True story: The first injury I treated at a football game as a real doctor (an attending orthopedic surgeon after I finished my residency and fellowship) was a patellar dislocation in a color guard member of the marching band that had just performed at halftime. She was carried to the bleachers screaming bloody murder. The athletic trainer for the football team asked if I wouldgo see her. I told the girl I would count to three before popping it back into place because she was scared. I did it on 2. All good. Since then I have seen many band members with shoulder, neck, lower back, foot and knee pain.

Marching band playing in football stands

In my latest newspaper column, I discuss the physical demands of marching band. While you might dismiss it, trust me when I say it’s hard work.

The physical demands of marching band

From the drum corps level to colleges and many high schools, these groups perform highly choreographed, highly competitive routines requiring endurance, cardiovascular conditioning, strength and flexibility. Today’s routines require members to carry instruments weighing 30 or 40 pounds, march in step and in perfect alignment all over the field at fast speeds while blowing air through instruments for 8 to 12 minutes.

Imagine running a mile in all different directions while carrying a dumbbell at shoulder level and not letting it drop an inch. Then rest a minute or two and do it again – for a few hours.

While I recognize and admire how physically challenging it is, my interest lies in the injuries and illnesses band members can suffer.

Injuries in marching band

Gary Granata, Ph.D studied the 172 members of Indiana’s Avon High School marching band. It won Grand National Champion at the 2008 Bands of America competition. He presented results of a survey of its band members after that season the American College of Sports Medicine’s 56th Annual Meeting.

95% of the members reported muscle stiffness or soreness after practice. 38% suffered an injury. Many band members suffered nausea, fatigue and feeling faint related to heat.

In a study of 21 college marching bands, researchers determined that 25% of the band or color guard suffered a musculoskeletal injury.

The need for guidelines to keep marching band members safe and healthy

Whether or not you believe marching band should be considered a sport, we all need to recognize the physical nature of the activity. We should create guidelines to prevent injury and illness. We have them for every major team sport. Marching band should be no different.

Here are 11 tips to keep marching band members healthy and prevent injuries and illnesses.

Prepare for the heat

Marching bands practice in the same heat and humidity as the football and soccer teams. Participants need to prepare weeks – or preferably months – ahead of time to get in proper shape. They also need to get their bodies used to the heat before band camp, with its 8- to 12-hour practices, starts.

Clothing and sun protection

Wear light-colored clothes that fit loosely to allow the body to dissipate heat and sweat. Wear sunglasses, a hat to shield your face from the sun and sunscreen.


Take frequent water breaks, and have access to water throughout practice. Due to the duration of these practices, sports drinksmight provide needed carbohydrates and electrolytes. Also drink enough water throughout the day, not just during practice.

Marching band member drinking water


As easy as it is to eat fast food, especially when you travel for competition, optimize your performance by eating healthy foods. Fruits and vegetables during meals and healthy snacks like protein bars are better than junk food.


Ideally marching band members should stay in shape all year. To be ready for band camp, you should start some endurance training like jogging a month or two earlier. If necessary, start with 20- or 30-minute walks each day.

Also read:
Prepare early to prevent heat deaths from summer sports

Emergency action plan

All marching bands should have an emergency action plan in place. Have and know how to operate the automated external defibrillator (AED). Know who will call EMS in the event of a medical emergency. Practice the plan at the start of each season.

Also read:
Football players’ sudden cardiac arrest shows need for emergency action plans

Athletic trainer

Ensure access to an athletic trainer. Even if one is not sitting on the sidelines at every practice, he or she should be immediately available to help should an injury occur.

Also read:
Athletic trainers: Some of sports’ true heroes


Develop ways to monitor for lightning. Seek shelter immediately if thunder and lightning develop.

Posture and core stability

Because of the weight of many of the instruments, practice good posture and work on your core stability. If you stand in a bad position for long periods of time, you could put stress where it isn’t supposed to go and develop an injury.

Watch for each other

As with all athletes training in the heat, watch your teammates for signs that they are struggling. Often athletes suffering heatstroke lose the ability to recognize that they are getting sick.

Watch out for yourself

If you have some ache or pain that isn’t getting better, get it checked out. See an orthopedic surgeon or physical therapist. Most musculoskeletal injuries related to marching band are overuse injuries. Often some simple changes can relieve your pain without making the problem worse.

Regardless of how you feel about marching band, we should all recognize how hard these young men and women work and take steps to keep them healthy.

Note: A modified version of this article appears as my sports medicine column in the August 23, 2017 issue of The Post and Courier.