Of the many musicians I know, most have experienced bouts of repetitive strain issues and/or pains from posture related issues. This article outlines some of the basic challenges facing musicians and begins the discussion of how to approach a solution.

Music Students

Music students go through a period of learning in several areas. They learn fingering and instrumental technique, they learn how to read music, and they learn basic postures that will establish their physical approach to playing for years to come. The postures required to play have the potential for basic ergonomic problems and often increase potential for repetitive strain injury. Fortunately, these risks can be minimize through application of specific stretch, postural and technique modifications that are learnable.

Professionals and Enthusiasts

Musicians have particular problems when repetitive strain becomes a problem. The basic postures required to play will frequently place the limbs in positions that are not optimum. This makes recovery more difficult.

Holding an instrument in playing position can be problematic. Professional musicians not only hold these postures while on stage performing, but through extended periods off stage — often 8 hours or more of daily practice.

Consider the violinist, who while playing continually must keep the chin rotated toward the left shoulder and exert a downward pressure to support the violin on the shoulder. Unless he or she is careful, this can be combined with a left shoulder elevation and or protraction (forward tilt) to keep the instrument more securely locked in place. Other stringed instruments have their own postural challenges, from balancing weight to extended reaching.

Brass and reed instruments are usually held balanced and central to the body. For the smaller instruments, shoulder internal rotation and protraction are the major issues (rounded shoulders and chest compression), along with facial stress (that can result in temporomandibular displacement problems). As the instruments get larger, weight and potential asymetry become more of an issue.

The larger instruments are geneally held wih assistance from a neck strap. This adds a forward neck position as a potential issue.

The flute and piccolo present a different postural issue. Left shoulder flexion (movement forward from midline) varies depending on body shape, but can be to 45° or more. At the same time, the left shoulder is internally rotated and adducted across the trunk so the hand can reach the instrument extending to the right from the mouth. The right shoulder maintains a substantially opposite posture. The shoulder is externally rotated, and abducted (held to the side, away from the body) to approximately 45°. Shoulder position alone creates massive asymmetry and frequently spinal twisting.

Symphony percussionists may have the best potential for avoiding postural issues. They generally use a variety of instruments giving them a good change of posture now and them. Most of the mid to heavier instruments are placed on stands so there is no need to support weight. They can sit or stand and even move around at will. There are other issues that affect them however, including rapid repeated motion, vibration, and force – not to mention the need to transport their instruments which can include a lot of heavy lifting.

The Principle of Stretching Opposite to a Sustained Work Position

Each of these positions, when they are repeated and held for a sufficiently long time, may cause problems in muscle imbalance and impair range of motion. Slow, smooth stretches moving into the opposite position for each limb will help.

Do not stretch into pain, but only to the point where you feel the stretch. Hold each stretch about 20 seconds. About every 5 seconds, try to take the stretch a little further, but again do not move into pain. Come out of the stretch slowly.

Actual changes to work technique may require specific coaching. Some basic principles and an introduction to a resource for more help will be presented in the next article.

None of the suggestions in this article should be taken as medical advice. There are many more potential injuries that are related to playing an instrument many of which require medical diagnosis and treatment.. It is very important to consult a doctor if you are experiencing aches and pains or if you feel you're in danger of serious injury.

Virginia Hixson is a Certified Professional Ergonomist and Project Management Professional working in the San Franciso Bay Area.

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