Hand Therapy Musician Overuse

Advice from a Certified Hand Therapist: Injury Prevention for Musicians

In a previous blog post we discussed some of the common injuries that can occur in musicians due to the repetitive and sustained nature of playing an instrument.  These can include pain and cramping of the neck and shoulder. Numbness, tingling, heaviness, tremors and pain can occur in the wrist and hand, and fingers can become “stuck” in a bent position.

While a musician may seek treatment when these injuries occur, we as clinicians would prefer to help musicians learn to prevent these injuries in the first place. This can help prevent loss of playing time, income, and the ability to participate in their passion. Fortunately, there are techniques that can be learned in order to keep a musicians body “in tune” – learning body awareness, healthy practice and play, and maintaining general health and wellness.

Body Awareness

The author Marion Woodman wrote, “Many people can listen to their cat more intelligently than they can listen to their own despised body. Because they attend to their pet in a cherishing way, it returns their love. Their body, however, may have to let out an earth-shattering scream in order to be heard at all.” This quote explains the concept of body awareness. A musician can put their instrument in the place of “cat.” A musician knows their instrument. They take care of it. They do not leave it in the heat, or the rain, or any other situation where it might be damaged. A musician needs to see their body in the same light – that if it is cared for, it will respond in kind. Unfortunately, usually by the time a musician seeks treatment they have already experienced that earth-shattering scream. Simple but consistent prevention techniques are important to avoid reaching that point.

“Instrument” Care and Maintenance

Overall attention to health can help to decrease a musician’s risk for injury. Good nutrition is important, avoiding foods known to cause inflammatory effects in the body. Caffeine and nicotine have physiological effects on the health of our tendons, nerves, and soft tissues, making them more prone to conditions such as carpal tunnel syndrome or cubital tunnel syndrome, tendonitis, or thoracic outlet syndrome. Getting the proper amount of sleep is also important to allow the body to rest and repair itself. Learning to effectively manage stress and anxiety can prevent conditions related to increased blood pressure, heart rate, and tension in the neck, shoulders, and back. A musician also needs to be aware of the influence of their other daily activities on their body, such as positioning during computer or device use, work activities, and repetitive tasks.

Healthy Practice and Play

Playing “smart” is not a new concept. Sassily Safonoff, one founder of the Russian Piano School in the 1880’s, is known in the literature for his focus on technique. While the literature speaks more to his focus on achieving a sound, his teachings were often ergonomically sound. He was diligent about seating positions and posture, and he taught smooth, synchronous arm and hand motions that focused on rhythm and not overusing any one part of the arm.

Musicians today have many resources to help them achieve the same. Maintaining flexibility, strengthening, and endurance can be achieved by working with a hand therapist or trainer to develop a specialized home exercise program. A certified hand therapist has specialized training in the prevention, recognition, and treatment of hand and upper extremity problems. They can help analyze playing habits and look for areas that could potentially cause problems in the future, and then develop a personalized prevention program that fits your needs. Other methods of body work can also be helpful, such as the Alexander Technique, yoga, and Feldenkrais. In addition, learning mindfulness and flow, proper breathing techniques, and imagery of play can be learned with a therapist, a coach, or even an app on a phone or tablet. And of course, a warm-up before play is always critical to preparing the body for a session of practice or a performance. Other resources for musicians’ health also can be found in organizations such as the Performing Arts Medicine Association and the British Association for Performing Arts Medicine.

If a musician does develop a play-related injury, a hand surgeon can be consulted in order to advise you of the best treatment. Depending on the injury, your surgeon may refer you to a hand therapist for treatment that might include an orthosis to resting painful structures. The hand therapist can also help manage any symptoms, such as pain, stiffness, swelling, abnormal sensation, and loss of function.

For more information about hand therapists and how they can help you with these and other types of conditions, please visit: https://www.asht.org/patients

If you would like to find a hand therapist in your area, please visit: https://www.asht.org/find-a-therapist


Kimberly Masker, OTD, OTR/L, CHT, is a Certified Hand Therapist, and is a member of the American Society of Hand Therapists and an affiliate member of the American Society for Surgery of the Hand.

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