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Hypermobility and Proprioception in the Finger Joints of Flautists

Artigues-Cano, Isabel MSc, BSc, HCPC, MCSP*; Bird, Howard A. MD, MA, FRCP†‡

JCR: Journal of Clinical Rheumatology: June 2014 - Volume 20 - Issue 4 - p 203–208
doi: 10.1097/RHU.0000000000000109
Original Articles

Background Ergonomically, the flute is especially complex among wind instruments, and flautists may therefore be at particular risk of performance-related musculoskeletal disorders. Yet little is known about injury prevalence among flute players, and even less in those flautists who are also hypermobile. Recent research has found hand and wrist pain to be common complaints among flautists. Understanding of the predictors of injury and pain is therefore crucial as the presence of pain decreases performance quality and causes unnecessary time loss. There is a strong relationship between hypermobility and impaired proprioception, although many musicians may acquire greater proprioception than the average population. We have compared flexibility and proprioception of the hand in a study of flautists.

Methods Twenty flautists took part in the study. General hypermobility, the passive range of motion of the 3 specific joints most involved in flute playing, and proprioception acuity were all measured accurately for the first time in this awkward instrument that needs high levels of dexterity.

Results Flautists’ finger joints have a greater range of movement than in the general population. This group of flute players had especially large ranges of movement in the finger joints, which take the weight of the instrument. Although flautists have hypermobile finger joints, they are not generally hypermobile elsewhere as measured by the Beighton Scale. Flautists, even with very mobile finger joints, have very accurate proprioception, which may be acquired through training.

Conclusions The study of instrumentalists may provide an ideal model for study of the interaction between localized joint flexibility and joint proprioception, both inherited and acquired.

From the *British Association of Performing Arts Medicine, UK; †University College London, London; and ‡University of Leeds, Leeds, United Kingdom.

The authors declare no conflict of interest.

Correspondence: Isabel Artigues-Cano, MSc, BSc, HCPC, MCSP, 13 Lakeview Estate, Old Ford Rd, London E3 5TB, United Kingdom. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.