According to a study conducted by Ruixi Niu, at least 50% of musicians who seek medical help for their injuries each year are pianists. The reasons for their injury vary, but improper playing technique is the leading factor influencing the development of injury.
Musicians, pianists included, are akin to athletes. Both subject their bodies to a great deal of stress, however, you don’t see a musician wheeled off the stage through a stretcher. Like performance anxiety, talking about injuries is something musicians tend not to discuss, whether it’s for a specific reason or for simply not jinxing the whole thing. For some reason, admitting to an injury can be perceived as a sign of weakness. Since most musicians are self-employed or freelance, without the cushion of statutory sick pay or health insurance, admitting an injury may mean losing employment and thus means of livelihood.
Musicians may appear like they’re playing effortlessly and freely but what you don’t know is that this style of playing often puts additional strain on one’s body.
What Causes Piano Injuries
Most piano-related injuries are muscular injuries, which happen due to prolonged periods of practice without getting any rest and improper form, many times caused by inadequate piano benches. Just like when exercising, our bodies do not get enough oxygen, which causes lactic acid build-up and affects blood flow; the type of music played also impacts blood flow.
Imagine playing octaves or falling thirds in rapid succession. This requires not just your full focus but also require your body and reflexes to keep up. The more work your fingers have to do, the more oxygen it needs.
When a serious injury is about to occur, the pianist usually has 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 that you should watch out for:
- Pain in the hands, arms, neck, shoulders, and back.
- Numbness in fingers and/or hands from nerve entrapment.
- Stiffness and/or a loss of mobility in fingers, hands, or wrists.
- Feeling weak while doing daily living activities such as opening a bottle.
All these signs and symptoms often appear as a result of tendonitis, arthritis, carpal tunnel, and other types of inflammation.
There will be a point where performing daily activities may seem harder to accomplish than they normally would. Performing ordinary tasks such as lifting something or even those which require fine motor skills such as writing will feel much more challenging to do. This is because all of those muscles have become sensitive from overuse or even normal amounts of use with the wrong technique and posture.
Aside from the overuse of your muscles, poor posture is a common cause of piano injuries. Pianists are at risk of this because some don’t sit high enough at the piano. The wrong posture can cause the pianist to put too much strain on their back, forearms, and hands; hence the great importance of a good piano bench.
Common Physical Problems of Pianists
Tendonitis or Tendinopathy
Tendinopathy or tendonitis is a type of tendon disorder that results in pain, swelling, and impaired function. The pain gets worse with movement. It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbow, golfer’s elbow), wrist, hip, knee (jumper’s knee, popliteus tendinopathy), or ankle (Achilles tendinitis).
Consistent with any musculoskeletal injury, the cause for this injury is repetitive activities. Groups at risk include people who do manual labor, musicians, and athletes. Aside from repetitive activities, tendonitis may also result from infection, arthritis, gout, thyroid disease, and diabetes.
Tenosynovitis refers to the inflammation of the fluid-filled sheath (called the synovium) that surrounds a joint. If this is present, one can typically experience joint pain, swelling, and stiffness.
Tenosynovitis can be either infectious or noninfectious. Common clinical manifestations of noninfectious tenosynovitis include de Quervain tendinopathy and stenosing tenosynovitis (more commonly known as trigger finger).
Carpal Tunnel Syndrome
Carpal tunnel syndrome, commonly known as CTS, refers to the pressure on a nerve in the wrist causing tingling, numbness, and pain in the hand and fingers. It can be treated at home, but in some cases, it may require minor surgery. Recovery can take weeks or months depending on the extent of the injury.
Referred to as “the yips,” focal dystonia is a rare neurological disorder that involves involuntary spasms in small muscles in the body. It results from overuse or repetitive stress and affects musicians and golfers.
A more specific type of focal dystonia, the focal hand dystonia, affects the hand and often causes cramps, tremors, or involuntary movement during highly practiced or repetitive hand motions.
Writing or playing a musical instrument can cause this condition, leading some people to dub it “writer’s cramp” or “musician’s cramp.” Doctors might refer to it as task-specific dystonia.
John Hopkins Medicine defines Bursitis as the “inflammation of a bursa. A bursa is a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The major bursae (this is the plural of bursa) are located next to the tendons near the large joints, such as in the shoulders, elbows, hips, and knees.”
The most common causes of bursitis are injury or overuse. It may also result from infection or other health problems such as arthritis, gout, tendonitis, diabetes, and thyroid disease.
What Can You Do to Avoid These Physical Problems?
Since the most common reason why pianists experience the physical problems stated above is due to excessive use of their muscles, the most important remedy is to take frequent practice breaks.
Spend an hour practicing and take a 20-minute break in between. Use the break for stretching and massaging your fingers. This allows increased blood flow to the affected areas. You can also rotate the wrists and massage the forearms to get the same effect. 20 minutes is ideal as it gives you enough time to let your muscles relax and for you to mentally regroup as well.
Poor posture is a common reason for physical injuries, so it is imperative to sit in the correct position to avoid any injury. For example, sitting too low will put too much stress on the fingers and the wrists to make a decent sound out of the keys, simply because the arms rest below the keyboard.
The definite solution in this regard is having a properly-designed piano bench with adjustable height that the pianist can use comfortably at all times. The capability of adjusting a piano bench’s height with precision is our best friend when it comes to preventing injuries and keeping the artist healthy and productive.
Practicing the piano is hard. We’re bound to experience a little discomfort along the way, but being injured is another story. The goal of this piece is to increase awareness that practicing hard is alright, but it should not result in overworking your muscles.
Preventing Injuries is Our Goal
At this point, we’d also like to emphasize that aside from taking care of yourself physically, you should also invest an equal amount of time to protect your mental health. Keeping self-defeating thoughts at bay, recognizing our improvements and accomplishments, being willing to make mistakes a lot, and keeping a good sense of humor are all things that can help us stay on top of emotionally hard days.
Injuries can be great opportunities to know where we need to make changes. But again, you don’t have to experience an injury to learn a lesson. You just have to pay closer attention to what your body and mind are telling you, and you’ll be on your way.