Presentation on theme: "1 Performing Artists as Athletes: A New Perspective Evan D. Collins, M.D. Center for Orthopedic surgery The Methodist Hospital Houston, Texas."— Presentation transcript:
1 Performing Artists as Athletes: A New Perspective Evan D. Collins, M.D. Center for Orthopedic surgery The Methodist Hospital Houston, Texas
2 Introduction Musculoskeletal injuries were reported by greater than 50% of the 264,000 employed Musicians in 2006 National survey of orchestral musicians 76% of the respondents had to take time off from performing because of injury during their career
3 Introduction Common injuries reported: Persistent pain in the extremity Loss of facility Loss of endurance Loss of strength Common diagnosis: Overuse syndrome Repetitive stress Myofascial pain Tendonitis
4 Introduction Recent review of Playing-Related Musculoskeletal Disorders (PRMD) indicated a 35% prevalence of recurrent problems despite treatment Approximately 1/3 of musicians require multiple visits to medical providers
5 Introduction No consensus on effective treatment No outcome data regarding treatment modalities Patient satisfaction
6 Introduction Questions: Why is it so difficult to effectively treat? What can we do differently to improve this problem for performing artists?
7 Approach Traditional Medical dogma People seek medical attention when something hurts People seek medical attention when things don’t work Medical treatment applies scientific approach Assumes that identifying the change from normal, and then correcting it, will alleviate the problem
8 Introduction Consider the type of problem the patient has Categories Mechanical - broken, torn or compressed Biological - infections or disease
9 Mechanical Examples X-ray of broken humerus
11 Mechanical Ulnar nerve decompression surgery
12 Biological Rheumatoid arthritis, cancer, bone cyst
13 Additional Category Capacity problem: All constructs have a defined “capacity” to perform work When you exceed the ability for a construct to perform work - “exceed capacity” Result is break down The majority fall into this category Repetitive stress Over-use syndrome Chronic Fatigue syndromes Tendonitis Bursitis
14 Science of Capacity Musculoskeletal system principle material is collagen Collagen cross linkage Strength dependent on amount of cross- linkages
15 Science of Capacity Stress increase cross linkage between collagen fibers decrease weakening the construct Exceed capacity, failure occurs
16 Capacity Lateral Epicondyltits (Tennis elbow) Pathology - Tendon fails after repetitive use Most people never played tennis Occurs between ages adults 30-65
17 Capacity Treatments Rest, injections, splinting, physical therapy Surgery Before After
18 Capacity Considering these musculoskeletal problems as a lack of capacity, can we apply this in a more efficacious way for the performing artist? How does this apply to athletes, and relate to the performing artist?
19 Capacity A Football play lasts on average 3.5 - 5.5 sec for sixty minutes Time from a pitch to completed out is less then 6 sec repeated until 27 outs have been recorded Soccer match has two 45 min halves
20 Capacity Opera – Some can last as long as 4 hours with one intermission Ballet – Nutcracker Symphony - Two hours with one intermission
21 Capacity Athletes train to achieve peak performance Athletes train to prevent injuries Athletes train to increase their capacity to do work
23 Capacity Energy used during a performance Violinist can burn over 700 calories per hour equivalent to 40 minutes on a treadmill with average heart rate of 140 bpm
24 Capacity The athlete trains to increase his/her capacity Why not a performing artist?
25 Treatment Example: Rule out biological and mechanical problems first Identify capacity problems Corrected with physical therapy, core strengthening, and training specific to that performer