Weight-bearing manipulation: A neglected area of medical science relevant to piano playing and overuse syndrome

A systematic review of prevalence and risk factors associated with playing-related musculoskeletal disorders in pianists

“…In the non-scored papers, hand size and anatomy (interconnections between tendons, hand shape), posture, technique and playing habits (warm-up, overuse/ fatigue, scheduling, choice of repertoire and seating) were the most frequently discussed risk factors [11,12,27,[56][57][58][59][60][61][62][63]. Of these, small hand size is the only risk factor that was found to be statistically associated with PRMDs in the 12 papers that were scored for methodological quality [7].…”

“…These definitions were less specific than those used by Shields and Dockrell [51]. Authors who did not define PRMDs used the term overuse syndrome [59], and other terms such as 'tendinitis' [57], 'repetitive strain injury (RSI)' [57,59], 'physical injuries' [59] or a general description of physical symptoms [58,60] to describe PRMDs. The wide variability in definition of PRMD in both scored and non-scored papers indicates a lack of consensus regarding the operational definition of PRMD.…”

Driving point impedance measurements during piano playing

“…O ther goals have been used in these studies as well. Hmelnitsky and N ettheim [69] used the goal of minimizing muscle tension, but only with respect to the forearm extensors, and An and Bejjani [39] minimized energy, force and jerk.…”

“…A general finding from these results is th a t minimizing the joint reaction force at the MCP and maximizing flexor tendon moments about the joints will minimize all finger forces. T h at is, use a curved finger with a large MCP flexion angle, as shown in Figure 3 In 1987, Hmelnitsky and Nettheim [69] attem p t to compare the weight-based and trad i tional playing based solely on observation and descriptions of which muscles are used. The authors propose th a t in traditional playing the wrist extensors and elbow flexors are used excessively to withdraw the hand from the keyboard, but th a t in weight-based playing, gravity is used to extend th e wrist and finger flexors are used to depress the keys.…”