Preventing and Resolving Piano Injury

Elizabeth “Beth” Mueller Grace spent thousands of dollars seeking the help of specialists in resolving her piano injury. Grace, a highly-trained pianist and teacher, is determined to pass on what she finally learned about healthy technique to others with similar problems.

Grace first experienced extreme hand pain after playing the Brahms Quintet at a summer music festival. She tried dismissing it until she found it difficult to practice, let alone perform.

More than a dozen tests led to anti-inflammatories, braces, and cortisone shots that temporarily relieved the pain. But the pain never fully subsided. Grace was determined to avoid surgery, knowing that scar tissue could create new problems. Rather than give up on her passion, she made it her life’s mission to figure out what it was about her playing that caused her injury.

Fast forward and Beth Grace is now a Certified Instructor of the Taubman Approach through the Golandsky Institute. She credits this work with saving her piano career, allowing her to continue her highly successful studio in Kansas City and New York City, as well as serve on the artist faculty at the University of Denver Lamont School of Music Summer Academy at the University of Denver. Since solving her own problem, she’s been an active clinician, collaborative artist, and directed and taught on the faculty of Rocky Ridge Music Center in Estes Park, Colorado.

Playing with Pain and Tension

“If I’d stopped playing when I was first injured and gotten help in the right way, I wouldn’t have had such a lengthy recovery period,” Grace says. She attributes her various diagnoses (tendinitis of the thumb, frozen shoulder, repetitive strain injury) to the way she learned to use her hands as a pianist. She now looks back on all she went through as a positive experience: “If I can help one person from being injured or help one person not have to go through all I went through, then it will have been worth the journey.”

Causes of injury

Through the Taubman Approach, Grace was able to address underlying alignment and movement issues. She also discovered fingering issues that lead to tension and then pain. For instance, she would strive to use the fingering as written on the music but this would often cause her to stretch her hands in unnatural and damaging ways that led to pain. She has since recognized that fingerings suggested by editors may not necessarily work well for those who perform the music.

The Taubman Approach makes it unnecessary to stretch the fingers or twist the hand to reach notes. According to Grace, “Twisting involves changing the alignment of the forearm and the hand to turn [the fingers] to the side. And when you turn [your fingers] to the side and play down with force, it’s not a good combination. It doesn’t feel good but people think this is the only way to master the passage and remain true to the score. The Taubman Approach allows the pianist all of the creative and musical freedom without the discomfort.”

Listening to Your Body

“If people are playing with pain and tension, it must be stopped immediately,” Grace says. “You cannot keep playing through the pain. The ‘no pain, no gain’ philosophy doesn’t work. Your body is screaming at you when you have pain, that it does not like what you’re doing.” If you keep doing the same activity despite the pain, i.e., the stretching, twisting, grabbing motions as well a a combination of those, the pain will continue and most likely worsen.

Pain also leads to compensation. The injured part of the body may be protected when another part takes over, but this can often lead to a secondary injury. Grace now knows that had she stopped playing and gotten the kind of help she finally found through the Taubman Approach, she could have avoided a long recovery.

Case Study: An Injured Student

“In my experience, pianists are talked to less about how their bodies work and how their instruments work than other instrumentalists,” claims Beth Grace. “That’s because it is thought that almost anyone can play (or make a sound at) the piano., i.e., anything striking a key will make a sound. As a result, most piano students are not taught correct positions and motions.” They end up using techniques that Grace refers to as “hand busters,” i.e., the motions that are likely to lead to injury.

In her work with clients, Grace looks closely at the onset of pain in conjunction with the repertoire. She also observes their previous technical habits. Muscle memory is so strong that a comprehensive re-education process is sometimes required in order to remedy the root problem.

In the video below, Grace works with an injured high school student who is seeking help in anticipation of college auditions.


  1. Suzanne

    At least now I know the pain in my thumb isn’t my imagination, will get worse if I keep playing piano the way it is and that I should get it checked out to figure out what it is and how to fix it (or at least how to not do more damage). I was taught very good technique but you’re right that students aren’t taught about the damage that can occur to your hands and how to manage it. One of my teachers had horrible arthritis in her fingers and seemed to think it was just part of the deal, which might be true but doesn’t mean you shouldn’t look after yourself.

  2. Orlando

    Thank you for all the excellent information. I’m at a point where my left thumb is practically useless due to pain and weakness. Ten years ago I had Carpal Tunnel surgery on both wrists. My job was very damaging to my hands. I studied classical piano when I was a teenager for 5 years and did not return to the piano until I retired 3 years ago. I am now 64 and have been relearning my old repertoire. In January of this year I began to play Chopin Etude 10-12. I had thumb pain before I started practicing the piece but as the weeks passed the pain became worse. I have learned the entire piece and have it memorized but since I played so many months through the pain, practice has now become a painful night mare. A Google search took me to your website and I decided to stop playing completely. I am going to seek a hand specialist orthopedic in the hope of gaining relief so that I may continue to play. Thanks for the advice to stop playing completely to prevent further damage.

  3. Elizabeth


    I am so thankful I found your website! I am a grad student preparing my Master’s Recital, and I am playing the Waldestein, Chopin’s Barcarolle, Liszt’s Un Sospiro, and a Scarlatti Sonata. I know I have increased up my practice hours, but now I have found that the muscle group below my thumb, I believe it is called the thenar eminence, is swollen, and I’m afraid that I won’t be able to perform if it is pretty serious. I haven’t been able to find much information regarding this symptom and piano playing, so I was wondering if you might recognize this symptom and would appreciate any advice you have.

    Thank you in advance!


    • You’re wise to get attention for this before it becomes even more incapacitating. It would be inappropriate for us or anyone else to diagnose and treat you without having direct contact with you. So we highly recommend that you visit the website of the Golandsky Institute They offer training programs in various places in the U.S. and internationally, as well as maintain a list of certified teachers who can work directly with you.

  4. Marina

    Hi! I am 14 years old and have been playing for nine years. About a month ago I developed pain in my right hand from playing a Chopin etude. I let my hand rest for about a month, icing it, wrapping doing stretches and strengthening exercises but it still won’t fully heal. At this point, there isn’t any pain at all until I start to play. I have tried your techniques and will continue to use them. Do you have any idea how long I should wait and how I can know when it is safe to go back to playing piano normally again. I practice 3-4 hrs a day and piano is a huge part of my life. Any advice would be greatly appreciated.

    • Good for you for taking this pain seriously and for writing to us! If you want to be able to continue playing piano without further injury, it’s important to find a practitioner who can evaluate you, ideally in person (Skype would be a last resort).

  5. I have played the piano since I was eight years old. I am now seventy five and have ulna nerve damage in the left hand and radial damage in the right hand. What kind of doctor should I see? Do the nerves rejuvenate? It is difficult to lose my ability to play! Any help is appreciated.

  6. Glenn

    Thank you for the guidance. I have a question. I’m a beginner pianist. I don’t know what’s my mistake while playing, but I got a pain in my under scapular (after 4 or 5 months practice), it feels like burning or cramp. I stopped practice for 2 or 3 weeks and I thought it solved and I start practice again, but after about 4 weeks the pain gradually came back. So again I stopped that for a week. I don’t know what’s my mistake while practicing… and the pain doesn’t disappear. Please answer if any one knows. I want to practice but it’s really frustrating… I still feel the pain. Sorry for my bad English…

    • We suggest you find a piano teacher who knows about performance injury and can help you correct your technique before you have further problems. Look for a teacher at a community music school, community college, or university. If that doesn’t help solve your problem, check the website of the Golandsky Institute to find a practitioner there who may be able to help you.

  7. Belle

    Hi Beth! These videos and the case study especially were very helpful! I’m 14 years old and I’ve never played the piano before, and I’m attempting to teach myself with various videos showing me proper posture and hand placement, etc as I am not in the position at this time to afford a constant teacher. I have done my best to sit with the piano to my belly button level to avoid any stress in the shoulders and any bad placement of the wrists, but I am not completely sure if what I am doing is correct. However I occasionally feel pain in the joint from my shoulder to neck and somethings in the muscles right below the elbow. I wasn’t sure if this is just the pain from my lack of experience and if i just had to play more and get used to it; or if this was the result of starting with hand placement. How do I really know? Could you please advise me on this issue? Thank you so much!

    • from Beth Grace: One should never feel ANY pain or discomfort while playing the piano. Pain is our body’s way of communicating to us that we are moving incorrectly, rather than an indication that we lack experience. The best plan is to seek the advice, when you are able, of a good teacher who can evaluate your posture and show you the correct movements from the beginning. Building a solid technique from the ground up will lead to future success and avoid a lifetime of problems.

  8. Dennis

    College 4 years IUSB piano major. One Senior recital short of a degree in piano performance. Had a Grad assistant at ND. Could not finish either because of so much pain. It got to the point of not being able to move. So………..I stopped. I’m now 69 years old and just finding out how to solve some of these problems by myself from videos like this. Still having some pain. Don’t know if its age or incorrect positions. Or both. Would like to do that recital before I leave this place.

    • Glad to hear you’ve found this article and the videos useful. You might also benefit by meeting with someone trained in working with these problems, who can assess your hand/finger positions and posture, see correlations with pain, and provide direct feedback and suggestions.

  9. enid

    I have just started playing the piano again (I stopped for over a decade) and I already stressed out my RH within just 2 weeks of practicing. So I figured, I must be doing it wrong and stumbled upon this site. My forearm feels a little tight and my fingers have tingling sensation (at rest) and my ring finger feels worn out especially when doing RH arps; so I’ve stopped playing for the third day now.

    I’d love to relearn the piano technique–and keen on not ending up with more injuries. I’d be re-starting from lower level lessons just to establish THE better way of playing (i.e. without straining). By the way, should I get a teacher? Or is it possible to learn this on my own?

    Thanks for this videos. I feel more inspired.

    • The discomfort you mention here is an excellent indication that your hand positioning, posture, and possibly more are needing to be adjusted. Much of it is about unlearning old habits that cause problems. Ignoring these warning signs could easily result in even greater problems. It would be very helpful to get a teacher who addresses all of this in addition to being an excellent teacher.

  10. Jan

    I am in my 70+ learning piano which has been fine without any pain or dicomfort but have now developed severe weekness in my fifth and fourth fingers of my left hand which appears to be entrapment of some area of the ulnar nerve, diagnosis is still underway, this makes it very hard to play chords or hold down my 5th finger as the finger is too weak. My question is should I carry on trying to use that hand or rest it? I get great enjoyment from the piano, and do not wish to stop learning, and do not want to make matters worse. I think it is very important to know about correct position and placement at the piano, but it seems to me that not many teachers know what to do if there is a problem. Can you please advise me with this issue.

    • Many piano students have learned to play in ways that have led to injuries. Our recommendation is to not try to push through and play right now, but instead to rest your hand. We hope the author of this article will add some input as well. In the meantime, we hope you’ll find other ways to enjoy music until you are able to play without further injury to your hand.

  11. Johan

    Dear Beth, I saw a few of your youtube videos on injuries. I do have pain in my thumbs from time to time and I want to prevent it by learning your way. Is there a way I can do this without a teacher? Do you have instruction or videos showing how to learn be tension free at the piano?

    • Johan, thank you for your message. I’m so sorry you’re having pain. There are many helpful resources online at Edna Golandsky also has a blog and has posted a number of helpful videos on YouTube. Visit to read her blog. There are also 10 DVD’s explaining the Taubman Approach which can also be purchased online through the GI website.

      I am happy you’re recognizing that your thumb pain isn’t natural and that it is possible play pain-free. I don’t know of anyone who has had success fixing problems and eradicating pain without a teacher. However, the Golandsky Institute has teachers in many locations (see the Golandsky Institute website) and many of us teach by Skype.

      Warm regards,

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