This study was designed to investigate the frequency of muscu- loskeletal disorders among musicians in a professional-level sym- phony orchestra in Greece. The sample consisted of 147 musicians (97 men, 50 women) of the Athens and Thessaloniki State Sym- phony Orchestra. The mean age of the musicians was 38.97 years (range 24 to 67, SD 9.68), while the years of experience in the orchestra ranged from 1 to 35 (mean 14.2, SD 8.47). The data were collected with the Standardized Nordic Questionnaire, which records the frequency of musculoskeletal disorders. Our results showed a very high percentage (81.6%) of the musicians had suf- fered at least once, during their professional career, some kind of musculoskeletal disorder that was associated with pain or discom- fort and was directly related to their profession. More than two- thirds of the musicians had also suffered a problem in the hand and neck areas during the last 12 months. Musculoskeletal disorders appeared to be related to gender, age, kind of instrument played, and duration of rehearsing/performing, along with previous experi- ence. In summary, there is a high frequency of injury among pro- fessional-level musicians in Greece reported in our study, highlight- ing the obvious need to develop prevention programs. Med Probl Perform Art 2013; 28(2):91–95. O rchestra musicians are at risk of developing muscu- loskeletal problems that can significantly interfere with their ability to perform and have a negative effect on their professional career. 1–5 In fact, this constitutes a common sit- uation for orchestra musicians in each level of virtuosity and all age-related categories. Numerous studies during the last 20 years demonstrated the high prevalence of injury among performing musicians. 3,6- 11 According to Zaza 5 in her systematic review of occupational risk factors for musculoskeletal disorders in musicians, this is attributed to the gradually increasing requirements and obli- gations that lead to musculoskeletal injuries ranging from 32% to 87% as reported by epidemiologic studies. 1,7,12–24 The main risk factors for musculoskeletal disorders in musicians include age, gender, anatomical characteristics, physical condition, inadequate training, joint laxity, and fac- tors directly related to the profession such as technique, pos- ture while practicing, support of the instrument, duration of practice or the sudden increase in duration, and mental and physical intensity. 9,18,25,26 Hence, a variety of risk factors leads to a broad range of musculoskeletal disorder occurrence that is also influenced by the organization level and support provided to symphonic orchestra musicians. 21 Reviewing the literature, however, it seems that there are no previous researches conducted that examine the prevalence of musculoskeletal disorders in Greek symphonic orchestra musicians. Thus, the purpose of this study was to investigate the frequency of musculoskeletal disorders among professional-level musicians of symphony orchestra in Greece and examine the factors affecting mus- culoskeletal disorder occurrence. METHODS Sample The Athens and Thessaloniki State Symphony Orchestras, together comprising 227 full-time musicians, are regarded as the most important and recognized musical ensembles and the only two state symphony orchestras in Greece. Thus, the sample of 147 out of 227 musicians (59.5%) who voluntarily completed and returned the questionnaire is considered to be representative of Greek orchestra professionals. The study was approved by the Institution Review Board at Aristotle University of Thessaloniki, Thessaloniki, Greece, and informed consent was received from all participants prior to completion of the questionnaires. The sample consisted 147 full-time musicians (97 men, 50 women; mean age 38.97 yrs; mean orchestra experience 14.2 yrs) of Athens and Thessaloniki State Symphony Orchestras. Of this group, there were 92 string instrumentalists (62.6%), 25 woodwind instrumentalists (17%), 20 brass instrumental- ists (13.6%), 8 percussionists (5.4%), and 2 harp and piano instrumentalists (1.4%). June 2013 91 Prevalence of Musculoskeletal Disorders in Professional Symphony Orchestra Musicians in Greece A Pilot Study Concerning Age, Gender, and Instrument-Specific Results Dimosthenis G. Fotiadis, PhD, Eleni G. Fotiadou, PhD, Dimitrios G. Kokaridas, PhD, and Argyrios C. Mylonas, PhD Dr. Fotiadis is a PhD candidat e , Dr. Fotiadou is Assistant Professor of Spe- cial Physical Education, and Dr. Mylonas is Professor Emeritus of Anatomy, at the Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki; and Dr. Kokaridas is on the Teaching Staff of Adapted Physical Education, Department of Physical Education and Sports Science, University of Thessaly, Trikala, Greece. <A U: pls conf ir m titles/af f iliations > Address correspondence to: Dr. Eleni G. Fotiadou, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thes- saloniki, Greece. Tel +30 2310 992215; fax +30 2310 992205. fotiadi@phed.auth.gr. © 2013 Science & Medicine. www.sciandmed.com/mppa.