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Play Through The Pain? Audition Season Means Injury Risk For Young Musicians

The Emerson String Quartet performs in 2004. Imagine a quartet without its instruments and it becomes more clear how unnatural their positions are, says neurologist Dr. Michael Charness. (AP Photo/Jennifer Szymaszek)

The Emerson String Quartet performs in 2004. Imagine a quartet without its instruments and it becomes more clear how unnatural their positions are, says neurologist Dr. Michael Charness. (Jennifer Szymaszek/AP)

By Ian Coss

Caitlin Cawley was only 15 when she developed tendinitis in both elbows. The condition is commonly known as “tennis elbow,” but Cawley wasn’t practicing her serve. She was studying classical percussion at a pre-college program for aspiring musicians.

She ignored the early signs until the prickling sensation grew to stabbing pain throughout her forearms so excruciating she had to stop playing. It took three months of rest for the inflammation in her tendons to subside, and she has had multiple flareups since then.

Now 21 and a senior at Boston University’s School of Music, Cawley is preparing to audition for graduate programs. So while most college applicants can breathe a sigh of relief now that their Jan. 1 deadline has passed, she and other music students are headed back to the practice rooms. Cawley currently averages six hours of independent practice a day, not including ensemble rehearsals. In her words: “Right now I’m doing as much work as I’ve ever done for music.”

Boston University senior Caitlin Cawley practices on the marimba (Photo: Ian Coss/WBUR)

Boston University senior Caitlin Cawley practices on the marimba. (Ian Coss for WBUR)

That diligence also means risk of injury. For Cawley and other young musicians, the question of this season is: How much practice can my body take before perfection turns to pain?

Their odds are not good. In the mid-2000s, a Chicago-based physician began surveying the incoming music students at a midwestern university, and after four years, the trend in the data was clear: Almost 80 percent of freshman “reported a history of playing-related pain.”

For players of string, keyboard and brass instruments the percentage was even higher. For percussionists like Cawley: 100 percent.

Dr. Michael Charness, who directs the Performing Arts Clinic at Brigham and Women’s Hospital, has treated thousands of musicians who play everything from bagpipes and sitars to violas and trombones.

He describes the crux of the problem: “If you look at a string quartet, it’s the most natural looking sight, but if you simply remove the instruments from their hands and pose them on stage, it’s nothing that we were ever really designed to do for any long period of time.” Continue reading