• Excessive training : Musicians are especially prone to overusing the small muscles of the hand and arm from long and demanding playing and performance schedules that require high repetition, and rapid, complex, coordinated movements

  • Changes to instrument or playing routine: Changing the instrument or playing routine without gradual practice can put extra strain on muscles and tendons that have not been conditioned properly

  • Quality of instrument: Instruments in poor condition with leaking valves, or keys require extra force to generate the sound that in turn can lead to musculoskeletal pain and injury.

  • Poor posture: Prolonged awkward playing postures place excess force across muscles and joints that can lead to musculoskeletal pain and injury.

  • Psychosocial factors: High pressure and performance anxiety can contribute to stress which in turn can exacerbate normal aches and pains.

  • Environment: Poor playing environment with inadequate temperature, space and light can lead to a range of musculoskeletal problems.



  • Physical warm up: warming up before playing increases the blood flow to the muscles and allows for playing longer with less pain and fatigue

  • Rest breaks: take a minimum 10-15 minute break every hour

  • Mindful practice:  Alternate repertoire and focus on problem passages. Don’t cram.  Supplement physical practice with mental practice and shadow practice to preserve your endurance.

  • Smart practice: vary the repertoire and gradually increase intensity and playing time.  This is especially important after vacation or injury. Stagger playing schedules throughout the week, and give your body one day a week of complete rest.

  • Pay attention to pain:  Rest and listen to your body.  If symptoms do not disappear seek attention from a healthcare provider who specializes in musician injuries

  • Pay attention to the environment: Make sure you are practicing in a room that has the right temperature and adequate space and light.

  • Instruments: Make sure your instrument is properly tuned and repaired, and has the right dimensions for your body.  Consult with a specialist who can make recommendations about instrument modifications to make playing more comfortable and safer.

  • Body mechanics: good posture and body mechanics place less stress on the joints and muscles and allow for longer and more efficient playing. Consult with a specialist who can make recommendations about posture and position, and can prescribe stretches that are specific to your instrument and performance demands.

  • Stay calm: Panic and anxiety can increase normal aches and pains.  If you feel an ache or pain, do not panic. Rest and ice. Most minor injuries disappear after a short rest or a few days.  If your symptoms persist seek medical attention from a specialized provider.