Hearing loss and playing music

Music enriches life in many ways. For people who play an instrument or sing themselves, hearing is of central importance. But what happens when hearing starts to decline? The following section explores the special relationship between making music and hearing health, highlights risks and protective measures, and explains how it is still possible to play music actively despite hearing loss.

Why hearing is particularly important for musicians

For people who actively play music, hearing fulfils far more functions than simply perceiving sounds. It is an indispensable working tool that must handle many simultaneous tasks. The following sections illustrate the role the sense of hearing plays in music-making and why musicians often notice changes in their hearing particularly early on.

The importance of hearing when making music

When making music, hearing is involved in numerous processes simultaneously. It enables musicians to monitor their own playing or singing, hear their fellow musicians, read and interpret sheet music, and emotionally interpret a piece. All these tasks occur in parallel and require precise auditory perception. Hearing is particularly indispensable when playing with others, as this is the only way to coordinate tempo, dynamics and intonation. Anyone who sings in a choir, plays in a band or performs in an orchestra relies on a functioning sense of hearing to blend into the overall sound. Directional hearing also plays a role, for example in identifying where a particular sound is coming from or how one’s own position in the room sounds.

Early detection of hearing problems in musicians

People who play music regularly often notice changes in their hearing earlier than others. This is because they pay attention to the finest nuances of sound in everyday life. Even small deviations in pitch, timbre or volume are more likely to be noticed. This trained sense of hearing can help those affected to seek professional help at an earlier stage. An early consultation with an ENT specialist or hearing care professional is generally recommended, as the sooner potential hearing problems are identified, the better suitable measures can be taken. Anyone wishing to learn more about the symptoms of hearing loss can find further information in our guide.

Risks to hearing when playing music

Playing music can involve increased noise exposure, which puts strain on the ears. During both rehearsals and performances, sound levels can reach levels that may become problematic in the long term without appropriate protection. The following sections explain which situations can be particularly stressful and which signs indicate a possible impairment.

Noise exposure at concerts and rehearsals

The volume during musical activities varies considerably depending on the genre and environment. At rock concerts or in nightclubs, sound levels of 100 to 120 decibels are frequently measured. Even in the orchestra pit, high volumes can occur during certain passages, particularly near brass instruments or percussion. Even when practising at home, the volume of certain instruments can be considerable. As a general rule, noise sources of 85 decibels or more can damage hearing if exposure is prolonged. The hair cells in the inner ear, which are responsible for converting sound waves into nerve impulses, can be damaged by excessive exposure. As these cells do not regenerate, prevention is particularly important.

Typical symptoms of noise-induced hearing loss

Noise-induced hearing damage can manifest itself through various signs. Those affected often report a dull sensation in the ears following loud events, or a temporary ringing or whistling, also known as tinnitus. If such symptoms occur regularly or persist for a long time, this should be taken as a warning sign. Difficulty understanding conversations in noisy environments, or the feeling that high-pitched sounds are no longer as clear as they used to be, can also be signs of hearing loss. If you experience such symptoms, it is advisable to visit an ENT specialist to have the causes investigated.

Hearing protection for musicians

Suitable hearing protection can help protect your hearing from excessive noise exposure without completely restricting the musical experience. There are various solutions specifically tailored to the needs of musicians. The following sections outline different options.

Different types of hearing protection

Specialised hearing protection is available for musicians, which differs from conventional earplugs. Whilst simple foam earplugs often make sound seem muffled and distorted, musician’s earplugs use special filters. These reduce the volume more evenly across all frequencies, so that the music sounds quieter but largely natural. Such hearing protection solutions are available in various designs, ranging from standardised models to custom-made earmoulds, which are fitted to the shape of the ear by a hearing care professional. The attenuation effect can be varied depending on the model and filter selection, allowing the protection to be adapted to different situations.

In-ear monitoring as protection and a working tool

In-ear monitoring systems are primarily used by professional musicians on stage, but are also becoming increasingly common among amateurs. With this technology, a personalised mix is transmitted directly to the musicians via earphones. The advantage is that the overall volume on stage can be reduced, as there is no longer a need to monitor via loud monitor speakers. At the same time, the personal mix can be adjusted so that one’s own instrument or voice can be heard clearly. In-ear systems can thus serve both as a working tool and as a form of hearing protection, as they shield the ears from ambient noise levels.

Making music with hearing loss

Even if hearing is already impaired, there is no need to give up making music. Modern technologies and various adaptation strategies can help you continue your musical activities. The following sections provide an overview of technical aids and practical tips.

Modern hearing aids and their capabilities

Hearing aids have undergone significant technical advancements in recent years. Many modern devices feature special programmes optimised for listening to music. These often operate with less compression and reduced noise cancellation to reproduce sound as faithfully as possible. For people with severe hearing loss, cochlear implants may also be an option, although consultation with an ENT specialist and a specialist clinic is essential. As a general rule, listening to music with hearing aids requires a period of adjustment and is experienced very differently from person to person. A discussion with your hearing care professional about your personal requirements when playing music can help to adjust the settings accordingly.

Adaptations in everyday musical life

In addition to technical aids, practical adjustments can also make playing music easier for those with hearing loss. Positioning within the room plays an important role, for example by standing closer to fellow musicians whom you need to hear particularly well. In cases of unilateral hearing loss, it can be helpful to turn your better ear towards the most important sound sources. The choice of instrument can also be relevant. Instruments with fixed pitches, such as the piano, guitar or drums, sometimes have different requirements to those where the intonation is shaped by the player themselves. In principle, playing many instruments is possible even with hearing loss, provided there is motivation and, where necessary, professional support is sought.

Training the ear through music

Interestingly, active music-making is also being studied in research in connection with auditory processing. The following sections highlight the findings on this topic and how music can be used as part of auditory training.

Neuroplasticity and active music-making

The human brain is capable of adapting and forming new connections throughout life. This property is known as neuroplasticity. Research is investigating whether and how regular music-making influences the auditory centre in the brain. Some studies suggest that people who actively play music over a long period of time may be better able to maintain certain auditory skills. For example, research is being conducted into whether musically active people understand speech better in noisy environments. However, these research findings are not yet conclusive and should not be misinterpreted as a promise of a cure. Nevertheless, playing music can be regarded as an activity that challenges and stimulates the brain in many ways.

Music as therapy

Music is frequently used as a supportive element in hearing training and auditory therapy. Listening to and recognising melodies, rhythms and timbres is employed to stimulate auditory processing in the brain. For people who need to relearn how to hear following a hearing aid fitting or the fitting of a cochlear implant, music can be a helpful component of the rehabilitation process.

It is often advisable to start with musically simpler pieces and gradually work your way up to more complex ones. The brain can draw on auditory memories and partially fill in gaps in the soundscape. Anyone interested in the topic of auditory training will find further information and exercises in our guide. In the event of persistent hearing problems or uncertainties, professional advice should always be sought from an ENT specialist or hearing aid specialist.