Vera Baadjou Vera Baadjou foto: Sacha Ruland

Painful love of music

In Body
Written by  Dunja Bajic Thursday, 12 May 2011 10:48

Research into the treatment of physical problems among musicians

Around seventy per cent of orchestra musicians suffer physical symptoms arising from the activity they love the most: producing music. In many instances the problems occur because musicians adopt unsuitable postures when playing their instruments. This can even influence the sound of the instrument. Vera Baadjou, rehabilitation doctor in training and a PhD student at Maastricht University, is to investigate whether a treatment based on the Mensendieck therapy is effective against such problems. This study has been made possible by a grant from Ans Samama, who developed the method and has applied it with thousands of professional musicians. She has set up a fund to test the method scientifically.


“It appears that a very large percentage of conservatoire students experience problems from playing music, comparable to occupational overuse syndrome, or repetitive strain injury (RSI). These problems manifest themselves through pain, tingling or even difficulties in controlling the arms or fingers. This occurs among other things because the conservatoires devote little attention to physical posture,” suggests Baadjou. “Students are not actually taught how they should use their bodies efficiently to preclude strain, while there is certainly plenty of attention devoted to technique, for instance.” Baadjou emphasises that it is in fact vital to teach correct posture at an early stage, because this can prevent many of the problems that arise later. “In practice it appears that the problems of around eighty per cent of Samama’s patients have been reduced or have disappeared entirely following treatment. With this study we want to test whether a ‘good posture for making music’ has an effect on preventing physical problems among conservatoire students.”


The Samama method

The treatment method which Baadjou will study was developed by Ans Samama and originated in the Mensendieck therapy. The therapy is a combination of awareness and posture. “It is important to be aware of your own body, of the muscles you use when playing and the way you should sit. Samama also asks her patients to sit with their torso a little further forward, to push the breastbone forward a little and to ensure that the pelvis can be tilted slightly backwards. This enables the back to be straight and strong, and there is more space for the arms to be able to move freely. This leads to a better balance of muscle use and results in better breathing,” explains Baadjou. In fact better breathing is vitally important for wind instrument players because of its direct influence on the tone quality.

The basis of the Samama method is that three types of muscles are used while playing: the balance muscles, the active playing muscles and the passive playing muscles. The balance muscles are the large muscles in the back – particularly the lower ones – which ensure that the body balance is firm. The active playing muscles are the active muscles which tense actively when playing music. For a violinist these are the fingers, wrists and arms. The passive playing muscles are the muscles which must be kept relaxed while playing, such as the shoulders and the upper neck muscles. The idea is to create good coordination between the three muscle types.
Samama’s method is unique because it is aimed specifically at musicians. “Physiotherapists can of course apply their general therapies, but these are never designed for a musician in particular. Because Samama has worked almost exclusively with musicians for many years, she knows the specific movements they make and the techniques for each instrument, so that a specific treatment is possible,” says Baadjou.

Research structure

The study is still in its start-up phase, where the exact approach is under consideration. Ans Samama herself is actively cooperating on the structure. Baadjou: “The idea is to divide a group of first-year conservatoire students, where half the group will not receive any therapy (and therefore progress through the conservatoire as currently happens), and the other half will undergo a preventive teaching programme, where the Samama method will be explained and applied. We want to start in the first academic year, and then carry out repeat lessons in the subsequent years. Within the programme we will explain to students how the body is constructed, how it is used when playing and what possibilities there are for improving the posture. We will then teach them the correct posture. We anticipate that the method will lead to a better posture and thus to fewer problems. We will test this at the end of the fourth study year, using pain scores, interviews and measuring muscle use, coordination and breathing volume, for example.”


Computer users

The Samama treatment could also be applied to those using computer screens. This is because they develop the same type of problems, arising partly through repetitive movements and the incorrect use of arms, neck and shoulders. Ten years ago Samama researched her method for the prevention of RSI symptoms, together with rehabilitation specialist Dr Marjon van Eijsden-Besseling, who recently graduated with this specialisation. However Baadjou does concede that there are major differences between musicians and those using computer monitors. “One major difference is in the level of performance. It is more difficult to achieve the optimum tone quality as a musician, than it is for a computer user to get the right letters to appear on the screen. So musicians experience greater pressure to always perform well. Once you make a couple of mistakes as a musician, you are often replaced by someone else without any apology. There are also few vacancies, and stage-fright plays a major role. All these risk factors contribute to the degree of stress musicians experience, increasing the chance of physical problems occurring.”

During the final year of her medical studies Vera Baadjou had already investigated the effect of body posture on musicians’ energy usage. As a result of that research Baadjou was approached to investigate the scientific value of the Samama method, a research position created with the help of the Samama Fund. The fund’s eponymous founder has donated 150,000 euros to the Universiteitsfonds Limburg/SWOL.

Baadjou is currently engaged in an AIOSKO programme in rehabilitative medicine (doctor in training to become a specialist and clinical researcher) with the Adelante Zorggroep. Within this programme she hopes to obtain her doctoral degree from Maastricht University in the Rehabilitative Medicine specialist group. The study will run for seven years; the results are expected to be published at the end of 2017. The study is being funded by the Ans Samama Fund. Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

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