This week’s post will be most useful if you’ve read last week’s post first. Last week I wrote about the ways in which the holding and playing of an instrument affects the body of the musician, and about neutral posture (in contrast to the posture most of us have been taught is “correct”).

Now let’s talk about specific problems one might experience, and possible ways to address them. The descriptions below apply to discomfort we feel as a result of playing our instruments (not from previous injuries, too much typing at a computer, fibromyalgia, and so on  –  those need to be addressed separately). These descriptions are not a substitute for seeing a medical specialist in person for diagnosis and treatment, but they’re a start.

Sore Neck:

You may tilting your head, which is what most of us do to see what we’re playing. If we only did it for a few minutes at a time, it wouldn’t hurt us, but we musicians do it for hours. If the pain is annoying but not knife-like,  and  if  your  neck  is  stiff,  you  may  have  stressed a muscle. If it’s knife-like, you might have pinched a nerve. There’s a reason our eyes move in their sockets: so we don’t have to turn or tilt the head so much. Try looking with just the eyes and not the whole head. If you wear glasses and tend to see under the rims, get glasses with larger lenses (For concerts I wear large, rounded glasses that meet my cheeks – it’s the only way I can avoid seeing under the frames. Sure, it looks not so sexy, but at least I can play!) If you see through the wrong part of a bifocal or trifocal, get glasses specifically for playing your instrument. No kidding. It works. Just be sure that when you go to the optometrist to bring your instrument and demonstrate what it is you need to see, so he or she will know exactly what your needs are. Otherwise they can’t help you much and you’ll end up with the wrong prescription.

 Uncomfortable Feeling Between Shoulder Blades Along Both Sides of the Spine:

You may be looking forward and down habitually with the chin held low. This pulls muscles along the spine because the head is actually quite heavy (think bowling ball). Try this: hold the chin at a normal height and look down with just your eyes. If you wear glasses and this causes you to see underneath the frames, see the above paragraph.

Sore Shoulders: 

If the pain is located toward the back of the shoulder along the trapezius muscle (the large muscle that covers the area between the shoulder and the spine) and is accompanied by a little  stiffness, you may be raising  the shoulder habitually. Changing this habit can require close attention, because if you’ve been unaware of doing it, it probably feels normal. It helps if you have someone who can observe as you play and tell you when it’s happening, or if you sit in front of a mirror and check it out every few minutes.

Soreness Between or Under Shoulder Blades:

You may be holding your elbows up. Drop them to less than 45 degrees.

Soreness Toward Center of Back:

1. Are you rounding your back and slouching a bit? The fellow in the upper part of the illustration below is slouching. This strains the back muscles that support the spine. See last week’s blog on neutral posture, and adjust your instrument to that posture.
2. You may be swaying your back too much. The woman in the lower par tof the illustration below is swaying her back. Amazingly, most people do this, because we’ve been taught that it is “correct”. But it causes many problems. Relax the top of the pelvic bone backward to eliminate the exaggerated curve in the lower back. (How do you know if you’re doing this as described? One easy way is to notice whether you tend to breathe in or out when doing moving the pelvis. If you inhale, you’re swaying the back even more by rolling the pelvis forward. If you tend to exhale, you’re doing it right.) Sorry I could not provide a larger illustration here; wordpress doesn’t provide much choice in formatting.

Pain in Upper Forearm Near Elbow:

Your pinky may be sticking out stiffly as you play. Believe it or not, I’ve observed that the “tennis elbow” feeling many musicians get is actually alleviated when they learn to keep the pinkies relaxed.

Stiff Fingers:

1. This is usually caused by the mistaken idea that plucking strings, fretting, or closing holes in wind instruments requires strength. It does not. It only requires finesse, which you don’t have when your fingers are tense. Tension in the hands can often be remedied by consciously relaxing them, which may take a lot of concentration until a new habit is formed.

2. Some tension comes from how you hold and use your hands, either on purpose or without thinking. For hands that pluck: you may be stiffening the fingers before plucking, and/or plucking too hard; or you may be spreading (splaying) your fingers  –  in other words, stretching them apart from each other (you can see the webbing between them as you pluck). Fingers that pluck don’t have to avoid each other; they can brush past each other as they move. Dexterity is lost when fingers are splayed.

3. For hands that fret an instrument: of course you have to reach to place chords and such, but in some cases if you turn the palm of the hand to face toward your body you will find that your fingers actually reach farther with less stress.

4. You may be resting your forearm on the edge of the soundbox of your instrument. To show yourself what this can do to your tendons, take an elastic band, stretch it, then bend it around the edge of your instrument and pull it back and forth in a sawing motion. The tendons inside your arm are like that elastic band. When the tendons of the forearm are compromised this way, it can affect your dexterity, because those tendons are connected to your fingers.

This is a rough drawing of the tendons of the fingers, and the muscles they attach to in the forearm.

 5. Sometimes hand tension comes from feeling nervous; that’s a whole other ballgame. Sometime in the future I’ll blog about stage fright. (Some folks even get stage fright in front of their teachers or friends. It’s still stage fright.)

Pain in Wrists:

This is often caused by bending the wrists and trying to play at the same time. Avoid playing with your wrists bent as in the illustration below, because the carpal bones are crowded in that position, and the tendons cannot work properly when they are also holding the hand in that position, which is one of the prime causes of carpal tunnel syndrome.

Any repetitive thing you do with your wrist bent in this direction isn’t a good idea.

Pain in Palm of Hand Near Thumb:

1. You may be reaching forward with your thumb as you pluck, as though you were trying to make it longer. The thumb is fine at the length it is! Relax it. For fretted instrument pluckers, one way to better reach with the thumb is to bring the hand around so it looks like you could hold a tennis ball; this puts all the fingers and thumb in easy reach of the strings. For harpists, be sure there’s a large open space between the thumb and the rest of the hand when you pluck, which allows you to pull the string away from you rather than pushing it away from you (and be sure to close the thumb after each pluck); see the Harper’s Handbook for detail.

2. For those who hold a flat pick, you may be grasping the pick too hard. Holding onto a pick can be tricky, but grasping too hard doesn’t help and makes it hard to play. Many try to hold the pick between the thumb and the index fingertip. It’s much easier and less stressful to hold it between the thumb and the first joint of the index finger. There’s more contact area that way, allowing the pick more flexibility. There are picks that have texture on the part you hold, which helps keep them secure, especially if your hands sweat. You ca also experiment with how thick and how stiff the pick material is; there are many choices.

Pain in Center of Palm of Hand:

This is often accom­panied by stiffness of the fingers. It’s often caused by bending from the second finger knuckle to pluck, whereas you’d be better off plucking from the joint where the finger meets the hand. Plucking with the whole finger is far less stressful and produces better tone.

Pain in the Back of the Hand:

1. This may be from lift­ing the finger away from the string when plucking. When the second finger knuckle is lifted higher than the knuckle where the finger is joined to the hand, the tendons are stressed.

Many musicians who played piano first are prone to doing this, because they were taught to lift fingers away fro the keys. (There are two vastly different piano techniques; one requires lifting the fingers while the other requires pulling them inward toward the palm. IMHO, the latter is better physiologically.) Plucking strings properly can require forming new habits of finger movement.

2. Splaying the fingers can also be a cause (see paragraph on stiff fingers).

3. Harpists: the strings of the harp should vibrate toward and away from you when plucked, not side to side. Therefore, don’t pull outward when you pluck. Pull toward your body with the fingers and away from your body with your thumb.  There is a detailed and illustrated discussion of this in The Harper’s Manual.

Fatigued or Weak Arms:

This may be due to habitually holding the hands above heart level, and it’s common for fiddlers and flute players  –  see the discussion on ergonomics in last week’s post. Or a raised elbow can be to blame –  just keep it lower.

Pain in Hips or Upper Legs:

1. This is often the result of leaning to one side when sitting down.

2. You may be sitting with the knees higher than the hips, which puts too much pressure on the hips and can strain lower back mus­cles, too. Try this: sit with equal pressure on both glutei maximi, and make sure your chair is high enough so that your knees are a bit lower than your hips. 

Pain in Lower Back:

1. Possibly you are rolling the top of the pelvis too far back or forcing it too far forward. In the first case your lower spine will be convex, and in the second, concave. Either way, this can strain lower back muscles. If you’re swaying your back, relax. If you’re slouching, sit up! (See posture illustrations above.)

2. Or you may be leaning backward. This is very common; ask someone to observe you and see if this is the case. People often lean slightly backward, thinking they are upright, especially if the instrument is large and/or leaned on the shoulder.

Dizziness, Faintness:

1. There can be many causes, but if this problem developed as a result of playing your instrument, there is a chance you have misaligned a cervical (neck) vertebra. A chiropractor can diagnose this problem and treat it. Realigning the vertebrae can bring immediate relief. (If it doesn’t, see a medical doctor in case you have an unrelated medical condition.)

2. Another possible cause is strained neck muscles, which can affect the structures of the inner ear that are responsible for equilibrium. You may be simply tilting the chin too high or bending the neck back too much, especially if you tend to lean forward a lot; this compromises the first cervical vertebra. Sometimes just straightening the neck can help. Of course a skilled, certified massage therapist can help a great deal.

Back or Neck Pain Not Relieved By Any of the Above:

You may have misaligned a vertebra in your back or neck by using poor posture, by carrying a heavy things, or from an unrelated injury. A chiropractor and physical therapist may help.

NEXT WEEK: Simple Exercises for Injury Prevention, and Treatments

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