Injury prevention is something that is discussed often in the physical therapy world. Many physical therapists that work with athletes focus on this area, whether its running, or soccer, or golf, etc. Perhaps more uncommon is the idea of injury that can take place for musicians, specifically when playing a keyboard instrument such as the piano or organ. One might wonder how an injury might occur just sitting on a bench playing the piano, but in reality there are multiple ways that injury can occur while playing the piano or organ. Recently a close friend of the family who is a music teacher and who offers piano lessons brought this topic up and wrote her own blog post about this very topic. I will be the first to admit that I had never considered this in the past. Please be sure to read her post here, as I was featured as a guest on her blog. She asked some great questions about this topic and I was able to give some expert advice. In my post I would first like to highlight some of the possible injuries that can occur, as well as to provide a list of ten exercises that one could do for prevention. These would serve as a warm up prior to sitting at the bench in order to prevent injury through proper posture and adequate flexibility.
So, what injuries are possible while playing a keyboard instrument? First, the wrist/hand and forearms are a potential source of problems due to development of carpal tunnel syndrome (CTS), ligament sprains at the wrist/digits, and even neural tension at the wrist, elbow, or shoulder (or all three) due to poor posture. Posture is a crucial aspect of injury prevention. Ideally, one should be sitting upright with feet flat on the floor (unless using pedal with right foot or playing pedals on an organ), shoulders back, and head erect with eyes relaxed looking at the keys/sheet music. The hands and wrist should be relaxed, as if sitting on top of a bubble. If this is NOT done and the individual is slouched, multiple impairments can result. Namely: shortened and tight neck muscles (can result in tension headache and compression of cervical nerve roots), increased strain of upper back and shoulder muscles (results in poor shoulder stability and lack of support for the neck), increased stress on the discs and facet joints of the lumbar spine (ligament strain of the joints of the back and possible disc bulge or rupture), shortened and tight hip flexor muscles (also results in more stress on lumbar spinal segments), etc, etc. The take away here is that posture is HUGE for preventing injuries at the piano/organ.
What can be done about this, besides maintaining adequate posture? The exercises I am about to recommend will go a long way to facilitate good posture while playing, flexibility of the neck, upper limbs, and trunk, as well as to promote warming up the tissues prior to playing. Let's face it, playing a musical instrument can by physically challenging and can certainly be a form of exercising. For piano, the hands must be limber and agile to play each key and to reach octaves, etc. And if the song is a fast tempo and has a large range of notes, the entire upper limb system is getting a workout. My hands and arms are always fatigued after a long session at the piano. This is expected and perfectly natural. So, as before any workout, a warm up is essential. And no, I don't mean sitting at the piano and cracking your knuckles and your neck. Leave that for the cartoons. The last part of this post will be to highlight the exercises that will provide a well rounded warm up for injury prevention. There is a video linked to this post to see the exercises in action and then a written list below the video.
Recommended Exercise Routine
The following exercises are found in the video that you just saw above. If you are looking for an exercise ball and yoga mat like used in the video you can get them via the links in this post. * For the following exercises, I recommend 5-10 repetitions of each immediately prior to sitting down on the piano bench. *As an Amazon Associate I earn from qualifying purchases
1. Standing pectoralis doorway stretch - This will help to open up the chest, stretch the pectoralis muscles, and to encourage erect posture.
2. Standing pectoralis/biceps stretch - Again, this encourages opening up the chest and bringing the shoulders and arms back. Tightness in pectoralis major and minor can result in neural tension of the brachial plexus (this is the bundle of nerves that exit the neck, under the collar bone, and into the shoulder and arm).
3. Standing upper limb prayer stretch/neural glide - This exercise moves the entire upper limb through a range of motion that encourages lengthening the nerves of the upper body through all of the bends in the limb. This is not as specific, but is a great warm up exercise.
4. Median nerve glide - This is a specific stretch for the median nerve of the upper limb. This is the culprit in carpal tunnel syndrome as the median nerve is often compressed at the wrist.
5. Radial nerve glide - Another specific stretch for the radial nerve. This supplies the sensation for the back of your hands and is the motor nerve for the muscles that extend the fingers and wrist.
6. Ulnar nerve glide - A specific stretch for the ulnar nerve. This supplies the sensation for the half of the palm near the ring and pinky fingers. This nerve can be compressed at the elbow (where your funny bone is) as well as at the wrist (Guyon's tunnel). Guitarists may need to worry about this one more than the medial nerve, but both are important to stretch for the keyboardist.
7. Cervical/neck rotation, side bending, and flexion/extension - These are combined due to the fact that they are all the same area of the spine. These are great for general flexibility for the joints of the neck while turning the head right and left, bending to the side, and looking up/down. This is important for limbering up the joints of the neck as well as warming up the muscles that will be working to hold your head up while playing.
8. Standing trunk rotation - General flexibility exercise for the upper and lower back to loosen up the joints of the spine and warm up the muscles of the trunk
9. Back extension - General flexibility exercise for the lumbar spine to encourage good sitting posture and to move the spine in the opposite direction of slouching. This can alleviate soreness in the back as well.
10. Lower trunk rotation with legs on ball - Good general flexibility exercise for the lower back muscles and joints. This can be a great one for relieving stiffness and soreness in the lower back as well. If you are looking for an exercise ball you can purchase one here.*
*As an Amazon Associate I earn from qualifying purchases
Dr. Michael Hyland, PT, DPT, CEEAA has been a physical therapist since 2012. He is a Certified Exercise Expert for the Aging Adult and LSVT BIG certified. He owns Hyland Physical Therapy and Wellness in Broken Arrow, OK