Music may be the one expression of communication that elicits essential listening. It exists as a universal language, having moved generations of cultures into a wide range of emotional and physical interpretations.
In a recent Music and Medicine seminar, held at Battle Mountain High School, Jan Idzikowski, physician assistant at Vail-Summit Orthopaedics and member of the Performing Arts Medical Association, discussed the dynamic aspects of the musical world and those who interact with it.
The hour-long presentation focused on the brain’s perception of music, the risk of injuries in musicians, as well as ways to prevent and treat the medical issues. Idzikowski introduced the similarities between musicians and athletes, as well as concerns surrounding noise-induced hearing loss and performance anxiety.
A ‘multi-sensory motor experience ‘
“Music is, in essence, vibration — it’s organized sound,” Idzikowski explained. “The physicists call it ‘simple, harmonic motion,’ but how can that be so powerful?”
Idzikowski shared how sophisticated imaging techniques, including functional MRI (Magnetic Resonance Imaging) and PET (Positron Emission) scans, allow researchers to see the brain as it is mapped in its response to a variety of stimuli in real time.
“When subjects are listening to music, what the studies show is an exceedingly complex and amazing multi-sensory motor experience,” he said. “The brain literally lights up with action, much like a Pink Floyd laser show, if you have ever been to one of those.”
Research has also shown that humans seem to be musical from the very start of their existence, according to Idzikowski. He said humans can perceive music from a very early age; in the fetus, the auditory system develops at 17 to 19 weeks of gestation, even before vision. A child’s common “mommy” is a minor third, and infants in nurseries have been found to synchronize their crying.
While every culture has its own way of speaking and musical form, what Idzikowski said is universal in just about every language is what’s called “mothers’ ease” — the sing-songy speech of parents to their children. Also, he said, the basic structure of lullabies in all cultures is almost identical.
“Music directly effects our physiology,” Idzikowski said. “It evokes hormone release; it will quicken or slow our heart rate and respiration; it can calm and energize us; it can diminish our perception of pain.”
This research has also recognized the brain’s neuroplasticity. Where human brains were once thought to stop developing after adolescence, Idzikowski said studies have shown that music can increase growth in the auditory and motor areas of the brain into adulthood, as well as the middle connecting piece, the corpus callosum.
“A lot of studies have been done on brain development as well,” he said. “Musically trained five to seven year olds have been compared to baseline controls, and those with music training showed a significant increase in fine motor skills and audio discrimination.”
With continued training, he explained, these skills transferred to other, non-musical activities, including: improved overall memory (especially verbal memory), increased literacy, math and reading skills, higher scores on all standardized tests, and significant links between music and language development.
“I guess these are all reasons why Mr. Qualman has provided a strong and continuing support for the music program here (at Battle Mountain High School),” Idzikowski said. “Despite facing budgetary shortfalls.”
Beyond brain development, music therapy has been used to treat disorders such as Parkinson’s, strokes, Alzheimer’s, stuttering, post-traumatic conditions, anxiety and stress.
Idzikowski said that Elena Mannes, author of “The Power of Music”, sums it up the best: “Music is central to our physiology, our psychology and out very identity and sense of self. It makes us forget our fears and stress. It awakens our oldest memories.”
Musicians in movement
“Do you consider musicians to be athletes?” Idzikowski asked the audience. “There are actually very similar mental and physical demands — they acquire skills through long hours of practice and perform feats of great dexterity, strength and stamina.”
He said it has also been found that musicians, like athletes, are prone to numerous neurological and musculoskeletal conditions, especially overuse issues and anatomical imbalances.
The Athletes and the Arts Coalition is a collaboration of professional sports medicine, musical arts and medical groups, “integrating the science of sport and the performing arts for the mutual benefit of both.” Idzikowski said this organization, along with others, has had a growing interest in evaluating and treating medical problems in performers.
“This is to recognize that success in music, like athletics, depends not only on the acquisition of the necessary skills, but also how to prepare and cope with the mental and physical strains associated with performance.”
Risk factors for musicians can be determined by the kind of instrument being played, the length of time someone has played, sudden increases in playing time or changes in repertoire, change in a teacher or conductor, playing conditions, practice techniques, general health, dynamic posture and physical conditioning.
“We try to prevent any injuries from happening before we have to treat them,” Idzikowski said. “We start by recommending enhanced physical and aerobic fitness, with strength training of your extremities and core muscles, as well as your endurance.”
Idzikowski emphasized the importance of daily practice (not crash practicing before evaluations or performance), physical and musical warm-ups, as well as stretching the muscles you use to perform. Children and adults should always practice and perform on properly fitting instruments.
Techniques like “body mapping”, with strategies such as the Alexander technique, for example, can teach a performer awareness of balance and body position, muscle tension and efficiency of motion, Idzikowski explained. Posture should be maintained with “balanced motion” to avoid unnecessary stress and strain.
Not so rock-and-roll
Idzikowski said every musician’s most important instrument is his or her ear, and damage to it can lead to irreversible effects.
“Prolonged and loud noises can damage the inner ear by damaging the hair cells that send signals to the brain, which is how we hear things,” he said. “The risk of injury is based on the sound intensity, as well as the duration — noise exposure is cumulative. Everything in your day is added to your little card of exposure.”
The worst part about hearing loss is that once it’s gone, you can’t get it back. Musicians are especially impacted, not only because of their constant exposure to a variety of sound levels and types, but also because hearing loss is not uniform across all sound frequencies — it effects higher frequencies much more. This can lead to a loss of pitch perception, a vital tool for any musician.
According to Athletes and the Arts Coalition, daily exposure to sound should be no greater than the equivalent to 85 decibels (dB) over an eight-hour period, with a 3 dB time/intensity exchange rate. This means for every 3 dB increase over 85 db, the time exposure is halved to prevent noise induced hearing loss — 88 dB for four hours max per day, 91 dB for two hours max per day or 94 dB for one hour max per day. (80 dB equals an alarm clock or busy street; 90 dB equals a lawn mower; 100 dB equals a snowmobile).
Idzikowski recommended using a sound level reader to track decibel levels (available as a smart-phone app), and to simply turn the volume down. He said half volume is generally 94 dB and full is well over 100 dB, so take breaks from the noise and enjoy the quiet. Performers and musical audience member will also benefit from earplugs or in-ear monitors.
“Start humming with the anticipation of a loud noise,” Idzikowski said. “This activates a small muscle in your inner ear and actually blocks sound transmission.”
Another downside to the musical performance is “stage fright” or performance anxiety. This can be a distressing and disabling condition for performers of all ages.
While Idzikowski said he thinks a little bit of anxiety is a good thing, to create some normal apprehension or adrenalin, once it becomes overwhelming it no longer has the potential to elevate performance, it becomes maladaptive. Techniques for overcoming this widely experienced issue are breath control, positive self-talk and recovery from mistakes.
“The focus should be working to control the anticipatory energy in order to optimize one’s performance,” the Athletes and the Arts Coalition states on an informative handout. “Most people perform better when they feel relaxed. Relaxation is an active process, not a passive one. It is something that needs to be practiced in order to be effective.”