The Violinist as a Small-Muscle Athlete


January 13, 2021, 9:53 AM · Do you know a violinist who has suffered an overuse playing injury? The likely answer is yes. The unfortunate reality is that most players learn a lot about the high injury rate for musicians only once they themselves are dealing with it.

It’s time we put the music’s dirty little secret front and center in our conversations, because overuse injuries are almost entirely preventable. The data for an informed discussion is there – I myself learned just how pervasive the problem is when I applied for a grant for technology development as an intervention for musicians and justified the need with the help of many studies. I’m summarizing what I learned for this blog post. The most prevalent injuries are PRMD’s, which stands for playing-related musculoskeletal disorders. The research paints a grim picture:

  • Over 80% of professional full-time orchestra players have had a playing injury severe enough to cause loss of wages at some point in their life.
  • Roughly 50% of studying musicians (conservatory and music departments) feel playing related pain more at least 3 times a week.
  • 40-60% of professional musicians suffer permanent hearing damage
  • In a recent study of amateur orchestral musicians, the PRMD rate stood at 67%

Wait, what? This is unacceptable. There are six main contributors to injuries, which for musicians, happen gradually over time, as opposed to all of the sudden. We say “contributors” as opposed to “causes” because there are usually several factors in play when it comes to injuries. The six main contributors are:

  1. Genetics
  2. Asymmetrical positioning (for example a violinist is more asymmetrically positioned than a pianist)
  3. Faulty positioning & faulty technique
  4. Overuse (too much time on the instrument)
  5. Binge practicing (too much at once, or coming back from non-playing too quickly)
  6. Lack of sleep and other life habits (computers, painting)

For us violinists, it means we have control over four out of six — everything but genetics and asymmetrical positioning.

The sleep data I reference is coming from the sports world, where sleep has been studied in much greater detail. Sports can teach us something. The table below displays the chances of suffering an injury within a season for high school athletes in relation to the average sleep hours per night.

Sleep not only keeps the body strong, but repairs minor damage overnight, it essentially continually resets the clock. Sleep also makes you perform better.

Let’s take a quick look at the main categories of physical overuse injuries:

  • Musculoskeletal – tendonitis, carpal tunnel, disc degeneration, low back pain, arthritis
  • Neurological – focal dystonia, thoracic outlet syndrome, nerve entrapment
  • Hearing damage – hearing loss, tinnitus, hyperacusis
  • Hearing damage deserves a blog post all on its own, so for now let’s concentrate on the PRMDs only. Some of the overuse injuries interfere with our playing, while others affect the rest of our lives. I have considerable overuse damage in my neck, which rarely affects my playing, but the reversal of the neck curve is something that I feel every single day. The severe arthritis I have in my left thumb joint (from tuning) does impact my playing. Here is a picture of a normal neck (left) and mine (right):

    Solutions? There are some, but it takes discipline. We need to make everyone aware and promote alternatives to endless hours on the instrument. Here are what I’ve dubbed the @REST strategies for injury prevention — you can remember them by the acronym @-R-E-S-T. Not only do these help prevent injuries, but every single one of the strategies can make you a better player, too:

    “@-R-E-S-T” – Strategies for Health and Artistic Excellence:


    • Tap, sing, shadow, conduct, study the score, read, watch a tutorial
    • Sing with metronome, sing into a tuner, shadow with an mp3 track


    • Record yourself every single practice session
    • Play for others, get feedback
    • Fix posture & technique now, not later
    • Don’t play through pain – pain is a sign that something is wrong
    • Always tackle learning rhythms away from your instrument


    • Warm up well
    • Stretch after playing (or at the end of the day)
    • Pursue yoga or swimming.
    • Consider body-mapping or Alexander Technique.

    S = SLEEP

    • Sleep regular hours.
    • Naps and rests are more important, too.
    • Ditch electronics 1 hour before bed for better sleep

    T = TIME

    • Limit overall time on your instrument – be mindful of ensemble days
    • Break every ½ hour or at the latest every 50 minutes
    • Practice shorter stints, several times a day
    • Make sure you count alternatives to on-instrument practice as practice
    • Keep regular hours – slow and steady wins the race
    • After extended time without practice, get back into shape gradually,not all at once
    • Pain means it’s time to stop – honor what your body is trying to tell you.

    Click here for a one-page handout of these strategies that can be tacked on bulletin boards and taped to mirrors.

    As a player, take it seriously and treat yourself as the small-muscle athlete that you are. Players feeling pain should take it seriously, rest, and remediate their set up and ergonomic approach to their instrument. Also take a look at all of life’s activities. It will make you healthier and a better violinist. If you are teaching, it starts with us. What we say and do matters. Treat your students like artist athletes and reference healthy habits constantly. Make students aware of the risks, and bench them if they are feeling pain. Pain is the warning sign for injuries in the making. Let’s promote a pain free culture early and often and forever.

    For more resources, including apps for recording and decibel monitoring as well as ear plug recommendations, visit



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