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Q: What have athletes known for years that musicians are just beginning to apply to their practice and performances?

A: Like athletes, performing artists:

• Practice and/or perform almost every day
• Often play through pain and need pain management
• Compete or are in challenging environments
• Experience little or no “off season’’
• Sometimes face extreme competition
• Risk the temptation of substance abuse
• Face significant risk of career-threatening injury

Issues facing both performing artists and sport athletes include:

• Travel / jet lag
• Nutrition / hydration
• Overuse
• Optimize performance
• Mental health

Sport athletes have access to nutritional information to help them understand what and when to eat, as well as medical support for injury prevention, management, and rehab. In addition, they have access to film reviews (with the help of athletic trainers and coaches) so they can work on modifying posture, mechanics, pitch, Moreover, they have a sport psychologist to help them get out of a slump. Sadly, the performing artist (musicians, dancers, and actors) has many of the same needs but with little to no access to these same resources.

The Target Audience

Athletes benefit from a system that educates not only themselves but also medical professionals, coaches, trainers, and even parents about how to optimize health and performance.

Performing artists would greatly benefit from the following:

• Having teachers who can provide them with the names of appropriate medical professionals, should a student need to establish a health care relationship.
• If possible, should an injury occur, perform for a health care professional, so they understand one’s craft
• Document a week of typical activities (it would be beneficial if students would provide this information to a physician, therapist or other medical professional if needed)
• Testing and education for musicians on music-induced hearing disorders as teachers should educate students about hearing preservation

Educators /Instructors in the performing arts should consider the following:

• Place practice sessions and performances in perspective so students understand the process of preparing for a performance with “practice performances” before the ultimate performance or concert
• Discuss optimal performance and how to achieve a satisfying end result, discussing rationale goals and avoiding wishing for “perfection”
• Be the Wellness Voice – Look for reliable information at reputable sources such as:
  –https://internationalmusician.org/staying-healthy-as-a-musician/
  –https://www.mtna.org/MTNA/Learn/Wellness_Resouces/Athletes_and_the_Arts.aspx
  –National Association of Teachers of Singing (NATS): https://www.nats.org

Medical Professionals seeing performing artists need to consider the following:

• Know you are seeing a performing artist and understand the volume and intensity of the activity
• Consider an annual pre-participation exam targeted to the specific activities of the performer
• Use a team-approach whenever possible—medical professionals, teachers, therapist(s)

Lessons Learned from sport’s research that can be applied to performing artists

Practice and Performance:

• The NUMBER of practice hours may hurt rather than help at some point – less is more
• Consider FOCUSED practice segments with different goals in each session
• Quantify the VOLUME and INTENSITY of performing arts activity(this should become standard practice of all performers using a simple tool for tracking performance hours for an appropriate session broken out by HIGH, MODERATE or LOW intensity)
• Large ACUTE increases in time spent physically practicing increases the risk of injury. If the AMOUNT or INTENSITY of practice must increase, do it gradually and include adequate breaks

Recovery / Cross-training:

• Emphasize the importance of both mental and physical rest and recovery
• Employ alternative mental and physical activities that contribute to performance but use alternative muscle groups or mental focus—mental practice away from the instrument can strengthen skills

Mental Health:

Youths in today’s culture are driven to train early and extensively. Early specialization and extensive training creates well-documented risks of over-use injury, burnout, stress, and less enjoyment in youth sports and in the performing arts as well.  The importance of a coach or an instructor in establishing a safe and healthy environment is key for both sport athletes and performing artists.

A 2021 collaborative article published by the International Olympic Committee emphasizes the importance of attending to mental as well as physical health. See: Gouttebarge V, Bindra A, Blauwet C, et al, International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health, British Journal of Sports Medicine, 2021;55:30-37 at: https://bjsm.bmj.com/content/bjsports/55/1/30.full.pdf

The System

Sport organizations such as the National Federation of State High School Association, the National Collegiate Athletic Association (NCAA) and various other governing bodies develop standards, guidelines and rules around practice and competition to enhance health and safety. For example, the NCAA has various guidelines shared with all institutions in a Sports Medicine Handbook and restricts formal practice of a sport to 20 hours a week.

Such oversite management would greatly benefit performing artists as well and provide them with accepted guidelines upon which to base practice, performance, and general participation.  A few examples are emerging, including The National Association of Schools of Music (NASM) Health and Safety Standard for all NASM accredited schools that reads in part: “It is the obligation of the institution that all students in music programs be fully apprised of health and safety issues, hazards, and procedures inherent in practice, performance, teaching and listening.” And “Music program policies, protocols, and operations must reflect attention to injury prevention and to the relationships among musicians’ health;” “Specific methods for addressing these issues are the prerogative of the institution.”  See NASM Handbook 2020-21: – F.; 2.d.p. 67-68: https://nasm.arts-accredit.org/about/current-notices/current-notice-nasm-handbook-2020-21-published/  and NASM Advisories – NASM-PAMA: https://nasm.arts-accredit.org/publications/publications-a-z/ 

Measuring optimal performance and incorporating researched concepts

Compared to sports, optimal performance in the performing arts environment is currently somewhat subjective. This area could benefit from repeatable quantifiable measures around performance so one can accurately measure how performance changes after an intervention.  For example, in sports, practice limits are imposed for safety by NCAA, Little leagues and USA football while there is not really any formal limits or guidelines imposed as a standard protocol in the performing arts with regard to length and intensity of rehearsals.  If such measures were established, it would open the door to a variety of alternative training options (such as track athletes doing pool workouts) that could then be evaluated to see if they achieve a desired result and would possibly reduce overuse and/or injury on specific body areas.

Final thoughts and summary

Sport athletes benefit from established research and targeted education to themselves and the medical personnel and coaches who work with them.  Many of these findings are applicable to performing artists and would help to optimize their health and performance as practicing artists.  In addition, further research should be conducted in this population to better understand their unique characteristics and needs.

As jazz musician Jon Batiste, a classically trained graduate of Julliard (both bachelors and master’s degrees) and Ambassador for Athletes and the Arts stated:

“The conservatory environment is very different.  I went to Julliard six years and never in any of my lessons was there any instruction about nutrition or any sort of quantifiable method to determine the pros and cons of playing long hours.   If I missed a note, I was just told to do it again, to practice more”.

“…Music is healing and if you want to heal other people, you’ve got to heal yourself first. The healthier we are as musicians and the arts community in general, the better the world will be.”

Please also see:

• Website: athletesandthearts.com
• Associated Athletes and the Arts (AATA) podcasts: https://athletesandthearts.com/aata-podcasts/