How to Deal with Piano Practice Related Hand Injuries and Muscle Pain?

Ideally, pianists should not experience hand injuries as a result of their practice. If you’re practicing regularly and correctly, constantly relaxing your shoulders, elbows and wrists, you should never feel pain, tension or discomfort in your muscles or tendons.

However, I don’t think there is a professional pianist in this world who had not suffered from a certain hand injury at least once in his/her life. No matter how relaxed we play, sometimes the pianistic challenges are too high and so is our desire to overcome them. As a result, tension and stress accumulate not only in our mind, but in our hands as well. Carpal tunnel syndrome and tendonitis are just two of the many repetitive motion related injuries that pianists may experience during their musical career.

I am not a doctor and I will not overwhelm you with complicated medical terms that will explain scientifically all these conditions. I will just share with you a few simple insights – the result of more than 20 years of hard work – that will help you understand the causes, the symptoms and the prevention measures of practice-related hand injuries. I will also tell you what exactly you should do in order to effectively deal with a muscle strain or a hand injury.

First, let’s analyze together the most common causes of practice related injuries:

1. Tension. Relaxed, heavy arms with flexible elbows and wrists – this is the foundation of an efficient, healthy and enjoyable playing habit. Tension is not only a productivity killer and a sure way of destroying the beauty of your sound. If your arms are tensed when you practice, if your elbows and wrists are rigid and immobile, then you also risk developing a hand injury! Always, no matter what you play, make sure that your posture is correct and there is no tension in your body – especially in your wrists!

2. Irregular practice. I actually call this phenomenon the lazy student syndrome. For many months, most students practice from time to time, without having an organized work schedule. When the exams or the concerts approach, the panic begins. One or two weeks before performance, these students start practicing 5 to 10 hours per day in order to ‘recuperate’ the lost time. They are stressed, they are in a hurry and they ‘skip’ all the necessary practice steps: slow playing, gradual assimilation of the musical material, awareness of the message encoded in each piece, a deep understanding of the emotional structure of the music and its dramatic content.

Unfortunately, this ‘student syndrome’ has a detrimental effect not only on the quality of your playing, but also on your physical and psychological health. The unexpected tension affects your untrained overworked muscles and tendons, leading to pain and other unpleasant manifestations. The panic and the unavoidable psychological discomfort make things even worse, aggravating the symptoms and making it impossible for you to achieve a quality performance.

I personally know many good pianists who gave up on their musical career because of severe hand injuries caused by incorrect irregular practice.

Piano playing is not just art; it’s also a high-performance physical challenge. Think what would happen to the legs of a long-distance runner if he or she would not go to training every day?

3. Playing ‘only with your fingers’.  This is another almost fatal mistake that leads not only to bad performance, but also to muscle strain and tension. As we all know, the correct piano technique is based on the involvement of your entire arm – shoulders, elbows, forearms, wrists and fingers. If you play by moving only the fingers, the rest of your arm will be tensed, which will lead to pain and discomfort, not to mention the hammering ‘percussion’ sound.

4. Incorrect posture. A correct piano posture harmonizes the anatomical particularities of the human body with the particularities of the instrument. If your posture is incorrect (slouching, raising your shoulders, positioning the elbows too close or too far from the body, straining your wrist or lowering your knuckles below the wrist level), then you’re dramatically increasing your chances of developing a hand injury.

5. Too much ‘enthusiasm’ in your finger stretching exercises. Did you hear or read about what happened to Robert Schumann? He was a brilliant pianist, but he was seeking perfection in his piano technique, so he invented a ‘device’ that helped him stretch his fingers. Maybe the idea itself was not so bad, but unfortunately Schumann exaggerated with these exercises and he developed an irreversible hand injury. After that, he could never perform in public his own virtuosity pieces, which started to be promoted by his talented wife, Clara Schumann.

Be careful when you do your finger stretching exercises! Your whole body should be relaxed and each stretch should be performed at exhalation – just like in yoga. This way you’ll avoid an accidental strain that could cause a more complicated trauma.

6. Psychological tension, stress and a negative attitude. Even if you practice regularly, even if your posture is correct and you play relaxed, by using the weight of your entire hand behind each note, you still risk getting a muscle pain if your attitude is incorrect. Our state of mind is the fundamental cause of all our problems. A negative attitude will amplify and worsen all our dysfunctions, while a positive one will accelerate the healing process of the most severe traumas.

Now let’s see which are the main symptoms of muscle strain and other ailments related to repetitive motion and constant stress.

  1. Hand pain and/or wrist pain
  2. Numbness and weakness in your fingers and arms
  3. Diffuse pain radiating towards the forearms
  4. Poor blood circulation and cold hands
  5. Sore shoulders and/or neck

If you feel any of the above-mentioned symptoms, it means that you have to take urgent measures in order to stop the destructive process before it makes even more damages. The good news is that even the most severe injuries manifest their first symptoms long before the condition becomes irreversible.

Now let’s see what exactly we should do in order to deal with a hand injury effectively.

1. Stop practicing for at least one or two days. Rest and relaxation are the best remedies for tired sore hands. Take your time even if it affects your school schedule, your exams and your concerts. After all, your health is much more important! If you’ll not protect your hands when the first symptoms appear, it will be much harder to heal your injury in the future.

2. Resume your practice routine gradually. After a few days of rest (in a severe case the break should be longer – weeks or even months), begin your practice with several easy exercises. Play slowly some scales or a piece from your repertoire by using the weight of your arm behind each note. Don’t play pp or ff; mf is your main dynamic for the time being. Monitor your wrist, your elbows and your shoulders – they should be relaxed and heavy. Don’t hurry to play fast, the more time you dedicate to this thorough detailed practice method, the better your hands will heal.

3. Practice regularly. It’s better and healthier to practice 1 hour per day EACH DAY than 5 hours per day twice or thrice a week. Regular practice will always keep your arms, your wrists, your hands and your fingers in good shape. When your muscles are trained and prepared for their daily work, it’s impossible to overwork them.

I’ve seen many pianists wearing hand or wrist bandages when they get a muscle strain. I don’t recommend such measures. A tight bandage will decrease the blood circulation, slowing down the healing process. The blood has powerful healing capacities, that’s why we have to allow it to circulate freely, bringing fresh energy where it’s required and washing away the toxins. However, you have to be careful not to expose your hands to a cold environment. Wear something warm and gloves (especially during the cold season).

And let’s not forget that prevention is better than any treatment. No matter how difficult your repertoire is and how little time you have at your disposal for learning it, try to avoid the causes of hand injuries mentioned above. Keep your hands and your mind relaxed while playing, try to enjoy the beauty of the music, to explore its mysteries and understand its message. Don’t play only with your fingers, use your arms like a bird is using its wings – this is the only way to ‘fly’ and conquer new peaks!

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113 Responses to “How to Deal with Piano Practice Related Hand Injuries and Muscle Pain?”

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  1. Jacob says:

    Hi Ilinca,

    I am very glad that you created this web page on Piano related injuries. The information here is really useful.

    One of the problems i face when playing the piano is worrying about hurting my index finger when i play the wrong note (e.g. hit edge of another note). Sometimes, this happens and the edge of my finger hurts quite a bit especially when i am playing at a fast tempo.

    Do you think that constantly hitting the edge of your finger when playing the piano will injure your fingers? I know that i usually experience coldness and swelling of my index finger when starting to practice but it gets a lot better when i practice
    more.

    Thanks, Jacob

    • Ilinca says:

      Hi Jacob!

      You can avoid the problem you mentioned by learning how to play correctly, in a relaxed manner – and also by always guiding your fingers with your mind (it’s called mental anticipation). When your mind is always one step ahead – you’ll see exactly where you place each finger – and you will avoid such injuries (which are not good for you, being an indication that you’re doing something wrong).

      In correct piano playing, we never hit our fingers on the edge of an adjacent note – we’re always pointing towards the middle of the key :). Plus, even if we DO touch the edge of another key – it should not hurt! The fact that this simple action hurts your fingertip is an indication that you use an incorrect key attack (too harsh, too brutal, without wrist relaxation).

      You can learn how to play correctly from scratch, using the professional ergonomic principles of the Russian piano school, by following the step-by-step Video Practice Guide for Beginners based on the famous method book “The Russian School of Piano Playing” by Nikolaev. You can find all these progressive Lessons (and many other hundreds of exclusive piano playing tutorials for ALL levels) on my Piano Coaching Program at PianoCareerAcademy.com.

      Good luck ;),
      Ilinca

      P.S. Free recommended videos/articles on PianoCareer.com:
      The 5 Basic Elements of a Correct Piano Posture
      The Secrets of a Correct Piano Key Attack
      Nikolaev’s Russian School of Piano Playing. Detailed Practice Guide
      The Key Principles of Correct Piano Practice: A Step-By-Step Holistic Guide

  2. Jacob says:

    Hello again Ilinca,

    Thanks for your advice.

    I understand how a relaxed mind is essential for playing well. I think a lot of the times, i worry about hurting my finger (it has been injured in the past) and i end up hitting edge of another note. I also know that looking at the note before i actually hit improves my accuracy.

    The other thing that I was told from my piano teacher was not to use my wrist or arm to press down upon the note. He said that i have to have strong finger tips to create tone contrasts (e.g. play soft). So in order to increase the strength, i regularly practice strong stacattos and legatos.

    Do you think that this is a good method? Or will it increase tension and worsen circulation?

    Thank you once again

    • Ilinca says:

      Hi again Jacob!

      In my reply, I didn’t mean only a ‘relaxed mind’ – but also a correct, relaxed key attack (playing from the entire weight of your arm, not only from your fingers).

      Your teacher is using the old-fashioned finger-only harpsichord technique – which is extremely dangerous for the modern piano (which has heavy keys), usually leading to tension and the resulting injuries and pain.

      In the Russian piano school, we use whole-arm action (a holistic system based on the balance between arm weight, flexible elbows and wrists, rounded hand dome and strong fingers).

      You can find out more by watching the free videos I recommended above – and, if you want to learn the professional principles of the Russian piano school in a step-by-step manner, you can join my Piano Coaching Program at PianoCareerAcademy.com :). There you’ll find answers to all your current (and future) questions! ;)

      Good luck,
      Ilinca

  3. Bob Hughes says:

    My son who is now 20 playing piano for only 8 years is developing hand pain and stiffness in both hands before during and after playing the piano. Is there anything he can or should do? Is there any vitamins, exercises that may help?
    the only thing that has really helped is rest but he loves to play.

    • Ilinca says:

      Hi Bob!

      As I mentioned in my article above, the most frequent cause of hand pain (for pianists) is incorrect practice. Vitamins or exercises will not help if your son practices irregularly, in a tensed manner, without using the natural weight of his arms and without keeping his wrists flexible.

      Whole-arm action (the foundation of correct ergonomic piano playing) is a very complex technique, and mastering it takes time, patience and dedication. The results, however, are well worth the effort!

      You can find detailed video and written tutorials about whole-arm action in the Members Area of my Piano Coaching Program at PianoCareerAcademy.com :).

      And, obviously, his hand pain might have a different cause, not related to piano playing. In this case, my advice is to consult a doctor.

      Good luck and enjoy your Sunday,
      Ilinca

  4. Stephanie says:

    Hi, my forearms hurt from playing too much octaves and big chords. My maximum handspan is only an octave. Wenever I have to continuously play many octaves and big chords like Beethoven’s Pathetique sonata my forearms hurt. I think it is due to tension and muscle strain. Do you have any tips in solving this problem?

    • Ilinca says:

      Hi Stephanie!

      You can find many detailed video tutorials on this topic (playing uncomfortable structures such as octaves, chords, the tremolos from the “Pathetique” etc. without tension and the resulting pain) in the Private Members Area of my Piano Coaching Program at PianoCareerAcademy.com! :)

      You’ll also have access to hundreds of other exclusive tutorials where I share the professional principles of the Russian piano school. They will help you to learn the secrets of relaxed, ergonomic, whole-arm, painless piano playing ;).

      Good luck!
      Ilinca

  5. Hi Ilinca,

    I have been your avid Youtube subscriber and viewer of your educational videos.

    I have been playing the piano since 2013 Febuary everyday. I have developed some fundamental piano skills such as pedalling, voicing and etc.

    I have noticed that my digital piano (which I use for practise) has an unsophisticated key weighing compared to a real upright or grand piano. That would mean I find my digital piano’s keys too light and find a real piano’s keys too heavy when I whenever I strike a key.

    Please take a look of this short marcato passage below:

    https://fbcdn-sphotos-f-a.akamaihd.net/hphotos-ak-ash4/t1/10006422_10202372399649111_1098998969_n.jpg

    After iteratively playing the passage above, I always experience problems with my nails such as paper cut. The resulting injury has been a nuisance in my 5-hour daily practise. I do not want to aggravate the injury untill it becomes severe as a nailbed injury or avilsion :(

    Do you have any advice?

    • Natalia says:

      Hi Gian,

      This is Natalia, Ilinca Vartic’s assistant at PianoCareerAcademy.com.

      I just sent you an email – please check it out! ;)

      Have a great day.

      Best wishes,
      Natalia,
      Customer Support
      PianoCareerAcademy.com

  6. Jaedin says:

    Hi! I’m a student studying ARCT piano and have been playing since I was 5. This article has given me lots of great information. I’m having some irregular pain just in the tendon of my left hand pinky finger, and it has just started to bother me. I think it’s because I’m playing a piece ( Chopin Étude in A-flat major ) which requires a lot of reaches in the LH from the low bass notes to regular bass notes. Do you think this is due to tension, stress or strain? Is there a more effective way to play so that this pain does not occur? And is this tendonitis or just chronic pain?
    Thanks for your help!

    • Ilinca says:

      Hi Jaedin!

      Good news! :) You can find a video tutorial (and a detailed article) on this topic – how to practice Chopin’s Etude op. 25 No. 1 without strain and the resulting tension/pain – on PianoCareerAcademy.com! ;)

      Good luck,
      Ilinca

  7. Tracy says:

    I’ve played piano and sung professionally for years now, and I can tell people with some certainty what circumstances they will be ‘injured’- eg singing in the presence of contaminants like cigarette smoke or perfume…playing or singing in cold damp environments where there is stress…performing or rehearsing too long ( my last injury occurred when after a day’s work I would go to church choir rehearsal as accompanist mid-week and the ‘director’ would drag rehearsals out for four or five hours…he was a bully and I was not good at dealing with him- and of course no one else cared beyond gossiping and criticizing behind his back )
    Trust your instinct- and try to avoid situations working with obsessive or uncaring people.
    Only other thing I would add- getting older and developing joint issues/ wear and tear issues…not much you can do only rest/ anti-inflammatories etc. The best technique in the world won’t protect against ageing/ serious illness.

  8. Mara says:

    Hi Ilinca,
    I’ve been watching your YouTube videos for a while now and I love your clear teaching style. I have a question about technique in a certain piece. I’m playing the Fantasy in F minor by Chopin, which I’m relearning for fun at the age of 45. I played it in college and was much younger then. I’m afraid my arms are not as toned and strong anymore as they used to be, because now the octaves are causing me some elbow pain. Is it ok to cheat and play single notes instead of octaves, or is that ruining the masterpiece? I’d honestly rather cheat and save my tendons than injure myself with heavy octave work. What do you suggest?

  9. Ruth Elfira says:

    Dear ilinca,
    I want ask to you, about repetitive strain injury. What kind hands injury usually as common a player piano? Thank you ilinca :) nice to meet you.

  10. Marissa says:

    Hi Ilinca,
    What you said was really helpful! I just had a specific question. I have been playing for 12 years and I have never really experienced hand pain. However, I went on vacation for a week and stopped practicing. When I got back and started practicing the middle of my hands and the tops of my arms (like the muscle) hurts really bad. Is that something of concern or should I just lay off the practicing for a couple days.

    • Ilinca says:

      Hi Marissa!

      You can find detailed tutorials on this topic – how to resume your practice after a vacation, how to practice correctly, how to avoid any type of hand/arm tension and pain – in the Members Area of my Piano Coaching Program at PianoCareerAcademy.com.

      Good luck and enjoy your week ;),
      Ilinca

  11. Pat says:

    I have been playing the piano over 50 years and the thought that I could injure my hand never came to mind. I wish I’d known the information I have just read, that you have provided. Unfortunately, I was zealous in a piece with a lot of octaves and have strained my right pinky. I tried playing with nine fingers, but the strain is still there and felt on the side of my palm. Realistically, how long does it take for a strain like this to heal? Is there anything at all that can be done to speed the healing process. Help. More knowledgeable now and will not make the same mistake twice. Thank you.

  12. Adria says:

    Hi Ilinca,

    First off I love this site it has helped me a lot. I want to ask for advice on having tension in your back and forearms. Sometimes when I play for a longer time or play some more difficult songs, I get a really bad pinching in my back and can’t play for a while and my shoulders get really sore. I’m not sure if it’s my posture or something else.

  13. Rachel says:

    Hi, thank you for this article! I have been having wrist pain in my right wrist for a few months now. I work at an ice cream shop all year round and I am a piano major. I realized that the combination of scooping hard ice cream and increasing my practice time as my rep. increased in difficulty resulted in this pain. However, I’m having trouble getting rid of it. I am looking for another job, but until I find one I have to keep working there. I’m not really sure what to do since I have two recitals coming up and I play at my church on a weekly basis. This past weekend I took a break from practicing. I didn’t play Saturday, but I played hymns in church on Sunday, but took a break for the rest of the day. What do you suggest I do?
    Sincerely, Rachel

  14. GIORGIO says:

    hi Ilinca, thank you for your useful articles. Quick question…..have you ever had a piano injury? thanks

    • Ilinca says:

      Hi Giorgio!

      You’re very welcome! ;)

      No, I have never had a practice-related injury – I was very lucky to have great teachers who taught me to play correctly from the very beginning :). However, I did feel tiredness in my arms/wrists very often, especially when I was studying and I was playing many hour-long programs simultaneosuly. The principles I shared in the article above helped me to stop this tiredness from transforming into an injury.

      However, I DID have injuries caused by training. When I was about 10, I hurt my wrist while playing badminton LOL – and even last year I had tendonitis because of weight-lifting (I did a weighted exercise incorrectly). Now the tendonitis is fully healed, and I have learned my lesson – I do my weight-lifting correctly :).

      Cheers,
      Ilinca

  15. Kim says:

    Hi Ilinca,

    I have been dealing with hand strain related to piano playing. I would get pain up my hand into my arm, numbness and tingling in fingers, and loss of control when playing. Fixing my posture and some bad habits nearly got rid of it, but it has recently come back with something new- finger spasms… Usually thumb and forefinger. The rest of my hand feels uneasy… Sort of like having restless leg syndrome but in the hands. Additionally, I work a lot on the computer, and I still nurse a fourteen month old, which causes my arms and hands to fall asleep pretty often. I am wondering if you heard of finger spasms in relation to playing, and if this is something that can be fixed with rest and reevaluation of practicing techniques. It is quite distressing, since playing piano and organ (whereI don’t feel pain) is my job.

    Thank you,
    Kim

    • Ilinca says:

      Hi Kim!

      No, unfortunately I have never heard about piano-related finger spasms – and since I am not a doctor, I don’t have the knowledge (or the right) to make a diagnosis of your problem. So I strongly recommend consulting a specialist! :)

      Lots of health wishes,
      Ilinca

  16. Lydia Matthews says:

    Hi,
    I am a freshman piano major, and have always had wrist issues, but since I’ve had a much heavier load since school started, my wrists have been giving me pain. My professor said I am very tense when playing, and I realize that I am; my wrists are always extremely tense, and overall I feel tense.

    What are some exercises to help get rid of the tension? It’s gotten slightly better, but whenever I play any louder than mf or have large chords, I get extremely tense again. I have very small hands, which may be part of this. It’s gotten so bad this past week that after playing for 30 minutes my whole entire right arm (rh is worse) aches from my hand to my shoulder. Any tips would be very helpful!!

    Thank you,
    Lydia

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