The show must go on—keeping injury at bay

Working at an elite level as an actor, musician or dancer, while artistically rewarding, is also physically and mentally demanding—and so, many major performing arts companies have a health and wellbeing program for artists and arts workers.

The show must go on—keeping injury at bay

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For orchestras hearing loss can be a major risk. Dancers are in danger of sustaining injuries to limbs and feet, and circus performers can take their pick of what injury could occur next.

Queensland Symphony Orchestra, for example, has had in place a program to protect its players from hearing loss for almost 10 years—a problem that can be quite common among orchestral musicians.

A recent study by the School of Medical Sciences at The University of Sydney has found QSO’s hearing conservation program is one of the most comprehensive in Australia.

Nine years ago, the orchestra started monitoring noise exposure, data reviews and plotting noise maps for concert halls and orchestra pits where the musicians played over a three-year period.

According to lead author of the study, Ian O'Brien, it is the largest orchestral sound survey on record and the results have been used by several orchestras to plan their own approaches.

The QSO has used wrap-around absorptive screens and a series of moveable diffusive panels for treating poor acoustic spaces since 2005. Many brass and woodwind players now use electronic earplugs.

The West Australian Symphony Orchestra also keeps a close eye on its musicians' hearing. The company manages the risk of noise-induced hearing loss for musicians by monitoring the noise levels in rehearsals and performances against acceptable exposure standards, employing noise control measures and encouraging musicians to undertake annual hearing tests.

It launched its new Health and Wellbeing program at the Perth Concert Hall in January 2015. As part of the program, the company has joined forces with the team at Star Physio WA to provide subsidised on site physio services to the musicians.

For each performance WASO reviews seating arrangements for the musicians and their instruments and liaises with musicians to test for ergonomically improved seating and stands.

Ballet and dance companies also have to mitigate any risk of injury through constant vigilance.

The ballet companies, including West Australian Ballet and Queensland Ballet, all have extensive medical teams on board, with specialist dance physiotherapists, masseurs, pilates and cardio instructors.

The Australian Ballet’s innovative Injury Management and Prevention Program received the award for 'Best Strategy for Health and Safety Management’ at the 2008 WorkSafe Victoria Awards.

The Medical Team comprises two touring physiotherapists, a touring myotherapist, a body conditioning specialist, two part-time sports physicians, a part-time general practitioner and a health and safety/WorkCover coordinator.

Its program is very much targeted to early reporting and intervention. It has found the key to injury prevention is early attention to minor musculoskeletal dysfunction such as cramp, fatigue, stiffness or low grade discomfort.

As a result, the company has managed to reverse high injury trends with a profound reduction in injuries to high- risk areas such as the ankle, back and hip.

It also has two psychologists, male and female, available to the dancers. On its website, the Ballet explains that ‘performance anxiety is not uncommon for dancers in addition to the fitness and production demands that are constant throughout the life of a dancer’.

Under the leadership of past and current Rehearsal Directors, Bangarra has developed a Safe Dance Program that focuses strongly on a multidisciplinary approach to injury prevention and on creating a healthy workplace culture.

The program is managed by the Bangarra Safe Dance Panel, which is composed of medical professionals who provide ongoing advice and support to the company’s performers.

The program provides on-site physiotherapy and massage therapy, body conditioning and dietary advice tailored to meet our performers’ needs, resulting in improved strength and fitness.

Sydney Dance Company’s health team includes a GP and an orthopaedic surgeon as well as an in-house physiotherapist.

All dancers are assessed before they start with the company and an individualised training program is developed to build their strength and prevent injury. This includes a gym membership and a personalised Pilates program.

Daily in-house technique and strength classes are tailored to build strength to suit the choreography the dancers will be working with.

At Circus Oz, preventing injury is all about pre-empting risk and proactively managing every element of act development, rehearsal and performance.

In the development of the show, each of the acts is broken down into its component parts and analysed for risk, with relevant mitigation strategies put into place. Before every season, a specific rehearsal is held in every new venue to work through the safety of each act under the specific technical set-up. A formal process before each rehearsal and performance ensures that each element can be performed safely, given any relevant changes in performers’ physical state or the equipment or venue, and all individuals are encouraged to raise any concerns at any time.

Each performer takes responsibility for their own health and wellbeing, but where possible, the company also provides access to medical support staff, such as osteopaths, to assist with each performer’s well being, and also provides access to some health-related equipment.

Opera companies have to deal with a range of issues, protecting singers’ voices being of prime concern.

State Opera of South Australia found that performing the Philip Glass trilogy last year threw up particular challenges.

Nine hours of opera performed over five days required an enormous amount of stamina and skill from both singers and dancers.

The company rehearsed for four months, gradually lifting the frequency of rehearsals so that singers’ vocal preparation and physical fitness were at a peak for the performance.

Vocal rest, preventing infection and ensuring singers are never cast in inappropriate repertoire for their voice type are standard health management issues for opera companies.

Actors are also at risk. Touted as a world-first research project, the actors’ union Equity and Sydney University have collaborated on a wellbeing study of actors in Australia.

Sydney University researcher Dr Mark Seton said 73 per cent gave details of the effects of ongoing stress on their physical and psychological wellbeing.

He said stress is more like to be experienced by people in theatre followed by film and then musicals.

Forty-five per cent have experienced bodily, vocal or psychological complaints in the last year and a significant number of the participants—35 per cent—had suffered from their complaint whatever it was for several years.

Dr Seton also noted that there is still more quantitative data yet to be analysed, as well as some very detailed qualitative data on actors’ experiences of financial, physical and psychological stresses and the impact on their lives and significant relationships.

A more comprehensive report will be published at June this year, to be launched at the annual Association of Theatre, Drama and Performance Conference at the University of Sydney.

Black Swan State Theatre Company tackles possible problems head on by including in a welcome pack for cast members information about health and voice care with a list of recommended health care service providers.

It also has an association with a physiotherapy service for emergency and ongoing treatment for company members who have a pre-existing condition which needs to be managed or who develop an acute condition during rehearsals.

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