Nancy Taylor is a professional musician (performer and educator) and certified occupational therapist. Her book, Teaching Healthy Musicianship: The Music Educator's Guide to Injury Prevention and Wellness, aims to help music educators avoid common injuries and equip them with tools to instil healthy musicianship practices in their pupils. This is a worthy goal, and one that has received increased attention the past few years, so the publication of this resource is welcome. This review is informed by my own research with instrumental/vocal teachers and healthcare professionals, which included an evaluation of similar resources (Norton, Reference NORTON2016).

My first impressions of the book were positive; it is attractively presented with a range of formats including lists, prose, and pictures. The inclusion of some anatomically correct diagrams might have made some of the medical terms and descriptions clearer. The book is structured sensibly with short chapters that have clear objectives and useful sub-headings (making it easy to dip in and out of the book), and which often include checklists and practical exercises. Quite a few chapters cater to instrument-specific audiences so there are sections that may not be directly relevant to all readers; these can easily be skipped but it does mean readers may find themselves not referring to significant amounts of the book.

The writing style is engaging and accessible but occasionally quite ‘hearty’ and American-centric. There is a clear consideration of musicians’ perspectives and a conversational style that makes it easy to read. Anecdotes provide memorable asides but it is not always clear whether Taylor is describing real or fictional scenarios. The tone of the book is not dictatorial but there is little balance provided through the use of others’ perspectives. It is likely that other healthcare professionals will disagree with some of the author's recommendations and statements; for example, her description of good posture as ‘lifting the head, tucking the chin, and pulling the shoulders down’ (p. xvi). It would have been valuable to explore those differences and outline the rationale for the author's choices.

The author states that the book is intended to address the needs of music educators at the middle- and high-school levels. I would suggest that it would be a useful introduction to healthy physical practice habits for early stage teachers or musicians who are intending to teach as much of the instrument-specific information introduced in this book is likely to be known by those with teaching experience. However, the very practical nature of the material cannot be denied and it is likely that any musician who reads it will find useful and memorable information that they can apply immediately to their own practice. Non-American audiences may be put off by the American focus of this book, which is made particularly evident by the writing style and inclusion of a Marching Band chapter.

The author has included a few ‘disclaimers’ to identify that the information in this book is not meant to be a substitute for professional medical diagnosis and that medical advice should be sought if first response strategies are not effective. What is not included is any advice regarding where such advice could be sought. When compared to the resource lists included in other books – see, for example, Playing (Less) Hurt (Horvath, Reference HORVATH2010, pp.201-227) – this is an omission that could leave worried readers with no further support to address their concerns.

Taylor places significant pressure on teachers when she suggests that they need to know how and why musicians become injured, what they can do to prevent it, and how to identify and manage overuse symptoms in pupils. While I would agree that teachers have a significant role in reducing pupils’ exposure to risk factors, they also need to recognise the limitations of their expertise and know when to refer pupils to other relevant professionals. The author herself has identified the need for further qualification beyond that gained as a musician in her pursuit and use of an occupational therapy qualification.

The author comments that ‘what we know about occupational wellness in music typically comes from personal experience’ (p. xv). This book draws on Taylor's professional experience as a musician and occupational therapist, but it is not always evident where the content goes beyond personal experience and into evidence drawn from research. References are used inconsistently and it is not clear why some statements are referenced when others are not; for a book that claims to go beyond personal experience it is worrying that the bibliography is only three pages. It is clear from the acknowledgements that the author has called on colleagues to provide information and support but their expertise and contributions are not explicitly stated. This book succeeds in being accessible and practical but falls down on academic rigour; participants in my own research emphasised the value of reference to relevant and up-to-date research, the inclusion of further reading and a comprehensive bibliography, and clear distinctions between authors’ opinions and information drawn from research.

Books such as The Musician's Way (Klickstein, Reference KLICKSTEIN2009), Secrets of Performing Confidence (Evans & Evans, Reference EVANS and EVANS2013) and The Musician's Body (Rosset i Llobet & Odam, Reference ROSSET i LLOBET and ODAM2007) provide information in a similar accessible and practical format for musicians; it would have been valuable for Taylor to signpost these books for readers to gain further insights and different perspectives. Resources such as Musical Excellence (Williamon, Reference WILLIAMON2004) and The Biology of Musical Performance and Performance-Related Injury (Watson, Reference WATSON2009) go into much greater detail and could have been recommended as resources to extend readers’ knowledge.

Given the author's expertise as an occupational therapist it is unsurprising that most of the book material is situated within a physical paradigm and relates, for the most part, to posture and healthy habits. Taylor introduces key risk factors that can lead to musculoskeletal disorders and provides advice for reducing exposure to those risk factors in an accessible and practical way. This information is interesting, useful, and welcome. Taylor achieves her aim to ‘present information in a sensible fashion and in a way that can be understood and applied immediately’ (p. xvi) by using simple explanations, providing clear explanations of jargon and including helpful glossaries in the ‘When it Hurts’ chapters.

As a first study violinist I read the chapter on ergonomics for string players with interest. I enjoyed the description of a string player as a mobile:

This chapter contains some good suggestions – for example, relating to adapting the sitting position and carrying the instrument – which some musicians may not have considered. However, it is often vague and rarely goes beyond the basics of instrumental technique. Without pictures some of the descriptions are unclear and do not specify in detail how to achieve a ‘correct’, ‘relaxed’, ‘balanced’, ‘comfortable’, or ‘appropriate’ position. The bow exercises are familiar but in many cases would only be clear to those who already know how they are supposed to work: for example, for the ‘Bow Crawl’ exercise (p. 95) should the bow be held vertically or horizontally? The five lines that deal with shoulder rests are inadequate given the importance of adjusting the type and positioning of chin- and shoulder- rests for a comfortable set-up. I would dispute the assertion that provision of a shoulder rest will prevent a pupil from raising the left shoulder or bending the neck; correct set-up takes a great deal of ongoing work and cannot be solved simply by providing any shoulder rest. Commenting on the specifics of chapters that deal with other instruments is beyond my expertise but from my reading of the string section I would suggest that there is likely to be content that healthcare professionals and teachers of those instruments will disagree with.

I cannot claim to be a hearing specialist but a few points differ from my understanding of the literature. For example, the statement ‘[hearing] loss is permanent; damage is not’ (p. 181) needs further clarification as some forms of hearing loss (e.g. that caused by ear wax or infection) can be temporary. Additionally, The American Tinnitus Association describes tinnitus as ‘the perception of sound in the ears or head where no external source is present’ whereas the definition provided by Taylor states that tinnitus is ‘a chronic ringing in the ears when there is actually no ringing in the environment’ (p. 185).

With a chapter on hearing having been included, it is not evident why other important healthy musicianship factors such as music performance anxiety and vocal conditions are not covered. Participants in my research negatively perceived books that attempted to cover topics in an unnecessary level of detail but also those that stated the obvious or omitted important information. ‘Teaching healthy musicianship’ is a broad and complex subject that cannot possibly be covered in one book. It is important that authors clearly define their contributions and situate them in relation to other resources so that musicians can access the web of information needed to teach themselves and their pupils to be healthy.

This book is a valuable addition to a still limited pool of resources as it provides information that will confirm or extend teachers’ knowledge and sets out clear strategies that can be implemented immediately. Future editions or contributions could be improved through the use of consistent referencing, explicit collaboration with appropriate experts, an acknowledgement of the limitations of the resource, and signposting to other resources to allow readers to further their knowledge and practical understanding of the topic.