Article
Fitting the task to the man, or the man to the task? Making music without pain
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Authors
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Freek Lötters
- Hand en Pols Revalidatie Nederland, Goes, Netherlands
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Anandi van Loon-Felter
- Hand en Pols Revalidatie Nederland, Medisch Centrum voor Dansers en Musici - Haaglanden MC, Den Haag, Netherlands
| Published: | February 6, 2020 |
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Outline
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Clinical issue/s: In the past two years we saw 132 musicians with hand problems in our rehabilitation clinic for hand and wrist complaints. Some core figures of this population: 58% male,42% female; age 45,2±20,3. 38% were professional musician, 51% amateur musician, and 11% were music students. Top 4 diagnoses were: 23% finger injury, 16% MCI/hypermobility, 15% osteoarthritis, 15% tendinitiden. Top 3 instrument groups were: 29% piano/organ, 20% violin/cello, 18% guitar.
Clinical reasoning: Musicians perceive a high target level when playing their instrument combined with a high grade of perfectionism. It's a matter of 'playing the piano' or 'being a pianist'. Hence, don't tell the musician, unsubstantiated, that he cannot play anymore. Often there are lots of possibilities, if you know where to look.
Innovative, analytical or new approach: In our rehabilitation approach we use an existing model of workload versus workcapacity modified for the population of musicians. This modification is conducted after an extensive literature review. Core terms in the model are: loading factors(physical, mental and work related factors), symptoms occurring due to these factors (the way loading factors are expressed in a disorder), the consequences of the load symptoms (disability and participation problems), processing power or workcapacity (one owns physical and mental resistance), and control options (autonomy, freedom of action and decision making).
It is essential to analyze the complaints of the musician while playing the instrument. A small impairment in mobility can go unnoticed in usual daily activities, but can have a devastating effect for the musician in handling his/her instrument.
Contribution to advancing HT practice: In order to give adequate treatment, the therapist has to be able to recognize the problems musicians encounter. Our model can be used in detecting and analyzing the potential perceived problems by the musicians, and can yield starting points for treatment and advise. It's often a balancing act between fitting the task to the man, or fitting the man to the task.
