Median and Ulnar Nerve Conduction Studies in Young Adult Violinists

Abstract

The incidence of musculoskeletal injuries among musicians is well documented. The purpose of this study was to describe the neural status of the median and ulnar nerves in young adult violinists. Twenty volunteer violinists were recruited from the Belmont University and the Vanderbilt University Blair School of Music Orchestras (age 18-30 years). The subjects completed a history form and underwent a physical examination. The electrophysiologic status of the median and ulnar nerves in both upper extremities was then evaluated using sensory and motor nerve conduction studies (NCSs). Upon completion of the NCSs, educational materials to prevent upper extremity cumulative trauma disorders were distributed to the subjects. In these subjects, the history and subjective examination were largely noncontributory of upper extremity neuropathies. Their physical examinations were also not diagnostic of upper extremity neuropathies. All subjects’ median and ulnar NCSs were normal when compared with a chart of normal values. However, when comparison studies between the median and ulnar NCSs in the same extremity were performed, seven subjects showed differences in their distal motor latencies (>1.0 msec) or distal sensory latencies (>0.5 msec) that could be suggestive of early median neuropathy at or distal to the wrist. In this descriptive study, 20 young adult violinists had no subjective findings of median or ulnar neuropathy, had normal physical examinations of the neck and both upper extremities, and had normal median and ulnar NCSs when compared with a chart of normal values. However, when comparison NCSs between the median and ulnar nerve in the same extremity were performed, seven violinists were found to have NCS values suggestive of early median neuropathy at or distal to the wrist. In this population of 20 young adult violinists, seven musicians were found to have electrophysiologic findings suggestive of early median neuropathy at or distal to the wrist.