Arizona's Premier Tinnitus & Hearing Center

cover photo

Musicians Clinic

Join Group
  • Dr. Rohe | Tinnitus and Hearing Center of Arizona Musicians Clinic
    10 months ago


    Using his model Wenmaekers calculated the effect of the most commonly used sound-reducing measures, like screens and higher plateaus for the different sections in the orchestra. Those effects appeared to be very small since the main source of the sound was the player's own instrument. The same cause lies behind the relatively small impact (around 3 d of the sound-intensifying effect of small orchestra playing areas like covered orchestra pits. According to Wenmaekers it is still advisable to avoid such small orchestra playing areas but then again, the sound levels are still too high in other areas.

    The only thing that really helps is to play more quietly or to use earplugs. Musicians have long been advised to play using earplugs but now it has been proven that there is no other feasible measure that can be taken.

    Too late

    Wenmaekers, himself a musician, realizes that this is not really what the doctor ordered. "A musician with poor hearing risks losing his job. So to avoid this, earplugs are inevitable. At the same time, you want to perform as well as possible, so earplugs may hinder this. Musicians will have to get used to playing with earplugs from a young age because once you have a hearing problem you are too late."

    Getting away with it

    There is, however, one part of the orchestra that can get away with it in part, the cello and the bass sections. These instruments produce a relatively soft sound and thus present no risk by themselves. The sound that affects the ears of the cellists and bassists tends to be generally lower and comes mainly from the other orchestra sections. So for this group there may be other interventions that are effective apart from earplugs.

    These results were published this month in the Journal of the Acoustical Society of America.

    Eindhoven University of Technology. "Earplugs unavoidable for musicians in the orchestra and at home: Own instruments are often responsible for excess noise levels." ScienceDaily. ScienceDaily, 22 November 2017

  • Dr. Rohe | Tinnitus and Hearing Center of Arizona Musicians Clinic
    10 months ago

    Many musicians suffer ear damage. Professional orchestras have therefore taken measures in recent years to reduce the sound levels. Studies now reveal that physical measures, like placing screens between sections or creating more space between them, have little effect. This is due to one's own instrument contributing just as much to the sound level that reaches the ear as all the orchestra's instruments together. So experienced musicians that play alone at home -- whether professionals or amateurs -- also produce excessive sound levels. The only solution that really helps is earplugs.

    The eardrums of trumpet players and flute players are the most burdened. During loud passages they are subjected to average decibel levels of 95 to 100 dB(A), just from their own instruments. The violin and viola produce decibel levels in excess of 90 dB(A) for their players. These levels are similar to those of a rock concert. They also well exceed the 85 dB(A) limit that European regulations stipulate for the compulsory wearing of ear protection on the work floor.

    Close to the ears

    Acoustics expert and researcher Remy Wenmaekers got these results using a calculation model he developed to work out the level of sound close to the ears of musicians. Wenmaekers chose to use a calculation model rather than measurements on the spot where musicians play their instruments. The reason is musicians never reproduce exactly the same level of sound, which makes comparison of experiments with 'real' musicians virtually impossible.

    As a foundation for his model he used recordings of orchestra music per instrument made in an anechoic chamber (a room without an echo). The model takes account of the direction of the sound of the instruments, the listening orientation of the receivers, reflection of sound, and blocking by people (the musicians themselves). He compared the results of his model with measurements in a real orchestra and there appeared to be a good correspondence.

    This video shows the sound levels at the ears of musicians as calculated by Wenmaekers' model, for the first two minutes of Mahler first symphony (4th movement). It clearly shows sound levels exceeding 100 dB(A) repeatedly.

    Eindhoven University of Technology. "Earplugs unavoidable for musicians in the orchestra and at home: Own instruments are often responsible for excess noise levels." ScienceDaily. ScienceDaily, 22 November 2017.

  • Dr. Rohe | Tinnitus and Hearing Center of Arizona shared 4 photos in Musicians Clinic
    3 years ago

    Providing musicians and audio engineers an opportunity to mix and demo in-ears in my clinic. Allen & Heath Board, Shure PSM 900 transmitter and belt...
  • Dr. Rohe | Tinnitus and Hearing Center of Arizona Musicians Clinic
    3 years ago

    NIOSH just released a new set of recommendations, "Reducing the Risk of Hearing Disorders among Musicians". To access the article, click here: www.cdc.gov/niosh/docs/wp-solutions/2015-184/pdfs/….

Musicians Clinic
Listening to or playing intense music may cause tinnitus symptoms. Modern and classical musicians are both at risk. Audio engineers, recording engineers, sound crews, managers, disc jockeys, music educators, and music students are all exposed to high sound levels and all face a real risk of incurring permanent auditory damage. There are three factors that contribute to noise-induced tinnitus: 1. Noise level. The higher the level the more likely a person will get tinnitus. 2. Duration. The longer the duration, the more likely a person will get tinnitus. 3. Impulses. Rapid bursts of high amplitude sounds such as those from cymbals or horns are known to be more hazardous to hearing. Because music levels vary widely, it is difficult to predict an individual’s true exposure over time. A measure of noise dose (dosimeter) provides a more accurate estimate of risk.

Music can cause hearing loss and tinnitus just like noise can. Tinnitus is a frequent complaint of classical music students who practice more than twenty hours per week. Musicians can wear earplugs or in-ear monitors to reduce the sound levels. Use of hearing protection by musicians and music industry professionals can dramatically reduce auditory risk.  Standard hearing protectors (foamies) are unacceptable because they provide too much overall attenuation, too much high frequency attenuation, and excessive occlusion all making music sound muddy and unclear. Inserting an earplug in the ear canal removes the ear’s natural resonant peak - which is approximately 17 dB at 2700 Hz in the average ear canal. When combined with the ear plugs attenuation characteristics, this results in a net treble deficiency 15-20 dB, causing music and voices to sound muffled. Earplugs with too much high frequency attenuation destroy tonal balance resulting in mishearing or overplaying to compensate for lack of high frequency sound heard through the earplugs.

Without question, musicians need to hear and hear well while they play. Specialized musician earplugs (customs) from Etymotic Research are designed to provide an equal amount of attenuation across the audible frequency range. Sound is reproduced as it is normally heard, but at a lower intensity, preserving tonal balance of music while lowering sound pressure levels at the ear drum. Noise cancellation headphones are least effective for music, which is often changing in frequency and level. They tend to work best when the noise source is constant such as from a machine or an airplane engine.

High frequency hearing loss is particularly detrimental to musicians and singers because they must be able to accurately match frequencies over a broad range, including frequencies above those required for speech comprehension. This may lead to excessively loud playing at higher pitches, resulting in an unacceptable performance. This may also lead to arm, wrist, and vocal strain. Loss of color and clarity, especially in the higher tones, can impair one’s ability to enjoy listening to music.

Music-induced hearing loss tends to be greater in one ear over the other (asymmetry). This is probably related to the position of one’s own instrument, other instruments, and the position of onstage monitors relative to the ears. Hearing tends to be worse in the left ear of rock drummers, owing to its closer proximity to the high hat cymbals. Hearing is worse in the left ear of violinists and right ear of flute and piccolo players. Because of the imbalance in hearing, it is not unusual for these musicians to complain of distortion, even in their better ear.

Those with professional training in music or for whom music plays an important role in life will be sensitive to even very small changes in tinnitus perception, as detecting and evaluating sound plays a vital part in their life. These individuals have a specially modified signal-processing and pattern-matching ability that is more acute than in untrained individuals. This is applicable to professional musicians, sound engineers, and other professions where the work requires identification, separation, and detailed evaluation of complex sounds. As artists in general, including musicians, can have a tendency towards higher emotional reactions relating to their work, they may also display a more significant reaction to tinnitus or hyperacusis and therefore have a tendency to be more distressed by it.

Numerous rock musicians have admitted to suffering from tinnitus to the point that they have limited their live performances or retired from the music industry altogether. There is currently no FDA approved medication to treat or prevent music induced hearing loss. Treatment is rehabilitative through use of amplification devices.

Dr. Rohe has extensive experience in working with musician's in the classical, worship, and pro touring industries. He also works closely with audio engineers involved in live sound and music production as well as roadies, security personnel, law enforcement, off-road racers and the secret service. His knowledge and experience will  help you to select which type of in-ear monitoring or other hearing protection system best suits your performance or listening needs. 

Visit the Audio Engineering Society website for a brief bio about Dr. Rohe and his work with the Conservatory of Recording Arts and Sciences Click Here

Tinnitus and Hyperacusis Center of Arizona
Wednesday, 29 April 2015
Group Admin
Dr. Rohe | Tinnitus and Hearing Center of Arizona
  • There are no discussions in this group yet. Why don't you create one?


No event created yet.

Learn More:

Pharmaceutical Approaches for Tinnitus

Cognitive Behavior Therapy for Tinnitus





Musician's Clinic

In-Ear Monitors