Posts Tagged ‘Dance’

BAPAM Psychosocial Working Group

Tuesday, May 7th, 2019

BAPAM has convened a Psychosocial Working Group to bring together clinicians including doctors, clinical psychologists, psychotherapists and counsellors, charities working with performing arts professionals to support mental health, and academics conducting key research.

The group provides a forum in which approaches to care and support can be discussed, and clinical leadership can be provided for developing and instantiating a service designed to support performing arts workers with issues related to vocation-related physical and mental health issues. We are using the NHS-approved evidence base produced by the National Institute for Clinical Excellence (NICE), who review the published evidence for healthcare interventions from a clinical and a cost-effectiveness perspective, to map the services available to performing artists against the clinical evidence for best practice and identify gaps in those services.

The prevalence of mental health problems is considerably higher in the performing arts community than in the general population, and suicide rates are well above the national average. There is an acute awareness of the problems within the performing arts industry and many artists have been sharing their mental health experience in the context of their work.

The group has mapped many of the initiatives developed to support performers including Help Musicians UK’s Music Minds Matter helpline, Theatre Helpline, Music Support, which has a particular focus on addictions, Equity supported Wellbeing Drop-in sessions at the Actors Centre,  Music & You, Music for Mental Wealth and BAPAM’s own free service, which provides clinical assessments for performers across the UK. In addition, there is a growing number of practitioners who have trained to work in this area, building on insights gained from previous careers in the arts industries, for example, the Music Industry Therapist Collective.

We are grateful to have had so many valuable insights from practitioners and agencies involved in this important work and together we’ve begun identifying what is available, what is missing and how we should work together to support a comprehensive approach to mental health services for performers.

Mental illness is not a straightforward condition. Some people will experience just one episode of mental ill-health in their lives. Of those who receive a brief intervention, half will recover and never have another one. Others, however, experience recurrent episodes and will continue to do so through their lives even though they may be well for significant periods of time. It is essential that performing arts professionals experiencing challenges to their mental health receive accurate diagnoses as quickly as possible to ensure they access the right care. Where brief interventions are indicated, these should be delivered by practitioners who have a track record of working with performing arts clients. Healthcare practitioners, however they are employed, need to be able to access professional support from mental health specialists to ensure they are making the right diagnoses and to refer on if necessary.

Discussions to date have identified many areas for action, but the immediate areas to take forward have been identified as follows:

  1. Development of guidance for the performing arts industry covering points of best practice for performers, care providers and all organisations commissioning care for performers
  2. Rapid access to clinical assessment to determine the best care pathway
  3. Provision of brief interventions tailored to the needs of performing artists,  focusing on performance anxiety
  4. Access to mental health specialists (e.g. psychiatrists and clinical psychologists) for advice on the management of patients’ complex needs, for practitioners working outside the NHS
  5. An annual CPD event for psychosocial practitioners working in, and developing their career in performing arts health care
  6. A collective effort to support fundraising which aims to meet identified gaps for all practitioners

Event Report: Occupational Health in the Performing Arts Industry – The Original Gig Economy

Tuesday, May 7th, 2019

Health in the performing arts industry – whose responsibility?

Every year BAPAM helps with hundreds of inquiries about health problems related to working in the performing arts. These include musculoskeletal problems caused by strain and intensive use of parts of the body, vocal health issues which need specialist diagnosis and treatment, psychosocial problems including performance anxiety, stress related to the uncertain nature of the work (82% of the workforce are freelance) and more complex and enduring mental health conditions as well as hearing health problems. Performers, in common with other freelancers, tend to ignore health problems and seek help at a very late stage.  The research shows that, at any one time, 75% of performers will have a health problem.

We were delighted when the Royal Society of Medicine chose to partner with BAPAM on a professional development event held on March 27, 2019 to consider occupational health in the performing arts sector and its relationship to the wider ‘gig economy’. We were lucky to have a stellar line up of speakers from the arts, academic and clinical worlds to provide a range of perspectives on this question.

Kicking off the conference, Jane Dyball, former CEO of the Music Publishers Association outlined the complexity of the industry and the relationship of an artist to industry bodies at different times of their career. In the early stages, the artist may be very dependent on promoters, venues, managers, but that relationship changes when they are successful so that those bodies are dependent on the artist for their own success.

Dr. Colin Thomas, Chief Medical Officer of the BBC, added to the picture as he described the plethora of jobs undertaken by freelancers in broadcasting and the difficult balance between their tax status as self-employed workers and the duty of care issues that organisations owe to both employees and freelancers.

Zeb Soanes, BBC Radio 4 broadcaster and BAPAM Patron, described the moment when he suffered paralysis of one of his vocal cords and his journey back to full health and employment. He spoke with courage of the isolation and anxiety of losing your identity and the difficulties of accessing the right care in this very specialist area.

Professor Aaron Williamon of the Royal College of Music’s Centre for Performance Science, described results from recent research which demonstrated the lack of general fitness, particularly amongst student musicians.

In the afternoon we heard examples of good practice from Peter Garden of the Royal Liverpool Philharmonic and Professor Emma Redding, Head of Dance Science at Trinity Laban. Peter outlined Liverpool Philharmonic’s approach to developing and supporting performance excellence through providing health and wellbeing services to orchestra musicians. He and the Board have seen the impact of this investment on enhanced performance, improved employee satisfaction and engagement, and positive signs of reduced reliance on freelancers to cover sickness absence due to playing-related musculoskeletal injuries. Professor Redding outlined the advances in healthy practice in dance education and how a specialist health insurance scheme is helping to provide access to occupational health services.

Dr Rob Hampton, RCGP representative at Public Health England and a practising GP, described his own caseload and the difficulties for freelancers in accessing support with work-related health problems, the impact on the NHS and the evidence that working itself improves health. Dr John Etherington, NHS lead for rehabilitation, drew on research on performance enhancement in the military and in sport to demonstrate that effective training for the physical and vocation-related psychological demands as well as good rehabilitation after an injury can significantly improve health.

In this conference, the problems were clearly laid out and examples of solutions are available, but whose responsibility is it to drive the improvements? With over £5bn in UK annual revenue coming from the performing arts, it doesn’t seem sensible NOT to look after the health of the workforce, and leaving this role to charities on their own is not a sustainable solution.

Here are some thoughts from the BAPAM team on how the current position might be improved. First of all, to answer the question, who is responsible for improving performing arts health?

  1. Employers and Education Providers. These bodies do have a duty of care to employees and students. Liverpool Philharmonic has demonstrated the economic and artistic case for employers investing in healthcare. Many employers can and do support occupational health for performers. A consistent approach here would improve the health of 18% of the workforce. There are 50,000 students in performing arts education and Professor Williamon’s research, the practice in Dance Education and the work of the Healthy Conservatoires Network demonstrate what can and should be done to develop healthy behaviours in students and ready them for the realities of working life.
  2. The Freelance Performer. The performer is responsible for their own health (however, see point 3 below), including seeking help at an early stage and following the health behaviours which are evidenced to reduce the likelihood of health problems. Freelance performers who have learned these behaviours in education should be equipped for the working environment, but many performers have not had access to performance education. The provision of educational sessions and written and online materials together with peer support networks is crucial for this group. The Musicians’ Union, ISM, Equity, Help Musicians, Music Support as well as BAPAM and many other individual coaches and writers are currently offering support in this area.
  3. The Performance Environment. Research evidence tells us that good self-care is best achieved within organisational structures that support individual wellbeing. While other organisations in the industry may not have a direct responsibility for performers, they do have a responsibility for ensuring that the environment enables the performer to carry out their personal health responsibility. In addition to statutory health and safety duties, a culture and environment that encourages and supports healthy practice will help performers. As a very basic example, hydration is vital for performers – if there is no water available in a venue, it becomes difficult for the performer to practise this behaviour. What if the acoustics are so bad in a venue that the only way performers can hear themselves is turning the amps up excessively? What if there is a culture in your organisation that discriminates against certain groups or individuals, contributing to negative social relationships and mental health problems? What if the people you depend on don’t know where to go for help when they need it?

If this is a structure we can organise around, then what would a Health Manifesto for the Performing Arts look like?

  1. Everyone in the performing arts world needs to understand what healthy practice means, from the educator to the employer, individual performance professionals and any organisation or individual working in the business (managers, promoters, agents, labels etc).
  2. Everyone needs to know where and how to get clinical help when they need it.
  3. All funding options should be explored to develop a system-wide approach to providing for the health needs of performers, combining charitable funding sources with other sources of support including industry-specific insurance schemes, access to work funding etc.

We welcome responses by email at info@bapam.org.uk

Occupational Health in the Performing Arts Industry: The Original Gig Economy

Tuesday, February 5th, 2019

 

Wednesday 27th March 
Royal Society of Medicine
London

 

Registration for this event is now open.

Training arts professionals in healthy practice skills is vital, but we believe that healthy individuals also require systematic support from the industry that is built on their work. 

The majority of workers in the performing arts are freelancers and all are likely to, at some point in their career, experience an injury or have other health problems as a result of their work. The particular needs of those in this industry translate to other areas of the national workforce where, with the expansion of the ‘gig-economy’, traditional occupational health provision increasingly may not reach. 

The Occupational Medicine Section of the Royal Society of Medicine and the British Association for Performing Arts Medicine have therefore come together to run a one day educational meeting that will be of interest to a wide range of people with an interest in health and work.

Talks and panels feature leading arts industry and occupational health experts, academics and clinicians, and include consideration of the economic case for investing in health, health promotion, injury prevention and rehabilitation for self-employed workers, key and emerging occupational health issues in the arts sector.

Contributors include:

Professor Aaron Williamon, Royal College of Music, Centre for Performance Science

Zeb Soanes, BBC Radio 4 presenter

Jane Dyball, CEO of Music Publishers Association Group, winner of Music Week Women in Music Award for Outstanding Contribution

Professor Emma Redding, Head of Dance Science, Trinity Laban Conservatoire of Music and Dance

Colin Thomas, Chief Medical Officer, BBC

Colonel John Etherington, Director of Defence Rehabilitation and Consultant in Rheumatology and Rehabilitation, Defence Medical Rehabilitation Centre

More information and registration

Performing Arts Medicine (PAM) day

Tuesday, November 27th, 2018

It’s been a busy year for all things Performing Arts Medicine (PAM). Here’s a look back at one of the highlights of the year.

The annual PAM DAY 2018 was held at the Institute of Sport, Exercise and Health on 21st July and organised by the Department of Performing Arts Medicine at UCL. It was a chance for health professionals, stage performers, and students and staff in health sciences and academics to get acquainted with this area. The idea is that they learn about clinical assessments, recovery and rehabilitation specific to performers in music and dance, as well as performer health education and injury prevention.

Programme lead of the Msc at UCL is musckuloskeletal doctor Dr Hara Trouli, who’s also one of BAPAM’s assessing clinicians. Here she is talking about how the day went.

“PAM day was a successful event for BAPAM practitioners and all clinicians and performers who attended. A range of presentations in music and dance with two streams running all day gave attendees the opportunity to learn a variety of topics, to meet MSc graduates and tutors and to hear about their research projects. PAM DAY received great feedback and we are pleased to see the growing interest and participation in these events.”

The Performing Arts Medicine MSc at UCL is a unique programme providing specialised training to those interested or already involved in offering health services to this very special sector of instrumental musicians, singers, dancers, actors and other performing artists.

Applications for the next academic year in September 2019 is open and closes on 26th July 2019. Click here to find out more

BAPAM Performance Environment Day

Tuesday, November 6th, 2018

What would an ideal performance environment look like? Is such a thing even possible when we work in such widely different spaces? How do our environments affect our health, our creativity, our social relationships? What can healthcare professionals, technicians, artists, support organisations and communities do to both support performing arts wellbeing and facilitate excellence in artistic practice?

Our Performance Environment Day explores these topics, from a healthcare perspective and including the experiences of other professionals including artists, technicians, educators and people working in arts support roles, some with additional needs due to illness, injury, difference or disability

You can now read the full programme.

The event takes place at Resource for London on November 17, 9.30 – 17.00.

Tickets are available here.

 


Presentations and Discussion

The Performance Environment: Challenges in the Performing Arts Industry
Sophie Lane, Specialist Performing Arts and Sport Physiotherapist

Saving Your Ears for the Music!
Gladys Akinseye and Jordon Thompson, Clinical Audiologists and Hearing Therapists

Preparing for Challenging Performance Careers
Arran Peck, Athletic Development and Conditioning Coach, National Centre for Circus Arts

Cognitive Function of Adult Amateur Pianists
Dr Marie McKavanagh, GP, MSc Performing Arts Medicine Shipley Rudge Award Winner

Anxiety and Psychological Support for Theatre Productions and Artists
Dr Anna Colton, Chartered Clinical Psychologist

Panel Discussion/Q&A

Do our performance environments facilitate or obstruct artistic practice? How can the ways in which we design, manage, use and share space be a positive factor in healthy practice? Collective support in creative communities, accessibility and participation.

Kris Halpin, Musician/Producer
Robin Townley, CEO Association of British Theatre Technicians
Lisa Tregale, Head of BSO Participate, Bournemouth Symphony Orchestra
Siân Willett, Co-creator of Wellbeing for the Arts

Dan Hayhurst, BAPAM Information Coordinator (Chair)

Arts health practitioners in focus: Massage Therapy

Tuesday, March 27th, 2018

Arts professionals and students are unlikely spend much time thinking about their health until something goes wrong. Yet they work in a tough industry and often push themselves to the limit. Problems can accumulate over days and years spent practising and performing. Taking care over physical and mental health is essential to sustainable performance practice and a successful career.

Sometimes things go wrong. A health problem or injury starts to affect your performance and you need help to beat it.

If you are a student or professional in the performing arts, a call to BAPAM’s Helpline can provide advice about where to get help for work-related health problems. You can arrange a free assessment at BAPAM with a doctor or clinician who will understand the demands of your career. You should always talk to your NHS GP as well – often excellent services are accessible by GP referral.

What if you are looking for independent expertise from a physical or psychological therapist? It is easy to be confused with the number of different therapies available. How do you go about finding a practitioner with the right experience and expertise?

BAPAM’s Directory of Practitioners lists information about high quality and accessible performing arts healthcare provided by skilled professionals working in a variety of modalities. In this series of posts, we’ll look at how these different kinds of practitioners can help you stay fit, overcome problems, and give your best performance. In this post, we look at a sometimes overlooked section of our Directory, Massage Therapy.

Massage Therapists work with the soft tissues – muscles, tendons & ligaments to apply pressure, manipulate and stretch them. Often these clinicians are termed Sports Massage, Holistic Massage or Sports and Remedial Massage practitioners.

You should check Massage Therapists are properly registered with the regulatory body, the Complementary & Natural Healthcare Council, which means they are highly qualified. ITEC level 3 certificates are a good entry point into massage but for detailed knowledge of anatomy & physiology and more advanced methods of working, it is important that the therapist is qualified to diploma level or above.

We asked four BAPAM Registered Practitioners for their opinions on how arts specialist Massage Therapists can help you stay fit and give your best performance.

Rebekah Gilbert:

Rebekah Gilbert trained as a singer at the Royal Academy of Music and has sung as a concert soloist, recorded for EMI, BBC Radio, Classic FM and at Abbey Road Studios. She trained at the London School of Sports Massage and ITEC. She has a doctorate in coaching and is an Associate of Canterbury Christ Church University, working with Professor Stephen Clift on worldwide publications relating to singing and wellbeing.

“A good Massage Therapist will do a lot more than just ‘pummel’ you! First they will take a history of the issues you are consulting them on, your artistic practice and the time you put into it, lifestyle, exercise, the environments in which you work, and your medical history. If they discover anything that may need referral to another medical professional they will know when not to treat you.

Secondly, they will assess your posture as you stand and sit, the way a musician plays their instrument, and look at your walking gait. Is anything out of alignment? What are your posture habits and why? Might you need orthotics to improve how you stand and walk or just more supportive shoes?

Thirdly, they understand the difference between palpating well toned muscles and tense ones. Massage Therapists are good detectives, examining how you may have formed adhesions (knots), and can recommend changes necessary to reduce them in the future. The muscular skeletal system has an integral deep & superficial layer of facia running through it, which connects to every part of the body down to cellular level. Because of this, a Massage Therapist will know that a pain in one location may be triggered by problems in another and, within their toolkit of techniques, which will be most beneficial to apply.

Fourthly, they will have a long list of stretching exercises to give you as ‘homework’. However well a Massage Therapist can work in one hour, the time until your next appointment needs your input to make a difference. They may suggest other local practitioners such as Pilates, Feldenkrais, Yoga or Physical Training instructors to help you improve core strength and posture awareness. As a singer, I also know how beneficial optimal breathing techniques are in performance.”

Felicity Vincent:

Felicity Vincent is a professional cellist and a Pilates Instructor and Massage Therapist specialising in exercise for cellists. Felicity is an experienced active performing cellist and teacher with a deep understanding of how a player’s body might accumulate problems and how these might be solved. She has gone on to study Fascial Release with Anatomy Trains. Please check the BAPAM Directory for contact details. 

“Every string player knows their body isn’t just made up of levers (bones) and pulleys (muscles) but a controlled flow of circular and rotational movement. This is made possible by your fascia, the soft tissue of the body which is now known to be a strong, bouncy, stretchy, highly intelligent and trainable cell matrix which is everywhere, joining muscles to bones, allowing muscles to glide over each other, and through and over organs. But the fascial system is the site of countless numbers and types of nerve endings. These can respond to overuse and misuse which may be caused by imbalanced body use or holding onto emotions. Some degree of hypermobility can be an advantage in playing but is a double edged sword because stretchy tissue is particularly vulnerable to injury when overworked. On the massage couch your therapist will coax adhesions to dissolve and encourage held patterns to let go.

I see regular exercise as the principal key to health and wellbeing for every string player. I enjoy Pilates because it can be challenging and, particularly using the equipment, is a sophisticated way to balance the body and strengthen it. There are many schools of cello playing; the most important thing is that playing shouldn’t be destructive.”

Zoltan Zavody

As a musician (and martial artist) himself, Zoltan Zavody understands the range of injuries, impediments to joyful playing, and pain that can result from muscular imbalances.

“Anyone who trains their body intensively is more prone to soft tissue injuries – musicians sit in the same position for hours, make countless repetitive motions at speed, and then lug their instrument or box of scores to their next session. They are perfectionists who put themselves under intense scrutiny and thus stress. In the course of their careers, many musicians are likely to experience an injury requiring time off from performing.

The conditions sustained through the playing of music vary. Some seem relatively innocent, for example tightness and soreness in the left shoulder of a violin player. Others are more insidious, like the burning pain in the wrist of a guitarist. Still others are structural, like a lower back torsion in a pianist. Massage Therapy can generally help with all of these. And they can be interconnected.

Interestingly, through years of practise, it is not only the muscles that are habituated to playing. The connective tissue, the fascia that surround the muscles, also adapt. Research shows that this connective tissue morphs, slides, and grips according to habitual movements. So a musician may end up with managing to relax their ‘playing muscles’, but unless it is released, the tissue enveloping these muscles continues to pull their body and limbs into a specific posture, like a skewed bodysuit. The person is relaxed, yet they still feel a tightness, a pull, a misalignment. This is where a Massage Therapist can help with a range of myofascial techniques; softening, stretching, and pulling the connective tissues, the bodysuit, into comfortable alignment.

Myofascial work is not all about injury and problems! All of us inevitably have muscles and tissues that are a little stuck, whether from old injuries or emotional holding or underuse, and we don’t even notice. Take a singer for example, who has no complaints but wishes to improve the smoothness of their sound. By working fascially through the diaphragm and along the ribs, a Massage Therapist can help release these areas, leading to greater lung capacity and breath control, and an easier, more joyful singing experience. We have essentially freed up the bellows – and who wouldn’t want that?

If musicians were sportspeople, they would have ‘pitch-side’ Massage Therapists and coaches to help them fulfil their potential and make life a little bit easier.”

James Wellington

James Wellington is a specialist musculoskeletal physiotherapist and Sports Massage Therapist who works extensively with circus performers and other artists. He Lectures nationally and internationally in the fields of physiotherapy, injury prevention & performance enhancement and conducts research in evidence based practice.

“Using sports massage within clinical practice is hugely beneficial, as evidenced by the hundreds of satisfied performers that receive and rave about it. However, there are few well controlled studies into its clinical efficacy.

The speculated effects are biomechanical (improved joint range of motion, reduced stiffness and tissue adherence), physiological (reduced stress hormones, improved blood flow and parasympathetic activity), neurological (less pain and muscle tension), and psychological (reduced anxiety and improved relaxation).

Let’s be honest. It does feel therapeutic getting a sports massage (depending on the pressure being applied of course). It’s my conviction, however, that its benefits rely most heavily on therapist experience and their choice of technique.

If you’re lucky enough to find a sports massage therapist that has a broad set of massage skills, the ability to clinically reason and be able to justify every technique they use – you’re way more likely to see positive results. Personally, I find it hugely beneficial in improving joint range, reducing muscle tension, decreasing pain and decreasing injury-potential factors.

My top tips for performing artists thinking about getting a Sports Massage:

1. Think about the reason(s) you want to book a Sports Massage (post-training soreness / poor flexibility / repetitive strain injury / accumulated muscle tension / a pampering treat?) and communicate this to the therapist (this will assist in selecting appropriate depth of pressure and duration of treatment).

2. Tell the therapist if you specifically intend for the Sports Massage to improve your performance and/or recovery as this may also determine the type of techniques they use.

3. Timing of the massage is important. If in doubt, ask the therapist before booking what is the most appropriate.”

International Symposium in Performance Science, Reykjavik

Thursday, September 28th, 2017

The MSc in Performing Arts Medicine and BAPAM were well represented this month at the International Symposium in Performance Science (ISPS) in Reykjavik, Iceland, with research papers by Dr Trish Halliwell, Dr Philippa Whebble, Dr Farrah Jawad, Dr Hara Trouli, osteopath Tommi Sliiden and physiotherapists Kari Arnason, Lindsay Wallace and Krzystoff Dabrowski. Projects on flautists’ injuries, breathing relaxation for singers, vitamin D levels in dancers, health issues of popular musicians, lung function when singing and dancing, muscle injuries in string players, footwear and dancers’ injuries, and palmaris longus in pianists were received with great interest by the conference delegates. It is important to see such a group on the international arena of Performing Arts Medicine and we hope this will encourage more researchers to bring their work to this level. Congratulations to all involved!

BAPAM Physiotherapist Supports Team GB at World Games

Wednesday, July 19th, 2017

The 2017 World Games commence in Wroclaw, Poland on July 20th, and we wish the very best of luck to the Team GB athletes and BAPAM physiotherapist, Louise Curley who returns to her role supporting gymnasts, acrobats and tumblers as the British Gymnastics Delegation Physiotherapist.

Here at BAPAM, Louise gives expert help to musicians, actors, dancers, circus and physical performers, providing free physiotherapy assessments and subsidised, affordable follow up sessions at our London clinic. She also runs her own practice Rejuven8 Physiotherapy in Warwickshire.

BAPAM is Recruiting a Full Time Director

Thursday, July 13th, 2017

The British Association for Performing Arts Medicine (BAPAM) is a unique medical charity providing health advice and support to members of the performing arts community. We provide a national Helpline and confidential clinical consultations for performers experiencing performance-related health problems, as well as education and resources on healthy performance practice and professional training in performing arts medicine.

About the role

Following the planned retirement this year of our current chief executive, BAPAM seeks a leader to take the charity forward over what promises to be an exciting new period of ambitious growth in partnership with our principal funder, Help Musicians UK. The role involves strategic and operational leadership of the organisation, including management of a small team of administrative staff and a clinical workforce comprising of voluntary and healthcare professionals working throughout the UK.

For this role we’re looking for someone who is a strong leader, someone who has the ability to innovate and offer creative solutions, whilst thinking strategically. The successful candidate will be passionate about the performing arts and have the ability to be flexible and adaptable whilst displaying personal integrity and high standards of work.

Click here for further information and to apply.

The closing date for applications is Friday 5th August 2017.

Health Education in the Arts Survey

Thursday, May 25th, 2017

Researcher, Lisa Brachfeld, from the MSc Performing Arts Medicine programme at University College London, invites musicians, dancers, actors, and singers who are professionals or students/teachers at accredited conservatoires to participate in a new study of health education in the performing arts. The aim is to prove that performers could benefit from more health and injury prevention education. Learning about attitudes towards this subject will help to improve the effectiveness of education curriculums.

Take the survey here