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When you attend a Bravo! Vail performance this summer, listening to the sublime works of Mozart or Copland, and look at the musicians arrayed before you, images of Lindsey Vonn or Usain Bolt or local Mike Kloser are unlikely to pop into your mind.

But maybe they should. Consider this; both athletes and musicians share similar physical and mental demands in their pursuit and mastery of optimum performance levels. They similarly acquire skills through long hours of practice, performing feats of great dexterity, strength and stamina, while enduring the psychological pressures and constraints of travel and the organizational “culture” of the professional team or orchestra.

And like athletes, musicians are prone to numerous neurologic and musculo-skeletal conditions. Studies show that more than 75% of performing musicians of all levels and all ages will suffer a “Performance Related Medical Disorder (PRMD)” in a 12-month span, severe enough to significantly affect the quality of their performance or stop them from playing altogether. These are primarily over-use conditions of the upper extremities and spine.  Injuries from non-musical activities can impact their professional careers. Occupational noise-induced hearing loss (NIHL) is an additional significant concern for musicians who are exposed to long hours of elevated sound intensity during rehearsal and performance. Contemporary and classical musicians are equally at risk.

Still dubious?  Here are a few comparisons. Professional baseball pitchers at most throw on average 146 pitches per game.  In a 2-minute section of 3 hour Handel’s Messiah (Why Do the Nations aria) violinist makes 740 strokes.  Another passage demands the violinist bow 38 notes in 3 seconds. In the 14-minute Ravel’s Bolero, the snare drum plays 5,144 strokes. Add the importance of getting the timing and placement of every note correct. A baseball professional with a .300 batting average is an all-star. An NBA basketball guard shooting .500 is considered extraordinary. Similar averages for a musician would be disastrous.

Treatment of these PRMDs, like that of athletic injury must be multifaceted, addressing both the physical and psychological aspects of these extremely high-level performers, employing the expertise of physicians, physician assistants, physical and occupational therapists, athletic trainers and psychologists.

The last 25-30 years have seen a growing recognition and awareness that musicians and athletes share many physical demands, personality traits and injuries.  And there is a corresponding growth in research and collaboration of university/professional music groups with traditionally non-musical associations such as the American Association of Orthopedic Surgeons and Sports Medicine. Together they are creating programs similar to those that abound internationally, geared to the development of athletes from crib to grave, incorporating multiple disciplines of research, education, coaching, training, nutrition, psychology, treatment of injuries. The premier group in the United States is the Performing Arts Medicine Association (PAMA), which originated in and is based here in Colorado.

PAMA and its members recognize that success in music, like in athletics, depends not only on acquisition of necessary technical skills, but also methods for preparing for and coping with the physical and mental strains associated with performance; to provide similar opportunities and constraints on developing performers as the NCAA does to athletes including pre-participation exams/screening, base-line evaluations, hearing evaluation, nutrition, strengthening and flexibility programs.

This begins at the community level, local school music programs, private music studios, community performing arts organizations; all are potential points of contact and influence in a child’s life-stream in developing and sustaining a performance career.

I am proud to be a member of PAMA, and with the encouragement of the physicians at Vail Summit Orthopedics, and with the help of local therapists, I have dedicated a part of my practice to treating musculo-skeletal problems in musicians.  For the last few years I have had the distinct privilege of helping the medical staff of the visiting Philadelphia and New York Symphonies during Bravo Vail, and experiencing first hand these amazing performers.

So, when you do see a visiting orchestra playing a masterpiece that has transcended time, look a little closer and you will see the fine, graceful lines of a Lindsey Vonn, the shear strength and velocity of an Usain Bolt, and the incredible endurance of a Mike Kloser. And you will see the passion for perfection of any athlete.

Jan Idzikowski, PA-C

Vail Summit Orthopaedics