The Lowdown on Upper Body Health

October 1, 2026

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by Jennifer Rhyne, DMA, and flutist of Local 76-493 (Seattle, WA) and Charlie Katica, Ph.D., CSCS

For musicians and conductors, the pursuit of artistic excellence may come at a physical cost. Long hours of practice and performance with the upper body in asymmetrical or forward-leaning postures can cause nerve and muscular issues over time. The asymmetry needed for string instruments and the flute can be particularly troublesome and lead to muscle imbalances.

Performers may develop poor posture because of the awkward positioning of their instruments. This can lead to discomfort in the shoulders and back. A musician’s posture can lead to weakness in the muscles of the back and sides of the torso, as well as tightness in tissues on the front of the shoulder and chest. Abnormal movement of the shoulders and back can result from dysfunction of stabilizing muscles in the back and chest.

Symptoms in Shoulders and Upper Back

Musicians with dysfunction in the upper body may feel weakness in the shoulders, especially when lifting their arms or pushing forward. They may experience limited range of motion in the shoulder, either when raising the arms to the side or in front of the body. Other indications of problems include pain, discomfort, or tingling as well as weakness and fatigue in the shoulders or upper back. Muscles in the upper part of the torso may feel tight and knotted and one or both shoulders may be rolled forward.

Muscle weakness due to poor posture can lead to other problems, such as one or both shoulder blades becoming “winged” and sticking out from the torso like the wing of a bird. A winged scapula can cause tingling, tenderness, or pain behind the shoulder blade.

Some musicians develop thoracic outlet syndrome—a compression of the nerves underneath the collarbone, which may cause numbness and pain in the upper torso and arms. Although postural issues may not cause discomfort immediately, pain and dysfunction tend to develop over time. It’s wise to take a preemptive approach and correct problems before they become chronic.

Exercises to Prevent and Correct Postural Deficiencies

Musicians should avoid hunching over by lifting the chest to find the best spinal posture. Aim to gently pull the shoulders back so that the arms rest alongside, instead of in front of, the body. Imagine placing the shoulder blades down and back. The shoulders should be relaxed and low rather than elevated toward the ears. Avoid over-retracting the scapulae, which can cause stiffness or imbalance.

Be sure that the pelvis is in a neutral position. Lift the chest, rotating the arms open, and bringing the head in line over the spine. This helps to lengthen the spine and neck, which addresses postural issues and can improve efficiency in breathing. These postural corrections can first be made while standing in a neutral position before and while performing.

The upper back and shoulders can more easily be brought into an appropriate position by strengthening muscles on the back and sides of the body. These muscles include the serratus, the latissimus dorsi (lats), the trapezius (traps), and the rhomboid muscles.

Try the exercises on this YouTube channel to help you strengthen your back and shoulders: www.plu.edu/flute/upper-body-health-for-musicians.

The exercises should be done two or three times a week, rotating between different exercises. Rest for 30-60 seconds between sets. Your primary focus should be on quality movements and control, not fatigue. Avoid quick, jerky motions or straining. Focus on your breathing throughout the movements and avoid holding your breath. Exhale as your arms move away from the body and inhale as the arms return. If at any point you feel sharp, pinching, or radiating pain, or any pain beyond mild muscular effort, stop movement immediately.

Postural corrections, strengthening exercises, stretches, and adjustments to the placement of the arms, chest, and shoulders are effective in preventing discomfort and dysfunction. The goal is to have pain-free longevity as a performer.

Before beginning any exercise regimen, consult your doctor. Suggestions in this article cannot replace the tailored advice of a medical professional.

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