Musicians are at high risk for overuse injuries due to repetitive movements over prolonged periods of time. Other injuries can occur from poor posture while playing or poor biomechanics during equipment transfers. Almost all instruments require the use of hands. However, unlike large muscle groups, like the legs, buttocks, and the back, that can tolerate endurance activities, the hands and forearms are composed of small delicate muscles, joints, and ligaments that are very susceptible to overuse injuries. Almost all instruments are played in wrist-curled and elbow-bent positions. Prolonged time spent in this posture gives us tight muscles and stiff joints, making us susceptible to elbow, wrist, and finger pain, and numbness & tingling. These injuries can impact tone quality, performance efficiency, and longevity.
Perhaps you are suffering in silence, but you are not alone. Over the years of practices and performances I have had my share of aches and pains, and many other musicians are in pain as well. I started playing drums at a young age using chopsticks in the back of the family van. I played violin for 7 years, piano for 4 years, and was a 4-year percussionist and drumline member of the 35-time Bands of America national finalist, Marian Catholic HS Marching Band, with whom I performed in the Macy’s Day Parade and Rose Parade. I currently play drumset for campus ministries at Andrews University and around the Chicagoland area. I have incorporated what I have learned in Physical Therapy School to prevent discomfort caused by playing instruments. Here are possible reasons for your discomfort and a few tips and tricks for prevention.
1. Technique Technique Technique: Yes, that famous word is back! As you may have heard in your lessons growing up, and what you probably tell your students now, technique is crucial to achieve the best sound quality and performance efficiency. But what is the science behind it and why is there a direct correlation between the those factors? Grip strength. In the Physical Therapy world it is termed Active Insufficiency (decreased muscle tension as muscle length is insufficient). Basically, your wrists are not in the ideal position for maximum strength and speed, therefore diminishing the efficiency of your playing and the sound quality of your instrument. Try this: curl your wrist then try to ball your fist as tight as you can and note how tight you can flex. Now keep your wrist in a neutral position and ball your fist. In a neutral position you have much more force because the muscles that flex your fingers are at an optimal length to generate the most force. Whether you play percussion, a stringed instrument, or a horn/wind instrument. Keep this in mind to get maximum strength and speed out of your hands, and a flawless tone out of your instrument.
If your pain is severe DO NOT treat yourself. Potential further damage can occur. Yes, I know, music is your livelihood and it’s what you love to do but it’s better to back off for a few days or weeks than have permanent damage. For professional treatment contact a Physician or Licensed Physical Therapist. If you do not know one, contact me and I will help to put you in touch with both.
2. Get Up & Enjoy Your Music: During practice and appropriate performances, stand while playing. Standing not only takes pressure off your spine, but it also decreases sedentary time and allows you to move to your next best posture more easily than sitting does, plus you dance better standing up anyway. Most performances require sitting, but sitting almost always leads to slouching, and slouching compromises your playing. Posture affects everything; when you’re slouched, your head is forward which can compress the nerves in your cervical spine that control your upper extremities, thus affecting the quality of your playing due to pain or lack of motor control. The Fix,
sit your butt completely back in your chair to create a neutral pelvis and a balanced spine, which immediately fixes forward head posture. Sitting upright opens your posture to allow you to get more air in your horn and move faster around the drum kit, puts your arms in a better position around the neck of your stringed instruments, and permits you to move more efficiently up and down the keyboard.
Famous Singer, song-writer, and drummer Phil Collins suffered a spinal cord injury because of his bad posture. In an Interview with Rolling Stone Magazine he stated;
“My vertebrae has been crushing my spinal cord because of the position I drum in. It comes from years of playing. I can’t even hold the sticks properly without it being painful… The first time I picked up the drumsticks after my neck surgery, they flew across the room because I couldn’t grip them. When I play, I’ve had to tape the sticks to my hand… I’m having an operation soon and there’s a good chance of it improving over time.”
3. You’re an Athlete:Athletes take very good care of themselves and we should do the same. Just like athletes, most musicians play their entire lives, compete in competitions, are sponsored, and go on tour. We are highly-tuned professionals, therefore we should treat ourselves accordingly. Below are a few pre- and post-show tips to keep you playing at the highest level. For a more comprehensive pre-show warm up and pos-show treatment, contact me through my website or Facebook.
Pre-show: Dynamic warm ups are great. Save the long stretches for after the show. After these few exercises, proceed with your instrumental warm up.
Post-Show/Rest days: Take time to rest after the performance. While resting, elevate your hands and perform a forearm massage.
For further information and specific questions regarding musical injuries, rehab, and prevention, contact me on Facebook or through my Website . For further specific questions regarding piano and violin, contact my physical therapy colleagues: Philip Duarte BS Music Performance for String instruments, and Christina Goosey BA in Piano Performance for piano advice.
Thank You for Your Attention.
* To learn how Physical Therapy can serve you, see GetPT1st , Greg Todd , Renewal Rehab Paul Gough Physio Rooms, Functional Patterns , Aaron LeBauer , Kelly Starrett, The Movement Fix, Anatomy Trains, The Prehab Guys, Modern Manual Therapy, Dr. Ben Fung , Andrews University Doctor of Physical Therapy
Edited: Ffrancesca Famorcan
Lukomski, Lynette, “Common Injuries of Musicians” (2004). Honors Theses. Paper 1635.
Marxhausen, P. (n.d.). Musicians and Injuries. Retrieved August 31, 2016, from http://rsi.unl.edu/music.html
McGuire, P. A. (n.d.). Musicians and Injuries. Retrieved August 30, 2016, from http://rsi.unl.edu/music.html
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Featured image: Musician, Heal Thyself www.peabody.jhu.edu