pianomap : Pianist's Injuries: Movement Retraining is the Key to Recovery

By Thomas Carson Mark

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  1. Introduction
  2. Four Causes of Injury
  3. How Injury Develops
  4. Cure of Injury
  5. Why Many Pianists Do Not Recover
  6. Two Obstacles to Understanding
  7. Conclusion

1. Introduction

Repetitive stress injuries bring misery to many pianists. They are very common, and the pain they cause can be dreadful. The list of famous pianists with injuries is much longer than most people think--it includes Gary Graffman, Leon Fleisher, Wanda Landowska, Artur Schnabel, Alexander Scriabin, Ignaz Friedman, Sergei Rachmaninoff, Clara Schumann, Glenn Gould, Michel Beroff, Richard Goode and many others. In most cases the injury did not end the career, but it forced cancellations of concerts or tours, or restriction of repertoire. This is a tragic situation, since injuries are preventable and curable. Unfortunately, the literature I have seen on pianist's injuries does not clearly explain how injuries are caused, and some of the most commonly recommended "cures" are band-aids: they are good in themselves and helpful up to a point but they do not remove the cause of the injury. In this paper I shall briefly describe the causes of pianists' injuries and then indicate what has to happen to permit an injured pianist to recover. I believe that every pianist and teacher should have this information, since injuries can lead to permanent damage if left untreated.

Injuries are caused by stressful movement.

Our hands and arms can move in many ways, but some ways of moving put extra stress on the tendons and other soft tissues. If a person moves in a stressful way, and does this repeatedly over a long period of time, the vulnerable structures may be injured. In this paper, I shall use the terms "efficient movement" or "stress-free movement" to refer to ways of moving that can be used even in highly repetitive tasks without causing injury. Which ways of moving are "efficient" or "stress-free" in this sense is a matter of anatomical fact, not of conscious awareness. Conscious awareness tells us whether a particular movement hurts right now, but it does not tell us whether that same movement repeated millions of times over a period of years would lead to injury. Note also that the stressfulness of a movement is not just a matter of position or outward appearance. A movement can appear right without being right (because of underlying tensions that the eye cannot see); conversely (but less often) it can look wrong without being stressful.

>> 2. Four Causes of Injury
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