Presenters for the Medical Problems of Trumpeters Symposium offered information to a full room of professional trumpeters, health care specialists, and teachers. The presenting teams credentials and accomplishments assured that the information was credible and useful to all attendees.
Kris Chesky began the four-hour session by acknowledging both the Texas Center for Music & Medicine (TCMM) and the Performing Arts Medical Association (PAMA) as the sponsoring organizations for the symposium. Following some informal questions about the backgrounds of the attendees, he provided an overview of how the afternoon would be structured.
Dr. Rubin began by describing the results of a recent study conducted at the TCMM and funded by the Grammy organization that surveyed over 4,000 musicians about health issues. Rubins analysis included data from 739 brass instrumentalists and was designed to highlight what trumpeters reported and how they differ from French horn, trombone, and low brass groups. Of the 227 trumpeters, 53% reported one or more musculoskeletal problems associated with playing. Dr. Rubin showed that trumpet players had a higher prevalence rate for problems on their right side, particularly with fingers, hand, wrist, and shoulder, when compared to the left side. He further explained how this kind of data helps focus additional research studies, like the one that was described on Wednesday afternoon. Dr. Rubin also focused on various non-musculoskeletal problems. Headache, blackout, hearing loss and loss of lip were mentioned as serious concerns and probably directly associated with the physical demands associated with performing the trumpet.
Using data from brass instrumentalists that he personally evaluated over the past 20 years, Dr. Lederman characterized the problems that he has seen as a clinician. From this series, he described brass players diagnosed with dystonia as having symptoms ranging from impairment in lip control, problems of articulation or tone quality, and loss of seal. Others with over-use phenomena and soft tissue injury were described as reported predominance of pain, swelling, or discoloration. Dr. Lederman explained that treatment typically consisted of a moderated period of rest and gradual return to playing with a focus on change in technique to prevent recurrence. However, retraining and other interventions for patients with dystonia were generally unsatisfactory. Dr Lederman used videos of patients attempting to play their instrument to demonstrate how dramatic such impairments influence a highly skilled musicians ability to perform.
As a Human Performance Engineer, Dr. Kondraske presented a model as a conceptual basis for studying the musician-instrument interface, particularly as it relates to trumpet. He defined this as a more generalized approach to problem conceptualization, research, and intervention strategies and that while musician health problems do have unique aspects, they are common with those related to other occupational and educational contexts. From this point of view, Dr. Kondraske introduced both Drs. Ashenbrenner and Henoch to provide extensive details about anatomical and functional aspects of both the face and lips, and the ear. Dr. Aschenbrenner used images from a series of cadaver dissections to detail the muscular, neurologic, and vascular aspects of the face, mouth and lips. Dr. Henoch relied on similar images and graphical representations to highlight the details of hearing. Following these two extraordinary anatomical descriptions, Dr. Kondraske skillfully argued how this information can be useful to further explore the functions of these structures and their respective contribution to the human capacities needed in the context of trumpet playing. As a basis for focused research, he argued that this perspective holds tremendous promise for advancing our understanding of music playing. Dr. Kondraske closed by announcing a new grant from the Grammys that is earmarked specifically to study musicians using this approach.
Ending the symposium, Dr. Chesky described recent changes in the National Association of Schools of Music (NASM) accrediting handbook that direct schools of music to offer instruction to all music students about medical problems. There are over 500 music schools accredited by NASM in the US. He also announced that the TCMM, together with PAMA, recently received grant funding from both the National Endowment for the Arts and the Grammy organization to host a national conference designed to help NASM schools address the new accreditation guidelines. Subsequent discussions with symposium attendees, particularly those with medical degrees, suggested that ITG has wonderful resources within its membership to help with this and other projects. Ending on a note of extended collaboration and future involvement, the ITG can look to this successful symposium as the beginning for a promising future as we collectively seek to reduce the risks associated with playing the trumpet.