Arts Medicine Journal N°90 Musician's hand

The goal of this study was to determine whether there is a link between tactile sensitivity and music playing. Does playing a musical instrument on a steady basis lead to alterations in the tactile sensitivity of the fingers? To look into this question, two groups of musicians were studied, pianists and string instrumentalists.

The first part of the study examines the mechanisms underlying tactile perception. A stimulus is perceived by the various mechanoreceptors located in the skin, and is then transformed into action potentials (nerve impulses) in the corresponding receptor fields. Discriminant sensitivity (tested by studying the discrimination threshold of two static points) is inversely proportional to the size of the receptor fields. Discriminating power is maximal at the fingertips, due to the high density of mechanoreceptors, the small receptor fields, and the extensive cortical representation. Tactile information is conveyed to the cerebral cortex via the lemniscal path. The excitatory and inhibitory areas of the receptor fields play a role in discriminant sensitivity. A review of the literature on the tactile sensitivity of musicians is also presented.

The aim of this study was to find out whether musicians can return to their previous playing level after undergoing surgery for a hand injury. The population studied included 54 professional or semi-professional musicians (13 pianists, 12 guitarists, 7 violinists, 7 cellists, and 15 players of other instruments). The overall rate of return to the pre-surgery level was 68.5%. The results are analyzed as a function of the instrument played; the type of injury; post-operatory sequelae, if any; recuperation time; and the musician's age.

The study pointed out the causes (mostly traumatic) of hand surgery in this population of musicians and the sequelae that hindered their ability to return to their instrument at the same playing level. Recommendations drawn from the findings are given.

Coldness causes specific reactions at the extremities of the limbs, especially in the hands. These mechanisms may have dire consequences for musicians.

The various symptoms are examined here, along with the factors likely to worsen them. A questionnaire conducted with 53 musicians showed that women's playing was more adversely affected by the cold than the men's (87.5% versus 67.9%), and that the principal symptom was a decrease in dexterity (48%). Nearly 70% of the musicians questioned did not warm up before playing.

A warm-up protocol for instrumental musicians was developed, both to limit their loss of heat and to provide them with warm-up exercises to be carried out before playing.

The authors report the clinical case of a professional bombard player with left cervical swelling when playing. The bombard belongs to the oboe family and requires the same breathing and lip-to-reed techniques. The diagnostic process is described. Additional tests and cross-sectional imaging during instrument playing provided evidence of a pharyngocele and eliminated other possible diagnoses.

With this clinical case as a starting point, a questionnaire-based survey was conducted on a population of bombard players and teachers. The goal was to assess the prevalence of deformations of the face and neck (including cervical tumefaction) among musicians during play. Out of the 72 respondents, over half reported deformations in the area of the lips and cheeks, and half reported cervical swelling. Three-quarters of the bombard players did not modify their instrumental technique in order to decrease the swelling.

A pharyngocele, seen as an overuse syndrome in wind instrument players, does not need to be treated, but it does call for continuous observation to eliminate a diagnosis or a complication that requires treatment.