enough to affect their playing ability. Questions also covered alleviating and aggravating factors, upper-body areas involved, type of symptoms, and type of treatment sought. After the questionnaire was completed, all players underwent a neuromusculoskeletal upper-body examination. Of the 75 musicians participating, 81.3% reported having had an MSKP that affected their ability to play. Of these, 83.6% reported their MSKP was directly associated to playing. Females were more commonly affected, 87.5% vs. 79.7% for males. Lower-body strings (cello, bass) players and percussionists (93.3% and 100%, respectively) and younger (22-29 yrs) and older (50-61 yrs) populations (83.3% and 90.9%, respectively) reported more MSKPs. These age groups played more hours per week (28.7 and 32.0 hrs, respectively). In all groups, low back pain was the most common complaint, present in 75.4% of those with MSKPs. Upper-body strings (violin, viola) players also reported neck and left shoulder problems. Contributing factors include hours of exposure and technical expertise. Female gender, age, and instrument played were found to be risk factors for developing MSKPs in this population.