Some pianists can play for many hours a day for years without injury, yet others who practise less may succumb to injury. It is not just the amount of practice which causes injury, it is the whole approach to piano playing which can pre-dispose some pianists to certain problems, alongside various physical, social and genetic factors. So it is worth taking some time to consider the possible triggers for injury and decide whether to start making changes now. Prevention is always better than cure.

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Social and environmental factors​

Possible reasons for the current increase in rate of injury amongst pianists may include:

• The general rise in overall standards of playing and the subsequent higher expectations placed on young musicians in terms of speed of learning, perfectionism, technical achievement and level of repertoire.

• Bigger concert halls and the emphasis on a louder sound.

• Increased use of typing, texting and other activities.

External pressures

​External pressures or unrealistic expectations from teachers, employers or parents may include:

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• An unrealistic work schedule, especially for accompanists and repetiteurs who are sightreading or learning a large repertoire quickly.

• Shortage of available practice time or space, resulting in rushed, overly tense practice

• Sudden increase in playing time, either after a holiday or in response to deadlines

• New repertoire with increased technical demands, particularly repetition at full stretch.

• Inappropriate repertoire for size of hand

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Physical predisposition

Physical predisposing factors which may make some pianists more susceptible to injury include:

• Pianists with small hands (and their teachers) need to consider repertoire carefully. Children, especially, should not be encouraged to play pieces with many wide stretches until their hand is sufficiently developed.

• Pianists with weakness or hypermobility may need a sensitive programme of strengthening exercises to ensure that the hand is strong enough to cope with more advanced repertoire.

• Growth spurt: during a growth spurt, bones tend to grow faster than the surrounding soft tissue, so muscles become relatively weaker and more predisposed to injury. This is particularly relevant to teenage girls.

• Tiredness, ill-health or other disability: pianists may need to take account of this when forming a practice schedule.

• Mental or emotional stress or anxiety may also lead to greater physical tension.

• Playing on a keyboard with a heavier action requires consistently higher levels of force.

Even if you do have a predisposition, a step-by-step approach to achieving a sound, healthy technique will help to guard against problems in the future.

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Piano technique 

​For pianists, the most common technical causes for injury are:

• Poor posture and lack of general fitness (see Yoga for Musicians DVD, Sitting Posture).

• Ill-advised practice regime, lack of warming up and insufficient breaks. Using excessive force during practice

• Bracing the wrist and elbow to produce forte.

• Co-contraction of muscles.

• Muscular imbalance and unnatural positions such as consistently high or low wrist or poor alignment.

• High, overly-curved finger action.

If you see yourself fitting into several of the above categories, or if you occasionally experience tension or fatigue, consider these as warning signs. It would be advisable to take some preventative measures now to guard against any problems in the future.

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General points to consider:​

• Assess your work-relaxation balance. Choose repertoire carefully and pace yourself.

• Reassess your practice methods.

• Improve your overall fitness and check out your general posture, perhaps by joining a class in yoga, Alexander technique, Tai Chi, or Feldenkrais. (See Penelope’s Yoga for Musicians DVD).

• Reassess your technique, looking out for tension, unnatural positions and excessive force (The Complete Pianist covers all aspects of healthy piano technique).

• Think carefully about other activities (typing, texting, carrying heavy music bags, or recreations such as sport or gardening) which may be putting additional strain on the hands.

​If you experience pain, stop immediately and contact a medical professional as well as an experienced teacher.