Case Histories of Pianists’ Injuries

MELANIE

When Melanie came to study with me, she had tendonitis from overpracticing for her recital at college. The pain ran from the little finger of her right hand up her forearm and had forced her to stop playing for a few months. Her posture was hunched over, and instead of flexing her fourth and fifth fingers to play she was extending them and
using forearm rotation to push keys down.

I adjusted her posture upright and asked her to place her hand on the keys in a normal curved position, which at first took a great deal of concentration. She practiced a simple five-finger exercise: playing one key at a time, using finger movement only, no arm movement, and checking after each note to be sure that the other four fingers were relaxed and resting on the keys.

She then practiced two simple pieces in this way for two weeks. During that time her fourth and fifth fingers were too weak to produce sound without arm movement. But at her third lesson they suddenly began to produce sound.

When her new finger movements became habitual I taught her to use her arm in conjunction with her fingers to play. At first she tended to move her back along with her arm, but I showed her how to let her shoulder and wrist be flexible and to move her arm forward without changing her upright posture. This flexibility resulted in greater ease and power. Then she practiced singing the bass line of her pieces while playing the right hand, and playing without looking at her hands. These techniques refined her coordination.

She limited her practicing to one hour a day at first and later increased it to two hours. At the end of three months, she was playing comfortably and well. She returned to school and gave a successful recital.

RICHARD

Richard is a professional accompanist. When he first came to me, he had been unable to work for a few months due to DeQuervain’s disease (tendonitis at the base of the thumb). He habitually overextended his right thumb and played with his hand turned toward the right (ulnar deviation), holding his elbow close to his body. The pain ran from his thumb up the inside of his forearm.

I adjusted his elbow to a normal dropped position and refingered many passages of his pieces to allow normal movement. He practiced moving his thumb loosely every time he used it. I also taught him to move his arm forward, bending his wrist, in order to transfer arm weight from long fingers to shorter ones, which helped him accomplish wide stretches without straining his hand. He later practiced noticing musical vibrations as they went through his body, which further loosened up his playing mechanism and whole body.

In four months his symptoms were gone. He played with ease and a beautiful tone and resumed his career as an accompanist.

MARIE

Marie is a gifted amateur who came to me in her forties playing with tremendous tension in her hands, arms, and back. Her piano study as a music major in college left her feeling as technically insecure as her earlier training, and she was afraid of being disappointed again. Since age eight she had not been able to perform without memory lapses and incapacitating tension and nervousness. In recent years she had limited her performing to occasional accompanying for her husband, a singer.

Her hands shook when she played, and her arms and shoulders were clenched. I worked with her on simple pieces, one hand at a time, focusing at first on stopping all movement in her hands after every note. Then, by placing her awareness on the movement of the bones in her arm and shoulder, she was able to slowly unlock the tension in them.

Although she had only forty minutes a day to practice, in a few months she began to play comfortably, and she performed well in a master class, using the score. She became inspired and bought a Steinway grand, and she began to play for friends at home. She also noticed that the relaxation she was learning at the piano extended into her other activities, and she became a happier person.

Her new physical and mental ease allowed a greater sense of flow, which increased her ability to play from memory. Listening techniques, including singing one line while playing another, helped her to be more aware of musical details, which also helped her memory.

After four years she played from memory for the first time in thirty years, in a master class. She had tremendous composure and played not only with perfect memory but with deeply affecting musicality. In the two years since, she has memorized several pieces and played confidently and beautifully in a number of recital programs, including one attended by six hundred people.