University woodwind students’ experiences with playing-related injuries and their management: a pilot study

Figures & data

Table 1 Summary of the type of data published

	All woodwind	Flute	Clarinet	Saxophone	Oboe	Bassoon
Lifetime prevalence anywhere/any duration
Pain	b	a
Injury	d
Musculoskeletal problem	c
Pain or injuries		a
Tingling		a
Weakness		a
Numbness		a
Duration prevalence – location-specific
Pain		a
Lifetime prevalence – location-specific
Problem		g	g	g
Pain		a
Point prevalence – location-specific
Pain whilst playing	f
Seeking treatment (during the university studies)		e	e	e	e	e

Notes:

a Ackermann et al;⁷

b Brandfonbrener;⁸

c Kreutz et al;¹²

d Guptill et al;¹⁰

e Cayea and Manchester;⁹

f Pratt et al;¹³

g Hartsell and Tata.¹¹

Table 2 Sample demographics

Demographic	Number (% of respondents)
Sex
Female	10 (77)
Male	3 (23)
Age (years)
18–19	6 (46)
20–24	3 (23)
25+	4 (31)
Program
Certificate IV in Music (Classical performance)	2 (15)
Bachelor of Music (Classical performance, first year)	4 (31)
Bachelor of Music (Music education, second year)	1 (8)
Bachelor of Music (Classical performance, third year)	5 (38)
Honours Degree of Bachelor of Music (Classical performance)	1 (8)
Major instrument
Flute	6 (46)
Clarinet	2 (15)
Saxophone	1 (8)
Oboe	1 (8)
Bassoon	1 (8)
Recorder	2 (15)

Table 3 Prevalence of playing-related injuries

	n (% of all participants)
	Ever	Longer than3 months	Current
Body regions
General
Neck/shoulder regions	5 (38)	1 (8)	4 (31)
Back	6 (46)	3 (23)	2 (15)
Upper limb	6 (46)	1 (8)	4 (31)
Jaw	1 (8)	0 (0)	0 (0)
Detailed
Neck (left side)	2 (15)	0 (0)	2 (15)
Neck (right side)	4 (31)	1 (8)	3 (23)
Upper back (left side)	0 (0)	0 (0)	0 (0)
Upper back (right side)	2 (15)	1 (8)	1 (8)
Middle back (left side)	1 (8)	0 (0)	0 (0)
Middle back (right side)	1 (8)	0 (0)	0 (0)
Lower back (left side)	3 (23)	2 (15)	1 (8)
Lower back (right side)	2 (15)	1 (8)	1 (8)
Shoulder (left)	1 (8)	0 (0)	0 (0)
Shoulder (right)	3 (23)	1 (8)	1 (8)
Arm (left)	2 (15)	1 (8)	1 (8)
Arm (right)	1 (8)	1 (8)	0 (0)
Wrist/hand/fingers (left)	4 (31)	1 (8)	2 (15)
Wrist/hand/fingers (right)	6 (46)	1 (8)	3 (23)
Jaw (left side)	1 (8)	0 (0)	0 (0)
Jaw (right side)	1 (8)	0 (0)	0 (0)

Figure 1 Management strategies tried.

Notes: ^Number of participants with a history of playing-related injury (n=8); *or increased discomfort.

Figure 2 Perceived effectiveness of management strategies.

Notes: Circle, median; line, interquartile range; crosses, range; 1, no help; 5, extremely helpful.

Table S1 Search terms

Woodwind player	flute OR flutes OR flautist* OR flutist* OR musician OR music student* OR woodwind* OR wind player* OR Instrument player* OR instrumentalist* OR musical instrument* OR wind instrument* OR instrumental music OR stud* music* OR saxophon* OR clarinet* OR oboist* OR oboe* OR bassoon*
University student	universit* OR colleg* OR tertiary OR conservat* OR student* OR studying OR education OR training
Musculoskeletal symptoms	muscul* OR overuse* OR injur* OR muscle* OR pain* OR discomfort OR strain* OR sprain* OR disorder* OR condition* OR syndrome* OR disease* OR problem* OR disab* OR symptom* OR weak* OR numb* OR medical* OR health*
Prevalence/incidence	preval* OR inciden* OR rate* OR frequen* OR common* OR percent*
Impact	consequen* OR impact* OR experienc*
Management	manag* OR therap* OR treat*

Note:

* indicates a truncation symbol (the symbol may be replaced by any number of characters by the search engine).

Figure S1 Flowchart of study exclusion.

Abbreviation: CINAHL, Cumulative Index to Nursing and Allied Health Literature.

Table

	No chance				Extremely likely
6 months	□	□	□	□	□
12 months	□	□	□	□	□
5 years	□	□	□	□	□
Ever	□	□	□	□	□

Table

	No chance				Extremely likely
Missed playing commitments	□	□	□	□	□
A negative impact on your playing reputation	□	□	□	□	□
A week off from playing	□	□	□	□	□
Ending your career	□	□	□	□	□
Reducing your playing time by half	□	□	□	□	□
Financial problems	□	□	□	□	□
Three months off from playing	□	□	□	□	□
A month off from playing	□	□	□	□	□
Social isolation	□	□	□	□	□

Table

	Not at all				Extreme impact
Not enough breaks when practicing	□	□	□	□	□
Poor posture/hand position	□	□	□	□	□
Sudden increase in playing intensity (eg, harder pieces)	□	□	□	□	□
Sudden increase in playing time	□	□	□	□	□
Carrying your instrument	□	□	□	□	□
Overpracticing	□	□	□	□	□
Playing with discomfort	□	□	□	□	□
Insufficient warm up (eg, playing long notes, slow scales)	□	□	□	□	□
Poor general physical fitness	□	□	□	□	□
Cramped playing conditions	□	□	□	□	□
Poor awareness of injury prevention	□	□	□	□	□
Stress (eg, performance anxiety)	□	□	□	□	□
Moving equipment (chairs, stands)	□	□	□	□	□
Facilities (eg, chairs, temperature, lighting)	□	□	□	□	□
Instrument setup (eg, thumb rests, reeds, neck straps, key height)	□	□	□	□	□

Table

	No effect				Will completely prevent an injury
Warm-up (eg, long tones, slow scales)	□	□	□	□	□
Yoga	□	□	□	□	□
Regular massage	□	□	□	□	□
Stop playing as soon as you experience discomfort	□	□	□	□	□
Pilates	□	□	□	□	□
Aerobic exercise (eg, running, rowing)	□	□	□	□	□
Stretching	□	□	□	□	□
Muscle-resistance exercises (eg, weights, Thera-Band)	□	□	□	□	□
Alexander technique	□	□	□	□	□
Osteopath	□	□	□	□	□
Bowen therapy	□	□	□	□	□
Physiotherapy	□	□	□	□	□
Relaxation techniques	□	□	□	□	□
Feldenkrais	□	□	□	□	□
Regular practice breaks	□	□	□	□	□
Chiropractor	□	□	□	□	□

Table

	Have done	Currently doing
Pilates	□	□
Stop playing as soon as you experience discomfort	□	□
Alexander technique	□	□
Relaxation techniques	□	□
Stretching	□	□
Yoga	□	□
Feldenkrais	□	□
Aerobic exercise (eg, running, rowing)	□	□
Physiotherapy	□	□
Chiropractor	□	□
Osteopath	□	□
Warm-up (eg, long tones, slow scales)	□	□
Regular practice breaks	□	□
Muscle-resistance exercises (eg, weights, Thera-Band)	□	□
Bowen therapy	□	□
Regular massage	□	□

Table

	Has prompted a change	Would prompt a change
Reading about injuries	□	□
Advice from a health/medical professional	□	□
Experiencing an injury that impacts on your playing	□	□
Starting to get symptoms (before they start impacting on your playing)	□	□
Having a class/workshop about injuries	□	□
Knowing someone who has experienced an injury	□	□
Advice from your teacher	□	□
Advice from other students/colleagues	□	□

Table

	Not at all important				Extremely important
Have a ‘no pain, no gain’ attitude	□	□	□	□	□
Understand the physical requirements of playing	□	□	□	□	□
Have a good posture/hand position	□	□	□	□	□
Understand injury prevention	□	□	□	□	□
Carefully structure practice sessions	□	□	□	□	□
Have good playing technique	□	□	□	□	□
Do exercises (stretches and strengthening to reduce injuries)	□	□	□	□	□

Table

	Completely disagree				Neutral				Completely agree
Injury prevention is the responsibility of the teacher	□	□	□	□	□	□	□	□	□
Injury prevention is the responsibility of the individual musician	□	□	□	□	□	□	□	□	□
Injury prevention is the responsibility of the university	□	□	□	□	□	□	□	□	□
Injuries can be prevented	□	□	□	□	□	□	□	□	□
If I had an injury, I would tell my teacher	□	□	□	□	□	□	□	□	□
If a musician has an injury, it reflects poorly on their teacher	□	□	□	□	□	□	□	□	□
Musicians should understand injury prevention	□	□	□	□	□	□	□	□	□
Discomfort is a normal part of playing	□	□	□	□	□	□	□	□	□
Health professionals need a good musical understanding to advise and treat musicians	□	□	□	□	□	□	□	□	□
I would not tell another musician if I had an injury	□	□	□	□	□	□	□	□	□
Musicians who have had an injury are at higher risk of future injury	□	□	□	□	□	□	□	□	□
Musicians who have had an injury should not be professional musicians	□	□	□	□	□	□	□	□	□
Musicians who have had to have time off because of an injury must not want to be musicians bad enough	□	□	□	□	□	□	□	□	□
Teachers should teach injury prevention	□	□	□	□	□	□	□	□	□
Injuries are an excuse for time off	□	□	□	□	□	□	□	□	□

Table

	Completely disagree				Neutral				Completely agree
Changing my posture/hand position would have a positive effect on my playing long term	□	□	□	□	□	□	□	□	□
Learning more about good posture/hand position will make me a better teacher	□	□	□	□	□	□	□	□	□
It is too difficult to change my posture/hand position	□	□	□	□	□	□	□	□	□
Changing my practice structure will help improve my playing	□	□	□	□	□	□	□	□	□
Changing my posture/hand position will help prolong my career	□	□	□	□	□	□	□	□	□
The discomfort and fatigue from doing exercises will make it hard to practice afterwards	□	□	□	□	□	□	□	□	□
Having a good posture/hand position will improve the way in which my performance is perceived, even if the sound is the same	□	□	□	□	□	□	□	□	□
Doing exercises will help decrease my injury risk	□	□	□	□	□	□	□	□	□
Doing exercises is embarrassing	□	□	□	□	□	□	□	□	□
Changing my practice structure will help decrease my injury risk	□	□	□	□	□	□	□	□	□
Doing exercises will improve my playing reputation	□	□	□	□	□	□	□	□	□
I need to practice for long durations to be able to perform for long durations	□	□	□	□	□	□	□	□	□
Changing my practice structure will help prolong my career	□	□	□	□	□	□	□	□	□
It is too difficult to change my practice structure	□	□	□	□	□	□	□	□	□
Doing exercises will help improve my posture	□	□	□	□	□	□	□	□	□
Doing exercises will improve my playing	□	□	□	□	□	□	□	□	□
If I found time to do exercises, I may as well practice	□	□	□	□	□	□	□	□	□
It would take too much time to change my posture/hand position	□	□	□	□	□	□	□	□	□
Changing my posture/hand position would affect my playing negatively in the short term	□	□	□	□	□	□	□	□	□
Doing exercises will help prolong my career	□	□	□	□	□	□	□	□	□
Changing my posture/hand position will help decrease my injury risk	□	□	□	□	□	□	□	□	□
There is not the space to do exercises at university	□	□	□	□	□	□	□	□	□
My duration of practice in one session is dictated by practice room availability	□	□	□	□	□	□	□	□	□
I don’t have the time to do exercises	□	□	□	□	□	□	□	□	□

Table

	Ever experienced	Longer than 3 months at a time	Currently
Neck (left side)	□	□	□
Neck (right side)	□	□	□
Upper back (left side)	□	□	□
Upper back (right side)	□	□	□
Middle back (left side)	□	□	□
Middle back (right side)	□	□	□
Lower back (left side)	□	□	□
Lower back (right side)	□	□	□
Left shoulder	□	□	□
Right shoulder	□	□	□
Left arm	□	□	□
Right arm	□	□	□
Left wrist/hand/fingers	□	□	□
Right wrist/hand/fingers	□	□	□
Jaw (left side)	□	□	□
Jaw (right side)	□	□	□

Table

	No help				Extremely helpful
Relaxation techniques	□	□	□	□	□
Massage	□	□	□	□	□
Heat	□	□	□	□	□
Cortisone injections	□	□	□	□	□
Stretching	□	□	□	□	□
Alexander technique	□	□	□	□	□
Yoga	□	□	□	□	□
Bowen therapy	□	□	□	□	□
Pilates	□	□	□	□	□
General body training	□	□	□	□	□
Warm-up	□	□	□	□	□
Stop playing as soon as you experience discomfort	□	□	□	□	□
Regular practice breaks	□	□	□	□	□
Time off from playing	□	□	□	□	□
Medications	□	□	□	□	□
Muscle resistance exercises (eg, weights, Thera-Band)	□	□	□	□	□
Reduce playing hours	□	□	□	□	□
Feldenkrais	□	□	□	□	□
Chiropractor	□	□	□	□	□
Physiotherapy	□	□	□	□	□
Osteopath	□	□	□	□	□
Ice	□	□	□	□	□

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