About 8 years ago I developed repetitive strain injury/tendinitis/carpal tunnel syndrome in both hands. It was brought on by my work where I sit at a mixing desk pushing faders.

It took 4-5 years of physio, posture change, the healing power of time etc to relieve the major pain. It was at that point I started playing piano again (after 20 years) with no major problems. In fact in the last few months I have been playing 18 hours a week with no problems.

A few weeks ago I had my first proper lesson and the first step taught was to minimise tension in my playing. I was given a routine which basically involved scales played at sub 40 bpm concentrating on total hand relaxation. Just using minimal finger movement to play extremely slow legato scales and a few Hanon patterns.

Slowly but surely my original hand/wrist/arm pain is returning. I'm absolutely devastated, trying to produce maximum relaxation is severely irritating my hands. A few days not playing the piano while still working hard at my job the pain reduced slightly.

My teacher is non-plussed, she feels my new hand/finger practice looks pretty relaxed. Without realising it my "old" pain free technique did not involve this new "independent" finger movement.

I'm not really sure where to go from here. I would really appreciate any thoughts or advice on my situation.

Regards, Chris

I don't understand why a teacher would recommend Hanon as a tool for learning to play with unnecessary tension. It's just not do-able without adding loads of strain to the wrist.

Chris,

I remember your earlier thread but don't recall you mentioning the past problems with repetitive motion injury.

If I understand correctly, you returned to piano and played heavily for months with what you've been told was tension (requiring a thorough revamping of your technique)—but never experienced any pain during that time. Now, after beginning your teacher's regimen to eliminate the harmful tension, you're having pain you believe to be related to the old injury.

Wow, that's a tough break. I'm not qualified to offer any concrete advice or suggestions, but one would sure wish in this situation that an expert in both the medical issue and the kinesthetics of piano playing could be consulted. Perhaps the closest thing would be a doctor who practices sports medicine?

I wish you the very best of luck for a successful outcome to this problem. Please keep us posted.

Steven

Chris,
I am in a similar situation but of course everyone is different. I am regularly using Hanon without problems but in order to be able to play I have radically changed many of my habits:
- I try to use the mouse as little as possible, I have learned to use the mouse with the left hand as the major problems are in my right hand
- I have a computer keyboard that requires a soft touch
- no more videogames... that sucks as I'm quite fond of them
- no hand bags for going into the office, only knapsacks that put weight on the shoulder
- do not work manually too much time in the same sessions, I try to have little breaks and put work that does not require to use my hands
...and a lot more, those are the most important examples.
With this and a lot of care to tension and relaxation, I can play 2-3 hours per day without problems.
When playing, I stop at the very first sign of pain or unusual feedback from my body, take a little pause and often I'm able to resume without problems.
That said, look for every variation in your lifestyle. I don't know how much scales and Hanon you play, but if it's only a few minutes then your problem might also depend from something else.
I sometimes still have periods of pain, the most recent lasted about one week, but I'm pretty much sure it doesn't depend from playing. That's my case of course, and I am very very careful on how I play.
Finally, let me say that it would be best to consult a doctor. I did when the pain grew stronger (that was several years ago) and I got no particular cure for it but at least I was assured there was no permanent damage, which is a nice psychological help.

Those who live in the UK are very lucky to have BAPAM . Check them out.

Thank you Steven, keyboardklutz and Alessandro for your kind responses.

After my first post I found this site Pianomap which provided some useful information.

During my first lesson my teacher asked me to lay my hands totally relaxed on a table and said that this should be the neutral position over the keys. Unfortunately I randomly had a more arched position than my normal relaxed hand state hanging at the side of my body.

I think therefore my new slow practice has been with a "claw", with vertical finger tip contact on the white notes. I think a better relaxed position for me is with a more gently arched hand with more contact made on the notes with the finger pad - does this make sense?

I have checked out the UK BAPAM site you mentioned Kklutz, that looks very useful. I intend to track down some medical help with a music/sport specialization.

Cheers, Chris

Can you post a video of your playing? That would really help in figuring out what may be causing the problem. While everyone's bodies work the same, there are slight variations in everyone's physiology, and so what may have been a "relaxed" hand might have looked like a "claw" to your teacher, and so adjustments were made that weren't necessary. I'm just guessing here, as I have no idea what you're doing now.

Of course, I strongly urge you to consult with a doctor who specializes in musician injuries, as well as to stop playing whenever the pain arises. Also, stay away from Hanon for the time being. That kind of repetition is hard to do without developing some tension.

I'll try and put up a video of my playing.

I probably didn't make myself exactly clear. I thought that my most relaxed hand state was a fairly arched hand shape with the last joint of the fingers almost vertical. That is how I practiced after my first lesson.

Off to get the DV Cam I borrowed from my father-in-law

Chris

Here are some video clips of my practice hand posture, I hope the angle provides some insight.

The first 3 clips are roughly how I have been practicing for the last 3 weeks or so. Chopin etude no.3 was on my music stand at the first lesson so in addition to the extremely slow scales and a wee bit of Hanon I was instructed to play that slowly HS and occasionally together. I've put that clip in in case it might be useful.
Scale 1
Scale 2
Chopin Excerpt

The next 2 clips are the hand position I realize is probably my most relaxed ( similar to hands hanging at my side ) and I haven't yet practiced for any time using this shape.
Scale 1 - Less arched hand
Scale 2 - Less arched hand

I would appreciate any thoughts

Chris

Chris, I'm afraid my observations are so basic as to be stating the obvious—and I wouldn't interpret them as indicative of anything—but here goes, for what it's worth.

In the first pair of scales (more arched), there seems to be some degree of superfluous movement in the non-playing fingers, especially in the descent.

In the second pair of scales (less arched), I don't see that; the non-playing fingers are at rest, there are no no wasted motions, and your whole hand seems "calmer."

I don't think you mentioned if the pain that you're experiencing anew is in both hands or not; we only get a look at your left hand in the Chopin clip (which, by the way, I found to be lovely).

While I don't see anything commentworthy in what your right hand is doing here, I notice that the fingers of your left hand frequently go into a curled position—including at times when your wrist is relatively low. I can't speculate whether the curling is good or bad; it just seemed worth mentioning, especially in the context of a lowered wrist.

While I know next to nothing about ergonomics, there's one particular wrist position/movement that I conscientiously avoid whether at the piano or computer: having the hand bent at an upward angle from the arm (as, for example, if the back of your computer keyboard were elevated higher than the front, or your wrists were kept low relative to the piano keyboard).

I believe that position puts a significant and unnecessary strain on the tendons on top of the wrists—and yet, incredibly, the manufacturers of computer keyboards put "legs" on the rear corners as though positioning the hands thusly were a good thing! (I wonder if there are schools of piano technique, too, that preach maintaining the wrists in an artificially low position.) Anyway, it seems willfully contrary to our physiology and something to avoid whenever possible.

Steven

Steven, I forgot to make clear that the left hand is suffering similar pain and practice of that hand has been similar to the right in terms of hand shape on the scales.

I also noticed the curled hand on the Chopin, doesn't look too good. I'll have another look at the LH wrist position.

Chris

I noticed in the Chopin that when you play with fingers 3 4 or 5, all 3 curl up quite a bit. While this is not a big deal when playing something slow, when you do scales quickly or faster, more demanding pieces, this will really cause some problems. When I'm using fingers 3 4 & 5, I try to get more bounce in my wrist. Your LH wrist also seems to be a bit low in general, which can also cause some problems. These aren't glaring issues, by the way,, but since you are having difficulty, I'm looking at anything that may possibly be causing it. Might there also be excessive wrist tension? The wrist should never feel rigid, but always bouncy, like a shock absorber (which is actually is when playing).

In your second set of scales, your wrist is still slightly low, but I didn't notice the finger issues. I would work at keeping the wrist in a level position to the rest of the hand and arm, but keeping it pliable/bouncy. One way you can do this is by exaggerating the bounce on each note. Try it with a 5 finger position at first. Play each note and let the wrist bounce down as you press the key, then back up to its level position. Always be sure you return to the level position before going onto the next finger. Also as you do this, be sure that the only finger with any amount of tension is the one that is playing, and it shouldn't be overly tense, just enough so that it can withstand the weight of the hand and arm pressing down on it.

I hope that makes sense...feel free to ask questions!

It doesn't appear that you are exactly 'tense' in playing. You do over-curl, if that makes sense, in the Chopin. There is no need to 'wipe the keys' as my teacher put it. Hanon, done properly, should not be a problem tho others might disagree. I've never had a problem like others here from practising Hanon, scales, or other exercises. My teachers--the good ones--did stress relaxation but gave me exercises on and off the keyboard to achieve that.

You might look for another source of your discomfort or the damage done previously hasn't fully abated and is somehow aggravated by movements. Is that possible? I practise daily with some sort of technical exercises and have no carpal tunnel or other discomfort and I'm sure some would think I'm doing damage but I assure you I'm not.

My teacher in Honolulu was probably the best at instructing and helping me to achieve relaxed posture for the arm and hands (and shoulders).

Perhaps your teacher can assess or refer you to someone skilled in helping you acquire it. I watched all of your videos and don't really see tension. After returning from Honolulu and playing for my former teacher, she remarked that if were any more relaxed I would slither off the keyboard. If you feel you are tense, then you should study ways to first get the feeling of being relaxed into your consciousness and then transfer that feeling to your playing mechanism. A certain amount of tension is necessary or there would be no control. How it is moderated is probably the key. Good luck.

Thanks again for all the insightful responses.

I think my physiological problems are pretty complex. The initial discomfort and pain in my hands/wrists/arms arose independently of piano playing.

My return to the piano over the last 3 years seemed to be causing no problems. The last 6 months I've been playing more and more, maybe I was building up dormant issues which reached a tipping point and appeared at my "technique analysis/change".

It's all rather depressing that I cannot play a scale or 2 without feeling the burning in my wrists so familiar from 5/6 years ago.
Being able to video yourself is very useful as I can see that I'm generally not inducing too much extra tension.

I've tracked down a few music/sport medical specialists on the web and I intend to follow that up as soon as possible. If anybody is interested I might revisit this thread occasionally to give a progress report.

Cheers, Chris

keyboardklutz - thanks for our email, very useful tips. Your email box is full so I couldn't reply directly.

I think your problems lie within the wrist action and the level at which you hold your wrists. Definitely pursue the avenue of finding a doctor who specializes in musician's injuries, but be aware that they may only treat the symptoms and not the cause. Perhaps find a teacher you can see who will help you in this area. I wish you the best of luck.

I think I'll stop playing for the next few weeks and try and get some professional help.

In the mean time are there any video or image/text resources on the web that people would recommend. I suppose I'm looking for examples of what is considered "good" hand/wrist/arm position. I have some old books but I'm not sure of the latest thinking.

Chris

Christian Zimmerman has a nice touch, and in this video you can see how his wrist stays pliable, but generally level.

http://youtube.com/watch?v=PCW3631sxkw

As far as instructional videos, I don't know of any that I could recommend. Anything that I've seen has been years ago and I'm not sure I'd recommend them now.

Morodienne, thanks here as well. This is good for the rest of us to see too (speaking personally).

Junst noticed something. By any chance, is this "oblique movement" that John vd Brooke talked about elsewhere visible in this clip? (John?)

Keystring,
Glad you enjoyed it . He's one of my new favorites. As far as the oblique motion, I'm not sure exactly what John was referring (I don't recall the thread, either), so perhaps he can enlighten us both.

My apologies to John if I put him on the spot. It was to someone in regards to softer dynamics perhaps, and had to do with the idea of using wrist and arm action to prevent the vertical fall of the fingers from being so vertical. A couple of times watching Zimmerman I had this "aha" moment where I thought I saw just that.

Um.. I think maybe at the 2nd movement around 2:25. (?)

In any case, Zimmerman is lovely to watch as well as hear. Thanks again for putting up the link.

Oh, yes, now I know what you're talking about . Well, it does tie into that, as the wrists act as shock absorbers. Imagine if you are jumping down from a high place, and you don't let your knees bend too much. All of the energy goes right to your ankles and knees, putting a lot of strain on them. If you jump and bend your knees, however, they will absorb the added energy. The wrists can do the same with the added downward energy placed on the fingers.

many pianists speak highly of the taubman approach

http://www.taubman-institute.com/html/home.html

http://www.balancedpianist.com/bptaubman.htm

I'm not a teacher, so I may be speaking out of turn, but I personally would not recommend looking at how other pianists play as a guide to how you yourself should play. Everyone's fingers, hands and posture are different, and what works for one person may not work for another. It may be that there are a few things in your technique that are causing the pain, but these may not be readily visible unless you really know what you are looking for. Therefore, watching what someone else does won't necessarily be of assistance.

One comment I would have, though, is that if you are having problems with tension, then I would not be practising pieces where you are holding down certain notes whilst also playing others in the same hand, since this could well exacerbate tension problems. There are quite a few instances of this in the Chopin etude you are working on, so it may be wise to hold off on this piece for the moment. The reason I say this is because when I started lessons again after a break of a few years, my teacher immediately identified some issues with tension and suggested that I avoid playing held notes. That really worked for me and I've been allowed to play held notes again for some time now.

For this sort of thing, I think you really have to have a teacher who is experienced with working with injuries and can guide you accordingly. There are an embarrassment of excellent teachers in London who should be able to help. If you need recommendations, please PM me.

I just thought I'd give an update since my last post 3 weeks ago.

I Googled "Music Injury Therapy" and found one particular practitioner here in London. He seemed very confident when I phoned so I decided to give him a try. I've had 3 sessions and there seems to be some improvement. He concentrates on deep tissue massage and mobilization of the hand/wrist/forearm.

He encouraged me to start practicing again, being careful not to overdo it. He told me to avoid the extremely slow scales which coincided with the return of my RSI. I've also been doing a lot of hand and wrist stretches and overall the pain is slowly reducing.

I'm certainly starting to feel more hopeful, and am really enjoying playing again. I'll wait a while before I think of getting lessons again. I think I may change to a different teacher, maybe one with experience of piano injury.

Thanks again for all the advice and help

Chris

PS I think I'll be able to make an assessment of my Osteopath in the near future. If anybody would like his details please don't hesitate to PM me.

That is really good news. Do keep us posted.