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Introduction

The Department of Music and Dance Program, accredited by the National Association of Schools of Music (NASM), makes this body of resources available to inform students and faculty of health and safety issues, hazards and procedures inherent in practice, performance, teaching and listening, both in general and as applicable to their area(s) of specialization. This includes, but is not limited to information regarding hearing, vocal and musculoskeletal health, injury prevention, and the use, proper handling and operation of potentially dangerous materials, equipment and technology.

These resources intend to aid in the formulation of protocols and operational procedures to guard against injury and illness in the study and practice of music, as well as to raise the awareness among our students and faculty of the connections between musicians' health, the suitability and safety of equipment and technology, and the acoustic and other health-related conditions in the University's practice, rehearsal, and performance facilities. The Department has also included materials and resources pertinent to the health and safety of dancers.

It is important to note that health and safety depends largely on personal decisions made by informed individuals. ºÚ°µ±¬ÁÏÍø has health and safety responsibilities, but fulfillment of these responsibilities cannot and will not ensure any individual's health and safety. Too many factors beyond the University's control are involved.

Each individual is personally responsible for avoiding risk and preventing injuries to themselves before, during, and after study or employment in the Department of Music and Dance Program at ºÚ°µ±¬ÁÏÍø. The policies, protocols and operational procedures developed by the Department of Music and Dance Program do not alter or cancel any individual's personal responsibility, or in any way shift personal responsibility for the results of any individual's personal decisions or actions, in any instance or over time, to the University.

Performance Injuries

Anyone who practices, rehearses or performs instrumental or vocal music has the potential to suffer injury related to that activity. Instrumental musicians are at risk for repetitive motion injuries. Sizable percentages of performers develop physical problems related to playing their instruments, and if they are also computer users, their risks are compounded. Performance related injuries often include carpal tunnel syndrome, tendinitis, and bursitis. Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain, disability and the end of careers.

What Instrumentalists Should Do

The Department of Music wishes to thank the Associated Board of the Royal Schools of Music and the Canadian Network for Health in the Arts for the following information:

1. Evaluate your technique. Reduce force, keep joints in the middle of their range of motion, use large muscle groups when possible, and avoid fixed, tense positions.
2. Always warm up. As an athlete would not begin a vigorous physical activity without warming up, a musician must warm up carefully before lessons, practice, and performance.
3. Take breaks to stretch and relax. Take short breaks every few minutes and longer breaks each hour. Two or more shorter rehearsals each day are more productive than marathon single sessions. Even in performance, find those opportunities to relax a hand, arm, or embouchure to restore circulation.
4. Pace yourself. No pain, no gain is a potentially catastrophic philosophy for a musician. Know when enough is enough, and learn to say 'no' to certain performances or lengths of performing that might result in injury.
5. Check out your instrument. Does your instrument place undue stress on your body? Is your instrument set up optimally for you to relieve pressure on hands, joints, etc.? Is there a strap, carrier, or stand available to relieve the stress?
6. Evaluate other activities. Pains and injuries affecting your music making could be caused by other activities in your daily life. Computer use is notorious for causing afflictions including carpal tunnel syndrome and tendinitis.
7. Pay attention to your body. Pain is the mechanism by which your body tells you that something is wrong. Listen to your body; if it hurts, stop what you are doing.
8. Get medical attention. Do not delay in seeing a doctor. A physician may prescribe a minor adjustment or, in worst-case scenarios, stipulate not performing for a period of time. As drastic as this may sound, a few months of rest is better than suffering a permanent, career ending injury. Likewise, the demands placed on singers' voices are immense. Hardly a month goes by where a top singer is not forced to interrupt a tour, take a break, or undergo a medical procedure due to problems with their voice. Medical professionals are making the case that the demands put on one's voice when singing one to three hours is as intense as those made on an Olympic marathon runner's body. Additional factors such as nutrition, smoking, drug use, noisy environments, and proper voice training (or the lack of it) all play a role in a singer's ability to perform at her/his best.

What Singers Should Do

The Department of Music wishes to thank The Singer's Resource, the Texas Voice Center, Houston, and the University of Michigan Vocal Health Center for the following information:

1. Maintain good general health. Get adequate rest to minimize fatigue. If you do become ill, avoid "talking over your laryngitis." See your physician and rest your voice.
2. Exercise regularly.
3. Eat a balanced diet. Include vegetables, fruit and whole grains, and avoid caffeinated drinks (coffee, tea and soft drinks) and alcohol. Avoid spicy, acidic and dairy foods if you are sensitive to them.
4. Maintain body hydration. Drink two quarts of water daily.
5. Avoid dry, artificial interior climates. Using a humidifier at night might compensate for dryness.
6. Limit the use of your voice. High-ceilinged restaurants, noisy parties, cars and planes are especially damaging to the voice. If necessary, use amplification for vocal projection.
7. Avoid throat clearing and voiced coughing.
8. Stop yelling, and avoid hard vocal attacks on initial vowel words.
9. Adjust the speaking pitch level of your voice. Use the pitch level in the same range where you say, "Umm-hmm?"
10. Speak in phrases rather than in paragraphs. Breath slightly before each phrase.
11. Reduce demands on your voice. Don't do all the talking!
12. Learn to breathe silently to activate your breath support muscles and reduce neck tension.
13. Take full advantage of the two free elements of vocal fold healing: water and air.
14. Vocal athletes must treat their musculoskeletal system as do other types of athletes; therefore, vocal warm-ups should always be used prior to singing. Vocal cool-downs are also essential to keep the singing voice healthy.

What All ºÚ°µ±¬ÁÏÍø Musicians Should Do

1. Stay informed. Awareness is the key. Like many health-related issues, prevention is much easier and less expensive than cures. Take time to read available information concerning injuries associated with your art.
2. Musicians might find the following books helpful:
   • Conable, Barbara. "What Every Musicians Needs to Know About the Body" (GIA Publications, 2000)
   • Klickstein, Gerald. "The Musician's Way: A Guide to Practice, Performance, and Wellness" (Oxford, 2009)
   • Norris, Richard N. "The Musician's Survival Manual" (International Conference of Symphony and Opera Musicians, 1993)

The following links may be useful:

•  (ABRSM), the world's leading authority on musical assessment, actively supporting and encouraging music learning for all.
•  (PAMA), an organization comprised of dedicated medical professionals, artists educators, and administrators with the common goal of improving the health care of the performing artist.
• , founded in 1989 for the diagnosis, treatment, and prevention of voice disorders.
•  (NCVS), conducts research, educates vocologists, and disseminates information about voice and speech.
•  University of Michigan Health System, recognized locally, regionally and nationally as a leading institution for the treatment and prevention of voice disorders. At the heart of the Center is a professional team comprised of experts from the University of Michigan Health System and U-M School of Music, encompassing the fields of Laryngology, Speech Pathology, and Vocal Arts.
• The  (HLAA) is the nation’s leading organization representing people with hearing loss. According to the National Center for Health Statistics, 48 million (20 percent) Americans have some degree of hearing loss, making it a public health issue third in line after heart disease and arthritis.

Local Chicago Area Performing Arts Health and Wellness Resources

•  (MPPA). The MPPA provides comprehensive performance oriented medical evaluation and treatment of medical problems that occur in instrumentalists, singers, dancers and actors at all performance levels, including students, professionals and amateurs.

What Dancers Should Do

Links to valuable resources for dancers on dancer health:

• Dance USA:
• Dance UK:

The Department of Music maintains a collection of musical instruments for checkout and use by members of the music faculty and students enrolled in its courses and performing ensembles. As with other items used in the course of our daily lives, musical instruments must be cared for properly and cleaned regularly. Each instrument in the Department's collection receives a thorough inspection at the conclusion of the academic year. Every year, considerable resources are dedicated to clean, adjust and return instruments to full playing condition.

Antiseptically Clean

More and more our society is pushing for products that are anti-fungal, anti-bacterial and anti-viral. Some even go the next step further aiming to achieve sterile. However, our bodies, by design, are not meant to live in a sterile environment. As children we played in the dirt, ate bugs and countless other things, and became stronger because of it. Keep in mind that total sterility is a fleeting moment. Once a sterile instrument has been handled or exposed to room air it is no longer considered to be sterile. It will, however, remain antiseptically clean until used.

Most viruses cannot live on hard surfaces for a prolonged period of time. Some expire when exposed to air. However, certain groups are quite hardy. Therefore, musicians must be concerned with instrument hygiene. Users of school owned and/or rented musical equipment might be more susceptible to infections from instruments that are not cleaned and maintained properly.

If the cleaning process is thorough, however, musical instruments will be antiseptically clean. Just as with the utensils used for eating, soap and water can clean off anything harmful. Antibacterial soaps will kill certain germs, but all soaps will carry away the germs that stick to dirt and oils while they clean. No germs = no threat.

Infectious Disease Risks

Sharing musical instruments is a widespread, accepted practice in the profession. However, recent discussion in the profession has included concern regarding shared musical instruments and infectious disease, especially HIV.

The Centers for Disease Control (CDC), has confirmed that there is no risk of transmission of HIV (the virus that causes AIDS), or Hepatitis B (HBV) through shared musical instruments. The reasons for this are that these diseases are passed via a blood-to-blood, sexual fluid or mucous membrane contact. There has been no case of sa