Musician Rehab

5 Essential Principles To Stop Pianist Injuries !

Are you having pain when playing piano? 

Piano is no doubt one of the most popular string instrument around the world. According to the Wisconsin Music Teachers Association Newsletter from May 2000, an estimated 20 million Americans play the piano!

However, almost every pianist suffered playing-related musculoskeletal disorders (PRMDs) (also called repetitive strain injuries, RSI) in their career.

Overall, common Pianist Injuries are carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, wrist tendonitis and focal hand dystonia.

No matter which piano method your instructor teaches, there are 5 critical principles you should know to avoid these injuries and continue playing forever!


⭐ Principle I: Posture is a Everything

* Keep your fingers curved and relaxed (rounded hand).

* Never sit on the whole piano bench – sit half of the bench.

* Relax your neck and shoulder, also engage your core muscles to maintain your back straight.

* Stop dangling your feet – Make sure your feet is resting on the ground. (Use a foot stool for kids)

* Maintain your elbow in 75 to 90 degree bending, and slightly higher than the keyboard.

* Keep your wrist aligned with small finger and elbow (moving your arm as a whole unit, not deviating the wrist)


⭐ Principle II: Warm Up is a Must

* We are very honored to invite Dr. Yelena Balabanova to demonstrate her warm up exercises for pianists!

(Dr. Balabanova has performed as a soloist, accompanist, and chamber musician in numerous festivals and concerts, including Steinway Hall, Benaroya Hall, a four-year tenure at Colorado Music Fest, and tours across the United States, Canada, Europe, and her native Russia.)

1. Lift your arm and let your wrist naturally dropped, and finger extended.

2. Naturally curve your fingers when wrist is back to neutral (wrist tenodesis).

3. Repeat this motion for each hand 10 times.

4. Then repeat the same motion for each finger 10 times.


⭐ Principle III: Take Frequent Breaks

Numerous researches indicated that prolonged sitting is killing your health. To prevent Pianist Injuries, it is critical to take frequent breaks even when you feel pretty good. I recommend resting for 15 minutes for every hour of piano playing.

Just remember,

It is usually too late to take a break if you already feel the pain… 

⭐ Principle IV: Stretch After Playing

Make sure to stretch for at least 15 seconds for each exercise!

1. Forearm Stretching 

2. Neck Stretching

3. Chest Stretching

* For more stretching exercises, please refer to Six Must-Do Office Stretching Exercises


⭐ Principle V: Respect Your Soreness and Pain

Pain Phases (adapted from Virginia Sports Medicine Institute ) is an important concept to understand and evaluate the level of discomfort when playing piano.

pianist injuries

* You should take a break immediately if you are experiencing pain in phase 3, to prevent further traumatizing your stressed upper extremity.

* Please seek for medical care ASAP if you are having phase 4 or 5 pain when playing piano!

* Overall, pianists should try to stay away from pain phases 3 to 5. It is not beneficial to work through this type of pain.


⭐ Conclusion

Like other musicians, pianists face many challenges throughout their careers, dealing with an injury should NOT be one of them.

To stop pianist injuries, make sure you always maintain an optimal posture, warm up before your practice, take frequent breaks, stretch after playing and respect your pain and soreness !!


Special thanks to Dr. Yelena Balabanova, who generously shared her warm up exercises and posture tip in piano playing. I won’t be able to write this article without her wonderful consultation. To learn more about her amazing piano career and workshops, please visit International Conservatory Studio




Andrew Tan, OTR/L, CHT, CKTP, CEAS
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Andrew Tan, OTR/L, CHT, CKTP, CEAS

The founder of "Rehab For A Better Life", specialized in ergonomic consultation, rehabilitation for upper extremity injuries, sports injuries and work-related injuries. Andrew believes rehab-related knowledge should be easy to learn and follow at home, because "knowledge is power only when we can share it" !