MEDICAL MATTERSMusicians are like performance athletes - an injury can set back, or even end, their career trajectory
AT THE AGE of four, it was decided that I should learn the violin. Following the purchase of a quarter-size instrument, I was entrusted to the tutorship of my music teacher, Ms L, a large-bosomed and well-powdered woman in her 60s.
Saturday mornings saw me hauled up the stone stairs of the music school for 20 minutes of her undivided attention. Because the teaching was one-to-one, there was no escape for this recalcitrant student.
With an aversion to practising between lessons, I soon attracted the ire of my teacher. When I combined this with an inability to press down firmly on the strings, and in accordance with the teaching methods of the 1960s, Ms L produced a wooden ruler from her desk. She proceeded to apply the edge of the ruler to the appropriate finger every time I produced a bum note.
The result? I soon gave up on the instrument of torture and became a reasonable tin whistle player instead. And with the exception of Vivaldi's Four Seasons, the sound of violins can still set my teeth on edge.
It was a conversation with Dr Juliet Bressan, a Dublin GP and clarinet player, that triggered that particular childhood memory.
Bressan is involved with the British Association of Performing Arts Medicine (BAPAM), which has set up a new health service for musicians in the Republic.
Aimed at full-time music students and performing artists and musicians, the ethos of the service is that professional musicians are performance athletes who need to have their health protected from the early stages of their careers.
"If a musician develops pain or has an injury that prevents practice or performance, it can ruin their career," Bressan says.
"This is especially worrying for students, so the colleges of music need to be very pro-active in protecting students' health and encouraging them to see a doctor who understands performance-related health problems early, rather than leaving it too late."
Why do musicians need specialist help with their health? They often work late at night and have to practise during the day and are expected to work long and anti-social hours. During tours they might practise for up to six hours a day and then perform at night, leaving them vulnerable to repetitive strain injury.
Andrew is a 31-year-old professional guitarist who plays mainly jazz, pop and rock.
Following a period in which he spent less time playing and more time arranging music, he started playing again with an intensity he had not been used to.
He developed pains and pins and needles in his left hand and arm. Following a diagnosis of carpal tunnel syndrome (where the radial nerve is trapped at the wrist) he was referred to an orthopaedic surgeon.
The subsequent operation went well but Andrew credits the BAPAM hand therapist - who gave him a splint, advice on looking after the scar tissue and how to build up his playing gradually - with getting him successfully back to work.
Singers also need help to learn how to use their bodies to avoid voice strain. The development of growths on a singer's vocal cords can spell the end of their career.
Other common health problems faced by musicians are hearing loss (especially in drummers and rock musicians) and addiction.
Bressan sees patients in her own music room and encourages them to bring their musical instrument with them. She goes through their practice routine with them as part of her assessment. So far, she sees mainly music students.
Traditionally, a musician's lifestyle meant that health problems tended to go unheeded: Rory Gallagher, Kurt Cobain, Bob Marley, Elvis and Ian Drury are just some examples of musicians who have died prematurely. So a dedicated health service for performing artists definitely makes sense.
Bressan would like to hear from orthopaedic surgeons, ENT specialists, physiotherapists and occupational therapists with an interest in music. Musicians or music students looking for help with health issues can contact her via BAPAM at www.bapam.org.uk or on 0044-845 602 0235.
Dr Houston is pleased to hear from readers at mhouston@irish-times.ie but regrets he is unable to reply to individual medical queries.