It can be argued that musicians have a lot in common with athletes, i.e. the physical demands of long hours of practice, a high level of technical expertise required to perform at the required level as well as issues around performance itself. Unlike athletes, however, there is little support to manage musculoskeletal problems in musicians despite a prevalence of playing-related musculoskeletal injuries (PRMDs) of up to 87%.

In Northern Ireland, Dr Liz Doherty and Dr Iseult Wilson are the first researchers to investigate PRMDs in Irish traditional musicians, and the Safe Trad project (initiated in 2009) is an ongoing initiative to investigate and address PRMDs within the traditional music community. Preliminary work was followed by a focus group study (approved by the Ulster University Research Ethics Committee and funded by the Arts Council Ireland and the HEA), the findings of which were published Medical Problems of Performing Artists and WORK. PRMDs in Irish traditional musicians is also the focus of a recent PhD study at Ulster University.  The initial findings from this PhD work, alongside the previous focus group study enabled further development of the Safe Trad initiative in the form of a Safe Trad Think Tank (funded by the Higher Education Innovation Fund). A range of stakeholders attended and contributed to the consensus meeting, and these included Irish traditional musicians, physiotherapists, academics from across the island of Ireland with expertise in Irish traditional culture, music and dance, and behavioural change, physicians with expertise in the area, a fiddle maker, a researcher who has investigated this area, and experts in the Alexander technique. Subsequently, three contributors published a paper in the European Health Psychologist. Further material has since been published in Medical Problems of Performing Artists.

The findings from our work to date highlight that

• Performance-related issues are prevalent among traditional music practitioners and there are unique psychosocial risks associated with playing Irish traditional music
• The Irish traditional musician will put music and its performance above their own health
• There is still a stigma attached to PRMDs within the traditional music community and so PRMDs are, for many, a taboo subject, making them difficult to treat and manage
• While some supports and interventions are in place for other musicians the traditional music community feels removed from such supports (for various complex reasons, many of them involving identity)
• The musicians do not trust health professionals and are very reluctant to access health care
• The impact of PRMDs is multi-dimensional and has negative effects on the physical (pain, weakness etc.), practical (i.e. loss of earnings) and emotional aspects of a musician’s life

These findings raise considerable challenges for those of us who manage musculoskeletal problems. Physiotherapists are in an ideal position to deliver health care to this group of people but we need to better understand the unique issues facing musicians in general, and Irish traditional musicians, specifically. We also need to educate musicians around the prevention and management of PRMDs, and this will then enable musicians to seek appropriate care more quickly, better trust the health care providers, receive appropriate support and management and ultimately reduce the frequency and impact of PRMDs in this population.