Orthopaedic Hand Specialist Offers Tips to Musicians on Injury Prevention this Season
Music brings great joy to the world. But not without musicians paying a heavy price in occurrences of pain throughout their careers. Playing an instrument is physically demanding and practice and performing often require many hours a day in stressful positions that can cause pain, numbness, weakness, or lack of control in the wrist, hand, fingers, arm, elbow, shoulder, and neck. “Overuse injuries to the hand are a serious threat to all musicians, whether or not they play professionally,” says Dr. Yariv Maghen of Somers Orthopaedic Surgery & Sports Medicine Group. “The hand is a very complex organ, with multiple bones, joints, ligaments, tendons and nerves. Repetition, fatigue, friction, vibration and awkward, static positions are all contributing factors to hand injuries in musicians.”
The most common repetitive strain injuries among musicians are tendinitis and carpal tunnel syndrome. Tendinitis, the swelling or inflammation of a tendon, usually affects the wrist in musicians. Overwork under conditions of high muscle stress leads to tearing and abrasions of the tendon and pain usually made worse by repetitive motion.
Carpal tunnel syndrome is caused by compression of the median nerve that passes through the carpal tunnel in the wrist. It stems from excessively subjecting the finger and wrist flexor muscles to repetitive and/or static flexion. If the flexor tendons become inflamed, the swelling presses on the nerve causing progressive symptoms of numbness and tingling in the hand or fingers, pain, reduced dexterity and reduced grip strength.
Dr. Maghen says: “There are many more potential hand injuries that are related to playing an instrument, most of them caused by overuse, repetitive strain, poor posture and incorrect positioning of the hands, fingers and arms. Most can be treated effectively with rest and by correcting posture and positioning, especially if addressed at the first onset of symptoms. But if allowed to progress, these injuries can be physically, psychologically and even financially devastating to musicians. So preventing injury in the first place should be foremost in every musician’s mind.”
Dr. Maghen’s tips for injury prevention apply to all musicians – professional and amateur, serious and casual, beginner and expert. They fall into two broad categories: positioning and conditioning.
It is critical that every musician start by learning proper body position and posture. It’s easier to develop good habits than to break bad ones. As a musician grows and the technical difficulty of the music increases, good technique and training are the foundation for continued ability to perform without injury. Poor training can put the musician at risk when difficult or advanced passages require perfect technique. Those who play a musical instrument as a hobby are not subject to the same pressures as professionals but still run the risk of getting hurt. When playing for pleasure and no longer taking lessons, it’s easy to forget basic principles of posture, hand position, and technique. It’s a good idea for the casual player to have a professional instructor observe their playing and correct any technique problems that might lead to future injuries.
Work settings should be designed to allow the musician to easily see the music as well as the conductor. Awkward positions, improper seating, poor lighting, and cramped performance spaces can cause a musician to play the instrument in an unnatural way and risk fatigue and injury.
A musician should prepare for practice and performance the same way as an athlete preparing for a workout or event. Before a practice session or performance, warm up with gentle stretches of the hands, arms and shoulders. This should be followed by playing simple passages of music slowly such as scales and arpeggios. Away from the instrument, a healthy lifestyle, taking into account rest, diet, exercise and overall fitness, keeps the musician in peak condition.
Demanding pieces should be practiced in chunks, taking small sections of the piece at a time, and then gradually working up to playing the piece in its entirety. Stop playing at the first sign of pain or discomfort and don’t try to work through it. Taking frequent breaks and stretching can relieve the repetitive cycle of playing and allow muscles and tendons to rest and recover.
Dr. Maghen concludes that it is mostly professional and serious musicians that are at risk for injury, primarily because of the amount of time they practice and play. But he adds that it is important that all musicians listen not only to the music but to their own bodies. Proper attention to positioning and conditioning will increase the opportunity for musicians to play and focus on making beautiful music without pain or discomfort.
Reprinted with permission of Yariv Maghen, M.D. of the Somers Orthopaedic Surgery and Sports Medicine Group, PLLC
Somers Orthopaedic Surgery & Sports Medicine Group, PLLC founded in 1988, is one of the most comprehensive and specialized practices in the region.
Yariv Maghen, M.D., a general orthopedic surgeon with Somers Orthopaedic Surgery & Sports Medicine and is fellowship trained in treating hand and upper extremity injury.