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Making music is a joyful experience

But pain can drain all that joy right out of you. When we listen to music, it often sounds effortless and depending on the type of music, can evoke an excited or relaxed feeling. Though good musicians make playing look easy, it’s demanding work. The precision and skill needed to do it well is physically and mentally arduous.

Take Alaina:

She had to play a complicated piano piece for Opera Steamboat, but her elbow started to hurt, which progressed to finger tingling. She was leaving in a week to go on assignment for the summer, and wasn’t sure how she was going to continue playing music. Sure, she could practice and play, but not without elbow and hand pain, so it wasn’t as fun as it once was. She didn’t have the luxury of stopping her activity to let the injured tissue recover – she had to make a living. To feel better while playing, required teaching her body new movement patterns. While relearning how to play an instrument might sound crazy, it’s much easier for professionals than you think.

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During the Evaluation

The most important component is watching musicians play their instrument, or sing. Trained PTs can pick up on subtle movement patterns that have become dominant when they don’t need to be. In fact, in most aspects of your life, the more ways you can move to accomplish a task, the less pain you will have. When brains claim a single movement pattern as the only viable option, pain can be created in two ways:

  1. An overuse injury develops as a repeated movement stresses a certain tendon, ligament, or nerve. The surrounding muscles get weak when they rely on the passive tension of ligaments or tendons to stabilize the joint.
  2. Brains begin to predict that pain will occur when a certain pattern of neurons light up. This can occur after a time that normal healing should have taken place. Or, even if the musician is in a stressful situation, a movement pattern may start to be associated with the stressful situation, resulting in pain.

Often, both scenarios will emerge simultaneously. The more chronic the injury, the more the brains adapt to these predictive patterns. However, addressing the movement pattern alone may also help to break up the pattern of neuron firing in the brain that has become predictive of pain, making the same task in a new movement pattern not painful. Most of the time, musicians don’t have the luxury of stepping aside from their activity, and will either have to play through the pain, or lose income. Learning how to move differently while practicing may be enough to manage or eliminate the pain during performances too.

Back to Alaina:

The first thing we had her work on was keeping her shoulder blade lifted as she played (not pulled down and back as the rest of the world suggests). For a more thorough rant on this matter check out our Instagram post:

Check out the movement assessment of Alaina’s hand movements and correction in the video below:

Other helpful treatments we may implement for musicians are:
  1. Additional movement tasks to help solidify the new movement pattern – often incorporating proximal stability (often in the shoulders) to improve distal mobility (in the hands).

                                    Typing while squeezing a ball with your pinky and holding a ball with straight fingers,                                    both to help improve the stability of the fingers by strengthening the palm.

     2. Resistance training while playing your instrument:

Holding it up an back into a more neutral shoulder position.

      3. Or general resistance training to strengthen the weak, underused muscles.

For more information on Alaina’s piano prowess, check her out at

If you are having difficulty playing an instrument without pain, or know someone who is, reach out to see how we may help you at ALTA in Boulder, CO! (Just remember to bring your instrument to your appointment😉).


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