At BAPAM we support a wide range of performers suffering all kinds of health issues. At the various stages of contact with patients we do our best to get a coherent idea of their issue and advise them about a treatment pathway.

22-year-old saxophone player Murphy Robertson is one such patient who came to BAPAM at a particularly low point in May 2019, during her fourth and final year at Guildhall School of Music and Drama.

The final year for most degree students is a busy period, but for Murphy the year has been quite relentless. It was all systems go for her ever since things kicked off in September 2018. On top of university commitments, she was also working as a peripatetic music teacher in schools, while regularly performing in shows outside her degree.

So what specifically brought her to BAPAM?

She says things started to really deteriorate in March 2019 while she was working on an exam piece. She felt severe cheek pain and pain around the mouth, recalling how she thought her mouth would “fall off”. It was then she realised she needed to tell someone. She went to her saxophone teacher and head of music department, who suggested she come to BAPAM for an assessment.

At BAPAM she saw assessing clinician and GP Dr Tamara Karni Cohen. Before the assessment Murphy said the uncertainty about what it could be caused her a lot of nervousness. But once she saw Dr Karni Cohen she felt a huge sense of relief and recalls breaking down at hearing it wasn’t all just “in her head.” She says she had been dismissing the issue and admits having a medical professional listen and understand was very reassuring and validating.

Dr Karni Cohen says: “Here at BAPAM we see a wide range of vocational related issues with a wide range of performers. Murphy was a very interesting case, demonstrating symptoms of muscle fatigue after a grueling and long recording session. The facial muscles can also present with a ‘repetitive strain’ type picture. Muscles being overused can overtire easily and we have factsheets on our website on how to maintain good physical shape as a performer. This includes the importance of strengthening, maintenance and appropriate rest intervals.”

Murphy was recommended a few options like osteopathy or physiotherapy, and Feldenkrais and was told that a consultation with a musculoskeletal or head and neck specialist maybe required if symptoms didn’t improve. As Murphy is a music student and matched the eligibility criteria for charity Help Musicians UK’s Emerging Musicians Health Scheme for financial support towards treatment, Dr Karni Cohen was able to help support her through filling out a funding application.

Looking back on the experience Murphy feels a combination of overplaying and lack of sleep and only one day off between September and March also contributed to the issue. She says juggling life as a final year student, working as a peripatetic teacher 6 days a week and other performing commitments created a lot of stress and exhaustion.

She also likens not being able to play for months to a “purgatory state” and says, “people start treating you differently, you feel like you lose your value.”

Dr Karni Cohen says cases like this show how physical symptoms like this can have an impact on mental health. She says; “When I see patients at BAPAM I like to cover all aspects of symptoms, including how it is affecting their psychological wellbeing. There is a lot of overlap between the mind and body, especially when it comes to a performer’s life. The impact physical symptoms have on people like Murphy, can really take their toll. As she aptly mentioned, people start to address you differently. We are trying to improve the stigma related to conditions, how they affect performers and how often they are not going to impede them on their overall abilities, especially once addressed and treated. Especially when it comes to mental health related issues – these are still unfortunately stigmatised but there is a wave of change happening. I always like to encourage performers to be open and connected with their mental and physical health. Prevention is key but recognition early leads to early intervention and prevention of chronic conditions.”

So how is Murphy doing now?

Murphy was successful in receiving funding from Help Musicians UK and has been using the funds to get treatment with a physiotherapist who has experience of treating performers. The treatments she has been receiving includes jaw massage, acupuncture and physiotherapy from the shoulder up. When we spoke to Murphy at the end of September 2019 she had received 5 sessions and said that even though the pain was easing she was still unable to play for very long. She also admitted she had underestimated how long the recovery would take.

What advice does she have for others who maybe in a similar situation?

Despite the challenges she has faced Murphy feels positive about the experience. She says it enabled her to take a step back and realise that she can’t do everything at once. Her advice to others is “don’t push it” and to stop and assess the situation sooner rather than later.