Despite the widespread view that only a talented few are ‘musical’, every human being has an inborn sense of musicality.

This is the view of Professor Clorinda Panebianco, newly inaugurated Professor of Musicology at the University of Pretoria’s School of the Arts, who tested this hypothesis informally with the audience attending her inaugural address in late March 2024.

“We are all musical. We are born with sophisticated ability and, in the first months of life, we communicate through melodic contours,” Prof Panebianco said, before asking audience members to respond to a single word – “Hello” – with the name of a song.

In quick succession, members of the audience volunteered the names of a variety of songs, from “Hello, Dolly” to Adele’s “Hello” and Lionel Ritchie’s song of the same name, as well as lyrics such as “Hello darkness, my old friend”, from “The Sound of Silence” by Simon and Garfunkel.

After quipping “now that we have proven we are all musical”, Prof Panebianco proceeded with her inaugural address, titled ‘Health, Well-being and Engaging in Musical Activity: Perspectives from Music Psychology and Music Performance Science’.

There is compelling evidence on the important role the arts can play in improving health and well-being, she said, mentioning a 2019 World Health Organisation scoping review of over 900 publications, which provided research evidence of the benefits.

Prof Panebianco said these benefits include social cohesion – as was felt in South Africa during the 2010 FIFA World Cup, when songs including “Shosholoza” became symbols of national pride – as well as promoting speech and language development, academic achievement and healthy living, while also preventing mental illness, cognitive decline and degenerative neurological disorders.

“Both music-making and listening can have significant positive effects on health and well-being – but therein lies a paradox,” she said. “Professional music-making places exceptionally high demands on the performer, which presents many health risks.”

A paradox and parallels

Prof Panebianco compared the physical and psychological demands on professional musicians with those confronting elite athletes. She highlighted the parallels between the performing arts and elite sport by playing a video clip juxtaposing the high-speed hand and body movements of a world-class concert pianist with an athletics track where top athletes were competing.

“Both are highly competitive, require psychological endurance, and involve a constant striving for perfection,” she said. “Economic success is dependent on the level of skill; both are prone to activity-oriented injuries, both require strength and flexibility, endurance and coordination; physical skills are honed over time to determine the level of success, and both begin training at a young age.”

However, one of the biggest differences between sport and music performance is that the latter places an immense cognitive load on the sensory motor system (how the brain and body receive and react to sensory information). “Aside from the extraordinary cognitive demands of music-making, there are many risk factors that contribute to musicians’ health,” Prof Panebianco said.

These include ergonomic constraints linked to awkward playing positions, as well as poor posture, poor physical condition – “because musicians are notoriously not fit” – long hours of playing, insufficient rest breaks, inefficient movement patterns and noise exposure.

Then there are various non-performance-related risks, such as injury from carrying heavy equipment and poor visibility of musical scores.

She noted that musicians are highly susceptible to musculoskeletal pain, resulting in overuse syndromes, and are also highly prone to psychological risk factors such as music performance anxiety, sleep disorders and eating disorders.

“A worrying phenomenon is the level of music-induced hearing loss in musicians,” she added.

Alarm bells ring over students’ health

Prof Panebianco said the health profile of music students is also concerning, and referred to the findings of one of her own research studies – the first in South Africa to provide evidence on the health behaviours of undergraduate music students.

“Music students do not fare well in healthy behaviours, stress management and use of coping strategies. And we now know that there is a significant difference in the mental health between music students and professional musicians.”

In investigating performance-related disorders among undergraduate music students at the University of Pretoria, the research revealed an 83% prevalence of injuries overall. These comprised musculoskeletal injuries, mostly in the neck and shoulders, and non-musculoskeletal problems such as fatigue, lack of concentration and sleep disturbance.

Mindfulness, conscientious and lessons from sports psychology

Prof Panebianco and fellow researcher Dr Susanna Cohen sought solutions to these health issues by conducting a study on self-efficacy among music students at six South African universities. They found that the personality trait of conscientiousness was the most consistent predictor of general self-efficacy, likely leading to health-promoting behaviour among students. This research provides “a fairly good clue that self-efficacy could be an intervention we could consider in future”, she said.

Other studies have also shown the positive effects of mindfulness training and the potential crossover role of sports psychology for music. “What they use in sports psychology is very helpful for musicians, too.”

Prof Panebianco also introduced the first compulsory health education module in South Africa on musicians’ health and well-being, with topics that include functional anatomy and physiology for musicians, caring for musicians’ ears, nutrition and stress management, and even yoga and Tai-chi.

Concluding her inaugural address, Prof Panebianco reiterated that “we are all musical beings” and that focusing on the health and well-being benefits of music-making could collectively work towards United Nations Sustainable Development Goal 3 – Better health and well-being in society.