Almost by definition, the performance of dance, music, or any other performing art involves physical exertion of some type and some degree. In most performances, the amount of energy expended appears to be substantially higher than the resting state but significantly lower than many athletic events that last about the same amount of time. Performing artists and performing arts medicine specialists have long been interested in the interactions between physical exertion and the quality of the artistic effort. Does some amount of physical activity actually improve performance through a “warm up” effect? At what point does the amount of physical activity expended start to cause lower quality of the performance? What role does mental versus physical fatigue play? The article by Drinkwater and Klopper in this issue of the journal provides new information on how fatigue during a performance may affect the quality of the music produced.