Return to play after injury: strategies to support a musician's recovery

The treatment of musicians' injuries has two distinct, overlapping, phases. Reducing pain or symptoms represents only the first stage. Too often, this is the end of the medical care. If the player has had to stop playing or significantly reduce playing time during the healing phase, a graduated, methodical plan for returning to full musical activity is essential to avoid emotionally and physically distressing relapses. In the field of occupational medicine this concept is called 'work hardening'. The worker performs his or her specific tasks, but starts out at a greatly reduced level in terms of time and intensity. A graduated program for return to play is discussed in terms of duration, tempo and technical difficulty with specific recommendations for various instruments. Minor set backs are to be expected and the patient should be advised from the start that this is a normal part of the process so as to avoid discouragement. Following the principles set forth in this article will optimize the musicians' chances for smooth, successful return to normal musical activity.