The CIM Associate Dean for Student Affairs coordinates general health issues with the Institute's partners at Case Western Reserve University (CWRU) Health Services and CWRU Behavioral Health Services. See below for further information on the student health program or health and wellness resources from Case and other nearby providers.

In addition, CIM maintains staffing of counseling hours on the CIM premises by having psychologists available to provide both individual and group therapies to CIM students. These trained specialists also provide additional programming through our residence life program to new undergraduate students on issues facing students in the arts including special discussions on issues such as performance anxiety.

All medical treatment required by an individual is managed through professional medical providers.

Hearing Health

CIM provides NRR33 (soft foam) earplugs for use by any musicians. These are available prior to any rehearsal or concert and may be picked up by the Ensemble Manager or the student manager on duty.

Acquiring permanent hearing loss is an occupational risk for musicians.  As part of CIM’s health initiative, CIM has also partnered with the Cleveland Clinic Section of Audiology to promote healthy hearing so we can listen for a lifetime.

  • Audiologists offer hearing tests in August to any and all students. For new students, it is highly recommended that a baseline hearing test is obtained. For continuing students, follow-up hearing tests are recommend to monitor for any changes that may occur over the course of the year.

  • Protecting your hearing is critical as your ears will be your livelihood. Use of high-fidelity earplugs when playing your instrument will protect you against the cumulative effects of overexposure to music or sounds. The Cleveland Clinic recommends obtaining either ETY earplugs available online (Amazon) or obtaining custom musician plugs. The Cleveland Clinic will provide and fit individualized custom musician earplugs for $125 per set for students. Faculty and staff can purchase for $175.00. Contact Audiology at 216-444-5370 to arrange for impressions to be taken for the custom plugs.

  • Practicing with your new earplugs will be necessary in order for your ears to readjust. Obtaining earplugs earlier in your career is recommended to allow adequate adjustment time.

  • Be aware of your instrument’s output. Follow these steps to determine if high-fidelity earplugs are necessary.

    1. Consult Table 1 to see the estimated output of your instrument.
    2. Compare your instrument’s output with Table 2, the Safe Level Chart, to determine the maximum time you should play and remain safe from hearing loss.
      • A more accurate method is to use a dosimeter, a small instrument you wear on your collar that measures the dose of sound exposure.
    3. A dosimeter is available from the Clinic. Wearing it for a day or several weeks will determine if you are at risk for hearing loss. This is based on your playing output, playing time, and playing environment. Please contact Audiology at 216-444-5370 to inquire about using a dosimeter.

Table 1:  Approximate values associated with different instruments (Chasin, M. (2001). Hear the music: Hearing loss prevention for musicians. Publisher not identified.)

Musical Noise Decibel Ranges

  • normal piano practice: 60-70 dB
  • fortissimo singer three feet away: 70 dB
  • chamber music in small auditorium: 75-85 dB
  • regular sustained exposure may cause permanent damage: 90-95 dB
  • piano fortissimo: 92-95 dB
  • violin: 84-103 dB
  • cello: 82-92 dB
  • oboe: 90-94 dB
  • flute: 85-111 dB
  • piccolo: 95-112 dB
  • clarinet: 92-103 dB
  • french horn: 90-106 dB
  • trombone: 85-114 dB
  • timpani & bass drum rolls: 106 dB
  • average personal listening device on 5/10 setting: 94 dB
  • symphonic music peak: 120-137 dB
  • amplified rock music at 4-6 feet: 120 dB
  • rock music peak: 150 dB

Safe Levels of Maximum Time Exposure

  • 85 dBA: 8 hours in a day
  • 88 dBA: 4 hours in a day
  • 91 dBA: 2 hours in a day
  • 94 dBA: 1 hour in a day
  • 97 dBA: 30 minutes in a day
  • 100 dBA: 15 minutes in a day
  • 103 dBA: 7.5 minutes in a day
  • 106 dBA: 3.75 minutes in a day
Vocal Health

Protecting Your Vocal Health: A NASM-PAMA Student Information Sheet

  • Vocal health is important for all musicians and essential to lifelong success for singers.
  • Understanding basic care of the voice is essential for musicians who speak, sing, and rehearse or teach others.
  • Practicing, rehearsing, and performing music is physically demanding.
  • Musicians are susceptible to numerous vocal disorders.
  • Many vocal disorders and conditions are preventable and/or treatable.
  • Sufficient warm-up time is important.
  • Begin warming up mid-range, and then slowly work outward to vocal pitch extremes.
  • Good posture, adequate breath support, and correct physical technique are essential.
  • Regular breaks during practice and rehearsal are vital in order to prevent undue physical or vocal stress and strain.
  • It is important to set a reasonable limit on the amount of time that you will practice in a day.
  • Avoid sudden increases in practice times.
  • Know your voice and its limits, and avoid overdoing it or misusing it.
  • Maintain healthy habits. Safeguard your physical and mental health.
  • Drink plenty of water in order to keep your vocal folds adequately lubricated. Limit your use of alcohol, and avoid smoking.
  • Day-to-day decisions can impact your vocal health, both now and in the future. Since vocal strain and a myriad of other injuries can occur in and out of school, you also need to learn more and take care of your own vocal health on a daily basis. Avoid shouting, screaming, or other strenuous vocal use.
  • If you are concerned about your personal neuromusculoskeletal health, talk with a medical professional.
  • If you are concerned about your neuromusculoskeletal health in relationship to your program of study, consult the appropriate contact person at CWRU: Louise Matchett, louise.matchett@case.edu.
  • This information is provided by the National Association of Schools of Music (NASM) and the Performing Arts Medical Association (PAMA). For more information, check out the other NASM-PAMA neuromusculoskeletal health documents located on the NASM website.
Neuromusculoskeletal Health

Protecting Your Neuromusculoskeletal Health: A NASM-PAMA Student Information Sheet

  • Neuromusculoskeletal health is essential to your lifelong success as a musician.
  • Practicing and performing music is physically demanding.
  • Musicians are susceptible to numerous neuromusculoskeletal disorders.
  • Some neuromusculoskeletal disorders are related to behavior, others are genetic, and others are the result of trauma or injury. Some genetic conditions can increase a person’s risk of developing certain behavior-related neuromusculoskeletal disorders.
  • Many neuromusculoskeletal disorders and conditions are preventable and/or treatable.
  • Sufficient physical and musical warm-up time is important.
  • Good posture and correct physical technique are essential.
  • Regular breaks during practice and rehearsal are vital in order to prevent undue physical stress and strain.
  • It is important to set a reasonable time limit on the amount of time that you will practice a day.
  • Avoid sudden increases in practice times.
  • Know your body and its limits, and avoid “overdoing it.”
  • Maintain healthy habits. Safeguard your physical and mental health.
  • Day-to-day decisions can impact your neuromusculoskeletal health, both now and in the future. Since muscle and joint strains and a myriad of other injuries can occur in and out of school, you also need to learn more and take care of your own neuromusculoskeletal health on a daily basis, particularly with regard to your performing medium and area of specialization.
  • If you are concerned about your personal neuromusculoskeletal health, talk with a medical professional.
  • If you are concerned about your neuromusculoskeletal health in relationship to your program of study, please consult with your principal teacher or the Associate Dean for Student Affairs.
  • This information is provided by the National Association of Schools of Music (NASM) and the Performing Arts Medical Association (PAMA). For more information, check out the other NASM-PAMA neuromusculoskeletal health documents located on the NASM website.