Research

EXCERPTS FROM RELATED ARTICLES

Beat the Heat: Managing Heat And Hydration In Marching Band

Breaking formation frequently to adequately hydrate is impractical…When the air’s moisture content is high, perspiration does not evaporate from the skin, and this cooling mechanism is lost. With 100% humidity, the sweat simply pours off the skin as liquid, and no cooling of the body occurs…treatment can also involve application of cool, wet compresses to the neck, wrists, and underarms.

Fluid needs increase during exercise in hot and humid climates, in high altitudes, when taking some prescription medications, and while dieting (Rabkin, 2000).  Table 1 – good listing of symptoms and treatment.

A practical solution was found with the discovery of water bottles that are carried in a nylon belt that has an insulated pouch to hold the bottle and keep the fluid cool. These belts resemble fanny packs (Figure 2). The standard bottles hold 22 ounces of fluid.  The belts have zippered pouches on each side of the water bottle pouch, which are ideal for carrying inhalers, change, keys, and earplugs for the percussionists. The student’s names were written on the belts with whiteout pen; permanent markers were used on the bottles.  Quotes were obtained from chain stores as well as local athletic stores.  One hundred bottle belts with pockets were purchased from a local sporting goods store at a reduced price of $15, which included the water bottles. This purchase of 100 bottle belts will last several years. Obtaining the belts alone and having the students provide their own bottle would have saved only $1. The cost of the belt was added to the fee for participation in marching band.

During rehearsals, the drum major or director would remind students to ‘‘drink!’’ 4 ounces of fluid every 15 minutes to keep within the required fluid replacement recommendations, and students were encouraged to drink water whenever standing at ease…Students were encouraged to use sunscreen liberally and to wear hats and light, loose clothing.  The students and director generally drank more than the recommended amount of water because it was readily available. It was noted that extra bathroom breaks were not necessary.
Subjectively, the number of students exhibiting symptoms of heat-induced illness decreased from previous years. Parent volunteers noted that fewer symptomatic students left the field. The drum major stated that students were better able to concentrate during rehearsals, and the director felt the rehearsals were more productive.  No calls were made to summon emergency services, which had been done twice in the previous year.

As a result of the educational materials, students were more aware of the symptoms of heat-related illness and were better able to recognize problems early in themselves or their classmates. This allowed them to leave the practice field on their own for treatment, if necessary, rather than fainting on the field, which had occurred weekly in previous years. The director was more understanding of problems and encouraged students to leave at the first sign of illness. The adapted Heat Index chart gave the director an objective system to use to determine if outdoor rehearsals should be shortened or canceled due to the Heat Index being unsafe for students’ health. The red-yellow-green color-corresponding chart uses simple parameters.

Heat-induced illness is common during marching band rehearsals. Students generally do not want to call attention to themselves by leaving the field during rehearsal, so they tend to continue rehearsing, hoping the symptoms they feel will disappear. Students and directors need instruction on how heat and dehydration affect the body and its performance.

From U.S. Army Band Injury Risk study

In univariate analysis, higher injury risk was associated with higher body mass index (BMI), less physical activity, prior injury, unit, functional group, and practice duration.  In the US Army Band, about half the performers had a medical visit for an injury in a 1-year period and injury risk was associated with identifiable factors

…”performers repetitively use specific muscle groups for long periods of time and this long-term, recurrent use may increase injury risk” (intro)

The questionnaire was constructed based on a review of the literature and information from
structured focus group interviews with 63 Band members (217 total in all parts of band, 205 returned questionnaires)  The final questionnaire administered to the entire Band asked about (1) the frequency and duration of practice, rehearsal, and performance, (2) the frequency and duration of exercise and sport activities, (3) tobacco use, and (4) medical care.

Information obtained directly from Band administrative records included individual arrival dates at the Band performing unit, primary musical instrument, physical characteristics (height and weight), & fitness test results.  Fitness test results were obtained from the most recent Army Physical Fitness Test (APFT) given on a biannual basis to all military members. The APFT consisted of three events, the maximum number of push-ups completed in 2 min, the maximum number of sit-ups completed in 2 min, and a 2-mile run.

Contrary to these data, we found only about 9% of reported injuries involved the wrist and hands while 34% to 42% of injury medical visits involved the lower body, and while the upper body was most frequently injured, it was largely because back issues doubled any other region…see table 3 pg 955(mean age of band members was 39 yrs).

See Table 4 p. 957 rating system for days of week frequency of physical activity, smoking history, race – assume rehearsal duration and frequency similar for all members (drumline?) was a key determinant in this study.

Playing without Pain

The Texas Center for Music and Medicine at the University of North Texas, the Performing Arts Medicine Association, and the Office of Professional and Continuing Education at the University of North Texas Health Science Center are currently developing core curricula for health promotion

“even the beginning of marching band camp after a musically inactive summer can demand such rapid physical adjustments that the body cannot adapt”

Foot problems related to marching can include blisters, calluses, and muscle strain, most of which seem to develop early in the marching season.

“For years I’ve advocated the 25-5 rule: practice twenty-five minutes at a time, then rest five minutes. Follow this schedule every half hour and get away from the instrument during break.”

Instrument modifications can decrease physical stress for many per- formers. Neck straps are available to support the clarinet, oboe, and English horn; they relieve pressure and stress on the musician’s right thumb. Bassoonists, on the other hand, should avoid neck straps and rely instead on seat straps while sitting and shoulder straps or harness when required to play while standing.           

Floor pegs (figure 2) can help support low clarinets, while harnesses and other body supports better distribute the weight of low saxophones and brasses, including orchestral tubas. This latter alteration may be especially helpful during marching season.

Proper seating minimizes the possibility of posture-related muscle strain. For all instrumentalists, the chair seat should not tilt backward; this position compresses the respiratory apparatus (in both chest and abdomen) and interferes with good breath support. A cellist’s seat should actually tilt forward slightly. Fortunately, several manufacturers of seating for musicians, including Wenger Corporation, Synapse Adaptive, and Soma Ergonomics, have addressed these concerns, and proper choices are plentiful. Chairs should be placed so there is a clear line of sight between musician, music stand, and conductor; this avoids twisting of torsos and necks while trying to see both music and conductor at once. Seats should be separated appropriately so instruments can be played without the performers having to assume cramped positions.

Flutists should not have to hang their right arms over the backs of their chairs and turn their heads to the left to see both music and conductor properly. Saxophonists, French horn players, and bassoonists especially need increased right-side space.

From Michigan Marching Band study:

 

See Figures 2 & 3 (injury form and exit survey) as well as injury analysis method on bottom p. 408

Asphalt was the surface reported injured on in 73.6% of cases (practiced on daily – ouch)

Greatest number of injuries occurred during warmer months (Aug and Sep)

85% of all reported injuries were lower extremity (35% ankle, 22% knee, 21% foot)

Tubas and piccolos (requires both hands placed to one side; requires extreme upper body torsion) had proportionately higher rates of injury; M/F injury numbers virtually identical

155 out of 179 reported injuries caused less than one full practice to be missed

Higher % of injuries involving first-year band members compared to returning members
More injuries were reported to occur during performances than rehearsals; 34% were pre-existing
Harmon’s Medical Problems of Marching Musicians

Evaluated at a professional travelling volunteer band from Baltimore (flagline included) n = 75 total

Instrument weights are always lighter than estimated by musicians; for example the largest of 4 tuned bass drums weighs just over 28 lbs, but vector analysis shows it produces a “carrying force” of 35 lbs

Highest % of reported injuries or pain involved lumbar spine, followed by thoracic spine

Surveyed complaints during marching with headache, dizziness, exhaustion, shortness of breath and chest pain