Fort Worth, Texas (UNT) - The American Osteopathic Association held its annual Osteopathic Medical Conference and Exposition (better known as OMED2015) from October 17-21, 2015.  Texas Center for Performing Arts Health (TCPAH) Co-Director Sajid Surve, DO was the Program Chair for the American Academy of Osteopathy program at OMED, creating an exciting three-day curriculum entitled, “Osteopathic Contributions to Performing Arts Medicine.”  Experts from around the country were gathered to share their expertise in the form of lectures and workshops, including TCPAH Co-Director Dr. Kris Chesky and TCPAH professor Dr. Stephen Austin.

After a presentation on the injuries of instrumentalists, Drs. Austin and Surve teamed up to present both musician and physician perspectives on vocal health.  Beginning with an overview of the biomechanics of vocal production and laryngeal anatomy, Dr. Austin illustrated the issues frequently experienced by singers.  He highlighted both organic and functional disorders, providing visual and auditory examples for the session attendees.  Following up on Dr. Austin’s exploration of the singer’s need for treatment, Dr. Surve then provided a lecture and hands-on demonstration of osteopathic manipulative treatment specifically suited for vocalists. Attendees were then able to “try-out” the new techniques on each other, with guidance from Dr. Surve for proper placement, pressure, etc.  Many attendees commented on how they had never before considered the muscles involved in singing, and how enlightening the combined presentations were in regards to treating this population of the workforce.

The next day, Dr. Kris Chesky presented a research update in performing arts medicine, providing attendees the historical background on performing arts research, and also making the case for all the work that is yet to be done.  Dr. Chesky took the opportunity to highlight his research data on the tendentious topic of musician health earplugs and, more broadly, musician hearing health overall.  The issue of how to protect musician’s hearing is so timely, given Dr. Chesky’s and Dr. Amlani’s recent research and the ongoing efforts to educate teachers, students, and professional performing artists about the dangers associated with the profession.  Attendee feedback listed this presentation as one of the most beneficial sessions of the program.

On the final day Dr. Surve assisted his mentor, Dr. Rebecca Fishman in New York, to present a lecture and workshop on the osteopathic medical care of dancers.  Attendees learned about the different styles of dance, the injuries and risks that are associated with them, and the best management for those injuries.  A workshop on osteopathic manipulative treatment for dancer injures again allowed participants to hone their skills for this specific population.

The Texas Center for Performing Arts Health is committed to collaborating with professionals to study, treat, and prevent the various occupational health problems associated with learning and performing music and other performing arts.  Through OMED, the TCPAH was able to showcase our national leadership and expertise in these areas to the medical community, and provide them with the information they need to better serve the performing arts population in their practices.

UNT professor Kris Chesky, student Melissa Hatheway and Performing Arts MedicineDENTON, Texas (UNT) – When University of North Texas senior Melissa Hatheway experienced pain while playing clarinet following a performance-related injury, the then-freshman was encouraged by her parents and College of Music professor Kris Chesky to research health issues of band musicians.

Following nearly four years of research, Hatheway was presented the Alice G. Brandfonbrener Young Investigator Award at the July 20-23 Performing Arts Medicine Association annual symposium. The Cedar Park student is only the second undergraduate to win the award – and the first from the United States. This is also the first time that a non-medical student has won the Young Investigator Award.

The symposium, which draws arts medicine professionals from across the world, addressed medical problems of performing artists this year. Hatheway received funding from the Honors College, of which she is a member, to attend the event with five other College of Music students and alumni, and Chesky. The five other students and alumni who made presentations were:

  • Amy Laursen, of Powell, Wyo. – presented a poster and lecture on “Addressing the National Association of Schools of Music Health and Safety Standard through Curricular Changes in a Brass Methods Course.”
  • Jason Powell, of Lufkin, Texas – presented a lecture on “Reducing Noise-Induced Hearing Loss Risk in Collegiate Ensemble Based Instructional Activities through a Human-Computer Interactive System.”
  • Kristen Thompson, of Boston, Mass. – presented a poster on “The Inner Instrument: What is the Role of the Vocal Mechanism in Playing a Wind Instrument?”
  • Eric Wallace, of Los Angeles, Calif., and Derek Klinge, of Colorado Springs, Colo. – presented a workshop and poster on “Pain and Music Related Musculoskeletal Problems: Results from the UNT Trombone Health Survey”

“Our students garnered respect with the research they presented at the conference,” said Chesky. “Melissa presented a superb keynote session prior to her award presentation for her comprehensive research on marching band injuries – the first of its kind.”

For Hatheway, the path to her research started when she felt pain in her hand. Though it was difficult, Hatheway played through the pain. The pain continued to spread, climbing up to her elbows.

“My hands felt useless. I turned 18 and I felt like my body was falling apart,” Hatheway said.

Yet, she was still able to audition and gain entry into UNT’s prestigious College of Music. It was here that she started to think about how other musicians often play through pain. There seemed to be a lack of preventative injury knowledge for those who played in marching band throughout high school and experienced health issues as they transitioned to college, Hatheway thought.

Her own process of obtaining a proper diagnosis and finding the right therapy took nearly four years – but she is now playing the clarinet again.

To help figure out what was going on with other band members, she developed a 70-question epidemiological study for members of the University of North Texas Green Brigade Marching Band. The questionnaire asked the performers about their perceived impact of marching band, musculoskeletal health, hearing health, stress and pain experienced. She divided their responses between music majors and non-music majors since music students put in more hours of daily practice. She then further segmented the responses by specific instruments, including the color guard, percussion, woodwinds and brass. Those answering the questionnaire were also given a drawing of the body to map out where they felt pain and how intense it was.

Hatheway hypothesized, based on her knowledge of marching band techniques, that music majors participating in marching band would experience more pain and injuries than their non-music major peers. The results of the study backed up this theory, showing that music-major participants experienced more musculoskeletal pain during and after marching band rehearsal, while non-music majors reported the exact opposite.

Although Hatheway, who is entering her senior year, plans to work as a teacher after graduation, she hopes to continue her research at UNT and earn her master’s and doctoral degrees – and eventually change the way band is taught in order to prevent health issues.

“I’ve come up with a list of what I would recommend to prevent injury, but, as a researcher, I can’t say, ‘You should do this to avoid injuries,’ because the research isn’t complete yet,” Hatheway said. “That’s really what I’m interested in – the pedagogical techniques that a teacher can use to lower the risk of injury.”

The research of Hatheway and the other students is as important as it is timely, noted Chesky. The National Association of Schools of Music has established national standards to address health risks for musicians. By identifying and working on the injury risks to musicians, these students are helping UNT stay at the forefront of research and solutions, Chesky said.

“Our time at this conference helped me see and better understand the relevance of our research,” Chesky said. “Three medical research scientists from Taiwan told me that a paper we published a few years ago prompted and guided a recent national musician health campaign across their country. I heard similar stories from Australia and South African researchers. Our impact is clearly global.”

DENTON (UNT), Texas -- The University of North Texas College of Music and Dr. Kris Chesky, director of UNT's Texas Center for Music and Medicine, have earned the 2010 Safe-in-Sound Excellence in Hearing Loss Prevention Award in the Services sector from the National Institute for Occupational Safety and Health (NIOSH), in partnership with the National Hearing Conservation Association (NHCA).

The award, presented at the 35th Annual Hearing Conservation Conference Feb. 26 in Orlando, Fla., was given to UNT and Chesky for raising awareness of the importance of hearing loss prevention in musicians.

Chesky and researchers at UNT's Texas Center for Music and Medicine have been studying ways to prevent noise-induced hearing loss from music exposure and discovering ways people can save their hearing at an early age, thus improving their overall health and quality of life.

"Receiving this award from NIOSH is a high honor, and we are so pleased that our work is raising awareness about this issue on a national level," Chesky said. "I believe that every person learning about music in the United States, from early grade school through college, must be taught to understand that music is a sound source capable of harming hearing.  This issue needs to be brought to the attention of everyone, particularly to those that direct music ensembles in colleges and public schools across the nation."

UNT takes steps to prevent noise-induced hearing loss in musicians by measuring sound levels produced during instructional activities, educating music students of the possible consequences of excessive exposures, and advising them of resources to protect their hearing. Ensemble directors and teachers discuss noise-induced hearing loss and prevention methods with their students.

In addition, Chesky developed and teaches a course, "Occupational Health: Lessons from Music," for undergraduate students of any major. The class focuses on musculoskeletal, hearing and mental health issues associated with musical occupations.

The NIOSH awards were given for hearing loss prevention programs in the construction, manufacturing and service sectors to honor individuals or organizations for innovation in hearing loss prevention and dedication in fostering and implementing new and unique advances in the prevention of hearing loss.

From left: Dr. Shrawan Kumar, Dr. Rita Patterson, Eri Yoshimura, Sam Durham, Dr. George Kondraske, Dr. Kris CheskyIn February 2008, a collaborative research grant was received by the UNT Health Sciences Center  and the Texas Center for Music and Medicine for a proposed study of the hand kinematics of piano players. The study was approved by the Institutional Review Board in May 2008 and is currently  in progress.

The study is being performed by Dr. Kris Chesky, Dr. Rita Patterson, Dr. Shrawan Kumar, Dr. George Kondraske and Eri Yoshimura in order to better understand musculoskeletal problems in the upper extremities of musicians, specifically piano players. Many pianists suffer from these problems  and the nature and causes of these problems are not well understood, while ways to prevent or  alleviate these problems are even less studied or reported. For this purpose, the study is measuring posture of the hands and force on the keys while playing different intervals and volumes on the piano.


Fitted with motion-capture markers, graduate student Yoshiko Shamoto performs the exercise in the study.Each of the 30 subjects are being asked to fill out a questionnaire about their musical background and other piano-related characteristics. Measurements of their upper extremities are taken, such as forearm length, hand volume, hand span, et cetera. Subjects are then attached with small reflective markers on the back of their hands, elbows, shoulders and forehead that will be used to track their movement with several motion-capture cameras as they play. Force sensors are placed under several keys to measure the amount of force a subject uses while playing.



A screenshot of the motion-capture data.Finally, the subject performs a 10 minute exercise that involves playing 5ths, 8ths and 9ths on the piano at varying dynamic levels to the beat of a metronome. The performance is recorded by video  camcorder and data is taken by a computer through the force sensors and motion-capture cameras.  After playing, each subject is asked a few more short questions.

Through the observation of movement, force, and posture of the hands while playing piano, the investigators of this study hope that it may eventually help pianists understand the origins of piano-related pain as well as direct the development of pedagogic, technical or ergonomic interventions.

DENTON (UNT), Texas - The University of North Texas College of Music has secured $60,000 from organizations within the music industry including the National Academy of Recording Arts and Sciences, the organization that awards the Grammys, to develop a nationally implemented health communication module for music schools across the country.

A $30,000 grant has been received from NARAS, together with $15,000 from the International Music Products Association and $15,000 from the International Foundation for Music Research. These grants are in addition to $20,000 previously received from the National Endowment for the Arts.

During the next year, the Texas Center for Music and Medicine will organize task force groups in four areas — physical health, mental health, audiological health, and vocal health, - to create core content for the communication module. The task force members will present that content at a conference organized by the Texas Center for Music and Medicine, the Performing Arts Medical Association and the UNT Health Science Center Office of Professional and Continuing Education in Fall 2004.

"This funding ensures that we will be able to draw together top scholars in their field to discuss musician's health and create a communication module that really makes music students and teachers aware that while music is a critical, positive part of our culture, there are risks associated with performing music just as there are risks associated with playing sports," said Kris Chesky, research director for the center.

Music, medical and allied health professionals from around the nation will gather at the "Health Promotion in Schools of Music" conference to create the module, which will inform college students about the health risks associated with music.

The National Association of Schools of Music, which accredits more than 500 schools of music, recently added a recommendation to its accreditation guidelines encouraging member schools to provide health information that promotes awareness about and prevention of performance injuries. The NASM is serving as a resource and consultant on the project.

Details about the conference dates, location and program can be found at

Directed by Drs. Kris Chesky and Bernard Rubin, the Texas Center for Music and Medicine was established to study, treat and prevent disorders related to learning and performing music. The center comprises educators, researchers and clinicians within the UNT System, including faculty from the College of Music, the College of Arts and Sciences and the UNT Health Science Center, who conduct interdisciplinary research and provide clinical treatment to musicians in the Metroplex.

The center's clinical and research programs address health issues related to hearing, physical problems and mental health. Ongoing findings support the concern for these problem areas and show that preventative measures can be effective at reducing risk.

As a result, the UNT College of Music expanded its mission to educate students about the physical concerns with performing and teaching music. The college now prides itself on its health awareness and prevention programs, specialized clinical services, and research.

"By making this commitment, the college has taken the first steps toward a cultural shift in how schools of music think about teaching and performing," said Dr. James Scott, dean of the College of Music. "Because we don't usually think about musician's health as being at risk, this is an important first step, but still just that - a small step in bringing about industry-wide belief changes."

The College of Music encourages its students to take advantage of the center's clinical resources, educational programs, and research initiatives. The college also offers courses in music and medicine for graduate students and has a unique music and medicine optional related field of study for students seeking a master's or doctorate of musical arts degree.

"We believe music is a critically important and immeasurably valuable part of our society. That's why we are engaged in preparing our students for successful careers in music as performers, teachers, scholars and composers," Scott said.

"We also want our students to have long careers and to be informed music educators, so we pay attention to the effects and potential harm that can be caused by the stress of demanding too much of the body or using it incorrectly. After all, a musician's body plays a role equal to the instrument in the ability to make music," he said.