Assessment of Performance Related Injuries Experienced
by Indian Instrumental Musicians

Praful Kelkar, M.D. (University of Iowa), Balwant N. Dixit, Ph.D., Scott Beach, Ph.D. and Shringi Sharma (University of Pittsburgh) 

Introduction:  Instrumental musicians are predisposed to neuromuscular and other complications due to repetitive motions of fingers, wrists and hands as well as due to the typical posture they must assume during long hours of practice as well as during performances.  Several studies done on Western musicians have shown increased incidence of musculoskeletal and neuromuscular disorders.  There are no studies looking at such injuries among Indian musicians.  The purpose of this study was to assess the incidence of neuromuscular, musculoskeletal symptoms and other adverse consequences experienced by professional Indian musicians. 

Survey: A survey with several specific questions was developed using the existing data obtained from studies conducted among Western musicians.  The survey was field tested in a small sample, modified and was distributed to 65 Indian musicians who have been performing at professional level for several years on the following instruments: sitar, sarod, santoor, bamboo flute, tabla, mridangam, veena, ghatam, and harmonium. Information on their current age, gender, years in performance, duration of daily practice, and the age at which they began learning was obtained. The survey included detailed questions on: assessment of pain, musculoskeletal problems, abnormal sensations, numbness, weakness, and lack of coordination, muscle cramps, impact on personal and professional life, and types of treatment and their effect. 

Results:   Fifty-seven out of 65 musicians completed the survey (88%).  They included six female and 51 male musicians. Their age ranged from 16 to 76 with a mean of 41.  Thirty-eight out of 57 started training between the ages of 5 and 11, and 56 have been performing professionally for more than 10 yr.    Because of the sample size detail analysis will be presented only for those performing on tabla, sitar, and harmonium.  The table printed the other side summarizes the results in these 39 musicians.  At the time the surveys were completed, 15 musicians reported that they experienced significant pain while 15 experienced joint problems.   Abnormal sensations were reported by 11, loss of strength by 6, lack of coordination by 7, muscle cramps by 15 and 24 reported some impact on their personal and/or professional life.   A majority of those who sought various types of treatments benefited from them.

Conclusions:  (1) Indian professional musicians seem to be predisposed to neuromuscular and musculoskeletal complaints.  The symptoms appear to be severe enough to impact personal and professional life in many of these musicians, (2) Studies involving a larger number of instrumental musicians and students at various stages of training with detailed neuromuscular evaluations are being planned to understand the full scope of such problems.   Efforts will also be made to evaluate the type of performance related injuries that may be experienced by classical dancers. (3) There is a need to develop appropriate physical therapies and medical treatments for avoiding observed problems/injuries and reducing their adverse effects.

View: Table 1: Data on the types of symptoms and problems experienced by instrumental musicians