Marina Petrov

Award-winning Pianist, Lecturer, Piano Tutor & Occupational Injury Specialist Managing Director of Around the Globe Music & Arts Executive Editor of Around the Globe Music Magazine

Award winning Pianist, Occupational Piano Injury Specialist, Lecturer & Piano Teacher / Managing Director of Around the Globe Music & Arts

Musician's health : Advice for pianists

Advice for pianists on healthy piano techniques

It is a well-known fact that pianists are more predisposed to occupational injuries than any other musicians. The most probable reason behind this is the nature of the instrument itself as well as its huge musical repertoire. In addition, both hands and fingers are equally under the constant pressure, prone to overuse. Professional pianists as well as students preparing for piano competitions or diploma exams often practise 6-8 hours a day or even more! Therefore, to prevent and avoid further injuries it is most essential to understand our body (anatomy), muscles and their function as well as the ability to spot physical traits that includes any restriction or hand's flexibility relating to the piano. It is also of importance to understand one's mind, the emotional charge and temperament as well as psychological traits (extroverts & introverts) that could influence the quality of performance.

One of the reasons in developing repetitive strain injuries is practising with bad habits that are difficult to break. However, it is not impossible. Even after a recovery from occupational injuries, a musician will most probably develop the same problems again if they continue to practise with unhealthy piano techniques. For this reason, it is necessary to try to correct your habits and improve your technique as soon as possible. Prospects of changing incorrect ways of playing depends on the person's abilities, determination, discipline, musical talent, power of concentration, deeper understanding of oneself and the body. It is crucial to be patient as it takes time to re-train the brain to learn different reflexes.

To implement healthy piano techniques it is fundamental to always pay attention to four main aspects: the body posture that relates to the instrument, the position of hands & arms and further problems followed by overuse and the release of tension in performance.

Body Posture

Many pianists suffer from chronic shoulder, lower back, and neck pain. To improve and prevent those injuries you should pay attention to your body posture while sitting at the piano:

  • Spine should be straight, holding it without much effort. It can help if one sits on the edge of the stool facing the piano. Such posture encourages the release of tension in shoulders that enable the arms to be used freely.
  • Neck should be straight and in line with the spine and head without moving forward.
  • Feet - for the body to have proper balance, it is also necessary to position the feet deep into the ground and next to the pedals. Your legs should be slightly apart and with no tension.
  • Seat Height - the position of the feet is vital for the spine to keep straight and its muscles not to overload with extra work or strain. Find a height (adjust the piano stool) that is more comfortable to position hands and arms above the piano as it is easier to play. This is going to depend on your own height and arms length.

Position of hands & arms

  • Hand Position is never static and steady on the piano. It depends on a task that you are doing including various techniques such as scales like passages, arpeggios, octaves, chords, etc. However, we should observe certain rules and understand how:
    1. Fingers work - they move faster and easier when hand is placed higher above the keyboard. Therefore, fingers should "land" on the key at the tip (the finger pad under your nail), apart from the thumb which should be almost in a vertical position. If you put your wrist too low, you will notice that the thumb is not able to move freely or fast enough. This can cause an extra pressure and the feeling of heaviness in your hand and wrist. Such piano playing may cause an injury if practising for long hours.
    2. Wrist work - wrist movement is at the core of healthy piano technique and it should be relaxed at all times. It is like a bridge between the fingers and the arm. It is often stiff when thumb is not being used correctly when playing fast chords or octaves. Pushing the key with the fingers also causes wrist tension.
  • Arm Position - if a pianist is constantly using the upper arm that supports the lower arm with a completely loose elbow whilst playing any texture or technique at all parts of the keyboard, then they are playing in the correct way. However, if the elbow is not completely relaxed, it does not allow proper function of the upper arm or wrist movement. Consequently, the chain arm-wrist-fingers will be broken and its function distorted. This could cause various piano-related injuries including tennis elbow or shoulder tensions.


The awareness of the modern style of living that can cause performers' injuries is also important. This includes the use of mobile phones (texting), computers (typing and using the mouse), games, and extra stress due to the fast pace of every day living (trying to achieve too many things in one day). All use of fingers is in addition to your hours of daily piano practise and this could cause overuse.

A piano player should be also aware of their natural ability as well as hand and arm strength. Pianists with smaller or less stretchy hands should carefully choose the concert programme, combining various piano techniques, styles and textures. If not carefully considered, it could cause harm through fingers overworking or hands overstretching.

Release of Tension

It is important for a musician to understand oneself and his temperament since psychological, mental or emotional tensions can be other factors for stiff and raised shoulders in pianists of all ages. Often the most talented piano students or even professionals are more vulnerable and emotionally tense than others. They are more prone to tense shoulders frequently, stiffen the elbows, make unnecessary movement with their hands (swinging with elbows, raising and lowering wrist while holding the same key, pushing the keys with the fingers and so on). All this may be counter-balanced through various meditation and breathing techniques as well as learning mentally how to control our emotions or fears.

Through my long performing and teaching career, I have found that it is crucial for any instrumentalist to see performing as a positive, fulfilling experience and be able to enjoy the thrill of their creativity. Therefore, it is important to raise the awareness of the problems facing a young performer as soon as possible whatever the age. It can only improve the mental and emotional state of the player. Prevention is always better than cure!

Recommended literature for further reading

  • Marina Petrov-Stoykovich, (2007). Prevention of Occupational Injuries, Piano Professional Magazine, EPTA UK, Issue 23, Summer 2010, 29-31.
  • Grindea, Carola, (2002). The role of the thumb in pianist suffering from Focal Dystonia, ISSTIP Journal, Issue No 74, 22-24.
  • Dr.Pronkova, E., Melnikova,T., Prof. Minsker, G. (1998). Prevention and Rehabilitation of Occupational Injuries in Musician, ISSTIP Journal, No 9, 11-12.
  • Long, Marguerite. (1957). Le Piano (Salabert Editions - 2002).

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