A Musician’s Guide to Avoiding Injury

Marina McLerran

Editor, McLerran Journal


We have all done it; pushed past the pain for the sake of a musical performance, but what are the potential long-term effects of these decisions? Because of the long hours musicians spend performing repetitive motions, we are at high risk of developing potentially permanent conditions or injuries if care is not taken to avoid unnecessary tension in the body. Music educators must make it a daily priority to remind their students about proper posture and the warning signs of dangerous medical conditions in order to promote a culture of healthy habits.   

The Power of Proper Posture

Posture is defined by Merriam-Webster as “the position or bearing of the body whether characteristic or assumed for a special purpose.” Good postures, according to the Cleveland Clinic, are positions that place minimal strain on supporting muscles and ligaments. Individuals who make a conscious effort to practice good posture are less likely to suffer from conditions like arthritis, or excessive muscle fatigue and pain (Cleveland Clinic).

American Chiropractic Association Guide to Good Posture

It is critical that music directors at all levels take the time to remind their musicians to sit properly and without tension, especially in long sessions of sitting without a break or before particularly stressful performances. Recently I had a private lesson student approach me about why it might be that her neck and shoulders ache after playing clarinet. I asked her to please get set up in her normal playing position and then paused for a moment and suggested she lower her shoulders. She was able to lower them nearly three inches and then looked at me with such a look of surprise! Mystery of the aching back solved; it was improper posture that was causing her musical experience to be a source of pain. In her book, “Playing Less Hurt: An Injury Prevention Guide for Musicians,” Janet Horvath discusses the importance of having proper posture and divides a musicians’ movements into two categories: dynamic and static. Dynamic movements are described as fluid actions in which the muscles alternate between tension and relaxation and blood flow is not hardly restricted. Static postures, in contrast, are much more strenuous, and significantly more likely to cause damage to the individual’s tendons, ligaments, and discs if performed too frequently and without rest (Horvath, pp. 33). An example of this type of “static load,” according to Horvath, would be sitting with one’s head bent in any direction. For the entirety of the time that your body is in this position, your neck and shoulder muscles are working to support your nearly fifteen-pound head and blood flow is being restricted. This type of tension can affect the “surrounding nerves, many of which extend down the arm” and eventually lead to disc or nerve problems, headaches, and eye strain (Horvath, pp.34). To avoid injury from improper posture, directors must regularly encourage musicians to evaluate their playing positions. This can be as simple as having an “alignment checklist” for your ensemble* or pausing periodically and asking them to politely evaluate their neighbor’s posture. Having proper playing posture must be a priority of the conductor throughout the entire rehearsal process in order to protect the health and playing ability of the musicians.

*With my beginners I try to make a daily effort to remind them that their feet should be flat on the floor, their shoulders should rest comfortably directly over their hips, and their ears should rest comfortably directly over their shoulders. Their spine should form an “S” from ear to hip.

The Risk of Repetitive Strain Injuries (RSI)

Repetitive Strain Injuries (RSI) are defined as “damage to tissues caused by repeated physical actions” (ADA Health). Common conditions that fall into this category and often affect musicians include carpal tunnel syndrome, epicondylitis (tennis elbow), and tendonitis (ADA Health). According to Horvath’s research, the majority of these issues occur in musicians’ shoulders and wrists (Horvath, pp. 41-42). In fact, she estimates that shoulder pains are “the third most common complaint instrumental players bring to doctors” (Horvath, pp. 41). Warning signs of these conditions include persistent pain or a burning sensation, weakness, impaired dexterity, numbness, or stiffness (Horvath, pp. 29). If addressed immediately, the majority of these RSI conditions can be reversed over the course of a few months, but if left unattended, these issues can eventually require surgical solutions (ADA Health).

It is the responsibility of music educators to establish a culture of self-care within their programs; remembering that musicians are people first. With selective word choice, directors can encourage more balanced and fluid motions that protect the ensemble’s physical health. Horvath suggests avoiding words like “strike” or “attack” (except in occasions that actually merit the style) and potentially harmful practices like asking musicians to play fortissimo, or louder, constantly (Horvath, p. 40). Educators, according to Horvath, can also help their ensemble practice healthy habits by providing stretch breaks in the middle of long rehearsals and allotting time for rest when creating concert or tour itineraries (Horvath, pp. 22-24). During rehearsals, instrumentalists should be reminded to avoid the overuse of pressure, jerking movements, or tense postures to can all cause damage over time. Minor changes in technique, like experimenting with the height or angle of the instrument (for string players especially) can have a major impact on an individual’s level of comfort during practice (Horvath, pp. 42-43). Conductors can help create a generation of self-aware musicians by simply taking an interest in the personal health of the musicians in their ensemble.  

Learn more about RSI diagnosis and treatment here  

In conclusion, yes, the show must go on, but not at the cost of one’s physical well-being. It is a major responsibility of music educators to encourage their students to recognize the warning signs of these dangerous (and potentially permanent) conditions for the sake of the music and also the musician.  





ADA. (2019). Repetitive Strain Injury. ADA. ADA Health Gmbh. European Commission. Web.

22 June 2019. <https://ada.com/conditions/repetitive-strain-injury/>


American Chiropractic Association. (2019). Maintaining Good Posture. American Chiropractic

Association. Arlington, VA. Web. 22 June 2019. <https://acatoday.org/content/posture-



Cleveland Clinic. (2019). Back Health and Posture. Cleveland Clinic. Cleveland, OH. Web. 22 June

2019. <https://my.clevelandclinic.org/health/articles/4485-back-health--posture>


Horvath, Janet. (2010). “Playing Less Hurt: An Injury Prevention Guide for Musicians.” Hal

Leonard Books. Milwaukee, WI. Pp. 23-46.


Merriam-Webster. (2019). Posture. Merriam Webster, Incorporated. Springfield, MA. Web. 22

June 2019. <https://www.merriam-webster.com/dictionary/posture>