The pudendal syndrome: A photo essay of nerve compression damage visualized at neurolysis in patients with chronic neuropathic pelvic pain.

AIMS: (1) To use intraoperative photographs to visualize and explain pudendal nerve compressions and anatomical variations of compression sites in patients with chronic pelvic pain. (2) To emphasize the diagnostic importance of sensory examination with a safety pin at the six pudendal nerve branches in all patients with chronic pelvic pain; the dorsal nerves (penis or clitoris; the perineal nerves; and the inferior rectal nerves). METHODS: Between 2003 and 2014, "definite" pudendal neuropathy was diagnosed by examination and with two neurophysiologic tests. Neurolysis, via a transgluteal approach, was recommended only after 14 weeks of conservative care failed to adequately improve symptoms and validated symptom scores. Photographs of surgical findings were culled for their educational impact. An illustration of each photo clarifies the surgical anatomy. RESULTS: The transgluteal incision permits access to pudendal anatomy and compression sites from the subpiriformis area through the interligamentary space and the pudendal canal (Alcock canal). Compressions were acquired or congenital and severity varied significantly. Pinprick sensory testing diagnoses pudendal neuropathy in 92% of both genders. Mid-nerve compression occurred commonly between the sacrotuberous and sacrospinous ligaments less frequently in the Alcock canal, but also at aberrant pathways, for example, between layers of the sacrotuberous ligament; a separate inferior rectal nerve passing through the sacrospinous ligament; at an anomalous lateral pathway posterior to the ischial spine. The results of international surgeons are discussed. CONCLUSIONS: Decompression surgery was recommended in approximately 35% of patients in this practice, when pudendal neuropathy (pudendal syndrome), did not respond to two conservative levels of treatment: (1) nerve protection and medications and, (2) a series of three pudendal nerve perineural injections given at 4-week intervals. Significant nerve compression is consistently observed. Pathophysiology includes axonopathy from ischemia and demyelination. Neuropathy is readily diagnosed using a pinprick sensory examination of six pudendal nerve branches. Monitoring with the National Institutes of Health Chronic Prostatitis Symptom Index records cures >13 years.

Prevalence of text neck syndrome, its impact on neck dysfunction, and its associated factors among medical students: A cross-sectional study.

BACKGROUND: Students increasingly rely on digital devices, leading to text neck syndrome, a common overuse syndrome caused by repetitive forward neck flexion. OBJECTIVE: This study aimed to determine the prevalence of text neck syndrome among medical students and the resulting neck dysfunction and to investigate the possible associated factors. METHODS: This cross-sectional study used an online self-developed questionnaire among medical students. Students' characteristics and data about smartphone usage were evaluated for diagnosis. Individuals with at least 3 of the 6 text neck syndrome symptoms and a history of more than four hours a day spent on a smartphone were diagnosed with text neck syndrome. Neck dysfunction was measured using the neck disability index. Descriptive statistics and the chi-square test were used. P values < 0.05 were considered statistically significant. RESULTS: The study found that 31.7% of students with text neck syndrome have mild neck disabilities, with a higher proportion of females (40%). The characteristics that have a significant relation to text neck syndrome include being female (p < 0.0001), overweight (p = 0.025), being right-handed (p = 0.001), using four digital devices or more (p = 0.002), having low levels of physical activity (P = 0.018), and spending more than three hours a day sitting down (P = 0.027). CONCLUSION: More than a quarter of medical students had text neck syndrome, and most of them had a mild neck disability. Text Neck Syndrome was linked to an increased number of gadgets used, low exercise, and more time spent in a sitting position.

[Stress injuries of bone in children and adolescents]. / Stressverletzungen des Knochens bei Kindern und Jugendlichen.

Stress injuries of bone in childhood and adolescence are the result of an imbalance between physical stress on the growing musculoskeletal system and its intrinsic resilience. Children who are very active in sports are particularly affected. The classical stress injuries mainly occur in the area of the lower leg, the metatarsus and the lower lumbar spine due to the disproportionate load on healthy bone; however, overuse syndromes can also occur in the area of the growth plates and possibly lead to growth plate disorders. The anamnesis usually shows stress-related pain that has existed for a long time without trauma. As part of the differential diagnosis, a stress injury must first be included in the considerations due to it being a rare entity. An X­ray examination can show the first signs of a stress reaction. In the event of a conspicuous periosteal reaction, a malignant event must also be considered. As a rule, the MRI examination is then groundbreaking and in some rare cases biopsies have to be considered. The treatment of stress injuries is usually conservative. Recurrences should be counteracted by exercise control.

Introduction to Limb Deficiency for the Pediatrician.

Owing to the lack of trained professionals in amputee care, the pediatrician is often required to assist in the care of children with limb deficiencies. An overview of the causes and epidemiology of limb deficiency is provided, as well as an evaluation and diagnostic workup. Important considerations for surgical interventions are discussed and an introduction to prosthetic prescribing and care of the amputee is described. Common overuse syndromes and mental health issues are also reviewed. Finally, resources for funding of prosthetic devices, as well as support and education for clinicians and families are provided.

Morphometric Parameters and MRI Morphological Changes of the Knee and Patella in Physically Active Adolescents.

Background and Objectives: The immature skeleton in a pediatric population exposed to frequent physical activity might be extremely prone to injuries, with possible consequences later in adulthood. The main aim of this study is to present specific morphometric parameters and magnetic resonance imaging (MRI) morphological changes of the knee and patella in a physically active pediatric population. Additionally, we wanted to investigate the morphological risk factors for patellar instability. Materials and Methods: The study included the MRI findings of 193 physically active pediatric patients with knee pain. The participants underwent sports activities for 5 to 8 h per week. Two divisions were performed: by age and by patellar type. We evaluated three age groups: group 1 (age 11-14), group 2 (age 15-17), and group 3 (age 18-21 years). In addition, participants were divided by the patellar type (according to Wiberg) into three groups. The following morphometric parameters were calculated: lateral trochlear inclination (LTI), the tibial tubercle-trochlear groove distance (TT-TG), trochlear facet asymmetry (TFA), Insall-Salvati index, modified Insall-Salvati index, Caton-Deschamps index, articular overlap, morphology ratio and contact surface ratio. Results: We found a statistically significant association between patellar type groups in LTI (p < 0.001), TFA (p < 0.001), Insal-Salvati (p = 0.001) index, and Caton-Deschamps index (p = 0.018). According to age groups, we found statistical significance in the Caton-Deschamps index (p = 0.039). The most frequent knee injury parameter, according to Wiberg, in physically active pediatric patients was patella type 2 in boys and type 3 in girls. Conclusions: The MRI morphometric parameters observed in our study might be factors of prediction of knee injury in physically active children. In addition, it might be very useful in sports programs to improve the biomechanics of the knee in order to reduce the injury rate in sports-active children.

The Magnetic Resonance Imaging Pattern of the Lesions Caused by Knee Overuse in the Pediatric Population.

Background and Objectives: Excessive use of the knee in patients with immature locomotor systems leads to a whole spectrum of morphological changes with possible consequences in adulthood. This study aimed to examine the morphological pattern in magnetic resonance imaging (MRI) that is associated with recurrent pain due to increased physical activity in children. Materials and Methods: This was a retrospective study conducted among pediatric patients treated at the University Children's Hospital in Belgrade in 2018 and 2019. MRI findings of patients who reported recurrent pain in the knee joint during physical activity and who were without any pathological findings on both clinical examination and knee radiographs were included in the study. Results: MRI findings of 168 patients (73 boys and 95 girls, mean age 14.07 ± 3.34 years) were assessed. Meniscus and cartilage lesions were the most commonly detected morphological findings: meniscus lesions in 49.4%, cartilage ruptures in 44.6%, and cartilage edema in 26.2% of patients. The medial meniscus was more often injured in girls (p = 0.030), while boys were more prone to other joint injuries (p = 0.016), re-injury of the same joint (p = 0.036), bone bruises (p < 0.001), and ligament injuries (p = 0.001). In children older than 15 years, tibial plateau cartilage edema (p = 0.016), chondromalacia patellae (p = 0.005), and retropatellar effusion (p = 0.011) were detected more frequently compared to younger children. Conclusions: Children reporting recurrent knee pain due to increased physical activity, without any detected pathological findings on clinical examination and knee radiography, may have morphological changes that can be detected on MRI. Timely diagnosis of joint lesions should play a significant role in preventing permanent joint dysfunction in the pediatric population as well as in preventing the development of musculoskeletal diseases in adulthood.

Factors associated with overuse injury in cyclists: A systematic review.

OBJECTIVES: To identify risk factors associated with overuse injuries in cyclists. DESIGN: Systematic review. METHODS: Data sources: Medline, CINAHL, EMBASE, SPORTDiscus, and the Cochrane Library were systematically searched. Reference checking and citation tracking of included articles were undertaken. Grey literature searches and a review of key publications by known experts in the industry were conducted. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies evaluating the association between specific measures of the bike, the cyclist's body and load characteristics, and overuse pain or injury in cycling. RESULTS: Of the 3596 studies yielded in the search, 18 studies were included in the review with only 3 of these studies deemed to have a low risk of bias. The best evidence synthesis showed moderate evidence of a relationship between load and symptoms, as well as moderate evidence of no relationship between cycling overuse injury or pain and many measures traditionally used in bike fitting. Conflicting evidence of a relationship exists between seat height and symptoms. CONCLUSIONS: Cycling is popular on a world scale for transport and exercise with cyclists experiencing a high prevalence of overuse pain and injury. Many theories exist as to the cause of these symptoms, however there are limited high quality studies of risk factors for overuse injuries. This review highlights that there is no strong evidence relating any measure of the bike, body or load to cycling overuse pain or injury.

Investigation of ligament, bone, synovial and plica pathologies accompanied by common extensor tendon in patients with lateral overuse syndrome of the elbow using magnetic resonance imaging.

BACKGROUND: Tendinosis in the common extensor tendon and accompanying ligament, bone, and plica abnormalities can be observed on magnetic resonance imaging (MRI). PURPOSE: To determine whether there is a difference between accompanying abnormalities according to the degree of common extensor tendon injury. MATERIAL AND METHODS: Patients who underwent 1.5-T MRI tests with a prediagnosis of lateral overuse syndrome were retrospectively reviewed, and 56 patients who had an injury in the common extensor tendon (CET) were included. The degree of tendon and ligament injury, muscle signal change, bone marrow signal change, presence of joint effusion, and morphological features in the presence of plica were evaluated via MRI examinations of the elbow. RESULTS: Overall, 32, 16, and eight patients had mild, moderate, and severe CET damage, respectively. As the severity of CET damage increased, the presence of joint effusion, and the presence and degree of damage to the lateral ulnar collateral ligament (LUCL) and radial collateral ligament (RCL) increased. The radiohumeral (RH) plica area was significantly larger in the group with mild CET damage. There was no statistically significant correlation between the severity of CET damage and the end of RH plica with a blind-end, coverage of one-third or more of the radius, its signal, thickness, and presence of olecranon fold. CONCLUSION: As the severity of CET injury increases, damage to the LUCL, RCL, and the presence of effusion in the joint increases. RH plica should be evaluated in terms of concomitant pathology in patients with mild CET injuries on MRI.

Overuse syndrome of the hand and wrist in musicians: a systematic review.

We systematically searched medical publication databases for articles in English on upper extremity overuse syndrome in musicians. We focused on non-specific pain disorders, including diagnostic definitions, epidemiology, pathophysiology, risk factors, symptoms, treatment, and prevention. We included 42 out of 156 identified articles. The point prevalence of playing-related musculoskeletal disorders ranges from 37% to 47% in musicians with the hand and wrist among the most commonly affected areas, and the lifetime prevalence is reported as high as 89%. Leading symptoms are pain, weakness, stiffness, and loss of control. Intense repetitive use during practice, or before an audition or concert, recent changes in conductors or teachers, psychological stress, the effort of holding a weighty instrument, wrong technique, and joint laxity have all been identified as risk factors. The need for prevention is highlighted. Today's therapy is mostly based on individual rehabilitation programmes rather than on long-term rest. However, treatment remains predominantly based on beliefs rather than on evidence. The entire subject needs intensive future research.

A painful symphony: the presence of overuse syndrome in professional classical musicians / Una sinfonía dolorosa: la presencia del síndrome de uso excesivo en músicos clásicos profesionales

Musculoskeletal problems are common in instrumental musicians. Little is known about the factors that place musicians at risk, and the ways in which musicians can prevent these problems. Overuse syndrome is the most reported diagnosis among instrumental musicians suffering from playing related musculoskeletal injuries. The study group comprised 50 musicians employed in Symphony Orchestra of the Serbian National Theatre of Novi Sad. Out of the 50 musicians, 30 (60 %) are male and 20 (40 %) female. Higher frequencies of the presence of musculoskeletal symptoms were neck, region of trapezius, back, shoulder, wrist, hand and arm. A larger number of musicians (81.8 %) had perception of high demand of the profession. This investigation with professional classical musicians should show the music-medical interest.

Los problemas musculo-esqueléticos son comunes en los músicos instrumentales. Poco se sabe sobre los factores que ponen en riesgo a los músicos y las formas en que los ellos pueden prevenir estos problemas. El síndrome de uso excesivo es el diagnóstico más informado entre los músicos instrumentales que sufren lesiones musculo-esqueléticas relacionadas al uso de instrumentos musicales. El grupo de estudio estuvo compuesto por 50 músicos de la Orquesta Sinfónica del Teatro Nacional Serbio de Novi Sad. De los 50 músicos, 30 (60 %) eran hombres y 20 (40 %) mujeres. La frecuencia más alta de presencia de síntomas musculoesqueléticos se produjo en el cuello, músculo trapecio, espalda, hombro, muñeca, mano y brazo. Un mayor número de músicos (81,8 %) tuvo una percepción de alta demanda de la profesión. Esta investigación con músicos clásicos profesionales debería ser de interés médico-musical.

Distal intersection syndrome progressing to extensor pollicis longus tendon rupture: a case report with sonographic findings.

The purpose of this case report is to describe the value of musculoskeletal ultrasound (US) in diagnosing both distal intersection syndrome (DIS) and rupture of the extensor pollicis longus (EPL) tendon in the same patient. A 38-year-old female presented for evaluation of a painful bump of unknown etiology on the dorsolateral aspect of her non-dominant wrist. US demonstrated tenosynovitis distal to Lister's tubercle of the EPL and extensor carpi radialis tendon sheaths, consistent with DIS. Immobilization therapy was employed, during which time the patient suffered rupture of the EPL tendon. Follow-up US examination confirmed this additional diagnosis. Characteristic US findings of DIS and EPL tendon rupture were observed. Surgical intervention was required and the patient recovered without complication. Although EPL rupture is relatively common in the literature, DIS is rare. This is the first known case of imaging-proven DIS progressing to EPL tendon rupture. This case underscores the value of US as a widely available, cost effective, and dynamic imaging modality for evaluation of wrist complaints.

Work-Related Musculoskeletal Disorders among Spine Surgeons / 대한정형외과학회잡지

PURPOSE: To investigate the prevalence and risk factors of musculoskeletal disorder (MSD) among spine surgeons. MATERIALS AND METHODS: A modified version of discomfort survey was sent via e-mail to surgeons that belong to the Korean Society of Spine Surgery. The survey questionnaires were composed of demographics, factors relating to spine surgery, and MSD. We investigated the common sites of occurrence of MSD and its risk factors. RESULTS: The survey was sent to a total of 420 subjects; of which, 80 subjects (19.0%) responded. About 78.8% of the respondents had MSD for the past year. The common sites of occurrence included the neck (52.5%), back (46.3%), and shoulder (18.8%). The prevalence of pain in the elbow joint/forearm was higher in the group performing a higher frequency of spine surgeries (p=0.033). Moreover, the prevalence of pain in the wrist/hand (p=0.008) and in the back (p=0.042) was higher in those with greater frequency of major surgeries (>10 case/year) as compared with those with lower frequency of major surgeries. CONCLUSION: As shown, about 78.8% of spine surgeons experienced MSD for the past one year. Its prevalence was higher as compared with the general population. Thus, more attention should be paid to the prevention of MSD among spine surgeons.

A case of occupational overuse syndrome improved, according to M-Test, with acupuncture / 全日本鍼灸学会雑誌

[Purpose]We report a case concerning 5 months of left elbow and knee joint pain thought to be caused by repetitive use at work. Symptoms were improved successfully (checked by M-test) by a single acupuncture treatment. <BR>[Case]We used acupuncture to treat a 50-year-old woman who visited our Acupuncture and Moxibustion Centerwith complaints of increasing elbow and knee joint pain in the left side. Since 4 months ago, her job involved frequent stair-climbing while carrying an 18-liter can of cooking oil. The soft tissues seemed to be damaged and caused pain due to the repeated lifting of heavy cans at work. Acu-points were decided by M-Test to check limitations of movement, which identified damaged regions and provided feedback for optimal treatment. According to the specific operations of the patient's work, we identified limited movements of left-elbow joint flexion-extension, left-shoulder joint extension, and left hip joint inner rotation and external gyration. These were regarded as target motions for the treatment. Her Visual Analog Scale (VAS) scores before treatment were 90 mm in the left elbow and 80 mm in the left knee. Despite only a single round of acupuncture treatment, the respective values dropped to 18 mm and 15 mm.<BR>[Consideration and Conclusion]The limited movement identified by M-Test could expose the affected areas and help in treating the appropriate acu-points. Therefore, acupuncture using M-Test might improve painful motions of the body.

Post-Thalidomide Syndrome at 50 Years / The Japanese Journal of Rehabilitation Medicine

Thalidomide embryopathy resulted in babies born with deformities such as phocomelia after their mothers took only a few tablets of thalidomide drug during 36 to 56 days after their last menstrual periods. There are two thalidomide embryopathy groups depending upon whether their hypoplasia is in the limbs or the auditory organs. In the limb group, deformities range from amelia to hypoplasia of the thumb. In the auditory group, the severity can be determined by the degree of deafness. This group is often associated with aplasia of the abducens and facial nucleus. Fifty years after the thalidomide scandal, the drug is still in use. It helps treat leprosy, multiple myeloma, AIDS and cachexia. As of June 2012, there are two hundred and ninetyfive victims still living in Japan. Disabilities include inadequate pinch and grasp, besides short reach. In the last two decades, the condition of these patients has worsened with chronic intractable pain due to overuse of hypoplastic skeletal muscles. They are now suffering from snapping fingers, stenosing tenosynovitis (trigger finger) and carpal tunnel syndrome. As their concomitant deformities or impairments include dislocation of the shoulder, droopy shoulders, hip dislocation, cervical block vertebrae, thoracic kyphosis, scoliosis, occult spina bifida, and L 6 lumbarization, these have become secondary etiologies for chronic pain, resulting in a dependent ADL condition. For these patients, physical exercise or recreation activities have become a viscous circle of ever increasing pain, weakness and fatigue. Furthermore, the resulting inactivity and weight gain has made ADL even more problematic. They also suffer from internal organ anomalies. Thus, a variety of problems including weakness and chronic intractable pain, which may be called post-thalidomide syndrome, has created an additional barrier for the surviving thalidomide embryopathy patients in social participation, as their aging is progressing.

Orthopedic disease and sports medicine related to lower limbs

In this study, the cause, diagnosis, and treatment of common lower limb injuries during the sports activities were presented. Sports injuries of the lower limbs are the most common injuries in the sports medicine field due to the high level of use of the lower limbs during sports activities. The common causes of leg injuries in athletes are traumatic force over the critical limit of normal tissue, repetitive microtrauma, and overuse. Common hip and pelvis problems encountered by the authors include trochanteric bursitis, snapping hip syndrome, and labral tears. The anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and meniscus have been most frequently involved in sports injuries affecting the knees. Lateral ankle sprain represents one of common injuries in the athletic population. Common overuse injuries are tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints. Athletic activity provides a variety of positive benefits to participants' health. To safely continue those activities, an injury prevention program focusing on injuries that may occur in specific sports activities is recommended for participants. Early diagnosis and proper treatment are also important in promoting prompt recovery and preventing secondary injuries.

Prevalence of cumulative trauma disorders of the upper extremity and identification of risk factors among non-medical personnel in the University of the Philippines - Philippine General Hospital

OBJECTIVES: This cross-sectional study aimed to determine the prevalence of cumulative trauma disorders (CTDs) of the upper extremity among non-medical personnel of the University of the Philippines - Philippine General Hospital (UP-PGH) and to identify risk factors that may have contributed to their development. METHODS: A total of 87 participants from five different administrative divisions of the UP-PGH were included in this study. Three assessment tools were administered, namely: 1) symptom survey form, 2) Rapid Upper Limb Assesment, and 3) ergonomic workstation evaluation checklist. RESULTS: The study showed that the prevalence of CTDs of the upper extremity was 47.1%. The highest prevalence of CTDs was noted in the Budget division (75%), which was composed mainly of budget officers and clerks. The most common CTD indentified was myofascial pain syndrome. Among the socio-demographic factors, only handedness was significantly related to the development of CTDs (p=0.022).CONCLUSION: This study did not show a significant relationship between the identified risk factors and the development of CTDs. Awareness of the existence of CTD cases as documented in this study, however should raise concern from the authorities to implement corrective measures to reduce or prevent CTDs and to improve the general health and thus, productivity of the non-medical personnel at the UP-PGH.

O uso da termografia infravermelha na avaliação do retorno ao trabalho em programa de reabilitação ampliado (PRA) / The use of infrared thermography in evaluating returns to work in an extended rehabilitation program (PRA)

Em certas ocasiões, mesmo com tratamento corretamente instituído em pacientes com lesões por esforços repetitivos/distúrbios osteomusculares relacionados ao trabalho (LER/DORT), depara-se com situações de difícil julgamento quanto ao retorno ao trabalho. Muitas vezes por uma queixa persistente de não melhora dos sintomas ou quando associado a outras comorbidades, como síndrome fibromiálgica. O objetivo deste estudo foi comparar os padrões térmicos encontrados com a avaliação pericial de retorno ao trabalho de pacientes acometidos por LER/DORT, por meio de avaliação clínica e termográfica duplo-cega. Foram avaliados 128 pacientes, acometidos por LER/DORT de uma empresa do setor da agroindústria-frigorífico, onde um grupo de 62 pacientes foi selecionado para perícia quanto ao retorno ao trabalho. Destes, 3,2% tiveram retorno imediato ao trabalho, 77,4% afastamento por 60 dias, 6,4%, afastamento por 6 meses e 12,9% aposentadoria por invalidez. As alterações térmicas tiveram direta correlação com a classificação de retorno às atividades realizadas pelos peritos, segundo critérios de número de lesões, natureza etiológica, diferencial térmico e índice termográfico para síndrome fibromiálgica. A termometria cutânea por termografia infravermelha demonstrou-se como método complementar útil e objetivo no apoio a avaliação pericial para definição de capacidade ou incapacidade para o trabalho.

Even with proper treatment of patients with repetitive strain injuries/work-related musculoskeletal disorders (RSI/WRULD), on certain occasions returning to work can be a difficult judgment call. There are frequent complaints of symptoms not improving or combined with co-morbid associations such as fibromyalgia syndrome. The purpose of this study was to compare the thermal patterns found by a clinical return-to-work evaluation of patients with RSI/WRULD in a double-blind clinical thermographic study. 128 patients were studied suffering from RSI/WRULD from a meat-packing plant from which 62 patients were selected for evaluation to return to work. Of these, 3.2% were cleared for immediate return to work, 77.4% were kept out for 60 days, 6.4% were kept out for 6 months, and 12.9% were retired on disability. Thermal alterations had a direct correlation with the experts? work classifications according to the number of injuries, etiology, thermal differential, and thermographic index for fibromyalgia syndrome. Cutaneous thermometry by infrared thermography has proven itself a useful and objective supplementary method to support clinical evaluations in defining one?s capacity to work.

Physical and mental practices of music students as they relate to the occurrence of music-related injuries.

OBJECTIVE: The purpose of this study was two-fold: To obtain descriptive information regarding general physical and mental habits of music students and to ascertain if there are any associations between specific daily activities or habits and the appearances of these injuries. STUDY DESIGN: Questionnaires were distributed to three hundred music students at Boston University. Of the 45 respondents, 19 students were willing to participate in an interview. Descriptive statistics were analyzed and comparisons were made to a similar study which was conducted at New England Conservatory in Boston, Massachusetts (Hagglund, K., Unpublished study, 1994). RESULTS: The results suggest that Boston University music students follow expected trends reported in previous research (Fishbein and Middlestadt, 1988; Manchester and Fielder, 1991; Hagglund, 1994). Eighty two percent (n=37) of the respondents were performance majors and the majority of them began playing their instrument at age 10. Out of the 45 respondents, 28 were female of whom 68% (n=19) reported having a music-related injury. Of the remaining 17 males, 53% (n=9) reported also having a music-related injury. Sophomores and juniors accounted for 15 (54%) of the total 28 musicians with injuries in this study. The typical practice habits that were described by the respondents included 2 h sessions, with 10-15 min breaks each hour. Most musicians disclosed to occasionally playing their instruments even when experiencing pain. RESULTS from this study suggest that as the hours spent playing increased, so did the incidence of injury. Medical attention from neurologists, general practitioners, performing arts specialists and laryngologists was pursued by 18 (64%) of the 28 injured musicians. Sixty-one percent of the respondents with injuries saw more than one rehabilitation specialists, including physical therapists (50%); Alexander/Feldenkrais teachers (44%) and massage therapists (28%). More than one treatment method was given to 74% of the injured. These treatment methods included methods such as: Altering posture, habits or playing technique, exercise and stretching, rest, ice and massage. Satisfaction in career and the ability to live up to self expectations was high, while performance anxiety was not bothersome for 82% of the respondents. Fifty-two percent reported reacting well to stress and 44% described having an average level of self-consciousness. Most respondents (89%) participated in some type of physical fitness, most exercising either one (30%) or three (23%) days a week, and 75% reported that they stretch prior to playing. CONCLUSION: This study provides information on the general habits of music studtents which can be beneficial to rehabilitation specialists, as well as other medical professionals treating musicians. By understanding the lifestyles and dynamics of being a musician, rehabilitation specialists can devise better individualized intervention and preventative strategies. Unfortunately, musicians remain uninformed on the current treatments, rehabilitation approaches, and most importantly the predisposing and preventative factors of music-related injuries. Occupational therapists, physical therapists and other rehabilitation specialists can and should be the professionals to provide guidance to the population of musicians on the above mentioned factors.