The Performing Arts Medicine Association Symposium 2016

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On my masters course in Performing Arts Medicine (PAM) we learned a lot about the impact of the performer’s health on their art and vice versa. I discovered that there are medical and health professionals out there who really care about performers and their health. Unfortunately it’s not that common. There are people working to change this, and if there is a demand for specialist care from performers themselves we build awareness and support from not only the medical community but also from within our own industries. My missions is to raise awareness and understanding of the unique considerations of a performer’s health and wellbeing for both the performer and those who work with and care for them.

I am a member of the PAM Association and attended this year’s symposium in New York. We heard research presentations, talks and workshops from health, medical and performance professionals; from doctors, nurses, physiotherapists, osteopaths, musicians, singers, dancers, nutritionists, performing arts teachers, sports medicine specialists and more.

The symposium

This year’s symposium was entitled, “Make it! Not Break it! Creating the Resilient Performing Artist Athlete”. We learned about research related to dance, instruments, voice, rehabilitation, psychology, nutrition, laryngology, sports medicine, health education, musculoskeletal, neurology and physical fitness.

There was a series of talks entitled “Life On Broadway” with New York-based orthopaedic surgeon, David Weiss. He works alongside Broadway productions and performers in order to fix injuries and more importantly to prevent them by advising on use of furniture, scenery, props and the stage in ergonomic and safe ways. He has worked on many productions including more recently Hamilton, Wicked, Motown and Matilda, as well as looking after various NYC-based dance companies. I loved his investigative approach to medicine and the performer, digging deep to ascertain where the origins of the complaint stemmed from. For instance he worked with the original actor who played Nessarose in Wicked who was experiencing severe pain. On investigating the wheelchair she had to operate during the show Weiss realised the ergonomics of it were setting her up for major musculoskeletal issues. In addition to her physiotherapy treatment he advised certain alterations to the chair to suit the actor and how to make adjustments for each consequent actor. This information has been passed on to all the productions since.

Here are some areas Weiss pointed out that might cause issues for performers, in particular in musical theatre:

Stage conditions

  • unsprung floor (i.e. no give, very wearing on joints)
  • may have planks and steel girders the performer needs to work around
  • might be raked (slanted on an angle – low front to high back – great for the audience, nightmare for the performer and their stance)
  • may contain up to one inch wide tracks for scenery
  • may have an irregular surface (e.g. Matilda)
  • may contain turntables (e.g. Les Miserable)
  • may need to work around stairs, traps, treadmills, trampolines or ladders 


  • may not be well made
  • varying heel heights
  • very high or low heel
  • on rollers
  • strange or large shapes
  • abused or over used
  • second hand or from stock
  • show may need frequent fast changes
  • street shoes being used for dance


  • heavy material (I have lifted Ephaba’s dress and was shocked at how heavy it was)
  • bulky shapes (e.g. Shrek)
  • restrictive (e.g. corset)
  • fast and/or many changes
  • suspended or moving parts  (e.g. Lion King
  • expansive and high (e.g. Lion King)

Wigs and head dresses – as above


  • a performer on stage may need to move furniture which can be heavy or awkward
  • they may need to manoeuvre around other objects or people
  • may need to be lifted, thrown, pushed or pulled

Microphone transmitter

  • the lead may need to wear two, one as a back-up if the other fails
  • may need to be worn under the wig or hat or in uncomfortable place on the body – difficult for dancing, acrobatics and fight scenes


  • usually crowded and busy
  • performers may need to get around ladders, stairs, stage furniture and props
  • scenery and gear
  • multiple levels to travel over
  • often poorly lit
  • limited area for warming up

Other –circus-835705_640barber-895147_640

  • props
  • smoke or haze
  • pyrotechnics
  • wearing a harness for flying (Wicked- Ephaba, Finding Neverland – Peter Pan)
  • doing aerial work
  • sweating is another issue as it makes for slipperiness
  • touring – frequent change of venue and environment
  • puppetry (e.g. War Horse, Avenue Q)
  • need for stage combat

Next time I go to see a show I shall be watching out for these things. And maybe now you too are realising just how hazardous in could be on stage!

Even if you don’t perform in the musical theatre setting there are still similar obstacles and health risks you will need to deal with. Maybe you already have had injuries or issues as a result of your performance issues. Let me know what your experience has been.