Performing arts medicine with a focus on functional disorders

In this article, special aspects regarding medical care for instrumental musicians from the perspective of functional medicine (i.e., structural/pathological disorders and injury not yet present, but the symptoms indicate a functional disorder or an impending functional pathology) are described. In the clinical assessment, the performing arts physician must be knowledgeable about and recognize special requirements/norms and the associated imbalances. In this regard, the conditional abilities of each musician play a fundamental role and are described in functional medicine as "triggering" factors. This assessment is crucial for the further course regarding an imbalance between physical load and strain. The majority of functional disorders develop when a person practices an instrument during the fatigue phase. In this article, the individual phases of fatigue and their effects (activation of synergistic muscles, change of stereotype, changes in metabolism) are described. Ergonomically unfavorable conditions when playing the instrument, including the need for corrective lenses, can also be responsible.