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Performing arts medicine.

Arts medicine has come of age, resulting from 3 important developments over the past decade: improved methods of diagnosis and treatment, an awareness that artists suffer from special problems related to their occupation and lifestyle, and the establishment of health programs emphasizing an interdisciplinary approach to these patients. We focus on the patterns of illness afflicting performing artists, specifically dancers, singers, actors, and instrumental musicians, and explain some of the things a health care team can do in treating these patients. The conditions governing these patients' lives--early exposure to high expectations of excellence, incessant demands for perfection, long periods of intense practicing, fierce competition, high levels of anxiety associated with performance, and uncertain careers--need to be understood. Levels of disease and disability are remarkably high, but artists often ignore symptoms. We discuss the musculoskeletal, neurologic, vocal, psychological, and other syndromes found among performers and some of the difficulties in treating them. The prevention of injury, conservative management, collaboration with teachers, and a psychotherapeutic approach are desirable. Arts medicine programs for professional consultation exist in several major cities of the United States and abroad. Although research is needed regarding the effectiveness of health care services for performing artists, the scientific literature devoted to this field is growing.

Dancing↗

Sports and performing arts medicine. 1. General considerations for sports and performing arts medicine.

UNLABELLED: This self-directed learning module highlights general considerations in sports and performing arts medicine. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To discuss similarities and differences of injuries sustained in sports and performing arts using case vignettes.

Anxiety↗

Odyssey: the history of performing arts medicine.

The first publication to summarize the occupational diseases of musicians was Ramazzini's Diseases of Tradesmen in 1713. While there was sporadic interest in performing arts medicine during the 1800s, the first book devoted to the subject, Singer's Diseases of the Musical Profession, was published in 1932. During the 1960s and 1970s, both physicians and performers became more interested in arts medicine. When pianists Gary Graffman and Leon Fleisher publicly discussed their career-ending hand problems in the early 1980s, a huge, previously unknown group of injured musicians was brought to light. Since that time, publication in the field has dramatically increased, numerous conferences have been held, and clinics catering to the needs to performers have been set up in various large cities. Although we still do not have all the answers to the problems faced by performing artists, arts medicine is now a recognized discipline, reaching out to performers, arts educators, arts administrators, and instrument manufacturers.

Dancing↗

Performing arts medicine and the Internet.

The tremendous growth of the Internet and the World Wide Web over the last ten years has revolutionized communication in the United States. A great deal of information is available to assist in patient education and medical decision making. The field of performing arts medicine represents only a small portion of the web, but the relevant sites provide much helpful material. Bibliographic sites lead the researcher to further print resources. Many of the organizations concerned with performing arts medicine have web sites describing their history, goals, and services. Sites maintained by individuals, universities, and associations cover the field in general, as well as specific topics such as repetitive strain injuries, related computer and typing injuries, carpal tunnel syndrome, and hearing loss. Performing arts medicine is a highly interdisciplinary field and the collaborative nature of the Internet is well suited to this diverse, geographically dispersed population.

Computer Communication Networks↗

Sports and performing arts medicine. 3. Lower-limb injuries in endurance sports.

UNLABELLED: This self-directed learning module highlights new advances in this topic area. It is part of the study guide on sports medicine and performing arts in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on (1) ankle pain in a runner, (2) heel pain in an adolescent, (3) anterior knee pain in a runner, (4) lateral knee pain in a cyclist, (5) shin splints in a runner, (6) buttock pain in a hiker, and (7) collapse of a marathoner from hyponatremia. OVERALL ARTICLE OBJECTIVE: To summarize lower-limb injuries commonly seen in endurance sports.

Athletic Injuries↗

Sports and performing arts medicine. 6. Issues relating to dancers.

UNLABELLED: This self-directed study module highlights biomechanics unique to dance that predispose to common injuries of the lower extremity and discusses preventative strategies. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To summarize lower-limb and back injuries commonly seen in dancers.

Biomechanical Phenomena↗

Sports and performing arts medicine. 5. Issues relating to musicians.

UNLABELLED: This self-directed learning module discusses classic topics and highlights new advances in this topic area. This article, which discusses upper-limb injuries in musicians, is a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes to elaborate on issues relating to musicians. OVERALL ARTICLE OBJECTIVE: To summarize overuse injury, nerve entrapment, and focal dystonia in instrumental musicians.

Cumulative Trauma Disorders↗

Sports and performing arts medicine. 2. Shoulder and elbow overuse injuries in sports.

UNLABELLED: This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. OVERALL ARTICLE OBJECTIVE: To discuss shoulder and elbow overuse injuries in sports.

Athletic Injuries↗

Sports and performing arts medicine. 4. Traumatic injuries in sports.

UNLABELLED: This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries. OVERALL ARTICLE OBJECTIVE: To summarize the approach to common traumatic sports injuries.

Algorithms↗

[Medicine: art or science?].

The question of how science, medicine and medical practice are related also compromises the crucial issue of the character of medicine. At the beginning of the 19th century, medicine tried to overcome the ancient contradiction within the unity of scientific thought and the deduction of guidelines and techniques for medical practice. This aim was partly achieved in medico-theoretical reasoning and practical procedures as well as for nosology, casuistic thinking and diagnostics. But medicine is a discipline directed towards healing. So the intentions of medicine and the reality of clinical healing possibilities, however, showed an increasing divergence since the middle of the 19th century. This divergence triggered considerable reactions not only from "Schulmedizin" and from other disciplines but also from practicing doctors and mainly from (disappointed) patients. Together with the continuous changes in empirical clinical research these internal and especially external reactions to medicine showed fundamental differences between medicine and the sciences. During the decades of this development it has become obvious that medicine will never become a pure science, not even an applied science. As medicine is concerned with patients who need to be considered as individual subjects, medical knowledge and medical practice consequently form a dialectic unity which is directed by the patient as a subject.

Art↗