Help me prevent a stress-related piano injury! (Shoulder pain/tingling)

February 15, 2013 3:07 AM

YANMD, but: I have been practicing a bit of piano as of late. Maybe too much, as I started again out of the blue, and am working on a song that is relatively difficult for me. i noticed recently that my left shoulder is starting to tingle while playing. At first I thought it was just a one-day thing, but the problem is persisting and seems to be getting worse.

It's a tingling sensation under the shoulder blade that travels a bit down the arm. It doesn't hurt, but it certainly distracts my playing and I want to nip this in the bud before it gets any worse. The last time I had it it went away quickly, but I still feel it as I type this message (but not as bad as when I was playing the piano). My right side is just fine, no uncomfortableness at all. In any case, I am taking a hiatus from piano until I recover.

Even before the tingling began, I would definitely notice tension building in my left hand/arm while practicing. My left hand is not as skilled as my right at the moment, which also may have something to do with it being in just one shoulder. I also think that my bench is too high, as my forearms and wrist are too far up from the keys.

The only other things I can think of that might possibly be related are that I am drinking way too much coffee lately and not exercising enough. But I'm not sure how that would translate into this shoulder-tingling while playing piano.

Also: I am a rather anxious person by nature. I have an unfortunate tendency to get inside my own head and tense up when performing any kind of activity. I also have had bruxism since I was a child. I have been under a lot of stress lately, and I can feel it in my body (especially in my neck and shoulders, but this is the first time I've had tingling). I have been asking my girlfriend for too many massages as of late.

In the meantime: Has anyone had anything like this (tingling, numbness, tension) happen to them while playing the piano before? How did you solve the problem? After I have recovered I would like to ensure that this does not occur again.

Thanks in advance - I rely on the piano as an outlet for stress, so I most definitely do not want my playing to become another reason for it!

PS: I am unemployed at the moment, and have an appointment for reduced pay health insurance but it is not for a few weeks. So please keep the responses to things I might be able to do on my own in the meantime. Once again, I know that YANMD.

posted by Thanquol180 to health & fitness (7 answers total)

Check your posture and height. One of the most common mistakes is leaning forward and putting weight on the arms. Your abdominals should be doing most of the work in keeping you upright, and your lower arm should be pretty much horizontal. Most of the variation in touch comes from the wrist and hand - avoid a whole-body forte.

I use the Vitruvian man as a teaching aid (one school I taught in had a fig-leafed version on the wall) - correct posture should allow the same range of movement and keep the same bit still (less so the legs with piano - but I also teach organ, where it's important to have the movement in legs/feet as well).

Video yourself playing, from the side and the back. Check everything's symmetrical and balanced. All good practice rooms have full length mirrors, which are great for wind and string players, but useless for pianists as the act of looking in them throws your posture out.
posted by monkey closet at 3:27 AM on February 15

not exercising enough. But I'm not sure how that would translate into this shoulder-tingling while playing piano.

Vaguely:
Exercise can help increase blood flow to an area, which in turn can combat rsi.
Exercise can help your posture, etc. This can help fix a wrist pain which is actually a pinched nerve in the shoulder.
There's also something about inflammation and exercise...

I also think that my bench is too high, as my forearms and wrist are too far up from the keys.
This would need fixing, yes.

So please keep the responses to things I might be able to do on my own in the meantime.
Don't suddenly overdo it on the computer and video games since you're doing less piano.
posted by sebastienbailard at 4:09 AM on February 15

Your elbows should be below the level of the keys by an inch or so, and you should sit far enough back that they are just forward of your chest if your back is straight - and your back should be straight. If you can't do this on the stool you have, you need a new stool.

After that, it's about relaxation. I had major problems with being too tense in my shoulders and upper arms, something I'm still not entirely over, but it's much better now.
posted by fearnothing at 4:24 AM on February 15 [1 favorite]

Seconding that relaxation is the key, after general posture. Your neck, shoulders, and arms down to your wrists should all be pretty relaxed while playing. My piano teacher used to reinforce this by occasionally slapping my forearms upward from below. They were supposed to fly up from the keyboard when she did this. If there was resistance, it meant I was not relaxing enough.

The tingling thing is likely not coming from tension in your wrist or fingers, but in your neck or upper back. It is a typical symptom of a pinched nerve in that area. Pay attention to what your are doing with your head. Are your shoulders, neck and even facial muscles relaxed? Are you tilting your neck in a strange way, or holding your head bent forward or sideways?

For relief you want to do things that relax neck muscles around the pinch. Do a bunch of different neck stretches, which you can Google or probably find on YouTube. But in general, sit up straight, (1) twist neck all the way left, back to center, all the way right, back to center, repeat 10 times, (2) bend neck all the way forward, back to straight up, all the way back, back to straight, repeat 10 times, (3) tilt neck all the way left, back to straight up, all the way right, back to straight up, repeat 10 times, (4) introduce a forward motion and back at the end of the left and right tilts in #3, (5) with head straight up, image someone pushing on your chin and move head backward without changing position of shoulders, return to normal, repeat 10 times, (6) stand up straight with arms straight out, move arms in 10 inch circles backward, forward for count of 30-60 each way, (7) same thing with larger circles. Then shake everything loose to really relax. Beyond that you could also apply hot and cold treatment — 5 minutes of cold pack, 5 minutes of hot pack, repeat 2-3 times, do that 3 times daily. Neck massage if a friend will do it for you.
posted by beagle at 5:07 AM on February 15

There are piano instructors and general practitioners specialising in Alexander Technique for piano. It would likely be a good investment of your time, both in giving you relief and correcting your posture and positioning whilst playing, to consult with a piano specialist practitioner. They're a thing.

Note: I am not the least bit woo and while individuals may be woo (or not) AT is legit.
posted by DarlingBri at 6:03 AM on February 15

Appending to my previous comment: if a regime of better posture, stretches etc. doesn't fix this in a week or two, you need to see someone for a real diagnosis, because tingling could be a precursor to nerve damage resulting in loss of muscle strength and dexterity, which takes a lot longer to fix.
posted by beagle at 9:56 AM on February 15

I've not had shoulder tension while playing the piano, but I have had it in my forearms and elbow, as a result of too much tension. Do take a brief break from it, or at least take a break from the sections or pieces that are giving you trouble. It's always gone away on its own for me, but with a bit of time and rest. In general, your bench being too high is going to be less of a problem than your bench being too low. Your anxiety and tension in your shoulders might be a more likely cause of the problem.

If, as you said, you just resumed playing after a long break it would probably be advisable to start on something that's easier for you before you jump into a challenging piece. Frustration can lead to tension.

I'm trying to think of what shoulder tension might be from - Are you playing pieces that require fortissimo? One tricky technique problem is being able to use the natural weight of the arm to play fortissimo rather than straining your muscles to produce extra force. Heinrich Neuhaus compared it to letting the arm drop onto the piano as if you were dead. It also could be that if you're stressed out, your shoulders are naturally raised into that guarded posture people get into.

There are some really good videos from the Taubman Goldansky institute on Youtube that talk about movement retraining for injured pianists (but it's also good general technique advice). Not sure if it would get directly at the specific trouble you're having, but it might be useful in any case. Finally some simple mindfulness exercises during practice might be beneficial to you. Sometimes I meditate for five or ten minutes in the middle of piano practice and it does wonders for body awareness, purposefulness and relaxation, even if I look weird sitting in the practice rooms doing it.
posted by mermily at 12:21 PM on February 15