Strung up, played out

Tennis Elbow, Apostles' Neck, Cellists' Buttock Fatigue: Ian Pillow on musicians and what ails them

The biggest surprise to emerge from the first-ever conference to address orchestral musicians' ailments - a conference organised by the British Performing Arts Medicine Trust on behalf of the Federation Internationale des Musiciens - was that the delegates found the idea of musicians getting ill through stress and strain surprising. Ten per cent of players, they learnt, took more than a month off each year through illness; nine per cent took beta blockers; and 6 per cent needed a drink to steady their nerves before a performance.

As a player myself, I can only say I am surprised the percentages are so low. A more useful study might have been a scientific one: how does a bow drawn slowly during a quiet passage, in the hands of a nervous string- player, still manage - despite considerable downward pressure from the fingers - to defy all known laws of gravity and keep jumping some six inches into the air? A good stiff drink, or a beta blocker, certainly helps the bow behave more scientifically.

I am also surprised that the teams of doctors who researched the project by examining the working lives of 1,600 musicians in 56 orchestras worldwide could come up with accurate statistics. I certainly can't tell you the pre-concert alcohol/beta blocker/valium consumption levels of the Bournemouth Symphony Orchestra, because one of the tricks of being the perfect professional musician is not to let on. The giveaway clank of a bottle of something strong coming from behind a locked loo door can be remedied by decanting the contents into a plastic container before leaving home. An extra beta blocker can be hidden in the palm of the hand and then popped into one's mouth during a large yawn. Or so I'm told. (I'm certainly not adding my name to the statistics.)

Apparently 40 per cent of orchestral players wake up unnaturally early. Research does not reveal how many of those make up for their insomnia during rehearsals.

If the doctors assigned to the various orchestras had spent just one period full-time with them, instead of making just a weekly call at Tuesday afternoon rehearsals, there would have been no need for questionnaires or interviews with musicians. The conclusion that stress and strain are due to incompetent conductors or inadequate and chaotic rehearsals would have been obvious.

In addition to the standard "classical" rep, orchestras spend a lot of their time playing cross-over concerts to bring in the punters: film nights, "The Magic of Broadway", the inevitable 1812. This means lots of loud, fast music, invariably scrawled out in illegible handwriting, illuminated - if that's the right word - by a low-wattage music-stand lamp, while special effects flash around you in all their psychedelic glory, and you find yourself smothered in purple smoke from fireworks or inhaling an overdose of dry ice. Such music is hard to play at the best of times, let alone on a single smash-through earlier in the afternoon.

You might also have an incompetent conductor. These characters frequently manifest themselves at conventional concerts. The numbers of times my orchestra has had to rescue a performance from disaster caused by some "maestro" driving without due care and attention qualifies us for a Red Cross medal. And yet, in most situations, it's the orchestra that gets the blame if things go awry. Every single player takes pride in the end result, so a score of 32 per cent for "long periods of anxiety" doesn't seem that high to me. Even good concerts with good conductors induce special strains, and playing to the limits of one's musical and technical resources - day in, day out - takes its toll.

Of all the types of RSI (Repetitive Strain Injury) prevalent in our orchestras, the tennis-elbow (tendonitis) forms are the most common among string-players. It may be obvious that fast scrubbing (endless semiquaver passages for second violins and violas in Beethoven symphonies; interminable "tremolando" - very fast bowing - in Bruckner symphonies) is one culprit. But the real killers are the long slow pieces. I recently suffered an acute case of a rare condition found only in British orchestras - Apostles' Neck - the result of playing the longest, slowest and yawniest of all Elgar's oratorios - The Apostles. Slow, quiet playing, with a controlled quality of sound, is mentally and physically exhausting. My back still aches just thinking about it. After a couple of days recording Delius - another master of the inertia principle - the Poole Arts Centre reeked of Algipan for a week. (Another new ailment that will have to be written into the medical textbooks is Cellists' Buttock Fatigue, while, after a surfeit of cross- over concerts recently, one of our violinists had to have a foot operation - caused, we suspect, by a severe attack of Foot-Tappers' Hooked-On Ligament Syndrome.)

Finding out who suffers from what may offer a few surprises. Tendonitis is actually more common in the first violins, who have more mental pressure, than in the violas, who endure more physical demands. Neck- and back-ache is as common among cellists as among violinists and viola-players. Poor posture is also to blame - not because of bad training but because of tiredness and having to play in cramped conditions. You try sitting and playing normally when the huge resources of a Mahler symphony force you to play in a space the size of a telephone box. The down-bow clonks the E flat baritone cow-bell, while the up-bow has an exciting rendezvous with a bass player's right nostril.

With so much sitting around on stage and in coaches, it's not surprising that problems of the rear end are a common, if minor, discomfort. They are, of course, simply dealt with. But when I visited our new village doctor, who wanted to impress his new patients with his thoroughness, it was off to the hospital for me - "just to be sure". Pants down, on the couch, and ready for The Nurse With The Torch. After the examination, she asked me what I did for a living. When I told her, she gasped with wonder, "Oh! But I come to all your concerts", before adding: "Normally you're just a group of musicians sitting up there in your white tie and tails. How nice to see you in a different light"

Ian Pillow is a viola player with the Bournemouth Symphony Orchestra