Revue Médecine des Arts N°95 Physical and mental health of musicians

When we're interested in art, we're astonished by its astonishing truth. What it tells us about people, places, times and events.

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The quality of single-tonguing is one of the most common problems encountered by wind players. When single tonguing, musicians articulate different phonemes ("ta", "ka", "da", "ga", etc.) depending on the musical effect desired. We know how to position the tongue to produce these sounds when we don’t have the instrument at hand. The tip of the tongue (the apex) is an important concept in lingual rehabilitation, particularly for the pronunciation of the palatals sounds (L, N, D, T) that are useful to musicians. But where should the apex be positioned when playing the instrument? Method: A review of the literature on the position of the tip of the tongue for tonguing in single-reed instrumentalists was carried out by means of a bibliographic search of various scientific databases. Results: 12 references were selected to address this issue. Conclusion: The tongue should work in the same way with and without an instrument. For single tonguing with the "T" or "D" sounds, the tip of the tongue is placed over the tip of the reed to stop the vibration and to articulate the notes. The movement of the tip of the tongue is difficult to objectify with current imaging in relation to the back or rear of the tongue. In addition, there is no consensus on the best technique for single tonguing due to the variety of techniques used by musicians and the difficulty of proprioception in this anatomical area. As a result of this research, tongue toning exercises are being offered to wind instrumentalists.

The main objective of this study is to investigate whether there is a causal relationship between the playing-related musculoskeletal disorders (PRMDs) observed in adult saxophonists and the type of carrying system used. The ultimate aim is to develop recommendations for saxophonists to help them choose the most appropriate strap or harness system to use while playing.

An epidemiological study was carried out using a questionnaire to which 251 adult saxophonists (amateurs, professionals, students) responded. The data collected included the type of saxophone(s) played (soprano, alto, tenor, baritone), the carrying systems used (cord, harness, Saxholder, other) and the criteria for choice, together with details of any PRMD experienced in the previous12 months and the previous 4 weeks.

The PRMDs reported by adult saxophonists have a multifactorial origin. Carrying systems play an important role, but other risk factors also come into play, such as gender, status, playing time, etc. There is no perfect carrying system, but choosing the right one is crucial in preventing the risk of developing PRMD. The use of an appropriate carrying system must be accompanied by appropriate work on the posture and gestures specific to the saxophone in order to optimize the potential of this interface. Saxophonists need to think holistically about their playing, based on a physiological posture and gestural approach to the instrument, which the carrying systems will support and reinforce.

The Covid-19 pandemic has plunged the musical profession into an unprecedented situation, with very specific medical and social consequences depending on the social status and the individual concerned. The cross-sectional descriptive study carried out by Médecine des Arts in 2023, using several validated questionnaires, examined the physical and mental health of French professional musicians in the wake of the Covid-19 pandemic. One section of this study asked musicians ten questions about the impact of the Covid-19 period on their professional activities and on their physical and mental health; the results and analysis of this section are the subject of this article.

The data from the 338 respondents show that the Covid-19 period has profoundly altered musicians’ relationships with their professional practice and their health. About a third of the musicians surveyed said that they were working at a faster pace, that their working conditions had deteriorated, that they felt socially isolated, that they wanted to change jobs, and that they felt less socially useful. A fifth said they felt less involved in their work, and a quarter said their lifestyle was less healthy than before. More than 40% expressed insecurity with regard to their work compared to the period before Covid-19. Finally, 40% of professional musicians said that their physical and mental health has deteriorated compared to the period before Covid-19.

Significant disparities, highlighted by the unprecedented situation of the Covid-19 pandemic and lockdowns, exist, and vary according to age, gender, status (public service, casual sector worker, salaried, etc.), practice (instrument, voice), main type of practice (orchestra, teaching, popular music, etc.), length of professional practice and intensity of daily practice. These differences must be taken into account in order to identify and introduce appropriate preventive measures.

Briefs on artists' health and working conditions