What can cause an injury?

Many musician injuries develop as the result of excessive stress on muscles and tendons over a period of time. Injuries are usually classified as either overuse or misuse. An overuse injury refers to an injury caused by doing too much work with particular muscles and tendons (overusing them). A misuse injury refers to an injury caused by improper technique (misusing the body) that results in damage to muscles and tendons. An injury can develop as a result of only overuse, only misuse, or a combination of both.

(For suggestions on how to help prevent injuries, please see the section “What can I do to minimize the risk of an injury?”)

Misuse: poor habits, technique and posture

Injuries are sometimes caused by misuse, meaning that they develop because we use our body in an incorrect way. Poor habits, technique or posture may cause parts of our body to be bent, stretched, held or tightened in a way that they were not designed for. Misuse of our body in these ways for extended periods of time could result in injury.

Insufficient rest or recovery time

The muscular effort involved in any activity, including playing an instrument, generates a waste product called lactic acid. Lactic acid forms inside the exerted muscles causing the tired and tight feeling that follows long or intense workouts. These workouts include practice sessions and rehearsals.

Our body naturally flushes itself of lactic acid when given enough time to rest between workouts. However, without enough recovery time, this waste product will continue to accumulate in our muscles without being properly flushed, making our muscles progressively tighter and inflexible. Continuing to strain these overused muscles may eventually cause them to become injured.


If your muscles feel tired, weak or sore after a long period of playing, your body is trying to tell that it needs rest. Fatigue is a warning sign, and continuing to play despite your body’s warning could result in overused muscles, leading to injury. (See “Insufficient rest or recovery time” above).

Abrupt increases in playing time and intensity

Musicians preparing for deadlines or who are impatient to improve may increase their total practice time significantly. Since muscles and tendons need to be strengthened gradually over time in order to handle a greater workload, increasing practice time or intensity too quickly could result in overused muscles and heighten the risk for injury.

Instrument and technique changes

Suddenly switching from your regular instrument (or bow) to a new one might shock your body. Your new instrument may be slightly larger, the weight may be distributed differently, it may demand more finger pressure, or it might require your fingers to stretch in new ways. Similarly, as you try to make a fundamental change in how you hold your instrument, form an embouchure or otherwise change your playing technique, you might overuse or engage muscles that you aren’t accustomed to using, resulting in injury.

Lack of musical preparation

It is likely that the more comfortable you are with your music, the safer and healthier your playing will be. Sight-reading a first rehearsal might be unavoidable, but continually showing up to rehearsals or lessons unprepared may make learning fast and technically challenging spots difficult. You may also tighten up and use excessive force in an effort to play passages that you aren’t familiar with. In isolated instances, this situation will probably not pose serious problems, but being chronically unprepared could cause problems and result in an injury over time.

Secondary instruments

All St. Olaf music majors are required to complete at least two semesters of piano class or lessons, regardless of their primary instrument or degree. Some students choose to take additional courses in piano or other secondary instruments above and beyond this requirement.

While this is a wonderful opportunity, secondary instruments sometimes have the potential to cause an injury. If you have never played piano before, you may not have the technique or muscle coordination to immediately take on music of interest to you. Since your muscles aren’t yet accustomed to playing your new instrument, overdoing it at the beginning could cause problems in the future. Likewise, improper technique could lead to injury. Be sure to get proper introductory instruction from your secondary instrument teacher when you begin your lessons and bring up any concerns you may have.


Stress can manifest itself both physically and mentally. Physically, stress can cause decreased blood flow, poor circulation and shallow breathing. Heightened levels of stress for a prolonged period of time may also weaken the body’s resilience and interfere with sleep. Mentally, stress can create disorganized, cluttered and anxious minds. Stress is not necessarily a bad thing, however unhealthy levels of stress over extended periods of time could increase the risk for injury.

Poor fitness

Musicians often neglect their bodies in favor of practicing, but making music is a physically demanding activity and requires a fit body. Weak, inactive muscles are much more likely to become tight and overworked; proper exercise can help keep muscles flexible and strong, making them less prone to injury. Additionally, cardiovascular (cardio) exercise helps increase endurance and circulation, both of which can keep your body in optimal condition to make music.

Consider making exercise part of your routine if it is not already. If you find it difficult to integrate exercise into your daily or weekly schedule you can include exercise as part of your normal practice regiment, since being physically healthy is an important part of making music. While exercise is important, please make sure you have a doctor’s approval before you begin exercising regularly.

Body size and build

Everyone’s body is different. If your body is not ideally suited to your instrument or the chair you must sit in to play, you may encounter certain physical or technical challenges. It may be necessary to craft an accommodation to these challenges in order to prevent an injury. Many fine musicians have found ways to negotiate their instrument in spite of these physical limitations. Your teacher is likely an excellent resource in this regard.

Muscle imbalances

Musical instruments are not necessarily designed to fit perfectly with the human body. Many instruments require asymmetrical holding postures. For example: horn players have to put their right hand in the bell of their instrument; the left hand of string players plays the notes and the right hand moves the bow; and flautists must twist their back and shoulders to hold their instrument. Normally these challenges of these postures are easily managed. However, maintaining these positions with excess tension or improper posture for long periods of time may lead to muscle imbalances, knots or alignment issues that could develop into an injury.

Everyday activities

Sometimes our non-musical daily activities are the primary triggers of injuries. These activities include using a computer, driving, washing dishes, lifting weights, playing sports, and carrying heavy bags or boxes. To this end, it pays to notice how our daily activities affect us.

In particular, computer use can cause damage to muscles and tendons since it requires repeated motions of our fingers. Bad posture while using computers (for instance, slouching or holding arms and hands at awkward angles) can also impact general physical health and compromise instrumental technique. Limiting computer use and using gentle motions when typing may help prevent computer-related injuries.

Works Referenced

Horvath, Janet. Playing (Less) Hurt. Milwaukee, Wisconsin: Hal Leonard Corporation, 2010. Print.

Watson, Alan H. D. The Biology of Musical Performance and Performance-Related Injury. Lanham, Maryland: Scarecrow Press, Inc., 2009. Print.