Playing-Related Musculoskeletal Disorders and Mental Well-Being Among Music Students

Öz

This mixed-methods study investigates the interplay between playing-related musculoskeletal disorders (PRMDs) and mental well-being among undergraduate music students in Türkiye. Quantitatively, PRMDs were assessed with the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and mental well-being with the Short Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS), alongside demographics and practice-behavior variables; descriptive statistics and non-parametric tests were employed. Qualitatively, open-ended responses were examined via thematic analysis. Findings indicate that PRMDs cluster predominantly in the upper back, neck, and lower back, with string and keyboard players reporting higher discomfort. Single practice sessions exceeding 90 minutes were associated with significantly greater PRMD severity, whereas regular micro-breaks related to lower discomfort. A moderate negative correlation emerged between CMDQ totals and SWEMWBS scores (ρ≈–.41, p<.01). In binary logistic regression, mental well-being was the strongest inverse predictor of PRMD presence (each one-point increase ≈ 9% reduction in odds), while weekly total hours showed only a trend-level effect. Qualitative themes converged on physical limitation and fatigue, performance anxiety and emotional exhaustion, reduced concentration and expressive quality, adaptive coping and self-regulation, and transformation through awareness. Collectively, results support a biopsychosocial understanding of musician health and advocate integrating ergonomic instruction, break-structured practice, and somatic/breath-based awareness programs into music curricula to foster sustainable performance and psychophysical resilience.

Anahtar Kelimeler

• Instrumental Practice
• mental well-being
• music education
• PRMD
• somatic awareness

Etik Beyan

Ethical approval and written permission were obtained from the Dokuz Eylul University Institute of Educational Sciences Ethics Committee (approval granted at the meeting dated 27 August 2025, meeting no. 12, application no.1508450).

Müzik Eğitimi Alan Öğrencilerin Çalgı Pratiği Kaynaklı Kas-İskelet Rahatsızlıkları ve Mental İyi Oluş Halleri

Öz

Bu çalışma, Türkiye’de lisans düzeyinde müzik eğitimi alan öğrencilerde çalgı pratiğine bağlı kas-iskelet rahatsızlıkları (PRMD) ile mental iyi oluş arasındaki ilişkileri karma yöntem yaklaşımıyla incelemektedir. Nicel bileşende PRMD için Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), mental iyi oluş için Short Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS) kullanılmış; demografik ve pratik alışkanlıkları içeren verilerle birlikte betimsel istatistikler ve parametrik olmayan testler yürütülmüştür. Nitel bileşende açık uçlu yanıtlar tematik analiz ile çözümlenmiştir. Bulgular, PRMD’nin başlıca üst sırt, boyun ve bel bölgelerinde yoğunlaştığını; yaylı ve piyano çalgılarında şikâyetlerin daha belirgin olduğunu göstermektedir. 90 dakikayı aşan tek oturumlar PRMD’yi anlamlı biçimde artırırken, düzenli mikro molalar daha düşük PRMD düzeyleriyle ilişkilidir. CMDQ toplam puanı ile SWEMWBS arasında orta düzeyde negatif ilişki (ρ≈–.41, p<.01) saptanmış; lojistik regresyon analizinde mental iyi oluş, PRMD varlığını anlamlı ve ters yönde yordayan en güçlü değişken olmuştur (her 1 puan artış ≈ %9 daha düşük olasılıkyıt). Nitel temalar, fiziksel sınırlılık-yorgunluk, performans kaygısı, dikkat/ifade azalması, uyumsal öz-düzenleme ve farkındalıkla dönüşüm başlıklarında bütünleşmiştir. Sonuçlar, müzik eğitiminde ergonomi, molaya dayalı çalışma yapıları ve somatik/nefes temelli farkındalık programlarının entegrasyonunu desteklemekte ve böylece sürdürülebilir performans için biyopsikososyal bir çerçeve önerilmektedir.

Anahtar Kelimeler

• Çalgı Pratiği
• mental iyi oluş
• müzik eğitimi
• PRMD
• somatik farkındalık

Kaynakça

1. Ackermann, B., & Adams, R. (2004). Physical characteristics and pain patterns of skilled violinists. Medical Problems of Performing Artists, 19(2), 65–71.
2. Ackermann, B., & Driscoll, T. (2010). Musculoskeletal disorders in musicians. Medical Problems of Performing Artists, 25(3), 155–166.
3. Ackermann, B., & Driscoll, T. (2010). Musician’s health: Assessing and improving physical well-being. Medical Problems of Performing Artists, 25(3), 135–141.
4. Ackermann, B., & Driscoll, T. (2010). Development of a new instrument for measuring the musculoskeletal load and physical health of professional orchestral musicians. Medical Problems of Performing Artists, 25(3), 95–101.
5. Araújo, L. S., Wasley, D., Perkins, R., Atkins, L., Redding, E., Ginsborg, J., & Williamon, A. (2017). Fit to perform: An investigation of higher education music students’ perceptions, attitudes, and behaviors toward health. Frontiers in Psychology, 8(1558), 1–15. https://doi.org/10.3389/fpsyg.2017.01558
6. Araújo, L. S., Wasley, D., Redding, E., Perkins, R., Atkins, L., Ginsborg, J., & Williamon, A. (2020). Fit to perform: A profile of higher education music students’ physical fitness. Frontiers in Psychology, 10, 3104. https://doi.org/10.3389/fpsyg.2019.03104
7. Baadjou, V. A., Roussel, N. A., Verbunt, J. A., Smeets, R. J., & de Bie, R. A. (2019). Systematic review: Risk factors for musculoskeletal disorders in musicians. Occupational Medicine, 69(4), 237–243. https://doi.org/10.1093/occmed/kqz063
8. Brandfonbrener, A. G. (2009). Musculoskeletal problems of instrumental musicians. Hand Clinics, 25(1), 101–111.

9. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
10. Chan, C., & Driscoll, T. (2014). The prevalence of playing-related musculoskeletal disorders in Australian music students. International Journal of Music Education, 32(4), 1–13.
11. Chan, C., & Driscoll, T. (2014). The effect of postural habits on the risk of musculoskeletal disorders in musicians. Occupational Medicine, 64(8), 605–610.
12. Cohen, S., & Kinsella, E. A. (2017). Embodied learning and the arts: The role of the body in learning and performance. Journal of Applied Arts & Health, 8(3), 351–366.
13. Cohen, S., & Bodner, E. (2019). Mindfulness and music performance anxiety among conservatory students: The mediating role of self-compassion and acceptance. Psychology of Music, 47(6), 948–963. https://doi.org/10.1177/0305735619864639
14. Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). SAGE Publications.
15. Çırak, N., & Kılıç, B. (2021). Müzik öğretmenliği öğrencilerinin performansa bağlı bedensel rahatsızlıkları ve farkındalık düzeyleri [Performance-related physical discomforts and awareness levels of music teacher education students]. Journal of Music Education Research, 8(2), 45–62.
16. Fotiadis, D. G., Fotiadou, E. G., Kokaridas, D. G., & Mylonas, A. C. (2013). Prevalence of musculoskeletal disorders in professional symphony orchestra musicians in Greece: A pilot study concerning age, gender, and instrument-specific correlations. Medical Problems of Performing Artists, 28(2), 91–95.
17. Guptill, C., & Zaza, C. (2010). Injury prevention: What music teachers can do. Music Educators Journal, 96(4), 28–34.
18. Guptill, C. (2011). The lived experience of professional musicians with playing-related injuries: A phenomenological inquiry. Medical Problems of Performing Artists, 26(2), 84–95.
19. Hedge, A., Morimoto, S., & McCrobie, D. (1999). Effects of keyboard tray geometry on upper body posture and comfort. Ergonomics, 42(10), 1333–1349. https://doi.org/10.1080/001401399184984
20. Hildebrandt, H., & Nübling, M. (2004). Providing further training in music physiology and musicians’ medicine for prevention and treatment of playing-related health problems in musicians. Medical Problems of Performing Artists, 19(3), 80–89.
21. Kenny, D. T., & Ackermann, B. (2015). Performance-related musculoskeletal pain, depression, and music performance anxiety in professional orchestral musicians: A population study. Psychology of Music, 43(1), 43–60. https://doi.org/10.1177/0305735613493953
22. Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197
23. Kok, L. M., Huisstede, B. M., Voorn, V. M., Schoones, J. W., & Nelissen, R. G. (2016). The occurrence of musculoskeletal complaints among professional musicians: A systematic review. International Archives of Occupational and Environmental Health, 89(3), 373–396.
24. Kok, L. M., Vlieland, T. P., Fiocco, M., & Nelissen, R. G. (2016). A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians. Medical Problems of Performing Artists, 31(1), 37–43.
25. Kok, L. M., Huisstede, B. M., Voorn, V. M., Schoones, J. W., & Nelissen, R. G. (2018). The occurrence of musculoskeletal complaints among professional musicians: A systematic review. International Archives of Occupational and Environmental Health, 91(4), 373–396. https://doi.org/10.1007/s00420-017-1307-6
26. Nyman, T., Wiktorin, C., Mulder, M., & Johansson, Y. L. (2021). The biopsychosocial determinants of work-related musculoskeletal disorders: An integrative review. Work, 70(1), 1–13.
27. Paarup, H. M., Baelum, J., Holm, J. W., Manniche, C., & Wedderkopp, N. (2011). Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: A cross-sectional study. BMC Musculoskeletal Disorders, 12(1), 223. https://doi.org/10.1186/1471-2474-12-223
28. Perkins, R., & Williamon, A. (2014). Learning to make music in older adulthood: A mixed-methods exploration of impacts on wellbeing. Psychology of Music, 42(4), 550–567. https://doi.org/10.1177/0305735613483668
29. Rickert, D. L., Barrett, M. S., & Ackermann, B. J. (2013). Are music students fit to play? A case study of health awareness and injury prevention. Music Education Research, 15(3), 307–323.
30. Rickert, D. L., Barrett, M. S., & Ackermann, B. J. (2013). Are music students fit to play? A case study of health awareness and injury attitudes among tertiary music students. International Journal of Music Education, 31(3), 292–310.
31. Rickert, D. L., Barrett, M. S., & Ackermann, B. J. (2014). Are music students fit to play? Physical and psychological health problems of music students compared to the general population. Medical Problems of Performing Artists, 29(2), 101–107.
32. Sari, E., Topal, M., & Kalyoncu, R. (2022). The relationship between musculoskeletal disorders and psychological well-being in music students. Journal of Education and Learning, 11(1), 39–49. https://doi.org/10.5539/jel.v11n1p39
33. Spahn, C., Strukely, S., & Lehmann, A. C. (2016). Health conditions, attitudes toward study, and individual health behavior of music students in comparison with other student populations. Medical Problems of Performing Artists, 31(1), 1–7.
34. Taggart, F., Stewart-Brown, S., Parkinson, J., & Warwick Medical School. (2015). Warwick–Edinburgh Mental Well-being Scale (WEMWBS) User Guide Version 2.
35. Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick–Edinburgh Mental Well-being Scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(1), 63. https://doi.org/10.1186/1477-7525-5-63
36. Vaag, J., Bjørngaard, J. H., & Bjerkeset, O. (2016). Symptoms of anxiety and depression among Norwegian musicians compared to the general workforce. Psychology of Music, 44(2), 234–248. https://doi.org/10.1177/0305735614564910
37. Williamon, A., & Thompson, S. (2006). Awareness and control in music performance. In E. Altenmüller, M. Wiesendanger, & J. Kesselring (Eds.), Music, motor control and the brain (pp. 65–74). Oxford University Press.
38. Williamon, A., Aufegger, L., & Eiholzer, H. (2019). Health promotion and prevention in higher music education: The shift toward a culture of health. Frontiers in Psychology, 10, 1042.
39. World Health Organization. (2004). Promoting mental health: Concepts, emerging evidence, practice (Summary Report). WHO.
40. Yoshie, M., Shigemasu, K., & Kudo, K. (2009). Emotions and psychophysiological responses during piano performance. Annals of the New York Academy of Sciences, 1169(1), 448–452.
41. Zaza, C., & Farewell, V. T. (1997). Musicians’ playing-related musculoskeletal disorders: An examination of risk factors. American Journal of Industrial Medicine, 32(3), 292–300.
42. Zaza, C. (1998). Playing-related musculoskeletal disorders in musicians: A systematic review of incidence and prevalence. Canadian Medical Association Journal, 158(8), 1019–1025.