The Healthy Pianist
Body Mapping
Disclaimer
I am not a medical professional.
I do not provide medical advice.
The information provided may be incomplete and/or incorrect.
“So, why?”
I became (re-) interested in the topic because…
A deadline can be an effective motivator.
The presentation is meant to provide food for thought.
Medical Problems Among ICSOM Musicians: Overview of a National Survey
(Fishbein and Middlestadt, 1988)
76% of respondents had experienced a serious injury during their career
that required time off from performing.
ICSOM: International Conference of Symphony and Opera Musicians
Numbers
Playing-Related Pain and Associated Factors
at a Major University Music Program
(Savvidou and Stanek, 2019)
play/sing
High-Performing Young Musicians’ Playing-Related Pain. Results of a Large-Scale Study
(Gembris, Menze, Heye and Bullerjahn 2020)
“I consider that pain associated with playing an instrument is normal.”
All parents of the children at the academically selective high school disagreed with this item, but 29 percent of the parents of children at the specialized music high school agreed and further 21 percent were neutral.
Co-contraction: When one muscle contracts, the opposing muscle must release and lengthen to permit movement. If this does not happen — that is, if the opposing muscle remains tense — then both muscles are contracting simultaneously, which is called co-contraction.
Awkward positions: A muscle attaches to the bone it moves by means of a tendon, and the tendon passes over a joint (or several joints). Awkward or extreme positions of the wrist and hand stress these tendons, making movement more difficult and also weaker.
Four Causes of Injury
Static muscular activity: If the muscle exerts force without changing in length, the activity is called static. Static muscular activity is more stressful than dynamic activity. Dynamic activity permits circulation of the blood, whereas static activity inhibits blood circulation, causing the muscle to become fatigued and making it prone to injury.
Excessive force: According to some studies, doubling the force multiplies stress on the tendons not by two but by five. Because of the extremely high levels of repetition involved in piano playing, excessive force is potentially injurious.
Types of Injuries
Nerve Entrapments
Emil Pascarelli: Repetitive Strain Injury – A Computer User’s Guide
Nerves that pass through “tunnels” created by bones, ligaments, and other tissue can be damaged if the surrounding tissue swells and presses on them. Tunnel syndromes can occur at many sites throughout the body and there are several that affect the movement of the arm. Symptoms of tunnel syndromes include pain, muscle weakness and numbness. With tendinitis, pain generally worsens with movement and gets better with rest. But with tunnel syndrome, pain can be constant, becoming worse with movement.
Three Areas of Weakness
Carpal Tunnel
Cubital Tunnel
Shoulder
Tendinitis
Tendons are long fibrous cords made of collagen.
They may be surrounded by lubricant-filled sheaths (synovial sheaths).
Circulation of blood flow is limited and therefore recovery slow.
Tendons may fray or tear apart, or become thickened and bumpy
The injured area may calcify.
The tendon sheath is also vulnerable and may produce excess fluid, causing swelling.
It may become “locked” in the sheath and move jerkily.
The sheath may become inflamed and press on the tendon
Inflammation and swelling in the restricted space of the carpal tunnel can put pressure on the median nerve.
Carpal Tunnel
Tendons are similar to ligaments:
The median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve provides feeling to the palm side of the thumb and to the index, middle, and part of the ring fingers (although not the little finger).
Carpal Tunnel Syndrome
Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists.
Women are three times more likely than men to develop carpal tunnel syndrome.
Cubital Tunnel
Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.
Cubital tunnel syndrome can cause pain, loss of sensation, tingling and/or weakness. “Pins and needles” usually are felt in the ring and small fingers. These symptoms are often felt when the elbow is bent for a long period of time, such as while holding a phone or while sleeping. Some people feel weak or clumsy.
Cubital Tunnel Syndrome
Shoulder
Rotator cuff: group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder
Shoulder injuries:
Back Injuries
ICSOM Survey: 22% of musicians have lower back injuries and 11% middle back
A normal lumbar curve in the back is almost impossible to achieve when seated with one’s hips and knees at a 90 degree angle – forward sloping seats would be helpful
Lordosis: natural curve of the spine
Body Mapping
Amy Likar (Andover certified Educator)
“Your body map is your self-representation in your brain of your own body – how you think it is and how you think you move. Body Mapping is the conscious correction and refinement of your body map.”
Thomas Mark
“Body Mapping is an activity in which, through the training of attention and the refinement of kinesthesia, information ceases to be “external” and becomes “internal”—part of the representation in the brain governing movement.”
Training Attention
Concentration is not a solution—it is part of the problem.
Concentration means directing attention to one thing and shutting out everything else.
The appropriate mental state for musicians is one of inclusive attention.
In order to evaluate the quality of our movement we need to know what to look for.
Attending to our movements without proper information may just serve to reinforce our current habits, since we are likely to call “good” whatever we are accustomed to.
We may know that a certain way of moving doesn’t feel good, but we don’t know how to improve it or how to accomplish the pianistic task any other way.
“Natural” is different from the feeling of “normal” to someone whose habits are poor.
Mapping the Structure
The ear marks the approximate center, front to back.�
The jaw is not part of the skull (attaches at the TMJ joint).
The Skull
Mapping Error: skull is supported toward the back
Mapping Error: head includes the jaw and the neck begins at the bottom of the jaw
The Spine
Twenty-four vertebrae: cervical (7), thoracic (12), lumbar (5)
Sacrum (5 vertebrae fused together) is actually part of the pelvis in function
Tailbone (4) provides attachments for muscles and ligaments, the vertebrae do not bear weight
The weight bearing part of the spine is the front part, close to the center of the body.
Mapping Error: tailbone bears weight, rock the pelvis backward for sitting
Mapping Error: weight is supported in the back
Spinal Movement
Discs permit movement of the vertebrae, movement should not be concentrated more in one region of the spine.
Mapping Error: sitting with a fixed pelvis and moving from the waist
Mapping Error: AO joint seems to be frozen, and the head and neck move as a unit from the base of the neck
The Pelvis
The weight-bearing part of the pelvis is an arch with the sacrum as its keystone.
The sacrum receives weight from the lumbar spine and delivers weight through the arch of the pelvis to the legs when we are standing, or to the sitting bones (or “rockers”) when we are sitting.
Mapping Error: the hip joints are lower than one thinks
The Foot
The foot is somewhat like a three-legged tripod, and we stand on the middle of it, not on one of the edges.
Mapping the Arm
It is vital to map the shoulder blade and collarbone as part of the arm.
The shoulder blade and collarbone do not connect to the ribs, nor do they rest on the ribs.
The arm structure attaches to the rest of the skeleton in only one place, the sternoclavicular joint, where the collarbone meets the breastbone.
Mapping Error: many pianists think that their arms end at the shoulder joint.
Mapping the Point of Sound
The key reaches the point of sound before it reaches the keybed.
Nothing that happens after the key passes the point of sound can change or affect the sound.
The volume and quality of the sound depend on the velocity of the key descent, not on the amount of weight or force delivered to the keybed.
The optimum point of contact is not the fingertip but slightly further cack, more on the pad, one reason is that the pad is a rucker source of tactile information.
Sitting at the Piano
Resources
Horvath, Janet. Playing (less) Hurt. Kearney, NE: Morris Publishing, 2002.
Mark, Thomas. What Every Pianist Needs to Know About the Body. Chicago: GIA Publications, 2003.
Norris, Richard. The Musician’s Survival Manual. Saint Louis, MO: MMB Music, 1993.