Avoiding Piano-related Injury: A Proposed Theoretical Procedure for Biomechanical Analysis of Piano Technique

Several biomechanical studies have been done with regard to the fingertip, hand, wrist, and upper arm in pianists. However, these studies have generally focused either on one isolated part of the anatomy, or on one specific motion. It is notable that none of the studies conducted to date examines the execution of a technical skill at the piano, such as a scale or arpeggio, in terms of the cooperative work done by all involved parts of the anatomy. Drawing upon established quantitative data, this study took a qualitative approach in describing and analyzing the execution of selected piano technical tasks. The procedure developed for conducting a biomechanical analysis can be readily applied in both medical and pedagogical venues with the goal of preventing injury. Med Probl Perfwm Art 15:55-64, 2000. F ocusing on human anatomy as a critical factor in piano technique is a somewhat recent innovation. Only since the late-nineteenth and early-twentieth centuries have pedagogues begun to address the motions of piano playing from a scientific or objective perspective. Some of their beliefs have been validated by later scientific observation. However, many of these pedagogues based their recommendations on an incomplete or even incorrect knowledge of anatomy and human motions. Their terminology in discussions concerning anatomy is frequently imprecise and many of the recommendations of these pedagogues are contradicted by medical, biomechanical, and/or ergonomic observations. Therefore, some of the practices and techniques recommended by these pedagogues have the potential to contribute to injury development. Undertaking systematic qualitative analpis of movement patterns performed at the piano can offer valuable information in developing or modifying piano technique. In developing technique, students and teachers have typically relied primarily on recommendations of skilled performers. However, advice offered by individual players is most often based on individual subjective experiences. Though such recommendations may prove helpful, in many instances they may actually be counterproductive to the development of biomechanically appropriate piano technique. Understanding of human biomechanics has vastly improved in the last hundred years. Dr. W~isten is assistant professor of piano at Chadron State Colkge, Chadron, Nebraska. Address correspondence and reprint requests to: Brenda G . Wristen, Ph.D., Chndron Stare College-Music Department, 1000 Main Street, Chadron, NE 69337. e-mail: . With input from the recently developed sciences of ergonomics and biomechanics, it is now possible to examine piano technique in order to determine how the human body may be used maximally and most efficiently. Since medical, biomechanical, and ergonomic studies have theorized that some physical motions, most notably extreme wrist motions, can contribute to the development of an injury, it is worthwhile to examine piano technique with the aim of minimin ing these motions. Unfortunately, qualitative studies with regard to motions used in piano playing have generally focused on motions so small and isolated from the integrated work done by the entire upper half of the body as to be completely inapplicable to practical piano technique. Wagner is perhaps the most familiar name associated with biomechanics and anthropometry of the hand. 'n2 However, Wagner dealt mostly with hand anthropometry, attempting to correlate relative success as a pianist to the size of the hand span and joint mobility. Wagner did attempt to measure active joint mobility, and demonstrated that the range of mobility in healthy joints, notably the meta~ar~ophalangeal (MCP) 1, was very wide. He also observed that pianists employ a position of pronation for inordinate periods of time. From these data, he attempted to develop an "ideal" hand profile for success in piano performance based on hand measurements. He suggested that this profile might be useful in improving the performance of "those who do not belong to the small group of people who are manually specially gifted," specifically by identifying certain players as at risk for occupational injury and in contributing to the ergonomic design of the piano. However, Wagner did not attempt to address the application of biomechanical forces to the playing apparatus or hypothesize motions that may potentially lead to injury. He noted that this task was an important one to be addressed in the future, but was beyond the scope of his present study. This project represents an attempt to identify potentially harmful motion in piano technique at large, and to theorize about normative motion patterns for selected skills. Trpes of overuse injuries commonly suffered by pianists were reviewed to discover presumable patterns of etiologies. Relevant medical, biomechanical, and ergonomic studies were reviewed to determine which motions used in piano playing may have the potential to cause injury. Building further upon theories gen-