Preventing Discomfort or Pain for Pianists

By Brenna Berman

Preventing discomfort or pain for pianists starts by addressing the underlying cause of the problem. Repetitive incorrect use of fingers, hands and arms can challenge even the most proficient performer. 

The following tips will be useful for beginners, advanced pianists, and anyone taking keyboard classes. They should also be helpful if you spend long periods of time on the computer.

Correct seating

Problems may stem from how you sit at the piano and what you sit on. Sitting on a bed or cushions when practicing can result in a variety of problems as can incorrect bench height, how you sit on it, and its distance from the piano.

Sit on the front half of the bench with your feet flat on the floor. Your feet should be under your knees, carrying some weight in them, aiding your back muscles in keeping you upright. This should allow for an easy, straight posture. Avoid having shoulders back and spine curved in.

To figure out the ideal piano bench or seat height, your elbow should be at the height of the top of the white keys. Half-inch-thick 12’’x12” foam mats can be added to the bench to help you sit at the right height. 

When you put your hand on the keys and lean slightly forward, your upper arm and forearm should make an angle slightly larger that 90 degrees. This allows for the best leverage of your forearm over your fingers.

Timing your practicing

The best time to practice depends on when you feel most able to concentrate. Extended concentration and productive practicing use an area of the brain called “working memory.” 

Working memory is a limited resource. If your working memory is depleted, practicing will likely be unproductive and you will be less able to recognize physical cues and warnings that you are doing things incorrectly.

Short, concentrated practice periods (up to about 45 minutes) are more likely to be productive. Note that you may be able to accomplish more in 15 minutes of focused practice than in 2 hours of unfocused practice. Recognize when you lose attention. It’s an important skill to develop.

If the only time available for practicing is when you are mentally fatigued (e.g. after many hours of homework), try to refresh your mind before practicing. Take a walk, do some jumping jacks, have a snack, lie down for a minute, stare at the wall, whatever gives your mind a rest. We can often recharge our working memory with short breaks or snacks.

Practicing on top of pain is generally not worth the risk of causing a more serious injury. If you are in pain, investigate the injury before practicing. Practicing after strenuous activity resulting in physical symptoms (e.g. arms aching after computer use) is a set up for problems. If you are physically tired or mildly sore from your previous task, proceed with caution. Rest before practicing if it makes the tiredness go away. 

If you do not have time to rest or rest does not make things better, it is best to skip the practice. Fatigue and soreness can make it difficult to discern between a movement error and leftover soreness. 

Practicing before a performance

As a performance approaches, it becomes less likely that you can make improvements. The more important consideration is having lots of energy for the performance. Gigs are usually quite draining due to the adrenaline involved. I shorten my practice in the last week before a concert. To save my mental energy, I only do brief rehearsing (less than an hour) on the day before and the day of a performance. I also get good sleep and eat well. I used to cram practice before performances, and I have had much better success with this “tapering model” common to athletes.

Piano habits causing fatigue, tension, pain or injury

It’s important that your fingering doesn’t make your hand do things that can lead to tension and injury such as stretching (between fingers), twisting (defined below), curling of the fingers, or crowding the fingers. Be careful to avoid fingering dogmas that ignore the physical effect on your hand. Find fingering that is comfortable and easy to portray the music on the score.

Habits that can lead to problems include:


This occurs when you use your fingers independently, without the help of your hands and forearms. If it is isolated, repetitive, and over a long period, it can cause problems. Isolating can happen in the lifting or dropping of the fingers and commonly causes tendinitis (inflammation) or carpal tunnel syndrome (pressure on the median nerve of the forearm and hand).


Injuries like tennis elbow (inflammation of the tendons that join the muscles of the forearm to the outside of the elbow) can result from pushing on the bottom of the key bed with undue force. A key will go down effortlessly if the forearm is helping the finger.


When your knuckles, wrist, or elbow collapses while playing a key, the fingers tend to isolate and you use more effort than necessary. Back and neck injuries often result as the body compensates for the collapse.


If you over curl your fingers by pulling them in from the knuckle closest to the nail, your arm will tighten, often leading to carpal tunnel syndrome.


Twisting” is the Taubman term (see side bar) for “ulnar deviation.” It happens when you bend your hand towards your wrist. This tightens your arm and causes myriad symptoms, often including pain on the side of your wrist.


By stretching to play a piano key, opposite muscles are activated at the same time. This results in tension. 

Warning signals

There are usually milder signs to pay attention to before other symptoms show up.

Indications that you’re doing something incorrectly may include:

• Unpredictable wrong notes

• Discomfort, tension, or fatigue

• Difficulty playing fast

• Inability to control your hands

• Inability to play with ease

• Unpredictable tone 

Ignoring these signs can lead to pain, tingling or numbness, especially in your forearms, wrist, neck or back. Serious injury can result.

Final takeaway

It’s important to figure out the cause of your problem, not just treat symptoms. If you experience any discomfort, quickly stop playing and investigate the cause before continuing. 

If your piano technique is the cause of your discomfort, treatments such as physical therapy, acupuncture, surgery, massage, botox shots, and cortisone can potentially mask the problem. The treatment could even make matters worse and cause more problems if you continue to practice incorrectly. You may find some temporary relief from these types of treatments, but the vital issue is to get to the root of the problem and solve it.

Bio: Brenna Berman is a Certified Master Teacher of the Taubman Approach, Executive Director of Effortless Artistry Music and a Golandsky Institute Associate Faculty member.

Taubman Approach

The Taubman Approach teaches efficient movements, making it possible to play musical instruments without limitations, fatigue, or injury. It incorporates body mechanics, basic physics, and a thorough understanding of the interaction between the body and the piano. In addition to being able to prevent and cure fatigue and pain, it enables an effortless technique where the pianist has utmost control over speed, accuracy, piano tone, and artistry.

The Taubman Approach has been used to heal and prevent injuries including: tendinitis, carpal tunnel syndrome, arthritis, rheumatoid arthritis, dystonia, focal dystonia, and general fatigue and pain. This approach helps pianists and other instrumentalists as well as anyone whose profession demands repetitive use of the finger, hand, and arm (computer users, writers, etc).

Also see: Preventing and Resolving Piano Injury


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