PURPOSE: Cellists sustain high levels of playing-related injury and are particularly susceptible to right shoulder pain, yet no studies have attempted to propose a mechanism for disease or establish possible causal factors. The aim of this study was to investigate shoulder injury levels and causes in two populations: professional orchestral cellists and college-level student cellists. METHODS: A questionnaire and physical testing protocol was applied to both groups of participants, eliciting information on lifestyle, playing habits, and self-reported injury rates as well as physical data on shoulder strength, range of motion, and signs of injury. RESULTS: Right shoulder injuries are common among both student (20%) and professional (42%) cellists and seem to be associated with measures indicating potential lack of strength in the scapular stabilisers as well as potential degenerative changes in the rotator cuff. Significant differences were found in the lifestyle and playing habits of the two groups. There were increased signs of pain and stiffness in the professionals and evidence of decreased muscular support in the students. Male cellists showed less scapular stability; female cellists, however, generally had higher levels of pain. CONCLUSIONS: These results indicate that injuries at the shoulder, potentially involving impingement-type pathologies, are a common cause of pain in cellists. Based on this study, future research for cello players could focus on targeted interventions, such as exercises for the scapular stabilisers and muscles of the rotator cuff.

Workplace rehabilitation in the orchestral setting poses a number of challenges that arise in part due to a poor fit between generic injury insurance and medical care and the elite performance requirements of professional musicians. Currently, the orchestral profession lacks information and strategies to best deal with the unique challenges of this complex rehabilitation environment. In order to inform future directions for research and suggest possible changes of practice, the researchers conducted a qualitative case-study aimed at understanding the injury and rehabilitation experiences of professional musicians. In-depth semi-structured interviews were undertaken with three chronically injured professional cellists from a single Australian orchestra. After initial data analysis, further interviews were undertaken with a set of five orchestral management staff as a means of data triangulation. All data were analysed using a themes-based analysis-of-narrative approach. The findings indicate that injury concealment played a considerable role in the development of chronic injuries for these musicians, and management staff felt that this concealment may be the norm amongst orchestral musicians. The musicians in this study suffered emotional and psychological trauma as the result of their injuries, and two participants felt socially marginalised. During rehabilitation, the musicians in this study encountered difficulties with medical staff not understanding the elite performance requirements of orchestral work. The article proposes recommendations that may assist in dealing with the complex challenges of injury rehabilitation in the orchestral environment.

The organisational culture, behavioural norms, and attitudes of a workplace have a profound influence on levels of injury and illness amongst its workers. While this is well established in Work Health and Safety literature, very little research has attempted to understand the influence of organisational culture on injury risk in the orchestral profession. To address this, the current study aimed to investigate the influence of organisational culture on injury outcomes for orchestral musicians. Using a qualitative case study methodology, in-depth semi-structured interviews were undertaken with 10 professional orchestral cellists (2 freelance and 8 fulltime members) from a single Australian orchestra. After initial data analysis, further interviews were undertaken with a set of 5 orchestral management staff as a means of data triangulation. All data were analysed using a themes-based “analysis of narrative” approach. The findings indicate that an orchestral culture exists in which musicians see injury as a sign of weakness, failure, and poor musicianship. Such negative perceptions of injury influence musicians to play through considerable levels of pain and continue performing with injuries. Because of perceived judgment from the orchestral group, musicians were found to conceal injuries from colleagues and management staff. Freelance musicians felt that disclosing injuries may lead to decreased work opportunities, and both full-time and casual musicians felt that “opening up” about injury may subject them to group judgment about their technique or musicianship. The study suggests education measures which may be effective at influencing individual behaviours and attitudes as well as cultural change initiatives which could lead to long-term positive health outcomes in the orchestral workplace.

Injury risks associated with musical performance continue to be a serious problem for professional and student musicians. Much research has focused on the incidence and severity of these problems yet less information is available on the potential influence of health awareness and attitudes to injuries in these populations. This study aimed to investigate health awareness and attitudes to injury amongst Australian music students. Using a qualitative case study methodology, in-depth semi-structured interviews were undertaken with 11 student cellists. Further interviews were undertaken with 10 orchestral cellists and five orchestral management staff as a means of triangulating student data. All data were analysed using a "themes-based" analysis of narrative approach. Findings indicated that in comparison to professional cellists students demonstrated poor health awareness and behaviours such as playing through pain and inaction in response to injury. Analysis of the combined interview data (student, professional and management) suggest that there is poor health awareness and knowledge of injury prevention strategies at all levels of education and training. All three participant groups felt that changes needed to be made to current music education practices and that health education should be integrated into core curriculum.

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