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Shirley S Kirsten

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Sports, Piano, and Injuries (Videos)
by Shirley S Kirsten   
Rated "G" by the Author.
Last edited: Wednesday, September 07, 2011
Posted: Wednesday, September 07, 2011

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Overuse injuries often spring from stretching the piano practicing limit. Just as pitchers might be sidelined for not taking necessary rest periods between extra inning games, pianists are vulnerable to the same.

You can't avoid it. Athletics is part of piano playing and if you abuse your hands, arms, wrists, let alone your fingers, you'll end up like a pitcher who's benched for most of the season.

Last tonight I pushed the envelope, upping the tempo of Domenico Scarlatti's Toccata in d minor, and after a zillion re-takes, the repeated notes dissolved into a drone, lacking desired definition. By that time, I had a recorded a few earlier playings with ample adrenaline. But by evening's end my fingers were like silly putty, and my arms felt achy. Like a pitcher, I had gone too many extra innings after a full night' work.

Word of warning: Even if you have a big arm swing, and can mix up your stuff, over-playing, especially repeating a particular motion over and again can cause an overuse injury.

From The Harvard Medical Alumni Bulletin, Summer 1999:

"Fred Hochberg, a neurologist at Massachusetts General Hospital, began treating instrumentalists’ injuries about 15 years ago, when a friend asked him to meet with Gary Graffman, a world-renowned pianist who was having difficulty with his right hand.

“He couldn’t lift his fourth finger,” Hochberg says. “And he wasn’t the only one—he had a list of friends with the same problem. These were pianists who played the same repertoire, what are called the heroic pieces.”

"Lifting the ring finger is difficult because it is inextricably tied to the middle and small fingers, Hochberg explains. “The tendons supplying the ability to extend the fourth finger are actually linked to the middle and small fingers.

Focal dystonias, involuntary movements of fingers, or an inability to freely move any one or more of them have affected pianists such as Leon Fleisher and Byron Janis who frequently practiced the big warhorse repertoire.

Selective Movements

"About two-thirds of Hochberg’s musician patients present not with dystonias but with overuse injuries. “They have a localized inflammation of the joint or tendon, probably due to microscopic tears of the tendon with hemorrhaging,” he says. “Almost invariably, the problem is related to the shoulder. Your arm weighs between 15 and 20 pounds, and even though playing an instrument tends to involve selective movements of the fingers and wrists, your shoulder musculature takes most of the brunt of the movement. Most people can’t stabilize their shoulder while using their fingers.”

"Hochberg recommends physical therapy and exercise to return a normal range of movement and to strengthen the muscles needed to stabilize the shoulder. “Playing an instrument is not good exercise,” he says. “You would think the more you play, the stronger your arm would get, but that’s not true .”

"Of the thousands of patients Hochberg has seen, fewer than 30 have undergone surgery, most commonly for carpal tunnel syndrome and ulnar nerve entrapments. On average, Hochberg says, patients take three months to recover. During that time, they may only play for ten to fifteen minutes at a time, two to three times a day.

"Michael Charness—director of the performing arts clinic at Brigham and Women’s Hospital and a member of the Charness Family Quintet with his wife and three children—has a unique take on what it means to be a pianist with an injury.

“I started treating musicians because of my own injury,” he says. “I was starting to play some difficult pieces. The more I practiced, the more my fingers weren’t doing what they should. They were sluggish, less accurate, and less controlled. I had an electromyogram, which was normal. I had a fairly normal hand exam too, but I felt I had an enormous problem.”

"Eventually, Charness underwent surgery to decompress his ulnar nerve on both sides. That was in 1984, and he slowly regained his strength and facility. “It was both frustrating and fascinating,” he says. “I had a debilitating problem, yet my hand appeared normal to skilled clinicians.”

"Charness sees focal dystonias as particularly vexing. “It’s a bizarre disorder,” he says. “People who have spent many years acquiring musical skills lose the ability to perform because their hands pull into a position that makes it impossible for them to play. Their ring finger, for example, may pull into their palm when they play a scale going up but not going down. For others it’s a more general degradation, although outside the context of playing an instrument, their hand appears normal.”

When Charness meets with patients, he watches them play their instruments. “We’ve learned how to change people’s position to make it easier to sustain playing,” he says.

How much practice is too much? “That’s a difficult question,” Charness says. “I think most people ought to be able to get everything done in four to five hours or less. It has to be individualized, but there are some general principles that encompass, for example, not playing for more than 25 minutes without a break.”

*****

I personally knew last evening, when it was time to stop, but it was well beyond Charness's recommended half hour break.

Veda Kaplinsky, a Juilliard faculty member and frequent judge at international competitions, said in a recorded interview, that after 5 or so hours of piano practicing, the blood supply to the muscles diminishes.

So right! That spurt of energy flowing down the arms into wrists, hands, and fingers maxes out and then begins to run dry. It's the body's warning to heed!

Before my reserves were thoroughly depleted I managed to post an upped tempo performance of Scarlatti's Toccata in D minor. This was a daredevil challenge to myself, notwithstanding the risk of overdoing it in one recording session.

http://www.youtube.com/watch?v=5Mi0M6Kntgs

http://www.youtube.com/watch?v=qdkwrsFM9QA

 

RELATED:

http://arioso7.wordpress.com/2011/09/05/domenico-scarlatti-toccata-in-d-minor-k-141-how-to-play-rapid-repeated-notes-and-make-hand-cross-overs-easier/

http://arioso7.wordpress.com/2011/07/10/piano-instruction-avoiding-injuries-using-butterfly-by-edvard-grieg-as-a-slow-practicing-example-video/

 

 

 



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