Keys to Pain-Free Playing

August 1, 2024

IM  -  

The rigor of playing an instrument, performing complex and demanding physical movements on a daily basis, means musicians are at high risk for tendonitis, bursitis, and carpal tunnel syndrome. Repetitive movement, especially for extended periods, can significantly strain muscles and joints.

Back pain and pain of the upper extremities are common, whether it’s shoulder pain for high string and flute players or elbow strain for violinists. Bowing techniques put strain on the right shoulder and elbow. Brass players may have back pain, consistent with having to support heavy instruments.

When a serious injury is about to occur, you will usually get a clear warning. The area will start to feel irritated or warm. In some cases, the skin may turn red. Here are some warning signs to look for:

• Pain in the hands, arms, neck, shoulders, and back.
• Numbness in fingers and/or hands from nerve entrapment.
• Stiffness and/or loss of mobility in fingers, hands, or wrists.
• Feeling weak while doing daily activities such as opening a bottle.

These signs and symptoms often appear as a result of inflammation.

Tendonitis

For keyboard and organ players, there is more freedom in hand motion than anywhere else in the body, which means many tendons move the fingers and wrists in multiple directions. All 24 of those tendons go through the wrist, which is the smallest cross-sectional area in the body. Wrist tendons that get swollen are confined to an already compact space.

Tendonitis is an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon. Tendinosis, on the other hand, is a chronic, degenerative condition that involves the deterioration of collagen. When tendonitis is not caught early or treated properly it can turn into tendinosis.

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve, which is a major nerve that supplies movement, touch, and pain to your hand, forearm, and wrist. CTS is the second most common injury in musicians. With repeated overuse, tendons can become inflamed. The tendons will then push the median nerve against the tunnel wall, inhibiting the flow of blood and oxygen to the nerve.

CTS causes numbness and tingling in the fingers. Symptoms worsen at night because blood pressure drops when you’re sleeping, resulting in even less blood flow to your hands. Experts say that long-term lack of blood flow to the median nerve can eventually lead to irreversible damage. That’s why it’s important to treat CTS immediately. 

Treatment for both conditions include taking a respite from playing from four to six weeks. A brace might also be recommended. If nonsteroidal anti-inflammatories such as ibuprofen do not work, a cortisone shot can quickly reduce inflammation. Failing that, surgery may be required.

Damage Control

Early intervention means to never play through the pain. Immediate treatment is essential to prevent long-term injury. Pay attention to your pain, noting changes, and especially increasing pain.

When not playing, keep your wrist in a straight position, instead of bent or flexed. This will help alleviate the added stress placed on tendons during a performance. Be sure to stretch regularly.

For keyboard and organ players, bench distance plays a critical role in pain-free playing. Players who consistently sit too high or too low are at risk for pain and inflammatory conditions. Sitting too close to the piano is also a common mistake. Those with longer torsos can tower over the keys, stressing the tendons. A rule of thumb: the hand, wrist, and forearm should be in a straight line to minimize friction.

Warming up and Winding Down

Playing an instrument is a physical experience. Moving your joints through their full available range of motion stimulates blood flow, lubricates joints, and improves flexibility, strength, and body awareness.

Some people start with scales. For instance, pianists may start playing at one note to the beat and with raised fingers, which gently stretches the muscles. Gradually build up your speed until you feel comfortable. You don’t have to warm up with scales or arpeggios; choose any piece of music, but just start slower than normal.

If you have an audition, concert, or festival coming up, don’t rehearse all night. Spread out practice sessions. Take a break after about 45 minutes, whenever possible. Researchers say the instance of injury goes up dramatically after 45 minutes of continuous activity. Adequate rest reduces muscle tension as do proper posture and body mechanics. Professional musicians often take 20-minute breaks for every hour of playing. That gives the muscles a chance to recover and provides a mental reset.

Many musicians and music teachers adhere to the Alexander Technique. This method is taught at universities and conservatories throughout the world. In fact, at several music schools, it’s mandatory for introducing students to proper technique. By studying your physical moments when playing, you will see how they contribute to recurring difficulties, whether it’s a bad back, neck and shoulder pain, restricted breathing, or fatigue. Through the Alexander Technique, musicians learn to release undue tension in their bodies, generating performances that are more fluid and livelier.

Whether you’re playing a string bass or a piccolo, an Alexander lesson is an ideal opportunity to study how your body interacts with your chosen instrument. The process involves three corresponding skills: body awareness, the ability to undo excess tension, and the use of thought rather than muscular resolve to engender more efficient movement.

Remember, to avoid injuries and recover from minor pains: use proper posture and body mechanics, stretch often, build your muscle strength and endurance through exercise, ramp up your playing gradually, and take frequent breaks. Always consult a physician at the first sign of pain or injury.

For further information on the Alexander Technique, visit: alexandertechnique.com.

---