In this blog, Dr Sarah Upjohn EdD MA MCSP, Specialist Performing Arts Physiotherapist, looks at how programme planning, including choice of repertoire, is important for instrumental musicians returning to or building up performance.

In my work as a physiotherapist with instrumental musicians, I see on a daily basis the impact of playing-related injuries on musicians. As a researcher and educationalist, I am passionate about and deeply involved with promoting strategies that have a positive impact on the musculoskeletal health and wellbeing of musicians. As we hope to be able return to live performance, it is important to plan to build up activity safely.

Throughout lockdown, I have continued to treat musicians, and I have seen first-hand the effects of reduced playing and performance opportunities, as well as the very real impact of reduced activity levels. In short, many of us have become physically deconditioned as a direct result of the drastic changes imposed on us by lockdown: in addition to being less used to the physical, emotional and cognitive demands of live performance, we may have a very real reduction in cardio-vascular fitness levels, muscle strength and soft tissue flexibility. A comparison between professional musicians and professional athletes or dancers may not be immediately obvious, but all are elite performers, and are dependent on their body working well for optimal performance – in whichever performance arena. So the deconditioning that I have watched in musicians during lockdown – both specific to playing, but also in general terms – raises a red flag for me:

Deconditioned athletes or dancers are more susceptible to injury if they return to high performance too quickly, and so are musicians.

BAPAM has published information about preparation and planning your return to live performance:

Returning to work in the performing arts after having COVID-19 | BAPAM
When the curtain goes up again: Building our fitness to perform | BAPAM (advice for musicians)
When the curtain goes up again: Injury prevention for dancers | BAPAM
Managing a return to performance | BAPAM (advice for managers)

Ideally, returning to busier performance schedules should include an equivalent of ‘pre-season training’ as done by professional athletes, with a gradual and systematic increase in the time spent playing, and an accompanying increase in general levels of fitness, strength and soft tissue flexibility.

It is also worth considering the following:

Repertoire choice: Consider the relative physical and cognitive demands of different repertoire. Some repertoire is, without doubt, more demanding than others. I suggest that, wherever possible, repertoire selection is thoughtfully matched to players fitness and preparedness to play it. This will reduce the risk of players developing overuse injuries. As fitness to play increases, so will capacity to safely perform more demanding repertoire.

Programming: Think creatively about programming. Consider the feasibility of programming a concert comprising several pieces, smaller in scale, each requiring smaller numbers of players – rather than one or two longer works requiring all players. This will enable players to rehearse for and play for part of the concert.

These two strategies form the equivalent of a ‘phased return’ to full live performance. A phased return is common practice in other occupational settings after an enforced period of not working, and allows time for people to accommodate to the demands of the job.

The enforced break from live performance has been terrible for many performers, and we all cannot wait to see you performing again. Please do not underestimate the impact of lockdown and the enforced break from live performance on your musculoskeletal self and health, and take sensible steps and reasonable precautions to mitigate for this when you initially return to live performance.