RSI (Repetitive Strain Injury) is among the most common physical problems that musicians can encounter during their studies or performing careers. For a professional musician reliant on performing for income, this can be disastrous. What are the root causes of this issue? Is it just bad luck? How do professional musicians get away with incredibly demanding schedules, performing concertos with orchestras around the world injury free? Having suffered from RSI myself since February 2015, I thought I would share my own experiences and hopefully this may help others to work through the issues surrounding it.
First Signs This problem first came to light during my final year of undergraduate studies in 2012. I was learning a demanding program for a final recital which included Chopin’s Polonaise in F# minor Op. 44. This piece contains octave passages, loud fortissimo chords, trills and a more intricate middle section that requires some nimble finger work. Whilst practicing this piece, I developed a dull aching in the fingers of both hands simultaneously, which prevented me from playing for a week. I wouldn’t describe it as a painful feeling, but it felt uncomfortable and strained, and it was clear that repetitive finger movements had cause the problem. After spending a week away from the piano, the problem disappeared and I was able to complete the recital. Three years later, having completed my Masters degree in music performance (injury free) and improved my technique a great deal, the familiar feeling resurfaced. This time, the problem didn’t recede so quickly. I was surprised it had resurfaced, as I wasn’t playing anything too difficult technically. Several months later, I was still finding it strenuous to demonstrate the simplest melodies during lessons. This was affecting my teaching, as I didn’t feel able to demonstrate anything comfortably. It was very frustrating because there is no clear-cut medical solution. One website suggested that if the problem persisted, you should simply stop the offending activity altogether and ‘find a new job’. For me, this was unthinkable.
The cause of injury can be wide ranging and may differ from person to person. I have discovered that deeper psychological and emotional issues can be responsible, which are far more complicated than the common assumption of over-practising. For me, a very busy teaching schedule and a lack of correct warm up exercises had caused the problem the second time around. It was crucial that I stopped playing immediately and didn’t ignore the pain. Many players choose to ignore it and hope it will go away, but this is likely to exacerbate the problem. Some performers who feel they have no choice but to continue often use painkillers, but I didn’t see this as a solution to the root of the problem. When the pain persisted, I sought the help of a specific piano teacher and performance coach who focused on helping instrumentalists to recover from performance related injuries. Through her I was able to identify the root cause of the technical issues that were holding me back. Crucially, she helped me to identify the psychological causes behind the issue.
Using the knowledge I gained from learning with my teacher, the causes of my initial injury in 2012 became clearer in hindsight. As a pianist coming to serious piano playing quite late in my teenage years, my mindset was always one of inadequacy. Instead of choosing more manageable pieces and ensuring an accomplished and comfortable performance at recitals, the self-induced pressure of catching up with more experienced peers drove me to choose a programme of music that was technically beyond me at that time. With countless hours of practice also reflecting this anxiety, my playing became very tense and I over-practiced the pieces. These competitive feelings may be familiar to students at Music College or conservatoires, but it is important to focus on your own development to avoid trying too hard and developing muscle tension. This is the primary cause of any muscle injury. Having worked through these issues and relaxed my mindset a great deal, I can play both the piano and the guitar comfortably without any problems.
In summary, there are two main points that I would encourage you to think about. Firstly, what are the psychological factors that drive you to practice to the point of strain and stress? If you can identify these qualities and keep a watchful eye on them, you will be able to address them. If you find yourself over practising out of insecurity, cut down your practice time to ensure productivity and focus. An hour of good productive practise can be plenty, so try and cut your practice time down and be more economical. Finally, my old guitar teacher used to tell me ‘You need time out to go and feed the ducks’. I think this is the best advice to give serious students. What he meant was to have something else in your schedule that is totally unrelated to music. Play football, go walking, go cycling – give your brain some time off!