Running head: ATHLETICISM INHERENT IN MUSIC !

Athleticism Inherent in Music:

An Analysis of Injuries, Training, and Prevention for Young Musicians

Adam Bess

Indiana State University

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Athleticism Inherent in Music:

An Analysis of Injuries, Training, and Prevention for Young Musicians

Introduction

In the world of olympic training, competitive athletes are well-known for their excessive

training regimens, precise dietary allotments, and emphasis on overall mastery physical health.

The peak performance required of these athletes is heralded during every olympiad, as nations

rally behind their representatives competing in contests of superhuman ability. Athletes often

train their entire lives, beginning at incredibly young ages, to reach their highest potential in their

respective sport (Stokstad, 2004). A topical analysis of olympic training methods reveals that

“the differences within top-level athletes are so marginal that, regardless of how minor, it is

important to take every opportunity that can improve performance,” (Zwols & Sierksma, 2009).

Music-making as a corporeal phenomenon matches itself with athletics in terms of bodily

involvement. Without opposable appendages, a drum would not strike itself; without vocal folds

and lungs, voices could not be raised in singing performance. However, compared with athletic

sports such as running, swimming, and jumping, these musical activities involve many more fine

motor skills than large groups of muscles (Palac & Sogin, 2005). But the foundational principle

remains the same; the body’s abilities, flexibilities, and physical limitations can be directly

correlated to overall success in performance, both athletically and musically.

Similar to sports participation, formal music-making and corresponding training can

begin at very young ages, with violinists often enrolling in the traditional Suzuki method of

instruction between the ages of 3- and 5-years old (Scott, 1992). During the prime developmental

years of a child’s physique and muscular-skeletal growth (ages 2-years-old through puberty),
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activities such as sports, dance, and even music can have profound impacts upon the child’s

growth and development through the adolescent stages, especially if these activities are not

instructed properly and proper physical self-care is not emphasized from the early stages (Taft,

1991).

Beyond the risks of common sports injuries incurred while children are involved in

organized sports, children are becoming injured more from increasing amounts of repetitive

movement over longer-sustained durations of time. “These… ‘over-use’ or ‘abuse’ injuries, such

as tendonitis [and] stress fractures,” were relatively uncommon in children (Taft, 1991). Now,

however, these injuries are becoming increasingly common in child diagnoses, due to adults who

“cajole children to exercise, train, and compete at a level beyond their bodies’ ability to

cope.” (Taft, 1991). These issues are not solely related to sports and athletic-related activities;

children participating in music, especially at younger ages, have been observed suffering from

the same stress-related, overuse physical injuries as adults in similar fields (Guptill & Zaza,

2010).

The knowledge of risks to musicians’ health from high-level, high-intensity participation

in music study and performance is not revolutionary. Additionally, “concerns about the risk of

becoming injured have been increasingly present in the music world,” which should indicate that

the issue of music-related injuries is in fact on the forefront of research questions (Guptill &

Zaza, 2010). While researchers are taking aim and targeting these injury issues, a majority of the

available prominent research outlines injury prevention techniques only for specific instrument

groups, and fails to provide documentation and wellness strategies for students of secondary-

school age, focusing instead on younger age groups (Guptill & Zaza, 2010).
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By academic standards, music education curricula of higher education institutions fall

short of preparing music education students for the instruction of proper performance techniques

among all potential instruments in a secondary music program. Many technique courses do

provide accurate information about instrument-specific performance practices, which may

include brief sections of negative player health as a result of improper technique. However, the

pace and orientation of this curriculum are more generalized towards overall instrument

technique for high-quality performance, not for injury prevention over sustained periods of time.

As a result, many high school students have observed a lack of health-based instruction, from the

beginning of instrumental instruction (often in middle school, grades 6-8) through high school-

level performance (Pierce, 2012).

The exception to this observation rests in the vocal area of music education, where a

heavy, collegiate curricular emphasis is placed upon the health of both student and teacher in the

vocal classroom. When compared to instrumental classrooms, vocal classroom instruction

provides more detailed warmup routines focused on better health for the voice and a warning

emphasis on the dangers of improper singing technique. Additionally, entire professional

development seminars and “virtual academies” have been opened and implemented, focusing

solely on the vocal health of both student and teacher in the music classroom (Ostrem, 2004).

The main issue surrounding injury-based research in music education seems to hinge

upon the lack of data surrounding physical problems in the music performance profession,

particularly among young musicians. This is not to be confused with proper warmup

methodologies and techniques, of which there are countless options available to music teachers

of all disciplines. Discrepancies in enumeration and differing definitions as well as

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methodological errors within leading journals and studies contribute to the general

misinformation about music-related injuries in children, ultimately resulting in an increase of

widespread poor performance practices among our secondary-school music programs (Guptill &

Zaza, 2010).

Music as a mental stimulant and outlet of artistic expression has presented its benefits

without question. Countless educational studies have revealed the positive impacts of music on

test scores, graduation rates, and vocational placement and performance. However, as

educational tools, musical activities are becoming increasingly athletic in nature, thus requiring

specific skills and knowledge bases to prepare students for potential wellness impacts and injury

prevention. This paper proposes to outline and investigate causes and common diagnoses of

music-related injuries as well as prevention techniques, which can be scaled appropriately

between the ages of 11 and 18 (grades 6-12). Additionally, comparisons will be made between

secondary-level athletics and music programs—the health opportunities and resources afforded

to both groups as well as the training received by educators in those specific areas—in order to

demonstrate the need for a comprehensive health emphases spanning all curricular areas of

secondary schools.

To achieve these efforts, these specific questions will guide research and provide

summative results in a comprehensive manner: Why is athleticism becoming more attributed to

music activities and what kinds of activities are becoming increasingly popular?; What

misconceptions have risen around general health and wellness with respect to music?; What is

the importance of athletic skill identification in music activities?; What kinds of injuries are

common to musicians?; How can injury prevention be taught appropriately across the age
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spectrum of secondary-level students?; And, how might music educators best implement health-

based curricula without sacrificing excessive time otherwise spent learning?

In support of the research questions outlined above, implementation of specific research

methodologies should guide the discoveries and answers to these questions in meaningful,

relatable, and quantifiable ways. By using peer-reviewed journals and articles, as well as their

respective data tables and references therein, the results of this paper should be presented as an

authoritative collaboration and synthesis of the findings and postulations of leading researchers

and academics in the field of music education and physical training. As stated before, one of the

biggest plagues of injury research in music education is the result of poorly-planned research and

inaccurate and confusing synthesis of results. By drawing comparisons between music education

journals in which common injuries and prevention practices have already been studied, this paper

will attempt to combine the results in a more meaningful, qualifiable way so as to serve as a

benefit to educators of secondary instrumental music.

By providing clarity and accessibility to information about the issues surrounding injury

within the activities of music education, one intention of this research is to bring about awareness

to participants and educators directly involved in musical activities. As an intended result, music

educators who consider the findings and suggested results should therefore create a more

positive and healthy learning environment in which students can be freely encouraged to practice

safely and productively, well-within their age-respective capabilities. The benefits to the music

community as a whole would produce more intelligent musicians and educators who can freely

practice and perform their music without fear of injury risk, which could otherwise draw the

curtain on a lifetime of worthwhile music-making.

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Athleticism and Music

In the eyes of many school corporation budgets across the country, marching band, show

choir, and indoor visual and music arts performances are not seen as sports activities nor worthy

of the same funding received by high school football, basketball, and volleyball programs. These

athletic designation benefits have not yet been rightfully bestowed upon the visual arts, even as

they incorporate more movement and athleticism in regular performance. In an article

summarizing recent educational financial policy trends, one author puts forth simple

comparisons;

“There are several areas—student engagement; development of positive character

traits such as self-discipline, teamwork, and personal responsibility; and capacity

to bring people together to build community—in which both football and music

have similar positive impacts. There is little, if any, difference, for example,

between the sacrifices made, lessons learned, and effort required as a sports-team

member whose goal is winning games and a band member who is working to

achieve a particular ‘sound.’” (Gerdy, 2015)

Regardless of the similarities and parallels which can be drawn between these activities and

popular team sports, the performing arts are still viewed as separate—and not at all equal—

entities in regard to budgetary allotments, public image, and support.

How, then, did large-scale movement and choreography enter into the performing arts as

musical and visual activities grew larger and more popular in spite of funding deficits and lack of

appropriate athletic designations and treatment? While the traditional sit-down performing

ensembles still thrive, public schools have seen large increases in the popularity of activities and
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opportunities under the governance of organizations such as Drum Corps International (DCI) and

Winter Guard International (WGI). Open to students up to age twenty-one, these “sport of the

arts” and “marching music’s major league” organizations claim to “bring the life-enriching

benefits and enjoyment of…performing arts,” (About Drum Corps International, 2017) and

“inspir[e]…participants to achieve the highest artistic and creative standards,” as mission

statements (What is WGI, 2015).

These organizations are rightfully entitled as the professional sports association

equivalents in the area of performing arts, yet athletic performance and participation are not

specifically enumerated in the mission statements, values, or purposes of either group. Despite

this fact, the necessity of high athletic performance for these groups should not be undervalued

nor understated. In a performance health study conducted by researchers at Indiana State

University, DCI members were monitored during performance using equipment similarly used to

detail the physical demands of athletes during athletic training sessions. Researchers found that

during the entirety of the performance, the ensemble members’ heart and respiratory rates and

metabolic functions were on par with “someone who was running a 400- or 800-meter dash

maximally,” (Greenwald-Gonella, 2015). Similar findings have been observed in other groups

spanning DCI, WGI, and even high school band programs competing at high levels.

The popularity of these activities can be directly correlated to competition, as well as the

subsequent wins and losses inherent to any kind of competitive activity. In this way, performing

arts activities today are more closely resembling participation in high school-sanctioned athletics

and extracurricular recreational sports leagues and clubs. Students want to participate, but they
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want to win. The higher the stakes of competition and promise of tangible reward, the greater the

participation factor for these performing arts groups.

The active participation in DCI, WGI, and other athletic performing arts groups can be

attributed to the increased integration of DCI- and WGI-like performance practices at the high

school performance level. The Bands of America (BOA) performance circuit—in which all

competitive marching schools can participate—places greater scoring emphasis on performances

which utilize choreographed body movements and complex athletic skills rather than musical

sophistication and effect. The overall performance (subtitled general effect, or “GE”) is judged

more based upon these athletic dance factors when compared to state circuits which rank groups

more based upon their musical ability (Music for All, 2010). Bands of America has seen growth

in participation across the country, as more schools choose to compete in the national BOA

circuit in tandem with local state music association performances and competitions. As more

students are introduced to the BOA-style of performance, those same students are increasingly

attracted to the similar performances of DCI and WGI groups. Those students who are fortunate

enough to participate in those groups are viewed as those students who “went pro” when

compared to high school athletics participants.

The close competition and incredibly detail-oriented demand of skill required for this

level of performance fosters a culture of heightened athleticism, one in which students may not

be the best prepared athletically. The same performance study by Indiana State University found

that in the case of one high school marching band, nearly all ensemble performers “reported sore

or stiff muscles after practice,” and that at least one-third of performers “had suffered injuries on

the field,” as well as “tiredness, nausea, faintness, and heat-related illness[es],” (Greenwald-
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Gonella, 2015). Once an injury is experienced, the likelihood of injury repetition increases as

well, thus increasing the importance of proper physical care of students who choose to

participate in athletic performance activities.

Music educators who actively safeguard against performance-related athletic injuries will

no doubt see the best results for student performance longterm. Understanding the causes, risks,

and treatments for performance related injuries, both indoors and out, will ultimately protect the

students and keep their activism alive throughout their performance careers. As athletic-based

movements and ideas continue to stream into music-related activities, athletic training-based

approaches become increasingly essential to music programs of all kinds. Unfortunately, not all

music educators have a fluent background in athletic training, and rather than be ignorant of risk

factors among musicians, educators should be more well-informed and vigilant so as to keep all

students at peak performance. 


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Injury Misconception and Athletic Identification

Some of the most solidified stereotypes in the popular culture of public school systems

resonate from the performing arts department, where band, choir, and orchestra students are

labeled as the music geeks, choir nerds, or the orchestra dorks of the school. Rather than shirk

the label, many students wear it as a badge of honor and strive to fulfill their musical potential by

practicing longer and with more intensity in an attempt to perfect their performance. This drive

for success does not stop beyond high school graduation, however. Music students in higher

education work even more diligently and with more dedication to meet the standards their

collegiate musical studies require. Unfortunately, this intensity of study and practice may be

leading unaware students of all age levels towards potentially career-ending health issues.

Common in all levels of professional sports, athletes who report injury or pain are often

tended to immediately, given proper medical care, and medically prepared to quickly return to

the game or event at hand. In high school and even some collegiate-level music departments,

however, the scene is much harsher. Not wanting to upset music directors or private lesson

instructors, students have reported practicing through tremendous amounts of pain, past breaking

points, and suffering the consequences of painful and expensive medical rehabilitation in order to

return joints and extremities to proper working order (Palac, 2008). Music students are instructed

to provide ample time for warming up the lips and fingers in preparation for practice sessions or

performances, but often underestimate the amount of time it truly takes to be “warmed up,” or in

a state of body which presents the least amount of risk for injury (Guptill & Zaza, 2010). This

risk factor along with other misconceptions about musical injury only serve to inhibit musical

development and career longevity, in some cases due simply to misinformation and unawareness.
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Among music education professionals, the most agreeable misconception surrounding

musical injuries involves the issue of overuse, or “playing through the pain,” ((Palac, 2008).

Characterized as “persisting pain and tenderness in the muscles and joint ligaments of the upper

limb due to excessive use,” researchers in Australia began to seriously document the prevalence

of injuries caused by strain and overuse in practicing musicians as early as the 1980s (Fry, 1987).

However, in the decades since these published articles, musicians and teachers alike have

continued to ignore the warning signs of overuse injuries in the pursuit of perfection.

Much like athletic professionals, repetition is key for musicians. Students spend an untold

number of hours practicing scales, arpeggios, tone and intonation building exercises and

passages from the repertoire in order to hone their craft. The countless hours spent using the

same repetitive motion or muscle formation is the leading cause of strain, overuse, and

subsequent injury among musicians (Palac, 2008). Particularly among string players, overuse

injuries are especially widespread, with studies “show[ing] a prevalence of painful overuse of

over 50% in these orchestral musicians,” (Fry, 1987). Additionally, the severity of these injuries

seemed to span more than a few months, with the majority of injured musicians reporting injuries

persisting between one and five years (Fry, 1987).

Though initial reports of overuse injury originated in the mid-to-late twentieth century,

similar injury reports have persisted throughout the years and continue to reveal unhealthy

practice strategies among large groups of musicians. One population especially at risk for injury

involves beginning students entering school music programs or beginning music lessons at

young ages. Unlike college-age students, younger musicians often do not receive the same

health-minded music instruction that academia professors can impart as younger students are
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often taught by the local music teacher, musician, or another who may not understand fully the

ramifications of unhealthy practicing habits. Additionally, to match the rapid growth of children,

instruments must be appropriately sized in order to have the least-restrictive effect on the child’s

practice and performance ability. Unfortunately, as instruments are often expensive, many

parents will scoff at the notion of buying multiple sizes of one instrument, citing instead that “the

child will grow into it eventually,” (Dawson, 2006). While parents who subscribe to this ideology

will undoubtedly save money on instruments, they unknowingly could bring physical harm to

their student and risk their child’s overall musical experience.

Among students in music programs, particularly at collegiate levels, one highly-revered

“badge of honor” is the amount of time spent in the practice room performing these repetitive

motions which too often lead to injury. This misconception about practicing has led some

students unknowingly towards injury, when they thought they were improving their performance

ability through countless repetitions. Lately, savvy music instructors have opted not to instruct

students to practice longer and more often, but to practice smarter. Instead of spending three

hours minimum per day practicing, students are asked to take quick breaks in between practice

sessions of forty-five minutes to an hour. In addition, students should maximize these breaks by

using the hands, arms, and lips as little as possible (Palac, 2008).

The injury-preventative steps taken by music instructors and directors alike have

undoubtedly led to a decrease in injury reports of musicians. However, students must take their

own humble approach in understanding when the pain during practice is too much. One author

writes in a leading music education journal that, “knowledge is power,” and, “early recognition

can lead to early intervention to minimize or treat these conditions, and in many case this may
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suffice,” (Dawson, 2006). Injury identification starts with the student, and with the aid of an

instructor and medical professional, potential overuse injuries can be prevented long before

lasting damage is incurred.

Aside from injuries and risks factors commonly seen from sit-down ensemble

participants, imagine the increased injury risk when musicians prone to overuse-type injuries are

taken outside and placed on the move. Now coupled with overuse and strain injuries of the upper

body, face, arms, and fingers are injuries involving the lower body specifically and even the

respiratory system. Most DCI groups as well as high school marching band groups rehearse

during the sweltering heat of the summer months, many times in week-long blocks of nine to

twelve hour days. The strain of the heat coupled with repetitive movements involving both fine

and gross motor movements can produce devastating health results if performers are not

monitored closely and given sufficient break times during taxing rehearsals.

These band camps, commonly equated with athletic training camps in which students

spend large amounts of time outside in the heat, often times can be treated with the same

precautionary measures with regard to heat advisories, water breaks, and on-hand medical staff;

but not always. While some football programs are fortunate to have medical trainers on staff to

help students recuperate from heat-related exhaustion and stress injuries, many outdoor musical

groups are barely lucky enough to have a band parent with some medical training and a first-aid

kit on hand with which to treat sunburn, minor cuts and bruises, and insect bites (Greenwald-

Gonella, 2015). The students involved in both athletic and music programs are subjected to the

same kinds of sports-related stresses in most cases and therefore should receive the same athletic

designation when appropriate. If students are to participate in outdoor summer activities like
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marching band, football, or soccer camps, they all should have at their disposal the same medical

resources to keep them healthy and able to participate fully in the activity.

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Injuries of Dexterity, Sensitivity, and Flexibility

When visiting a traditional band or orchestra classroom, one can immediately observe

that the instruments are all made to vibrate, resonate, or otherwise produce pitch with the

assistance of the hands in some fashion. Some instruments will involve more hand dexterity than

others, requiring greater use of fine motor skills. Stringed instruments, for example, produce

sound entirely from the impetus of both left and right hands. Conversely, brass instruments

typically only utilize one hand—or no hands at all, in the case natural horn performance—in

concert with an embouchure formation of the lips to produce vibrations interpreted as sound.

Woodwind instruments fall directly in the middle of this continuum, involving both left and right

hands as well as an embouchure formation to produce sound on the instrument.

As previously mentioned, orchestral musicians were found to have the greatest risk of

overuse injury, particularly in the areas of the fingers, hands, wrists, and both upper and lower

arms (Fry, 1987). Because of their employment of both hands for performance, string

instruments require the most amount of care in terms of hand and finger dexterity while

woodwind instruments come in close second. In the same study, woodwind instruments were

found to have the greatest incidence of performance-related overuse injury overall because of

their involvement of both hands as well as the lips in embouchure formation (Fry, 1987). Brass

players were not exempt from issues related to hand dexterity and overuse injury, but were found

to be much more at risk for mouth, face, and throat-related injuries (Fry, 1987).

For musicians using their hands as the primary sounding technique, common injuries

range between common joint, muscle, and tendon soreness to more severe injuries such as

fibromyalgia, carpal tunnel syndrome, and severe strains involving the wrists, fingers, and arms
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(Palac, 2008). In the mid-to-late 1900s, these types of injuries were commonly referred to by the

blanket term of overuse syndrome (The Medical Problems of Musicians, 2001). Also noted by

the same journal, the diagnoses of tendonitis and tensynovitis were common during the same

time frame, accompanied by variable symptoms of “pain, swelling, stiffness, weakness, and

tingling,” (The Medical Problems of Musicians, 2001).

Today, the diagnoses of fibromyalgia and carpal tunnel syndrome (CTS) are increasingly

widespread among practicing musicians, including those of younger age. Particularly for

woodwind and string players, CTS is commonly seen as a diagnosis for an overuse injury. CTS

in particular documents risk factors including “highly repetitive movements at a fast pace using

forceful movements,” (ChiroTrust, 2016). Any virtuosic display of technique for any instrument

will demonstrate just that, fast-paced movements, often repetitive, and some with great force.

Particularly with string and woodwind instruments, these idiomatic aspects of technique are

unavoidable, and are unfortunately leading to potential injury for a great number of musicians.

While fibromyalgia has not yet been causally related to repetitive strain injuries incurred

by musicians, those who do suffer from the condition often compound symptoms and delay any

kind of treatment or recovery due to the intense, repetitive movements involved in music-making

(Mayo Clinic, 2017). The debilitating pain of fibromyalgia has been attributed to endurance

athletes and musicians alike along with symptoms of anxiety, depression, and fatigue. Treatments

for both fibromyalgia and CTS vary case by case, but the most promising recovery treatments

involve preventative care such as stretching and flexibility exercises, as well as early diagnoses

for both conditions (Mayo Clinic, 2017).

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For all wind instruments, the single-most important factor of sound production is the

wind stream used to power the instrument. With the exception of a few marginalized instruments,

nearly all wind instruments are powered by a wind stream produced by the lungs of the musician.

For brass and woodwind players, the wind is channeled through the lips in formation of an

embouchure and into a mouthpiece where it either vibrates an air column or reed in order to

produce sound. Before the wind stream ever reaches the air column or reed, the air must first

pass through the aperture of the lips. The shape of this aperture in formation of the embouchure

requires incredibly-fine muscle dexterity and sensitivity for proper air stream direction, speed,

and support. As a result, musicians are tempted to use too many muscles of the face surrounding

the mouth at one time in order to “force” the air through the instrument. In this way, musicians

set themselves on a path towards potentially dangerous muscle memory which could result in

painful muscle fatigue, limited range on the instrument, and a decrease in overall sound and tone

quality.

Musicians who are not properly trained from the beginning steps as a wind

instrumentalist can develop these potentially harmful habits in embouchure formation,

potentially requiring months of frustrating and tedious embouchure adjustment. Unfortunately,

many of these musicians do not know they have developed an improper embouchure until they

reach collegiate study. Many continue to play throughout their high school careers and adult lives

with unhealthy mouth shapes and embouchure formations which, when left untreated or

uncorrected, can lead to a loss of music-making ability (The Medical Problems of Musicians,

2001).
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The primary cause of injury for brass and woodwind performers in terms of embouchure

development comes not only from overuse, but primarily from acquired muscle tension due to

improper embouchure development (The Medical Problems of Musicians, 2001). Over-pinching

and tightness can cause the facial muscles which form the embouchure to easily become

overworked, strained, and otherwise fatigued (The Medical Problems of Musicians, 2001).

Additionally, when too many of the facial muscles are used in embouchure formation, this causes

unnecessary pain and strain on muscles that would otherwise be left undamaged if the musician

was properly trained in embouchure formation.

Unlike injuries of dexterity caused by improper technique, injuries involving the facial

muscles are much harder to detect, diagnose, and correct due to their bodily placement. It is

much easier for a band director or private instructor to observe a woodwind or string player using

an incorrect wrist shape or an overextended finger placement than for one to observe incorrect

mouth shape or over-pinching of incorrect facial muscles, especially from a distance. In the

music classroom, differentiated instruction can only go so far, and unless individual students are

examined thoroughly for correct technique, small musculoskeletal issues can often go

undetected.

One of the more frightening injuries to be observed and suffered by musicians involves

music performance-related focal dystonia, otherwise known as musician’s cramp. Seemingly

without known cause, fine motor sensitivity can be lost instantly and persist for decades without

specific treatments available. Focal dystonia results from misfires between synapses of the brain

as it tries to communicate with finer muscles controlling contraction and extension (King, 2014).

When the brain cannot control specific muscles pushing and pulling, sensitivity is lost in specific
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areas of the body, often concerning areas involved in musical performance such as the lips,

hands, fingers, and even the tongue (King, 2014).

Often caused by “performing repeated hand movements,” “focal task-specific dystonias”

can be caused by any number of triggers related to musical performance such as “increase in

playing/practice, dramatic change in technique, return to playing following a protracted break,

history of nerve injury, [and] change of instrument,” (King, 2014). Those suffering from focal

dystonia of some kind must often go through a “re-learning” phase of their instrument in order to

regain the muscular sensitivity and control once gained. Many famous musicians who have

undergone through this rehabilitation have devised their own treatment methods with varying

levels of success in the return of muscle sensitivity and dexterity. Much like embouchure

readjustment periods, these rehabilitation strategies can be exhausting, frustrating, and painful as

musicians must “return to basics” in order to relearn the techniques they may have mastered

years ago (Gambaro, 2014).

As previously mentioned, all of these injuries common to indoor performance ensemble

still exist when students participate in musical activities outdoors. The modern marching music

repertoire may seem simpler by some standards but still involves incredible technical skill

requiring students to be at their topmost peak performance. This high level of skill requires much

dutiful musical practice on top of the physical demands of the choreography and drill for the

overall marching ensemble. When performers are put on the move, injuries typically seen with

any athletic group become much more common. Rolled or sprained ankles, knee injuries from

improper dance technique, and heat exhaustion are all-too commonplace for high school, college,

and even DCI-level performance groups (Greenwald-Gonella, 2015). In addition, outdoor

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marching performers often switch instrument types, requiring them to bear the entire weight of

fifteen- to thirty-pound instruments, whereas most of the instrument’s weight would be otherwise

taken up using a stand or prop indoors. This change can cause strain on upper-body muscles

unused to the weight of the marching instrument, particularly in those performers who are not

properly conditioned nor trained to handle such load.

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Injury Prevention and Training through Instruction

Almost all of the injuries experienced during musical activities, both inside and outdoors,

can be prevented through proper care, identification, and prevention. Unfortunately, many music

educators do not receive adequate preventative medicine techniques as they relate to musician

health during undergraduate study. Additionally, some educators who were fortunate enough to

receive some preventative training or instruction may not be actively implementing such

strategies in the classroom, only disadvantaging the students in their musical activities. Simple

professional development readings and instruction should suffice in preparing music educators

for the potential injury causes and risks of their students, resulting in safer musical activities for

all students.

Many music education trade journals and publications offer several techniques for

reducing strain on students during practice sessions. One author suggests that students and

educators abide by the “25-5 rule,” in which students practice for twenty-five minute sessions

with five minute respites in between. Additionally, students should avoid practicing challenging

repertoire continuously without any kind of skill break to punctuate these practice sessions

(Dawson, 2006). In comparison with sports, track athletes are advised not to run “all-out” in a

sprint time and time again without an adequate rest period in between. Likewise, students should

not be told to perform or practice the same sections which challenge finger dexterity, range

boundaries, or both repeatedly. Instead, educators can rehearse one instrument section at a time,

giving other sections opportunity to rest in between repetitions of a difficult selection of music

(Dawson, 2006).
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For beginning students, education about potential injuries and their prevention is

especially important. Many of these beginning students are young enough at the start of their

music education experience that their bodies are still in key developmental stages of physical

growth. Any kind of improper performance technique learned incorrectly early on could have

incredibly damaging effects on not only the student’s musical ability but musculoskeletal

development as well. While the resource of time is not always abundant for music educators of

beginning students, strategies to help groups en masse can ensure the right start to a musical

career and should always be used in favor of removing such instruction from the curriculum.

As embouchure development and placement are fundamental keys to success for any

wind player, beginning students are encouraged to practice in front of mirrors in order to identify

potential issues with embouchure formation. Additionally, brass players can utilize parts of their

instrument in order to simulate a mouthpiece placed on the lips, thus allowing the student to see

the mouth shape formed without the mouthpiece obstructing vision. If educators demonstrate for

students the proper shape and formation of embouchures, students can then be asked to match the

example, allowing instructors to spot-check individual issues with relative ease.

Common in the field of special education, instrumental adaptations can also be adopted in

the regular music education classroom in order to assist students who may have an existing

physical condition or may be prone to the development of aforementioned conditions. Key

adaptations on woodwind instruments can allow for fingerings to be more easily reachable by

students with smaller hands, thus eliminating the chance of overreaching for keys which could

lead to unnecessary strain on finger muscles and tendons (Dawson, 2006). For beginning string

players, educators cannot overstate enough the need for an appropriately-sized instrument for
ATHLETICISM INHERENT IN MUSIC !24

individual students’ arm lengths and overall physiques. While adaptations can be modified for

use with string instruments to lessen somewhat any physical issues caused by an ill-fitting

instrument, many of these problems should be solved immediately by using an appropriately-

sized stringed instrument for each student instead of heavy modification (Pierce, 2012).

In observing typical music rehearsals, both inside and outdoors, many students when told

to warm-up often perform tiring exercises and passages inappropriate or too taxing for the warm-

up stage of rehearsal. Many leading educators suggest beginning a rehearsal with long tone

exercises and ear tuning warm-ups only, saving more taxing and technical passages for the end of

the warm-up period (Guptill & Zaza, 2010). If the music to be played later in rehearsal exceeds

the range or technical skill demonstrated by the simpler warm-ups, students should then be

allowed to exercise their range, finger, and articulation dexterity and flexibility, but only after a

proper and comprehensive beginning warm-up has been completed (Guptill & Zaza, 2010).

Reducing early fatigue will allow students to perform longer segments of music in tandem, thus

minimizing the chance of strain and short-term overuse injuries from improper muscle

preparedness.

Even without the benefit of conclusive evidence, “athletic trainers in the past have

claimed that stretching improves performance and reduces injuries in athletes,” (Guptill & Zaza,

2010). Beyond athletes, musicians should also engage themselves in proper physical warm-ups

involving stretching anytime physical moves or choreography are to be executed. Health

professionals have also recommended that while performing simpler music warm-ups at the

beginning of rehearsal sessions, educators should encourage physical warm-ups to take place as

well, especially if students are about to begin physical activities on top of musical performance.
ATHLETICISM INHERENT IN MUSIC !25

Stretching while warming up large-group muscles needed for musical performance can save

rehearsal time and put students in the mindset of playing and moving simultaneously, an

important skill for any marching band to master (Guptill & Zaza, 2010).

One of the most dangerous pitfalls encountered by younger musicians involves time spent

in the warm-up portion of rehearsal or practice. In formal rehearsal settings, unknowledgeable

band directors may leave warm-up routines up to the students’ discretions. Even worse, students

who are self-taught musicians may not engage in any kind of warm-up activities at all, not

introduced to the necessity of proper warm-up techniques before performance. As the educated

professional in the room, it should be the responsibility of every music educator to ensure that

proper warm-up strategies are performed by each student, both in large-group settings and during

individual practice. For at-home practice, students should be encouraged to use a timer when

warming up to ensure that enough time has elapsed before practice time begins (Guptill & Zaza,

2010). Additionally, students should be instructed to use the same warm-up techniques employed

in the classroom when they practice individually at home. By adopting identical warm-up

practices both at school and at home, students benefit not only from the effects of a proper warm-

up routine but also the reinforcement of the procedure and muscle memory of the routine itself,

resulting in long-lasting injury prevention techniques and appropriate preparedness for

performance.

More common to collegiate-level education of musicians, some professional performers

have found that an increased emphasis on ear training can prevent the necessity for repetitive

practice. Ear training involves what is known as the “mind’s ear,” allowing a student to hear an

excerpt upon seeing it. Particularly useful in situations of impromptu at-sight performance, ear
ATHLETICISM INHERENT IN MUSIC !26

training can also aid those musicians struggling with difficult passages due to challenging

technique. Rather than practice said passage ad nauseam and risk the formation of bad habits,

one professional recommends that students have a solid grasp of the passage in the mind’s ear

before performing, resulting in increased accuracy when the student performs the same passage

on the instrument (Sternbach, 2009). Without good ear training and sight singing skills, “many

students find it easier to use repetitive practicing to learn a piece,” thus resulting in the potential

for overuse injuries (Sternbach, 2009).

Ear training is often incorporated into the traditional music classroom in a less direct way,

used instead to build intonation and listening skills. By allowing students to listen across the

ensemble, the individual’s ear is able to permit the student to play better in tune with specific

sections and the ensemble as a whole. To instruct students on proper ear training practices as they

relate to individual performance passages, music educators need look no further than the

resources and skills they gained during their undergraduate study. The same techniques learned

as performers at the collegiate level can be appropriately tailored for secondary-aged students in

order to increase their accuracy on challenging excerpts, both in practice and in performance

(Sternbach, 2009).

As performers move outdoors during the summer months, proper precautions become

paramount to not only the general safety and wellness of the students but also the productivity

and reinforcement of rehearsal. Students who are sunburned, exhausted, and unprepared for

rehearsals in intense sun and heat see a decrease in material retention and performance during

crucial summer rehearsals (Greenwald-Gonella, 2015). Music educators often recommend

drinking plenty of fluids—water mostly, and sports drinks only occasionally—before, during,
ATHLETICISM INHERENT IN MUSIC !27

and after rehearsal. Additionally, educators are recommended to afford lengthier breaks during

longer rehearsals, especially if heat indices are especially high. As a guideline, for every hour

spent outdoors, students should receive a collective of fifteen minutes of break to “allow the

heart rate to decrease…out of performance mode,” preferably in shaded areas while drinking

plenty of fluids (Greenwald-Gonella, 2015).

Before lengthier camp rehearsals begin in the summer, directors are encouraged to invite

students to participate in conditioning practices in order to acclimate students to the demands of

potentially-intense summer rehearsals. One director of a noted competitive high school program

explained that “instead of being conditioned through hundreds of drill repetitions, it is better to

build stamina prior to the marching season actually beginning,” (Greenwald-Gonella, 2015).

Often, this conditioning can take place indoors away from the intense heat, utilizing athletic

training equipment if possible. If possible, music educators should explore the possibility of

utilizing expert assistance in the conditioning of large groups of students. If athletic programs at

local high schools already have such a conditioning program, marching band directors could ask

for assistance with conditioning training or allow music students to participate alongside other

athletes when the activities are appropriate for athletic musical performance activities.



ATHLETICISM INHERENT IN MUSIC !28

Conclusion

As recent educational opinions and findings indicate, test scores, graduation rates, college

placements, and overall academic success can be widely attributed to participation in music

activities during secondary-level instruction. As this trend continues, one could expect more

parents and educators to encourage their students to participate in such musical activities, thus

increasing enrollment of music programs overall. If this enrollment is to increase, the greater the

need for overall instruction regarding the potential for injury and the necessity for prevention in

music education.

Injuries in music performance afflict not just the topmost performers in the profession.

Students of all ages are at risk for a spectrum of injuries affecting dexterity, flexibility, and

sensitivity, ultimately resulting in an inability to perform at a professional level or a loss of

performance ability altogether. While injuries of dexterity are more common among instrumental

musicians, music educators should still be aware of injuries caused by improper technique

involving facial muscles, breathing processes, and posture. When taking a athletic trainer’s

perspective and approach to musical injury prevention and instruction, music educators will

experience a greater chance of success when treating such injuries.

Musical activities involving athletics under the umbrella of groups such as DCI and WGI

will continue to grow in popularity among high school-aged students. The opportunities for

travel, networking, and professional instruction afforded by these groups speak for themselves

and attract more and more students each year to the activity. DCI prevalence coupled with the

popularity of Bands of America-style competition and instruction in high schools across the

country results in students becoming subjected to more athletic styles of movement,

ATHLETICISM INHERENT IN MUSIC !29

choreography, and performance than ever before in the activity of marching band. As the

demands of marching band shows grow and become more complex, some students may

encounter a risk of injury which could end their involvement in the activity overall. While some

groups have been afforded staff with the expertise to instruct students properly on this kind of

choreographed marching technique, not every school band program has been so fortunate. Music

educators who expect high levels of performance from their students without incorporating the

necessary instruction and safeguards only increase the risk of overuse and repetitive injuries

among their students.

To prepare educators for the potential of injury during increasingly-athletic musical

activities, proper instruction from the beginning moment of music education is paramount. In

effect, “both music teachers and students, along with parents and school nurses, play important

roles in recognizing the causes and symptoms,” of injuries related to music performance

(Dawson, 2006). Students should not be told to “play through the pain,” or to expect incredible

amounts of technique to result from performing and practicing under such conditions. Students

who know their own limits and practice smarter rather than longer will see greater results overall

than those who attempt to force technique through overly-repetitive practice.

Student instruction on good practice and warm-up habits can be accomplished

successfully either individually or as a large group, and should be implemented whenever

possible. Either by coaching ear training for individual students struggling with tricky music or

large-group conditioning in preparation for band camp, music educators can do no harm by

exposing students to proper warm-up and performance techniques which can even be adopted in

at-home practice. At any opportunity, educators should actively spring for chances to include
ATHLETICISM INHERENT IN MUSIC !30

information regarding individual performance health. Rather than send students through a snore-

inducing crash course of wellness information, educators can greatly improve the injury

prevention practices of their students by adding knowledge such practices appropriately when

instructing the basics of music such as notes, rhythms, and fingerings.

Current music educators should not be required to return to school solely in order to learn

best practices in preventative medicine for their students. Instead, they should be consciously

aware of these issues that could afflict their students at any time during their performance career,

especially if the proper groundwork for injury prevention is not established during the beginning

months of music education. Bad habits are increasingly difficult to break as years of improper

technique continue, and adjustment periods for musicians can be frustrating and painful enough

to question one’s involvement in music programs. Music educators can capitalize on the wealth

of knowledge which already exists in the field of sports medicine and athletic training. Many of

the techniques in the area of sports medicine can be appropriately tailored for music education

instruction, especially when more athletic activities are involved in relation to music. By

consulting health journals and athletic training professionals, music educators “can diminish the

risks of music making for our students and enhance the benefits of our precious art to

all,” (Palac, 2008).

Without a doubt, professional musicians together form a population known for their

emotional expressivity and dedication to the art as a whole. The countless hours spent dutifully

practicing solos and ensemble selections in preparation for auditions for highly-competitive

opportunities, or solely for the pursuit of perfection, have only contributed to a culture among

musicians which emphasizes repetition. Unfortunately, this method of practice and performance
ATHLETICISM INHERENT IN MUSIC !31

can lead to devastating injuries which can end musical careers or produce years-long setbacks to

performance techniques. At younger ages, while the performance stakes my not be so severe, the

risk of injury does not diminish.

From the beginning players to the professional virtuosos, musicians of all ages are at the

same risk of athletic-type overuse and repetitive strain injuries. As trained professionals, music

educators should adopt the best medical practices possible to prevent injury to any and all

students across all levels and disciplines of music. Simply instructing music performance and

practice methods without the necessary curriculum needed in order to sustain such learned

methods, musicians tempt the risk of rendering the numerous hours spent perfecting their

technique useless. As educators, it should be a welcome responsibility to ensure the ability of

performance for our students beyond our short-lived contact. Music-making can be a fulfilling,

worthwhile experience, and with the comprehensive expertise of music educators, that

experience can be made to last a lifetime. 


ATHLETICISM INHERENT IN MUSIC !32

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