There are various specific techniques and common mistakes among musicians that can be conducive for acquiring a performance-related musculoskeletal disorder. This section will cover general recommendations for playing mechanics as well as some common problems which have been associated with some of the most widely used instruments. As stated by Fischer S. (1998), positive corrections to technique, even very slight, can not only prevent an injury from occurring, but can also improve one's sound (Wynn Parry, C.B. 2003).
The ideal posture for a musician should reflect the body's natural position. This means that the head should be aligned centrally, the shoulders should be level, the wrists should be in line with the fifth finger, and the weight of the body should be distributed evenly (Wynn Parry, 2003). Seats should be adjusted so that the feet can plant firmly and flat on the floor, with a 90° angle at the ankles, knees, and hips (Guptill & Zaza, 2010; Hansen & Reed 2006). It is important to maintain the natural curve of the spine. This may encourage one to move with the music, leaning to one side or the other with the upper body and pelvis as needed (Wynn Parry, 2003).
One common problem among musicians that must stand while they play is locking the knees. This often results in slouching of the upper back and shoulder area and, therefore, should be avoided. In both standing and seated positions, the musician should maintain a tall torso with shoulders down and back, and a centered chin.
Piano
Among piano players, there are often complaints of pain within the hands, wrists, fingers, and even more so in the neck and shoulder area. The most prominent reports of injuries in this group are carpal tunnel syndrome, tendinitis, overuse syndrome,
and radial nerve compression (Allsop & Ackland, 2010). Common mistakes by piano players that can lead to PRMDs include excessive practice of parallel octaves, playing with a stiff wrist, playing with too much pressure on the keys, having a hunched or bent over posture, and playing too close in a cramped position (Wynn Parry, 2003).
Strings
Instruments with a neck such as a violin, cello, and guitar may lend themselves to median and ulnar neuropathies or lateral epicondylitis as a consequence of repetitive grasping of the neck (Shafer-Crane, 2006). Care should be taken to make sure this
hand remains relaxed and avoid excessive strain (Allen, 1996). String instruments that require bowing, as in the violin and cello, also engage a great deal of flexion of the thumb, which can contribute to a risk for Dequervain’s Tendonitis (Shafer-Crane, 2006). The general movement pattern for bowing with string instruments should not be rigid, but performed in a free and flowing full-body motion (Wynn Parry, 2003).
-Violin
In violinists, symptoms of pain are often reported in the neck, shoulders, wrists, and hands (Wynn Parry, 2003). Common mistakes among violin players that can lead to PRMDs are having an inadequate chin or shoulder rest, playing with too much pressure on the bow, pointing the violin too far forward, excessive rotation of the wrist and hand, excessive finger pressure, excessive twisting of the neck to meet the violin (Allen, 1996), and limited internal rotation of the right shoulder (Wynn Parry, 2003). The posture required to play the violin also incorporates pressure between the chin and the shoulder, which can become a catalyst for thoracic outlet syndrome and neck pain (Shafer-Crane, 2006).
-Guitar
Many guitarists are self-taught. Thus, they may not have had instruction on appropriate form and safe techniques. As a result, injuries and physical symptoms are very common among guitar players. Pain in this group is most often felt in the fingers, wrists, hands and, to a lesser extent, in the neck and shoulder areas. Common mistakes among guitarists that can lead to PRMDs include playing without the appropriate height of the guitar or footstool, excessive tension in the shoulder and neck area that may alter wrist position, and generally poor practice habits (Wynn Parry, 2003). A study on injuries of guitarists specifically found that the most common problem leading to a PRMD is playing with an awkward posture or without a back support (Dhrithi, Agrawal, & Aju, 2013).
-Cello
The most frequent reports of pain in cellists occur in the neck, wrists, hands, and shoulders. Common mistakes of cellists that can lead to physical symptoms and PRMDs include excessive tension in the neck, limited movement of the torso and arms, too much bowing pressure, and generally weak muscles (Wynn Parry, 2003).
Horns
A common mistake among saxophone players that can lead to physical problems is failing to properly adjust one's neck strap so that their instrument sits at a comfortable height (Allen, 1996). Trombone players sometimes have a habit of resting the bell of their instrument on the knee (Allen, 1996). This can cause awkward positioning and should be avoided.