Health and Safety Information for Musicians

Performance Injuries

Keeping Instruments Clean

Additional Information

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Performance Injuries

Anyone who practices, rehearses or performs instrumental or vocal music has the potential to suffer injury related to that activity. Instrumental musicians are at risk for repetitive motion injuries. Sizable percentages of them develop physical problems related to playing their instruments; and if they are also computer users, their risks are compounded. Instrumental injuries often include carpal tunnel syndrome, tendinitis, and bursitis. Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain, disability, and the end of careers. 

Neuromusculoskeletal and Vocal Health  

The neuromusculoskeletal system refers to the complete system of muscles, bones, tendons, ligaments and associated nerves and tissues that allow us to move and to speak and to sing. This system also supports our body’s structure. The “neuro” part of the term “neuromusculoskeletal” refers to our nervous system that coordinates the ways in which our bodies move and operate. 

The nervous system consists of the brain, the spinal cord, and the hundreds of billions of nerves responsible for transmitting information from the brain to the rest of the body and back again in an endless cycle. Our nervous systems allow us to move, to sense, and to act in both conscious and unconscious ways. We could not listen to, enjoy, sing, or play music without these structures. In fact, making any change in our approach to movement, particularly to the array of complex movements needed for the performance of music, means working closely with our nervous system so that any automatic, unconscious or poor habits may be replaced with healthy, constructive, and coordinate movement choices. 

Protecting Your Vocal Health 

The following information was provided by the National Association of Schools of Music (NASM) and the Performing Arts Medicine Association (PAMA): 

  • Vocal health is important for all musicians and essential to lifelong success for singers. 
  • Understanding basic care of the voice is essential for musicians who speak, sing, and rehearse or teach others. 
  • Practicing, rehearsing, and performing music is physically demanding. 
  • Musicians are susceptible to numerous vocal disorders. 
  • Many vocal disorders and conditions are preventable and/or treatable. 
  • Sufficient warm-up time is important. 
  • Begin warming up mid-range, and then slowly work outward to vocal pitch extremes. 
  • Good posture, adequate breath support, and correct physical technique are essential. 
  • Regular breaks during practice and rehearsal are vital in order to prevent undue physical or vocal stress and strain. 
  • It is important to set a reasonable limit on the amount of time that you will practice in a day. 
  • Avoid sudden increases in practice times. 
  • Know your voice and its limits, and avoid overdoing it or misusing it. 
  • Maintain healthy habits. Safeguard your physical and mental health. 
  • Drink plenty of water in order to keep your vocal folds adequately lubricated. Limit your use of alcohol, and avoid smoking. 
  • Day-to-day decisions can impact your vocal health, both now and in the future. Since vocal strain and a myriad of other injuries can occur in and out of school, you also need to learn more and take care of your own vocal health on a daily basis. Avoid shouting, screaming, or other strenuous vocal use. 
  • If you are concerned about your personal vocal health, talk with a medical professional. 
  • If you are concerned about your vocal health in relationship to your program of study, consult the Department of Music. 

Protecting Your Neuromusculoskeletal Health

The following information was provided by the National Association of Schools of Music (NASM) and the Performing Arts Medicine Association (PAMA):

  •   Neuromusculoskeletal health is essential to your lifelong success as a musician. 
  • Practicing and performing music is physically demanding. 
  • Musicians are susceptible to numerous neuromusculoskeletal disorders. 
  • Some musculoskeletal disorders are related to behavior; others are genetic; still others are the result of trauma or injury.  Some genetic conditions can increase a person’s risk of developing certain behavior-related neuromusculoskeletal disorders. 
  • Many neuromusculoskeletal disorders and conditions are preventable and/or treatable 
  • Sufficient physical and musical warm-up time is important. 
  • Good posture and correct physical technique are essential. 
  • Regular breaks during practice and rehearsal are vital in order to prevent undue physical stress and strain. 
  • It is important to set a reasonable limit on the amount of time that you will practice in a day 
  • Avoid sudden increases in practice times. 
  • Know your body and its limits, and avoid “overdoing it.” 
  • Maintain healthy habits. Safeguard your physical and mental health. 
  • Day-to-day decisions can impact your neuromusculoskeletal health, both now and in the future. Since muscle and joint strains and a myriad of other injuries can occur in and out of school, you also need to learn more and take care of your own neuromusculoskeletal health on a daily basis, particularly with regard to your performing medium and area of specialization. 
  • If you are concerned about your personal neuromusculoskeletal health, talk with a medical professional. 
  • If you are concerned about your neuromusculoskeletal health in relationship to your program of study, consult the Department of Music. 

Noise-Induced Hearing Loss 

Part of the role of any professional is to remain in the best condition to practice the profession. As an aspiring musician, this involves safeguarding your hearing health. Whatever your plans after graduation – whether they involve playing, teaching, engineering, or simply enjoying music – you owe it to yourself and your fellow musicians to do all you can to protect your hearing. If you are serious about pursuing a career in music, you need to protect your hearing. The way you hear music, the way you recognize and differentiate pitch, the way you play music; all are directly connected to your hearing. 

In the scientific community, all types of sound, including music, are regularly categorized as noise.  A sound that it too loud, or too loud for too long, is dangerous to hearing health, no matter what kind of sound it is or whether we call it noise, music, or something else. Music itself is not the issue. Loudness and its duration are the issues. Music plays an important part in hearing health, but hearing health is far larger than music. 

We experience sound in our environment, such as the sounds from television and radio, household appliances, and traffic. Normally, we hear these sounds at safe levels that do not affect our hearing. However, when we are exposed to harmful noise-sounds that are too loud or loud sounds that last a long time-sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensitive structures, called hair cells, are small sensory cells that convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back. NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by continuous exposure to loud sounds over an extended period of time. The humming of a refrigerator is 45 decibels, normal conversation is approximately 60 decibels, and the noise from heavy city traffic can reach 85 decibels. Sources of noise that can cause NIHL include motorcycles, firecrackers, and small firearms, all emitting sounds from 120 to 150 decibels. Long or repeated exposure to sounds at or above 85 decibels can cause hearing loss. The louder the sound, the shorter the time period before NIHL can occur. Sounds of less than 75 decibels, even after long exposure, are unlikely to cause hearing loss. Although being aware of decibel levels is an important factor in protecting one’s hearing, distance from the source of the sound and duration of exposure to the sound are equally important. A good rule of thumb is to avoid noises that are “too loud” and “too close” or that last “too long.” 
It is very important to understand that the hair cells in your inner ear cannot regenerate. Damage done to them is permanent. There is no way to repair or undo this damage. 

Protecting Your Hearing Health  

The Following information was provided by the National Association of Schools of Music (NASM) and the Performing Arts Medicine Association (PAMA): 

  • Hearing health is essential to your lifelong success as a musician. 
  • Your hearing can be permanently damaged by loud sounds, including music. Technically, this is called Noise-Induced Hearing Loss (NIHL). Such danger is constant. 
  • Noise-induced hearing loss is generally preventable. You must avoid overexposure to loud sounds, especially for long periods of time. 
  •   The closer you are to the source of a loud sound, the greater the risk of damage to your hearing mechanisms. 
  •   Sounds over 85 dB (your typical vacuum cleaner) in intensity pose the greatest risk to your hearing. 
  • Risk of hearing loss is based on a combination of sound or loudness intensity and duration. 
  •   Recommended maximum daily exposure times (NIOSH) to sounds at or above 85 dB are as follows: 
    • 85 dB (vacuum cleaner, MP3 player at 1/3 volume) – 8 hours 
    • 90 dB (blender, hair dryer) – 2 hours 
    • 94 dB (MP3 player at 1/2 volume) – 1 hour 
    • 100 dB (MP3 player at full volume, lawnmower) – 15 minutes 
    • 110 dB (rock concert, power tools) – 2 minutes 
    • 120 dB (jet planes at take-off) – without ear protection, sound damage is  almost immediate 
  • Certain behaviors (controlling volume levels in practice and rehearsal, avoiding noisy environments, turning down the volume) reduce your risk of hearing loss. Be mindful of those MP3 earbuds. See chart above. 
  • The use of earplugs and earmuffs helps to protect your hearing health. 
  • Day-to-day decisions can impact your hearing health, both now and in the future. Since sound exposure occurs in and out of school, you also need to learn more and take care of your own hearing health on a daily, even hourly basis. 
  • It is important to follow basic hearing health guidelines. 
  • It is also important to study this issue and learn more.
  • If you are concerned about your personal hearing health, talk with a medical professional. 
  • If you are concerned about your hearing health in relationship to your program of study, consult the Music Department. 

Safe Lifting and Carrying Techniques 

Make it a habit to follow these steps when lifting anything-even a relatively light object. 

  • Size up the load and check overall conditions.  Don’t attempt the lift by yourself if the load appears to be too heavy or awkward.  Check that there is enough space for movement, and that the footing is good.  “Good housekeeping” ensures that you won’t trip or stumble over an obstacle. 
  • Make certain that your balance is good.  Feet should be shoulder width apart, with one foot beside and the other foot behind the object that is to be lifted. 
  • Bend the knees; don’t stoop.  Keep the back straight, but not vertical.  (Tucking in the chin straightens the back.) 
  • Grip the load with the palms of your hands and your fingers.  The palm grip is much more secure.  Tuck in the chin again to make certain your back is straight before starting to lift. 
  • Use your body weight to start the load moving, then lift by pushing up with the legs.  This makes full use of the strongest set of muscles. 
  • Keep the arms and elbows close to the body while lifting. 
  • Carry the load close to the body.  Don’t twist your body while carrying the load.  To change direction, shift your foot position and turn your whole body. 
  • Watch where you are going! 
  • To lower the object, bend the knees. Don’t stoop.  Make sure your hands and feet are clear when placing the load. 

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Keeping Instruments Clean

Antiseptically Clean 

More and more our society is pushing for products that are anti-fungal, anti-bacterial and anti-viral. Some even go the next step further aiming to achieve sterile. However, our bodies by design are not meant to live in a sterile environment. As kids we played in the dirt, ate bugs and countless other things and became stronger because of it. Keep in mind that total sterility is a fleeting moment. Once a sterile instrument has been handled or exposed to room air it is no longer considered to be sterile. It will however remain antiseptically clean until used. 

Most viruses cannot live on hard surfaces for a prolonged period of time. Some die simply with exposure to air. However, certain groups are quite hardy. Therefore, musicians must be concerned with instrument hygiene. Users of school owned and rented musical equipment might be more susceptible to infections from instruments that are not cleaned and maintained properly. 

If the cleaning process is thorough, however, musical instruments will be antiseptically clean. Just as with the utensils you eat with, soap and water can clean off anything harmful. Antibacterial soaps will kill certain germs but all soaps will carry away the germs that stick to dirt and oils while they clean. No germs/ no threat. 

Infectious Disease Risks 

Sharing musical instruments is a widespread, accepted practice in the profession. However, recent discussion in the profession has included concern regarding shared musical instruments and infectious disease, especially HIV. 
The Centers for Disease Control (CDC), has confirmed that there is no risk of transmission of HIV (the virus that causes AIDS), or Hepatitis B (HBV) through shared musical instruments. The reasons for this are that these diseases are passed via a blood-to-blood, sexual fluid or mucous membrane contact. There has been no case of saliva transmission of HIV (the virus that causes AIDS), or Hepatitis B (HBV). 

Instrument Hygiene 

While the possibility of transmission of the above bacteria and viruses is not a real consideration, it is apparent that there should be a protocol with regard to shared musical instruments. Sharing of instruments is routine in music schools, where students practice and perform on borrowed instruments throughout the year. Certain basic considerations and recommendations for standard operating procedures regarding shared instruments are recommended as follows: 

  1. All musicians or students should have their own instrument if possible. 
  2. All musicians or students should have their own mouthpiece if possible. 
  3. All students and faculty sharing reed instruments  MUST  have their own individual reeds. Reeds should  NEVER  be shared. 
  4. If instruments must be shared in class, alcohol wipes or Sterisol germicide solution should be used before sharing instruments between different people. 

Mouthpieces 

The mouthpiece (flute head joint, English Horn and bassoon bocal, and saxophone neck crook) are essential parts of wind instruments. As the only parts of these instruments placed either in or close to the musician’s mouth, research has concluded that these parts (and reeds) harbor the greatest quantities of bacteria. 

Adhering to the following procedures will ensure that these instrumental parts will remain antiseptically clean for the healthy and safe use of our students and faculty. 

Cleaning the Flute Head Joint 

  1. Using a cotton swab saturated with denatured, isopropyl alcohol, carefully clean around the embouchure hole. 
  2. Alcohol wipes can be used on the flute’s lip plate to kill germs if the flute shared by several players. 
  3. Using a soft, lint-free silk cloth inserted into the cleaning rod, clean the inside of the headjoint 
  4. Do not run the headjoint under water as it may saturate and eventually shrink the headjoint cork. 

Cleaning Bocals 
Bocals should be cleaned every month with a bocal brush, mild soap solution, and running water. English Horn bocals can be cleaned with a pipe cleaner, mild soap solution, and running water. Be careful not to scratch the inside of the bocal with the exposed wire ends of the pipe cleaner.

Cleaning Hard Rubber (Ebony) Mouthpieces

  1. Mouthpieces should be swabbed after each playing and cleaned weekly. 
  2. Select a small (to use less liquid) container that will accommodate the mouthpiece and place the mouthpiece tip down in the container. 
  3. Fill the container to where the ligature would begin with a solution of half water and half white vinegar (50% water and 50% hydrogen peroxide works too). Protect clarinet mouthpiece corked tenons from moisture. 
  4. After a short time, use an appropriately sized mouthpiece brush to remove any calcium deposits or other residue from inside and outside surfaces. This step may need to be repeated if the mouthpiece is excessively dirty. 
  5. Rinse the mouthpiece thoroughly and then saturate with Sterisol germicide solution. Place on paper towel and wait one minute. 
  6. Wipe dry with paper towel. 
  7. Note: Metal saxophone mouthpieces clean up well with hot water, mild dish soap (not dishwasher detergent), and a mouthpiece brush. Sterisol germicide solution is also safe for metal mouthpieces. 

Cleaning Saxophone Necks (Crooks) 

  1. Swabs and pad-savers are available to clean the inside of the saxophone neck. However, most saxophonists use a flexible bottlebrush and toothbrush to accomplish the same results. 
  2. If the instrument is played daily, the saxophone neck should be cleaned weekly (and swabbed out each day after playing). 
  3. Use the bottlebrush and mild, soapy water to clean the inside of the neck. 
  4. Rinse under running water. 
  5. Sterisol germicide solution may be used on the inside of the neck at this time, if desired (not necessary). Place on paper towel for one minute. 
  6. Rinse again under running water, dry, and place in the case. 
  7. If using pad-savers, do not leave the pad-saver inside the neck when packed away. 

Cleaning Brass Mouthpieces 

  1. Mouthpieces should be cleaned monthly. 
  2. Using a cloth soaked in warm, soapy water, clean the outside of the mouthpiece. 
  3. Use a mouthpiece brush and warm, soapy water to clean the inside. 
  4. Rinse the mouthpiece and dry thoroughly. 
  5. Sterisol germicide solution may be used on the mouthpiece at this time. Place on paper towel for one minute. 
  6. Wipe dry with paper towel. 

Other Instruments 

  1. String, percussion, and keyboard instruments present few hygienic issues that cannot be solved simply by the musician washing their hands before and after use. 
 

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Additional Information

Peak Performance Bibliography  

  • Bruser, Madeline. The Art of Practicing. Bell Tower, 1997. Subtitled: A Guide to Making Music from the Heart. 1997.  
  • Conable, Barbara. What Every Musician Needs to Know About the Body. Andover Press, 2000. Subtitled: The Practical Application of Body Mapping to Making Music.  
  • Dunkel, Stuart Edward. The Audition Process. Pendragon Press, 1989.  
  • Gallwey, W. Timothy. The Inner Game of Tennis. Random House, 1974. 
  • Gorrie, Jon. Performing in the Zone. Create Space, 2009. 
  • Green, Barry. Mastery of Music. Broadway Books, 2005. 
  • Greene, Don. Audition Success. ProMind Music, 1998. 
  • Greene, Don. Fight Your Fear and Win: A 21-Day Plan. Broadway Books, 2001. Subtitled: 7 Skills for Performing Your Best Under Pressure – at Work, In Sports, On Stage. 2001.  
  • Greene, Don. Performance Success. Routledge, 2002. 
  • Klickstein, Gerald. The Musician’s Way. Oxford, 2009. 
  • Kruger, Irmtraud Tarr. Performance Power. Summit Books, 1993.  
  • Lieberman, Julie Lyonn. You Are Your Instrument. Huiksi Music, 1991.  
  • Maisel, Eric. Performance Anxiety: A Workbook for Actors, Singers, Dancers, and Anyone Who Performs in Public. Back Stage Books, 2005.  
  • Ristad, Eloise. A Soprano on Her Head. Real People Press, 1982. 
  • Roland, David. The Confident Performer. Heinemann, 1997.  
  • Werner, Kenny. Effortless Mastery. Jazz Aids, 1996. 

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