Volume 14, January 2022
Musculoskeletal symptoms of double bassists: a literature synthesis

by Frances Levenderis and Bridget Rennie-Salonen

4. Literature on double bass players' performance health

A small number of studies focus solely on the double bass, offering valuable information on the musculoskeletal aspects of double bass playing. Most of these studies do not aim to report double bassists' MSS, but they do provide insight into the possible risk factors for injury.

In 1984, using electromyography, Allan Dennis explored the effect of three methods of supporting the double bass on muscle tension and performance quality, namely the Bass Standing Method, Student Standing Method, and Sitting Method. Anatomical locations studied included the upper and lower back, and left and right arms. The results demonstrated no particular advantage in utilising any one approach to double bass playing position, nor for bow hold (French or German). The author suggested that fluid balance and movement derived from weight shifts whilst playing was most advantageous. Another interesting finding was that although lower back pain was acknowledged as a common 'occupational hazard', the average lower back muscle tension was lower than the other muscle tension areas measured (Dennis, 1984, p. 100).

Knut Guettler's 1992 study, inspired by his many years as a double bass teacher, also analysed electromyographic readings of double bassists, focusing particularly on muscle use during vibrato. Electrodes were placed on the left shoulder and the upper left arm while the bassist played. Important results on muscular activation in the left arm during playing found that good technique was associated with reduced muscle tension which may therefore prevent injuries such as tendonitis (Guettler, 1992).

Linda Gilbert (2009) surveyed the musculoskeletal and psychological symptoms of over 520 bassists, obtaining data on the intensity, types, and locations of MSS in double bassists. Questions on demographics and bass setup were included in order to make comparisons between French or German bow, as well as sitting or standing. The symptoms studied included pain, fatigue, tension and weakness, and were graded as minimal, moderate, intense, and extreme. The areas of the body specified included hips; legs and feet; back; neck, chest and shoulders; arms, wrists, and hands; and eyes and jaw. Symptoms were cross-referenced with primary focus of work (professional orchestral, professional jazz, professional higher education, or professional other). The study results showed that all bassists experienced moderate to intense symptoms in the back, arms, wrists, and hands. French bow players generally had more symptoms on the right side of the body, while German players report more on the left side of the body. French bow players also experienced 'more symptoms in the neck and higher intensity levels of symptoms in the neck and shoulders' (Gilbert, 2009, p. 33). Ninety per cent of Jazz professionals stand, possibly associated with their reported fatigue in the feet and upper legs. Both jazz and orchestral professionals experienced high rates of MSS in the arms, wrists, and hands, although the side and exact location of the symptoms differed between the two genres. Most (70-90%) of college-, high school-, and middle school-level students experienced MSS in the back, neck, shoulders, arms, wrists, and hands (Gilbert, 2009).

Yun-Chieh Chou (2013) and Thierry Barbé (2017) focussed on the size of the double bass player and its association with playing. As a 'petite female bass player', Chou's research documented her experience of using the Alexander Technique (AT) to alleviate muscle tension (Chou, 2013, p. 11). Following intensive AT lessons for one year, she reported a significant reduction in lower back pain and increased stamina for long rehearsals and performances. Barbé's article provides helpful techniques for double bassists with small hands, as well as instrument setup changes that can be implemented, such as raising the tailpiece nut, finding a bass of a suitable size, and using a German bow for orchestral music where power can be difficult to achieve with the French bow (Barbé, 2017).

Woldendorp and colleagues (2018; 2016) surveyed posture and musculoskeletal complaints in a sample of over 100 professional and student bassists who played both double bass and bass guitar. The effects of playing double bass on MSS occurrence in the left shoulder (or neck side of the double bass); the effects of playing bass guitar on MSS occurrence in the right wrist area (or box side of the bass guitar); and the effects of using the German bow on MSS occurrence in the right wrist (or the wrist of the double bass bowing arm), were investigated. Self-reported questionnaires, designed for the study, assessed MSS in various locations of the upper body. Although the study results found no association between MSS and posture, findings demonstrated that 73.9% of bassists (bass guitar and double bass) reported experiencing MSS in the upper body. The most-reported complaints were MSS of the neck and back. The bow style (French or German) did not have an effect on MSS. The study shows that the identification of risk factors for MSS in a population is complex and requires the consideration of multiple factors rather than one aspect (such as posture) in isolation (Woldendorp et al., 2016). Subsequently, Woldendorp and colleagues (2018) published a further analysis of their original survey data on bassists' MSS, in two subpopulations: those who played more than one instrument, and those who played only the double bass or the bass guitar. Results demonstrated that multi-instrumentalism did not protect the participants against MSS, and in fact, resulted in an increased prevalence of MSS in the left shoulder (Woldendorp et al., 2018).

Although these examples provide double bass-specific scholarly literature in the field of musicians' health, it is evident that this literature is limited. Information more accessible for double bassists comes from pedagogical sources, most often penned by experienced double bassists in the community. What follows is an outline of these pedagogical sources which contain information on double bass performance health.