Musicianship and teaching : aspects of musculoskeletal disorders, physical and psychosocial work factors in musicians with focus on music teachers

Abstract: Musculoskeletal disorders are common among musicians at all levels of performance. Since music teachers train our future musicians it is important to understand their work environment. By creating good examples of a healthy work environment, they can teach their students how to stay healthy and to prevent pain. The aim of this thesis was to study the work environment of music teachers at municipal music schools, with regard to physical and psychosocial factors and musculoskeletal disorders with the focus on neck and shoulder disorders. An additional aim was to investigate the variability of the playing technique in string players and to investigate if they could play with greater variation in the trapezius muscle activity pattern after a training intervention program.In a cross-sectional study at 23 municipal music schools, 171 out of the 208 (82%) music teachers reported that they had experienced work related musculoskeletal disorders (WMSDs) during the previous year. Women reported significantly more symptoms in the neck, the shoulders and the upper back compared to men. Both physical and psychosocial work factors were associated with neck and shoulder disorders. For women “high mental work demands” and “teaching at many schools” could be seen as risk factors and for men “lifting”, “playing the guitar” and “low social support at work” were risk factors.The occurrence of WMSDs was also investigated, over an eight-year period, in music teachers at one music school. The result showed that neck, shoulder and lower back disorders were common and tended to be of long duration and to increase over the years.In an interview study, nine music teachers focused on what they perceived to be important for their health and well-being. Replenishing and using up energy was found to be the core category. Creativity in the music and working with other musicians were perceived as sources of energy, while the goals of the organisation were experienced as stressful and used up energy. Whether the work was regarded as pedagogical or musical could affect the perception of health and the strategies for dealing with the strains of work.In two studies using electromyography, the variation in the trapezius muscle activity pattern in string musicians was investigated. The results suggested that each musician could repeat their muscular activity pattern in a similar way between two playing sessions. No difference was found in the trapezius muscle activity between five violinists who trained basic Body Awareness Therapy (BAT), a technique having its roots in Tai Chi Chuan tradition, compared to a reference group of nine violinists who did not take part in any training. However, the training group perceived positive changes in breathing, muscular tension, postural control and concentration during practice sessions.Neck and shoulder disorders were associated with physical and psychosocial factors at work. A process of replenishing and using up energy was important for music teachers’ health. The playing technique in string musicians seemed to be repeatable but difficult to affect over a short-term period. For future musicians it is crucial to learn good working technique at an early age. In the learning process the music teacher is a vital role model.