Health & Medical Rheumatoid Arthritis

Hypermobility and Proprioception in the Fingers of Flautists

Hypermobility and Proprioception in the Fingers of Flautists

Abstract and Introduction


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.


Performing artists in general and instrumentalists in particular spend many years training from a young age to achieve high levels of skill and artistry, and this is likely to have an effect on their body. As elite athletes of the hands, prevention of injury and pain is crucial as its presence decreases performance quality and causes unnecessary time loss.

In recent years, our medical knowledge of hypermobility syndrome has increased, but little is known about injury prevalence in musicians with abnormally flexible joints and its effects. Although some studies have found hypermobility more frequently in performing artists than in the general population, few studies of adequate size have been done, none in flautists.

On the other hand, studies of hand and arm symptoms among professional flautists and students have been conducted recently, and the impact of hypermobility in the hand in musicians has been a further area of recent interestfs. Any relation between proprioception and hypermobility in the hand has not previously been reported in musicians. An earlier study on a normal population found that those with higher scores on the Beighton Scale (≥4/9) had significantly impaired proprioception, especially at hypermobile joints; it is still unclear if this disturbance is a cause or effect of hypermobility, but patients with hypermobility syndrome tend to present with a range of complaints due to the effects of joint instability such as muscle and joint pain.

The present study was designed to investigate the relationship between hypermobility and flute playing, to study the impact of the amount of practice and the years of training, as well as the ergonomics of the flute itself, and focused on how the presence of joint laxity might play a role in the hand position, with any change in proprioception that might subsequently occur.

Leave a reply