Celebrating our 40th anniversary in 2024, BAPAM will co-chair PAMA’s 42nd international performance arts medicine symposium in London in July

We are thrilled to be co-chairing the in London from 18-21 July. The symposium will be hosted by the Department of Performing Arts Medicine of the Faculty of Ģ��tv Sciences at University College London (UCL), and co-chaired by Dr Hara Trouli, Associate Professor of Performing Arts Medicine at UCL, Claire Cordeaux, CEO of BAPAM and Dr Steven Sims, Otolaryngologist and Director of the Chicago Institute for Voice Care (CIVC).

This unique symposium is the world’s largest event focused on performing arts health and is organised every year by PAMA USA. This year it will take place outside of the USA for the first time, bringing together over 350 performers, researchers, academics and medical Ģ��tvs from 21 countries.

Entitled Come Together: Putting Research into Practice for Performing Arts Medicine across our International Community, this year’s event will offer a platform to share new research and best practice in performing arts medicine and drive forward the advancement of treatment for Ģ��tv injuries and conditions. It will also provide education, networking and collaboration for professionals spanning various disciplines, from dentistry and orthopaedics to psychology.

With more applications received than ever before, this year’s programme comprises more than 110 presentations, 27 workshops and numerous panel discussions addressing a range of topics, including mental, musculoskeletal, vocal and hearing health, covering musicians, dancers, actors, musical theatre and circus performers. Highlights include an exclusive interview with the Grammy award-winning Scottish percussionist and BAPAM Patron Dame Evelyn Glennie CH OBE and a keynote presentation by the Chief Ģ��tv Officer of Disney Parks, Experiences and Products, Dr Pamela Hymel.

This year’s PAMA symposium received an unprecedented level of demand from researchers and academics, all of whom dedicate their time to understanding the Ģ��tv nature of performers’ injuries and illnesses to drive positive change in medical practices. It’s only through further education, networking and collaboration that we can prevent and solve the nuanced problems that arise as a performer, and we look forward to learning from each other, sharing best practice and paving the way for a healthier future for the performing arts Hara Trouli, Course Lead, Performing Arts Medicine MSc., UCL

Registration is open now:

PAM Rounds is a new series of face to face events bringing together health professionals and students to discuss performing arts medicine clinical cases. Organised by the department led by Dr Hara Trouli, PAM Rounds will be held approximately quarterly at the ISEH (Institute of Sport, Exercise and Health), on Tottenham Court Road, London. The first session takes place on Wednesday 22 February, 2023, 6 – 8pm and focuses on musculoskeletal problems in the performing arts. PAM Rounds events are free of charge to attend.

To register, please email hara.trouli@ucl.ac.uk     

Submissions on musicians’ and performing artists’ health and performance are invited to the conference, , in Oslo 22–24 September 2022.

The MHPC22 will be a national, Nordic and international forum for physicians, therapists, educators, artistic directors/employers, athletic trainers, musicians/performing artists and music/performing arts students and other performing arts and health care professionals who seek to improve the performance, health and well-being of musicians and performing artists within all genres.

The conference aims to combine scientific knowledge and practical experience through a range of keynote speakers, panel debates, paper presentations, demonstration or performance presentations, workshops, poster presentations, round table/symposiums as well planned networking.

Virtual 3-day conference: 3-5th September 2021.

BAPAM is very proud to be hosting a wonderful panel of experts in vocal health this week at the British Voice Association . The theme of the conference is ‘Crossing Boundaries in Voice’, with an emphasis on multidisciplinary approaches to health, performance, and research in the field of voice. Key areas for discussion include; physical and mental wellbeing for voice users, voice and the workplace, and crossing genre boundaries in pedagogy and performance.

Over 40 hours of lectures, workshops and masterclasses, from the world’s top practitioners in the field of voice, include keynotes and masterclasses from Markus Hess MD, Steven Zeitels MD, Prof. Janice Chapman, Prof. Kenneth Bozeman, and Christina Shewell.

BAPAM’s panel has been put together by Sarah Wright-Owens, one of our Vocal Rehabilitation Coaches who is also facilitating the Q&A, and BAPAM CEO Claire Cordeaux. The session will explore our Vocal Health Care Pathway, the importance of expert clinical assessment in the Voice Clinic and the multidisciplinary team.

Up to 20% of our callers present with a vocal health problem and our message to any professional voice user in this position is that they should always seek a diagnostic assessment in a Ģ��tv voice clinic run by a laryngologist or speech and language therapist.

There are so many potential causes of voice problems, that a clinical diagnosis with a scope of the vocal folds is the only way to fully understand what is going on, rule out any surgical options and guide effective treatment to resolve the problem. Once this has taken place, with a multidisciplinary team involved in the assessment, the right rehabilitation can take place.

Our panel includes presentations from key members of the multidisciplinary team:

• Declan Costello, consultant laryngologist, will talk about his role in the diagnostic process
• Tori Burnay will describe how she works as a speech and language therapist, including how she has established an SLT-led Ģ��tv voice user clinic at Guys and St Thomas’ NHS Foundation Trust with support from BAPAM
• Dr Anna Colton, clinical psychologist, will discuss how she works with performers where there is a psychological cause for their vocal problems
• Michael Mehta, osteopath, will talk about his approach particularly in relation to muscular tension
• Pippa Anderson, Vocal Rehabilitation Coach will outline how she uses her skills as a singing coach in the clinical setting

We are so grateful to the clinicians who bring their combined skills to work with BAPAM to resolve vocal health problems, and we thank the BVA for allowing us to bring together this stellar group of Ģ��tvs to talk about their work.

BAPAM was very well represented at the this year with no less than 6 presentations by BAPAM Practitioners and staff.

Health Promotion

Claire Cordeaux (BAPAM CEO) and Dr Pippa Wheble (GP Assessor and Trainer/Facilitator of our online Community Drop In series) spoke separately about health promotion initiatives at BAPAM. With online sessions offering improved access to health promotion and a significant audience of locked down performing arts professionals with no work, BAPAM was able to deliver online training, mentoring and peer support to nearly 3500 people over the last year.

Claire focused on the development of health education interventions timed to correspond with touring (2019) and the pandemic (2020), using the literature of behaviour change which shows that significant events, or transition points, present an opportunity for individuals to review healthy behaviours. Using a “healthy practice checklist” which was transformed into a “healthy practice diary” during COVID, artists were encouraged to review their own health, and to set goals and access ongoing support and training to adopt healthy routines. Whilst qualitative feedback was positive, BAPAM was also able to measure the number of participants who subsequently accessed health services because they had identified a health problem which needed intervention. 25% of the touring cohort and 40% of the COVID cohort made an appointment with a health professional.

Pippa described her work with the Community Drop In as a means of embedding healthy practice through online peer support. She highlighted how, as mastery as an artist requires technical skills and resilience, the same is true in maintaining physical health and mental wellbeing. The Community Drop In consists of weekly online sessions, aimed at promoting physical and mental health practices to support performing artists during the covid-19 lockdown. The weekly sessions introduced new practices including meditation, stretching, anxiety management, mental skills, Pilates and much more. The sessions provided space for group discussion and peer support addressing physical and mental health and barriers to change. Many performers had lost motivation, hadn’t picked up their instrument, experienced a loss of creative space and many were experiencing high levels of stress.

Participants were encouraged to complete a Warwick-Edinburgh Mental Well-Being Score (WEMWBS) and the Music Quick Dash score which measures physical wellbeing, at the start and end of their participation in the group. The following scores were collected:

Qualitative responses show how participants valued this:

A Multidisciplinary Pianist’s Clinic 

(BAPAM Clinician and Hand Surgeon) and (Professor of Piano) described their joint clinic for pianists who have a long standing health problem, highlighting some interesting case studies. Patients attend the clinic as a result of a referral from either Mark or Penelope. The clinic shifted to online over COVID which has made it cheaper and more accessible. Penelope advises educators interested in this approach to have some understanding of anatomy and to work within a clinical governance framework. It is a very different environment to a teaching environment, and BAPAM requires teachers to sign a BAPAM Code of Practice for Educators. Both parties described how mutual respect for each other and the pianist is important. There is a potential conflict with the regular teacher, and this has been overcome by inviting them into the session. Mark also described the risk of giving advice beyond your individual area of expertise. The success of the project has expanded into work with violinists, guitarists, cellists and other instruments using the same principles, and inviting other clinical practitioners (hand therapists for example). Penelope and Mark have also set up a group for pianists with focal dystonia.

Risk and Occupational Hazards

Dr Naomi Brecker (Consultant Occupational Physician) and Dr Finola Ryan (Occupational Medicine Specialist Registrar) ran a workshop which considered occupational hazards for performing arts workers including light, sound, temperature, make up, costume, stage fog, COVID, instrument & character postures, equipment use, touring, financial, antisocial hours, working at heights and young performers. The sessions also looked at risk assessment tools both for hearing conservation and for freelancers returning to work environments during COVID. A future post will explore these sessions further.

A Health Lesson from the Performing Arts: How Clinicians can Perform Better

BAPAM’s musculoskeletal clinicians Dr Hara Trouli and Mr Nikos Reissis, together with young surgical trainee Dr Markos Reissis, demonstrated how the results of their literature search have revealed common ground of training and performing between clinical practitioners and performing artists. These similarities can spark new educational and technical skill approaches with extended cultural and humanitarian benefits. At a time when the clinical professions as well as the performing arts are practised under social and health challenges, a mutual collaboration can have a long-lasting effect on the physical and mental health preservation for both professions.

Tuning up the Body: Warming Up and Cooling Down for Musicians

BAPAM Physiotherapist, Lucie Rayner‘s workshop explored practical examples of appropriate neuromusculoskeletal warm-up and cool-down protocols for instrumental musicians, examining the underlying theoretical principles behind them. Musicians would benefit from viewing themselves as ‘Musician Athletes’ and managing their physical health accordingly. This should include integrating appropriate physical preparation and post-playing regimes into their habitual practice.

There is some evidence that warm-up routines are an effective component of injury prevention and may help to optimise practice and performance. However, musicians often neglect to warm-up in preparation for playing, and prioritise tuning up their instrument rather than their own body. Musicians may also benefit from performing a cool-down routine following practice or performance. There is currently a lack of specific evidence regarding the role of a cool-down for instrumental musicians. However, we can apply knowledge gained from research in the fields of Sports and Occupational Medicine to guide this element of healthy practice. Some musicians may already recognise the importance of warming up and cooling down, but may need guidance on structure, duration, intensity, and type of exercises most appropriate to precede or conclude their playing.

Lucie’s workshop covered the proposed mechanisms and benefits of warming including:

• Increased blood flow and oxygen delivery
• Increased muscle temperature and metabolism
• Enhanced motor control and accuracy through pre-activation of neural pathways
• Increased muscle-tendon suppleness and joint range of movement
• Improved focus, attention, and awareness
• Supporting the transition to a creative mindset

The cool-down period is to promote recovery and allow the body to return to baseline function. In addition, it enables the musician to reduce muscle tension resulting from prolonged static loading, helps prevent muscle imbalances linked with asymmetrical playing positions, and supports healthy posture. It may also be an opportunity for self-reflection, evaluating practice, and consolidating learning.

BAPAM training events are a key resource for healthcare and education professionals.

We explore key topics in current performing arts medicine practice and share unique insights into performance health and wellbeing. The approach is multidisciplinary: physiological and psychological care, preventing as well as treating problems, supporting healthy and sustainable creative practice.

Through 2020/21, we are delivering a series of monthly CPD webinars, expanding our training provision and enabling wider access to a flexible ongoing programme. Sessions are held on the last Wednesday of the month from 7pm.

Our first session, Lockdown Health of Performance Professionals, takes place on October 28 at 7pm. The full programme for this event has now been published. All events in the series are open for booking, and we will be adding detail for future events in the series soon.

Find out more and book tickets here

We plan to make sessions available for ticket holders to view after the event if required.

Ticket prices per session:

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BAPAM Registered Practitioners:��£15

BAPAM Registered Practitioners who paid us a fee in 2017/2018 for their BAPAM Directory listing are welcome to contact us about complimentary booking options for these events.

BAPAM Assessing Clinicians and Colleagues: £10

For clinicians working in BAPAM clinics and colleagues providing services administered directly by BAPAM. If unsure, or to request authorisation, please reply to this email.

It was a great privilege to be invited to Sydney to speak at the  (ASPAH) conference at the end of 2019, and inspiring to hear about the great practice happening in Australia. The conference Lasting the Distance: a Lifetime in the Performing Arts considered physical and psychological approaches to support career longevity. Dr. Sue Mayes, the Australian Ballet’s principal physiotherapist and keynote speaker outlined how their approach to healthcare had minimised injuries over the years, measured by insurance claims – a compelling argument for the value of investing in performance health.

There were some really interesting presentations on dance, from child education to foot adaptation of wearable technology and athlete management systems used by athletes, and developing a career in health after dance. On mental health, identification and intervention in eating disorders and management of music performance anxiety were explored, and Ben Steel, former Ģ��tv and Away star, movingly discussed his documentary on depression in the performing arts. I presented on our experience of Developing Evidence-Based Policy and Practice in Psychosocial Health in the Performing Arts.

There is a thriving performing arts medicine community in Australia and we were honoured to be part of the discussions, and look forward to a continued relationship. ASPAH has produced a great set of healthcare guides which they have kindly allowed us to share with you: