Owen Piano Studio, Inc.
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Rosann Owen |
Article:
Recognize, Treat, & Prevent Hand Injuries
It is essential that music instructors teach playing-related injury prevention techniques. Unfortunately, less than 50 percent of teachers have ever received education in prevention strategies. “Playing too much, too intensely, over the weeks, months and years of a career can do cumulative damage. Repetitive action, especially when combined with poor posture, excessive force and stress, brings about overuse injuries” (Horvath123-124). Much research has been found on this subject. It is important that we educate ourselves before the damage is done. We need to know what causes injuries, what injuries are most common, how to prevent injuries from happening, what to do when injuries occur, and our role as teachers if an injury should occur to our students.
Cause of Injuries:
There are a number of different reasons for an injury to occur; such as playing the piano with faulty technique, poor environment, substandard quality or instrument, stress, and overuse (Rosen 156). Injury can be caused by weakness or tightness of the shoulders. Fatigue contributes to overloading in a different but in an equal way by lowering the threshold of use, resulting in the development of symptoms or injuries at lesser loads than those that would otherwise cause problems. It is important that musicians get the adequate amount of sleep and nutrition.
Common Injuries:
Many musicians besides just pianists have been known to suffer from carpal tunnel syndrome. Carpal tunnel is a narrow tunnel at the wrist. Nine tendons and their membranes have to pass through this tunnel. A highly proficient typist can type 60 words a minute. Typing 60 words a minute (with tendons sliding thousands of times per hour) translates roughly to five letters per second, fifteen letters per three seconds. Frank Wilson, admired neurologist and author of Tone Deaf and All Thumbs and The Hand, in a 1994 lecture at an American Symphony Orchestra League conference, calculated that musicians are able to execute 38 notes in three seconds. That’s more than twice as much” (Horvath 31)!
Myofascial pain syndrome (myo-which refers to muscle and fascia-which refers to the linings of muscles) occurs when injury, overload, or fatigue cause pain in the muscles and their fascial linings. The pain then causes the nervous system to reset the tone of the involved area of the body. Fibromyalgia is a widespread disease of muscle. This disease is different from myofascial in the fact that the muscle pain in this disease is due to physiological events that are occurring in the brain and spinal cord, and not in the actual muscle itself (Rosen 168-169).
Raynaud’s disease is a vascular problem involving nerves and circulation. I have been diagnosed with Raynaud’s. The blood vessels constrict and cause cold, white fingers, accompanied by tingling and numbness. Exposure to cold may trigger the condition. Raynaud’s episodes last an average of fifteen minutes and normally occur sporadically. Luckily they do not cause permanent damage. Above all, reduce stress and be sure to warm up and exercise, all of which will help increase blood flow. Episodes may occur before an audition or performance for which you are nervous, because your circulation is affected by shallow breathing. Keep your fingers wiggling and keep moving by walking, stretching, reaching above your head and swinging your arms. Breathe deeply (Horvath 103-104).
Arthritis may be the result of simple daily wear and tear on the joints. Previous injury due to overuse can lead to arthritis. Joint pain has many causes, although the most common cause of joint aches is inflammation of ligaments, tendons or bursae due to tendonitis or bursitis. Arthritis is not an “old people’s” disease. It has been found in children. Pianist should be aware of osteoarthritis because it is known as the wear-and-tear arthritis. Osteoarthritis can occur with age, as well as with prolonged wear and tear on joints, by repeated injury. That is way it is important to seek immediate help when you are in pain (Horvath 114).
Preventing Injuries:
To prevent injuries the pianist must be very observant of their own practice. They must check that the height of the bench is appropriate for their own body size. They need to make sure that they are sitting at a comfortable distance from the piano. The pianist must have proper posture at the piano. Posture influences playing technique and if the pianist has unhealthy posture this can lead to back problems later in life. Yoga and tai chi exercises are important to practice because they reinforce good alignment. The body must be flexible. Beginning with the consideration of all the fingers, hands, forearms, arms, shoulders, neck, spine, rib cage, and finally the diaphragm; all these areas need to be assess for their flexibility and free range of motion. If any of these areas are tense then this is where the pianist should begin to exercise and use customized exercises to relax these tense areas. The pianist should practice the myofascial release technique where after playing each note on the piano they complete release the tension (Elkiss 179).
In order to play healthier and play better, you must properly warm-up, which means you need to actively move your body. When areas of the body are properly warmed up, they are less susceptible to being injured (Horvath 134). Arm and shoulder stretches are the most crucial exercises for pianist to focus on. Once the pianist has warmed up their body, away from the instrument, then it is time for them to warm-up at the piano. How you start playing is more important than what you play. Avoid strenuous technical exercises or phrases when you first begin. Stretching or working a muscle too quickly can cause a muscle to contract (Horvath 222). Start your practicing by moving gently and gradually increase in intensity (Horvath 223).
Although wind and brass players use their breath, we other instrumentalists ignore the importance of breathing. In fact, we may even hold our breath. It is advisable to learn and practice breathing technique daily. Breathing keeps muscles replenished with oxygen and it can aid in relaxation. We can use our breathing to feel in control of our bodies and the situation. That is why it is important to breath during a performance. It enhances our concentration and focus (Horvath 223).
Dealing with Injuries:
It is the pianists’ responsibility should an injury occur, that they seek immediate help and not ignore the pain. It is important to not only talk to your piano teacher about the pain but to many different doctors. By communicating to a number of doctors about the pain, you have greater odds that a doctor will diagnose the correct hand injury. It is important to be specific in your details of the pain. This will help the teacher and doctors narrow down the possibilities of the type of hand injury.
Besides seeking help with the pain, pianist can be doing things to relieve the pain on their own. Stretching should be done throughout the course of the day, with specific target muscles being the low back, the neck, and the shoulders. Because the pianist spends so much time sitting, a key exercise involves stretching the back backwards (extension exercises), although rolling the trunk into a ball while lying on the floor with the knees pulled to the chest is a good way to stretch the back as well (Rosen 174).
The primary medications that the pianist should be aware of are subdivided into two categories: those that treat both the pain the inflammation, and those that simply treat pain. The former group includes aspirin, the entire class of medications called the non-steroidal anti-inflammatory drugs, and the steroids. The latter group includes virtually all the preceding medications but also includes other medications such as Tylenol, and the various codeine-containing compounds (Rosen 175).
Preventing Injuries in Our Own Students:
It is essential that music instructors teach playing-related injury prevention techniques. They need to teach their students to take breaks during their practice and to increase their practice load gradually. “Overall physical conditioning is of the utmost importance to prevent injury. Teachers and parents should encourage some type of low-impact, low-resistance flexibility and endurance-promoting aerobic exercise” (Horvath 124). Each person is unique, and tolerance levels vary with every individual. Some students are more susceptible to injury. It is essential that both the teacher and parent are aware of the possibility of injury should practicing go unmonitored (Horvath 125). Teachers should openly let their students understand that if they feel pain they need to immediately report this pain. The teacher then must discover what caused this pain. They need to discover if the pain is due to piano practicing or other non-piano activities. If the pain is coming from practicing the piano they need to ask the student if they start to feel the pain during a certain passage in their music. The need to know how soon does the pain begin after they start practicing and if it goes away after they stop practicing. Since the teacher isn’t a doctor they should always insist that the student seek professional medical intervention as soon as possible (Berenson 186).
In conclusion we need to respect our bodies. If we don’t take the steps now to prevent the injuries or heed to the pain we will create even more discomfort and more serious problems. To be fully educated we need to know what causes injuries, what injuries are most common, how to prevent injuries from happening, what to do when injuries occur, and our role of the teacher if an injury should occur to our students. Playing music can be a life long hobby if we take the necessary steps today to ensure that we will be able to keep that hobby for a lifetime.