Attitudes to Pain

In addition to ill-informed technical instructions, worrying attitudes abound, such as “no pain no gain”, or pain as “normal”. This mindset was glorified in 1980s sports slogans such as Jane “feel-the-burn” Fonda (Thompson, 1986). Pain was “almost celebrated as necessary for the development of a virtuoso technique” (Alford & Szanto, cited in Bragge, 2006, p. 4), reflected in findings that 80% of musicians considered pain to be acceptable in mastering one’s instrument (also see Fry, 1986b, p. 53; 2000; Zaza, 1993, p. 119).

 Unfortunately, recent studies show an ongoing belief among musicians that pain is still acceptable. Britsch found that 35% of musicians subscribed to this belief (2005, pp. 41-42). In 2008, 64.6% of Italian conservatory students surveyed believed in “no pain no gain”; 90.6% of them admitted to mild pain symptoms in the preceding month (Bruno, et al., 2008, p. 857). Worrying outlooks such as upholding the “pride of the virtuoso” by refusing to redistribute passages for greater comfort (Berman, 2000, p. 124) may be partly responsible for this attitude of prioritising the music over one’s health.

Furthermore, the commitment to continuing to play despite pain seems commonplace among students, performers, and pedagogues alike. Bragge, Bialocerkowski, and McMeeken also describe a concerning 79% of musicians play through pain (2006c, p. 75; 2008, p. 21). This tendency is aided by a “culture of silence” among injured musicians, which Guptill confirms continues (2011, p. 91). As an example, Kampmier, a pianist, describes in her online blog being given an anaesthetic spray by her teacher at the lesson so that she could play through pain (2011). Preliminary results from a survey of Australian symphony orchestras suggests that 50% of these musicians have a PRMD that has lasted for more than three months, and have thus been rehearsing and performing for many hours each day in pain (Ackermann, cited by Rickert in lecture 26 May 2011, QCGU). As Fry and Rowely note, playing through pain creates risks of further disintegration of technique, tissue damage, weakness and loss of control (cited in Watson, 2009, p. 67). If music students and teachers were aware of this outcome, these practices may not be as common. Clearly, Fry’s warning to never play through pain (2000, p. 262) needs to be adopted more widely by performers, with support from their teachers.

 Admittedly, identifying to PRMDs has complex personal and professional ramifications. Graffman compared admitting to PRMDs to an unmentionable social disease, declaring, “Nobody wants a wounded pianist. There is an oversupply of healthy ones. Admitting difficulties is like jumping, bleeding, into piranha-filled waters” (1986, p. 5). Two decades later, Horvath continues this evocative metaphor in describing that musicians would rather confess to leprosy than injury (2004, p. 187).

 There is little reason to believe that this situation has changed today. Many musicians are poorly paid, and balance multiple, irregular commitments, without the benefits of paid sick leave. The demands of the music industry continue to raise, due to international competitions, access to high-quality training and globalisation (see Lehmann, 2006, p. 7). Furthermore, due to the proliferation of the commercial recordings, performers face the pressure of reproducing the artificial perfection of the recording studio each time they perform (Altenmüller & Jabusch, 2009, p. 152). As the role of symphony orchestras in today’s society and subsequently their funding is threatened, competition is greater for fewer paid performing positions. In such a context, musicians are understandably reluctant to declare to injury, as by doing so may affect their income, employment, and career development.

 Many sources in the literature highlight the dangers of such attitudes as “no pain no gain” (see Alford & Szanto, cited in Barker, Soklaridis, Waters, Herr & Cassidy, 2009, p. 145), although this may not yet be reflected in musicians’ practice. As Fry and many others promote, pain should be a strong indicator to cease the activity, and seek professional help to avoid the condition deteriorating further (1986a, pp. 47-48; 1987, p. 40; also see Culf, 1998, p. 33). Some pedagogues, including Sándor, similarly dispute this theory, advocating coordinate movement rather than enduring pain (1981, p. 20). Taubman believes that the slogan “no pain no gain” is “responsible for the advent of medical clinics for musicians” (cited in 1994, p. 14).

Extract from Learning and Teaching Healthy Piano Technique: Training as an Instructor in the Taubman Approach. Available through:  Advance orders below cost price until Aug 31.

Reference List

Altenmüller, E., & Jabusch, H. (2009). Focal hand dystonia in musicians: Phenomenology, etiology, and psychological trigger factors. Journal of Hand Therapy, 22, 144-155.

Barker, K. K., Soklaridis, S., Waters, I., Herr, G., & Cassidy, J. D. (2009). Occupational strain and professional artists: A qualitative study of an underemployed group. Arts & Health, 1(2), 136-150.

Berman, B. (2000). Notes from the pianist’s bench. New Haven, CT: Yale University Press.

Bragge, P. (2006). Performing arts medicine: Past, present and future. Victorian Journal of Music Education, 2004-2006, 6-14.

Bragge, P., Bialocerkowski, A. E., & McMeeken, J. (2006c). Understanding playing-related musculoskeletal disorders in elite pianists: A grounded theory study. Medical Problems of Performing Artists, 21(3), 71-79.

Britsch, L. (2005). Investigating performance-related problems of young musicians. Medical         Problems of Performing Artists, 20(1), 40-47.

Bruno, S., Lorusso, A., & L’Abbate, N. (2008). Playing-related disabling musculoskeletal disorders in young and adult classical piano students. International Archives of Occupational and Environmental Health, 29(4), 23-25.

Culf, N. (1998). Musician’s injuries: A guide to their understanding and prevention. Tunbridge Wells, UK: Parapress.

Fry, H. J. (1986a). How to treat overuse injury: Medicine for your practice. Music Educators Journal, 72(9), 46-49.

Fry, H. J. (1986b). Incidence of overuse syndrome in the symphony orchestra. Medical Problems of Performing Artists, 1(1), 51-55.

Fry, H. J. (1987). Prevalence of overuse (injury) syndrome in Australian music schools. British Journal of Industrial Medicine, 44(1), 35-40.

Fry, H. J. (2000). Overuse syndrome. In R. Tubiana & P. C. Amadio (Eds.), Medical Problems of the Instrumentalist Musician (pp. 245-272). London: Martin Dunitz.

Graffman, G. (1986). Doctor, can you lend an ear? Medical Problems of Performing Artists, 1(1), 3-6.

Guptill, C. (2011). The lived experience of professional musicians with playing-related injuries: A phenomenological inquiry. Medical Problems of Performing Artists, 26(2), 84-95.

Horvath, J. (2004). Playing (less) hurt: An injury prevention guide for musicians (Rev. ed.). Minneapolis, MN: J. Horvath.

Kampmeier, V. (2011). The injured musician – a taboo subject? Retrieved April 2, 2011, from

Lehmann, A. (2006). Historical increases in expert music performance skills: Optimizing instruments, playing techniques, and training. In E. Altenmüller, M. Wiesendanger & J. Kesselring (Eds.), Music, motor control and the brain (pp. 1-24). Oxford: Oxford University Press.

Sándor, G. (1981). On piano playing: Motion, sound, and expression. New York: Schirmer Books.

Thompson, D. (1986). Walking out on Jane Fonder’s (sic) regime. Retrieved March 1, 2010, from

Watson, A. H. (2009). The biology of musical performance and performance-related injury. Lanhan, MA: Scarecrow Press.

Zaza, C. (1993). Prevention of musicians’ playing-related health problems: Rationale and recommendations for action. Medical Problems of Performing Artists, 8(4), 117-121.


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