No Pain, No Gain?

How many times have you heard this phrase? A fair few, I would imagine. It may be true for some activities, perhaps those where grit and determination are necessary in order to achieve the desired outcome. But this phrase certainly does not apply to the activity of playing the piano. Yet, increasingly, pianists suffer from a plethora of injuries, and whether a piano student, adult amateur or a professional pianist, these injuries can appear at any time causing much pain, distress, and in the case of a professional pianist, loss of work and income, too.

If you are in pain when you play the piano then there is generally something wrong. It may be that you are suffering from tension, physical strain, or possibly even mental stress. Tension can be a real killer for pianists. Mental tension and anxiety are certainly serious issues too, but are probably best dealt with by those trained to tackle these issues (such as a psychologist). However, much tension in piano playing comes from the challenge of circumnavigating the instrument. What may begin as a small, albeit irritating, ache or pain, can suddenly morph into something considerably more serious such as tendonitis.

Once pain is ongoing and clearly caused by movement around the keyboard, the pianist is sadly on the way to developing a host of problematic ‘injuries’ such as tendonitis, repetitive strain injury or focal dystonia (see the interesting link below, where you can read an article written for this blog by Austrian pianist Andreas Eggerstbegger, about his journey with focal dystonia).

My understanding of complaints such as tendonitis, repetitive strain injury and focal dystonia is limited as I am not a medical professional, but they all seem to point to various levels of inflammation and pain in the body, and frequently in the shoulders, arms, wrists or hands.

 ‘Tendonitis is when a tendon swells up and becomes painful after a tendon injury.’

UK National Health Service (NHS) website

Many pianists suffer for years, visiting various doctors, physiotherapists and acupuncturists, hoping for a miracle cure. Meanwhile, they cancel concerts and performances, and in many cases, give up playing altogether. Renowned pianists are also amongst the legions who have endured some form of physical pain, including Wanda Landowska, Artur Schnabel, Alexander Scriabin, Ignaz Friedman, Sergei Rachmaninoff, Clara Schumann, Glenn Gould, Gary Graffman, Leon Fleisher, Michel Beroff, Richard Goode, and more recently, the Chinese pianist, Lang Lang.

‘Repetitive strain injury (RSI) is a general term used to describe the pain felt in muscles, nerves, and tendons caused by repetitive movement and overuse.’

UK National Health Service (NHS) website

The physiology of the hand is different for every human being, which makes deciphering the actual cause of any discomfort, quite a challenge. Men, for example, generally have larger hands than women, which makes some types of movement easier for them such as big stretches, as when playing octaves and chords, but they still have plenty of pain issues, as the list of luminaires above illustrates. It also makes deciding how to tackle and ‘cure’ such problems difficult for teachers – that’s if it’s possible to rid the pianist of pain at all. And it’s simply not true to say that we play the piano only with our hands and fingers – in order to develop a secure piano technique, the whole upper body should ideally be involved.

There are plenty of expert teachers who specialize in this subject, and they all approach it differently. The first step for the pianist in pain must be to seek a teacher who really knows what they are doing, and who is experienced in dealing with and alleviating tension.

For the past ten years I’ve worked with students who have suffered various prolonged tension issues. I would go as far as to say that seventy percent of my teaching focuses on alleviating tension, with the aim of building a stronger, more workable technique. You’re probably surprised that only around thirty percent of my teaching focuses on interpretation or musicianship. Of course, I do teach these important facets, but first and foremost, a piano student must be able to move around the keyboard freely and flexibly, and be able to play accurately, as well as produce a good sound.

Piano technique is a fascinating topic. And there’s always more to learn.  I’ve written on copious occasions about how I work with students, but there is no doubt in my mind that best way to start eradicating tension in piano playing is to help teachers and students identify the issues before problematic symptoms manifest. This is why I like to work with piano teachers.

My way of teaching is only one method, and there are many, but we must begin by spotting physical tension. Therefore, I will finish this post with a short list of how to start recognizing tension or a taut, tight,  ‘locked-up’ technique:

  1. Raised shoulders. This is usually a sure sign of tension, especially if the shoulders are continually raised. The neck, back and shoulder blades may also be involved, too.
  2. Tight forearms. These are trickier to spot, but they are often related to stiff elbow movement and therefore much jerkiness during performance. Watch the arm as it moves – can you spot its stiffness? If stiff, it will often feel rigid during practice and performance.
  3. Wrists. The worst offenders! High wrists can cause a host of problems, as can low wrists. We should aim for wrists that are aligned with the keyboard but which are also loose, flexible, and can easily move in any direction.
  4. A stiff, taut hand. I spend a long time working at freeing the hands. It’s the main reason that students can’t seem to play (or ‘reach’) octaves and chords. And a relaxed hand enables the fourth and fifth finger to come alive, too.
  5. And finally, a stiff or locked jaw, locked feet or legs, or, a locked body. This last point is not always so noticeable, but students sometimes complain that their body ‘freezes’ as they play, whilst others forget to breathe or move at all.

Apart from physical pain and the uncomfortable feeling of tautness, playing the piano with tension of any description always has negative impact on sound quality, and it also renders playing at speed a challenge. Once tension has been identified, we can begin to retrain the upper body to play with a variety of different movements so that pain becomes a thing of the past, and the arms, wrists and hands are able to support the fingers, as they become firmer and assume greater control.

For those who would like to read more information about this topic, the following links and articles might be of interest:

Andreas Eggertsberger speaks out about Focal Dystonia

Painless Piano Playing Part 1, Painless Piano Playing Part 2, and Painless Piano Playing Part 3.

A Young Pianist’s Journey

British Association for Performing Arts Medicine

My recent interview with Russian pianist, teacher and founder of Piano-Yoga, GéNIA  (Genia Chudinovich) focuses on aspects of piano technique and tension:


Melanie Spanswick has written and published a wide range of courses, anthologies, examination syllabuses, and text books, including Play it again: PIANO (published by Schott Music). This best-selling graded, progressive piano course contains a large selection of repertoire featuring a huge array of styles and genres, with copious practice tips and suggestions for every piece.

For more information, please visit the publications page, here.

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