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sai-national.org • SUMMER 2017 • PAN PIPES 21 MUSICAL HEALTH playing condition, as poor mechanism, "necessitates extra or excessive force on the part of the player, with increased risk of injury" (Norris, 6). Instruments that are used more frequently will require more frequent adjustment. Also, it is important to note that if a student's instrument requires adjustment more frequently than what is typical, the student's technique must be evaluated to ensure they are not applying excessive force. e mechanism of cheaper model instruments is oen largely inferior to that of professional line instruments; therefore if a musician is having overuse injury an upgrade can be considered. [Reminder: Norris' Overuse Factor #5.] Norris' Overuse Factor #12 - Environmental factors e so tissues of the body function best when the body is warm and experiencing good circulation. Avoid cold, dray, and dry practice spaces when possible and keep the body hydrated. When performing in cold spaces performers can wear warm clothing, compression sleeves or gloves, and use heating pads. Avoid stretching when the body is cold as this can cause tearing of so tissues. One Additional Factor - Age: It is important to note that the risk of injury changes for musicians at different ages. One of the most common age groups when musicians are at an increased risk of injury is during the growth-spurt period for each gender. Initially the bones grow and then so tissues follow placing the child at increased risk (Horvath, 87). Children in growth spurt periods should increase overall aerobic or physical activity and proper warm-up and stretching while also developing an initial decrease in duration of practice sessions by taking more frequent breaks. CONCLUSION By understanding the factors which place musicians at increased risk of overuse injuries and by being watchful of our musical habits it is possible to create more healthy habits for musicians as they build successful careers. As we age, as our bodies change, and as our commitments change, it is increasingly important to know all of these factors and continually evaluate our musical habits. As we process and use the injury prevention information from the medical field we must be unafraid to address problems in our habits and our health in their earliest stages so that we can better prevent debilitating injury. Dr. Mary Alice Druhan has enjoyed an active career performing and teaching across the U.S., and she currently resides in the Dallas, Texas area where she is Professor of Clarinet at Texas A&M University-Commerce. She is a Performing Artist for Backun Musical Services and a member of the Silverstein Pro Team. In 2011 Mary suffered a serious playing-related injury which threatened her career and inspired her research into musician injury, prevention, and recovery. Her research has been featured in a six-part series of e Clarinet and she gives presentations about injury prevention around the country. She has faced the challenges and rewards of her career with her family, including her husband Sean and their four amazing daughters. NOTES: Some concepts and material for this article were pulled from my previous publications: Druhan, Mary Alice and Kristin M. Keesey. "Don't Warm Up Yet: An Injury Prevention Guide for Clarinetists – Part I A Healthy Lifestyle." The Clarinet, 40.4(2013): 47-49. Druhan, Mary Alice and Kristin M. Keesey. "Don't Warm Up Yet: An Injury Prevention Guide for Clarinetists – Part II A Healthy Approach to the Integrated System." The Clarinet, 41.1(2013): 50-54. Druhan, Mary Alice and Kristin M. Keesey. "Why We Need to Focus on Our Musical Bodies: A Look at Injury Among Clarinetists." The Clarinet, 40.2(2013): 49-59. SOURCES: 1. Brandfonbrener, Alice. "The Epidemiology and Prevention of Hand and Wrist Injuries in Performing Musicians." Hand Clinics, 6.3(1990): 365-77. 2. Brummit, Jason. "The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction," North American Journal of Sports Physical Therapy, 3:1 (2008) 7-21. 3. Dommerholt, Jan. "Performing Arts Medicine – Instrumentalist Musicians Part I– General Considerations," Journal of Bodywork and Movement Therapies. 13(2009): 311-319. 4. Fishbein, Martin Ph.D., Susan Middlestadt, Ph.D. with Victor Ottati, Susan Straus, and Alan Ellis. "Medical Problems Among ICSOM Musicians: Overview of a National Survey," Medical Problems of Performing Artists, 3(1988): 1-8. 5. Fry, Hunter J.H. "Overuse Syndrome in Clarinetists," The Clarinet, 14.3(Mar 1987): 48-50. 6. Horvath, Janet. Playing (Less) Hurt: An Injury Prevention Guide for Musicians. New York: Hal Leonard Books, 2010. Print. 7. Klickstein, Gerald. The Musician's Way: A Guide to Practice, Performance, and Wellness. Oxford University Press, 2009. Print. 8. Manchester, Ralph A. "Looking at Musicians' Health through the "Ages"," Medical Problems of Performing Artists, 24(2009): 55-57. 9. Markison, Robert E. "Tendinitis and Related Inflammatory Conditions Seen in Musicians," Journal of Hand Therapy. 5:2 (April-June 1992): 80-83. 10. Newmark, Jonathen and Richard Lederman. "Practice doesn't Necessarily make Perfect," Medical Problems of Performing Artists, 2(1987): 142-144. 11. Norris, Richard. The Musician's Survival Manual: A Guide to Preventing and Treating Injuries in Instrumentalists. Published by the International Conference of Symphony and Opera Musicians (ICSOM), MMB Music, Inc. 1993. Print. 12. Paull, Barbara and Christine Harrison. The Athletic Musician: A Guide to Playing without Pain. Landham, MD: Scarecrow Press, Inc., 1997. Print. 13. Sataloff, Robert T., Alice G. Brandfonbrener, Richard J. Lederman, ed.s. Textbook of Performing Arts Medicine, 1st edition. New York: Raven Press, 1991. 14. Weerapong, Pornratshanee, Patricia A. Hume and Gregory S. Kolt. "The Mechanism of Massage and Effects on Performance, Muscle Recovery and Injury Prevention," Sports Medicine, 35:3 (2005) 235-256.

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