Overuse Syndromes in Small-Handed Pianists

Piano players (pianists) are often subject to overuse syndromes of the hand and arm. The problem tends to occur when they increase their practice time. Musical pieces with trills, octaves, arpeggios, and broken octaves are special problems. These skills require fast and forceful finger movements.

In this study, researchers look at the span of pianists' hands. They wanted to see if pianists with larger hands have fewer problems. A digital keyboard and video-based system was used to track motion in three dimensions (3-D). Of particular interest was the distance between the thumb and small finger when the hand was fully open (abducted).

Professional and amateur pianists were included. Pianists were compared based on hand span size (large versus small). The results showed that players with smaller hands must open the fingers wider (abduct more) than large-handed players. Small-handed pianists may be at increased risk of de Quervain's tenosynovitis, a common problem among pianists.

de Quervain’s is a painful condition affecting the inside of the wrist and forearm just above the thumb. The lining around two tendons in that area get inflamed from overuse. The tendons don’t glide smoothly.

The use of computer technology to measure stress and strain on the wrist, hands, and fingers of pianists may help reduce or prevent de Quervain’s in pianists. Difference in hand size is one issue. Differences in motion may be another key feature for future study.


Naotaka Sakai, MD, et al. Hand Span and Digital Motion on the Keyboard: Concerns of Overuse Syndrome in Musicians. In The Journal of Hand Surgery. May/June 2006. Vol. 31A. No. 5. Pp. 830-835.


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