How music schools can better protect the health of musicians

About 75% of musicians regularly face injuries or pain from their practice. Experts say it’s time to take their concerns seriously.

Stephen Gange hated knowing his daughter was in pain playing the violin—an instrument and hobby she loved.

As he attempted to find her relief, he struggled to find a physical therapist who understood the distinct issues a violinist faces compared to an athlete. In particular, they didn’t seem to grasp the emotional costs of her injury.

Gange, an epidemiologist and executive vice provost at Johns Hopkins University, said the most effective therapists were those who watched his daughter play, understood the specific movements of playing, and acknowledged that simply suggesting that she rest wasn’t a viable option.

“These weren’t just health care visits; they were collaborative problem-solving sessions focused on returning her to the art form she loved,” he said.

Gange recounted this story at the recent inaugural Global Summit on Occupational Health in Music held at the Johns Hopkins University Bloomberg Center, where experts in medicine, academia, and the performing arts discussed ways to better address the unique health care needs of musicians in an educational setting. Here are three steps they said music schools can take to keep their musicians safe and healthy.

Shifting occupational health in music from individual to institutional responsibility

Studies estimate roughly three-quarters of professional musicians experience injuries or pain that affect their ability to play. Musicians are at risk for musculoskeletal conditions like carpal tunnel syndrome and tendinitis, neurological conditions, vocal strain, hearing loss, chronic pain, and performance anxiety.

Despite these risks, most music schools don’t provide much education to students on managing their health, preventing injuries, or recovering from them. Too often, music institutions consider health and well-being to be an individual responsibility instead of an institutional priority, said several panelists at the summit.

Raluca Matei, a postdoctoral research fellow at the Peabody Institute of Johns Hopkins University, urged schools to recognize systemic factors—such as unsafe educational norms, silence around mental health, and curriculum overload—that contribute to poor mental or physical health.

“Sometimes health is framed as physical, other times as psychological, occasionally both, and all too often, it is framed as personal, as something you must manage, monitor, and fix alone,” she said. “The message becomes, ‘If you’re struggling, try harder.’” 

That framing, she warned, ignores the structural conditions that can cause harm in the first place. Meghan Taylor, a musician-researcher and wellness educator, underscored this point and encouraged music programs within higher education to lead the way, pointing to a variety of new teaching frameworks that shift responsibility from the individual to the institution.

These frameworks address systemic challenges such as overwhelming course loads and unsafe sound levels. Taylor highlighted the Total Worker Health model, developed by the National Institute for Occupational Safety and Health, which emphasizes creating supportive and safe environments. When applied to music programs, this model encourages student involvement in developing solutions, whether through access to campus resources or student representation on institutional committees. The result is age-appropriate teaching that supports the development of healthy, sustainable habits throughout a musician’s education and career.

Building a framework that addresses musicians’ health needs

Moreover, when students do ask for help with an injury, they often turn to their teachers—who aren’t trained to provide medical assistance—because there isn’t another designated person to turn to.

By contrast, college athletics programs stress health and safety. NCAA athletes must undergo pre-participation exams, be informed of injury risks, and adhere to equipment standards tied to known safety regulations. Rose Schmieg, professor and department chair of physical therapy at Howard University, said music programs should embrace a similar approach.

“It is our time to develop a performing arts medicine administration handbook that has teeth, as does the NCAA’s,” Schmieg said, adding that there must also be an effort to find a governing body to manage it. 

Based on two ongoing Delphi expert consensus studies, the PEOCOC Group for Collaborative Musicians’ Health Advocacy Initiative has already identified 10 cross-disciplinary core competencies and 5 institutional and organizational responsibilities for health care providers working with musicians. According to Shelly-Anne Li, research director and scientist at The Artists’ Health Centre of the University Health Network and the competencies project co-chair, each preliminary recommendation received at least 90% consensus from the experts, underscoring the broad acknowledgement that these are the skills needed to adequately support this population.

Among the competencies, experts emphasized that providers must be able to treat and manage musicians’ clinical conditions while promoting safe participation in music making. They also suggested establishing board-certified discipline-specific subspecialties with credentials. Additionally, they called for clear oversight structures to guide accreditation, training, and care standards that are tailored to the unique needs of health systems based in different areas. These competencies—and many others—mark an important step toward ensuring that health care providers are informed about musicians’ unique risks and are equipped to address their complex and multifaceted health needs.

Ensuring health outcomes are properly defined and measured

Still, evaluating such programs is tricky. Ana Zão, a physical and rehabilitation medicine and pain physician, said additional tools and guidelines that reflect musicians’ priorities are needed.

She argued that in order to define patient-centered clinical outcomes, there must be a collaborative effort in which health care workers hear from musicians. Without this insight, she said, “there is a risk of developing tools that are scientifically sound but clinically irrelevant, or worse, measuring what’s easy rather than what is meaningful.”

“To serve the musician population, we need funding for research and specialized training for healthcare professionals who encounter musicians regularly in the clinical space. This is what the musicians deserve,” said Serap Bastepe-Gray, co-founder of the Johns Hopkins Center for Music and Medicine and chair of the PEOCOC Group. “We are truly excited about the possibilities ahead and how we will bring these initiatives off the page and into practice where health care professionals, together with musicians themselves, shape the systems that support and benefit musicians’ occupational health. This is our moment to raise the global standard of care for musicians.”