Are we doing enough for physical health in the music industry?

With one of the biggest contemporary performing arts festivals in the world just a few weeks away, hundreds of thousands of fans will be preparing to make their annual pilgrimage to Worthy Farm to enjoy the music, theatre, dance and circus performances that Glastonbury has to offer. It’s exciting and encouraging to see, especially after the performing arts community’s experience during Covid. 

As the specialist clinical provider of health and wellbeing services for the performing arts, we at BAPAM saw firsthand the impact that these years had on performers, particularly their mental wellbeing. The number of mental health consultations delivered by our clinicians across the UK soared during this period. Between 2019 and 2023, mental health consultations quadrupled and, in 2023 alone, accounted for a third (32%) of all medical consultations we handled. 

But, in 2024, we see the landscape of health in the performing arts starting to change once again. As the industry reverts to its pre-pandemic levels of activity, we are seeing a surge in musculoskeletal consultations due to issues affecting bones, joints, muscles and tissues. It’s not surprising. Being in show business is a risky business. 

A vicious cycle

The work is intense, the environment is competitive, and the role can feel isolating, with so many in the arts being freelancers. While freelancers make up 15% of the UK’s workforce, they represent 32% of the creative industries, rising to 70% in the visual arts and theatre actors and 80% among musicians, according to the Authors’ Licensing and Collecting Society. 

Research indicates that approximately 75% of performers will encounter health issues that impact their careers, from the dancers or circus performers predisposed to injury due to hypermobility, to the actors and singers who experience larynx or vocal cord strain. All these ailments can be heightened by the intense and repetitive nature of performers’ work over prolonged periods of time.

In 2023, musculoskeletal issues accounted for over 40% of BAPAM’s medical consultations, with this type of problem further increasing in 2024. That’s not to say that mental health issues have reduced; we often find that the two are interlinked. Physical issues that affect performance can lead to anxiety, while with anxiety, performers are more likely to tense up, which can create a physical injury. It’s a vicious cycle.

So, what can we do?  

Unlike our closest equivalent of sports medicine, performing arts medicine is an emerging specialism. But over the course of BAPAM’s 40-year history of supporting the arts with bespoke clinical expertise, we’ve built up a body of experience that can be applied to the most complex issues encountered in our community, whether you’re a highly paid elite performer or just starting out in your career.

If you’re a performer, our first piece of advice is to seek help for an injury or condition as early as you can. Diagnosis is key and we have clinicians who can help with the nuanced injuries that performers experience. We’ve seen people hesitate to seek help at an early stage because of the stigma associated with injury or illness in a competitive environment, or the fear of missing out on the next gig. 

However, a lot of physical occupational health problems have simple solutions. BAPAM's free clinical service provides accurate diagnosis and advice from health professionals who understand what it takes to sustain a creative career.

Prevention is always preferable to cure: we offer a range of resources to help performers prevent injury and ill health. Our Healthy Touring Checklist and Rider provides practical and easy to implement tips on how to maintain your health while away from home or touring. We also run training designed for creative professionals, from courses for strings players, to sleep workshops and sessions for those living with neurodivergent traits.

A collective effort to improve health

The UK’s creative sector is built on the talents of diverse grassroots individuals and groups, and we can all play a part in supporting our community. Individuals can be empowered to take responsibility for their health if the wider sector also works together to build an environment that enables good health. In doing so, barriers and disadvantages related to factors such as disability, race, gender and economic inequality must also be addressed.

As a clinical partner, we work with sector organisations to support positive change. Some solutions are simple and effective in creating a positive and healthy workplace for all. In venues, for example, is there a quiet space or room to warm up or cool down? Do staff and visiting artists have access to healthy practice information? Are venues accessible to those with health needs?  

To build systemic improvement, we help organisations meet their duty of care, understand occupational health risks, provide a safe work and performance environment and ensure employers meet their obligations under the Health and Safety at Work Act. To improve accessibility, initiatives have included partnering on training for creators with neurodivergent traits, and a scheme for music industry professionals from the Global Majority entering psychotherapy careers. 

We are heartened to see a greater trend towards collective effort to improve health in the performing arts. As BAPAM moves into the next 40 years, we hope to work with more organisations and to address physical and mental health with equal emphasis and care, to protect and support the artistic success of those who form the backbone of our world leading creative industry.  

Claire Cordeaux is Chief Executive Officer of the British Association for Performing Arts Medicine (BAPAM).
 bapam.org.uk/
@ukbapam | @ClaireHealth