Invited Review: Peripheral nerve injuries in the performing artist
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Abstract
Dancers and musicians have unique physical demands that can lead to injury of the peripheral nerves. Specific dance movements and specific instrument positions, combined with countless hours of practice and repetition, create an environment for potential nerve injury. Familiarity with these variables and recognition of the common presentations of neuropathic syndromes are essential in the evaluation of a performing artist with a suspected peripheral nerve injury. Assessment should include an understanding and analysis of their dance style or instrument playing posture, particularly in the position or motion that recreates the symptoms if possible. Practice and performance schedules should also be considered. Diagnosis may require electrodiagnostic testing, imaging, or diagnostic injections. Treatment should be comprehensive and may include modifications in practice schedule, posture/position, and technique in addition to consideration of medications, splints/orthoses, physical therapy, and injections. The instructor/teacher should be involved in the treatment plan if applicable. Complete rest in this population may not be realistic or necessary. Early and accurate diagnosis of nerve injury is important for safe return to dance or instrumental music.
Objectives:1) Be able to take an appropriate history, perform a focused examination, and order indicated diagnostic tests for a dancer or instrumental
musician presenting with possible activity-related nerve injury;
2) identify and implement appropriate non-surgical treatments for dancers and musicians with peripheral nerve injuries;
3) be able to recognize specific peripheral nerve injuries most common in dancers and instrumental musicians.
ACCREDITATION STATEMENT The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CREDIT DESIGNATION The AANEM designates this enduring material for a maximum of 1
AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 8/9/2027.
DISCLOSURE INFORMATIONThe authors declare no conflicts of interest.
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Berdale Colorado DO, MPH; Breanna Willeford DO; Jacob Schultz MD