Some musicians and music teachers may not be aware of the work of the British Association for Performing Arts Medicine (BAPAM), which connects those working and studying in the performing arts with clinical specialists in this field, offering free clinical assessments. The MU is proud to support the work of BAPAM.
BAPAM and the MU are currently working together on a new guide for instrumental and vocal teachers that provides advice on how to support and promote students’ health and wellbeing. This column is a quick preview of some the ideas that will feature in that guide.
The guide will be structured around the mnemonic PERFORMANCE, which was developed for BAPAM by Dr Christina Siomos. Each letter stands for a different aspect of musicians’ health and wellbeing, as follows:
- Posture
- Environment
- Routine
- Fitness
- Overuse
- Rest and Recovery
- Mental Health
- Anxiety
- Nutrition
- Clinical Expertise
PERFORMANCE is a useful and memorable summary of the dimensions of health and wellbeing that teachers should be aware of when working with learners.
Poor posture is the cause of many aches and pains, and improving posture can vastly improve the quality of playing and performing. Teachers should encourage healthy posture in their students, adapting this as young learners grow. Equipment like shoulder rests, straps and chairs should all be selected to promote good posture. Alexander Technique, body mapping, Feldenkrais and yoga can all help musicians better understand their body and improve their posture.
The performance environment is not always a space that performers have control over. Checking the environment in advance is as important as a sound check, and students should be encouraged to find out where they will be located on stage (encourage a parent or carer to do this for younger students). Check for access, sight lines, lighting, stage set-up and temperature. Think about what food and drink will be available and consider preparing meals ahead.
Encourage your student to structure their time to ensure that health and wellbeing are embedded into their daily and weekly routine. A balance of activity is helpful for mental and physical health. This should include necessary activities like schoolwork or practice, but students should also make time for pleasurable, relaxing, restorative activities. Diaries can be a helpful way of encouraging students to plan their time.
Turning now to fitness, the term ‘musical athlete’ was first coined by Nicholas Quarrier in 1993. He noted that strength, flexibility, endurance and co-ordination – as well as ability – are required by athletes and musicians, and that both work in a competitive environment with high expectations. Musicians should therefore undertake cardiovascular, strength, endurance and flexibility training to give themselves the best chance of developing the strength and stamina they need while reducing the chance of injury.
Instrumental musicians are prone to numerous playing-related musculoskeletal disorders associated with overuse. This occurs when excessive, repetitive or unaccustomed use leads to soft tissue damage, either acutely or over time. Teachers should introduce new and possibly demanding work to learners with enough time for them to build up to a performance in order to avoid injury.
Time for rest and recovery should always be part of musicians’ schedules. Practising away from the instrument is a useful way to ‘rest’ actively. Musicians who have suffered an injury should take care to build back gradually. And of course, getting enough sleep is vital.
Good mental health is vital for us all. Practising techniques and exercises that support mental health should be part of the weekly schedule in the same way as fitness training. Such techniques include breathing, mindfulness, mediation, journalling and yoga.
Anxiety is frequently experienced in relation to performance. Encourage students to use pre-performance routines – warming up the body by marching on the spot, for example, can help increase arousal if you are feeling lethargic, and breathing exercises can help reduce stress. Distraction techniques to help manage stress levels can be helpful when waiting backstage. Bring a book or something that can take the mind away from the task ahead.
On nutrition, encourage students to find a healthy balance with the food they eat, including staying hydrated. They should ideally develop good eating habits when they are not under pressure and then keep these up when the pressure is on.
Encourage your student to speak to someone with clinical expertise if you think they may be struggling with a health problem, whether physical or mental. The most important thing is for them to get a clinical diagnosis so that the most effective treatment can be provided. BAPAM can provide a free clinical assessment for musicians over the age of 13. An NHS doctor is also a first port of call.
Watch this space for further information about the forthcoming guide and training to support it. Meanwhile, feel free to contact BAPAM or the MU about any aspect of health and wellbeing.
