The following are discussions I've had regarding playing with pain in the

last couple of months.

Tim Janof

Anyway, I'm a highschool student that has been playing the cello for about 11

years, and have had different arm/hand pains, but recently, my right hand has

been bothering me very very much.  I play with a straight thumb and I've

tried changing it, but it hasn't changed.  Also, I notice that my hand creeps

up a lot on the bow. Anyway, my hand hurts immensely at the base of the thumb

and on the top and bottom of my wrist.  Another thing that happens is that

when my hand starts to hurt, it follows with the thumb slipping through and I

lose all control.  This used to only happen when I would play Bach Suites,

particularly the Preludes.  Recently, it hampered my playing a lot at a

competition and performance of the Dvorak Concerto.  I'm worried now, because

it happens really badly when I'm playing the Shostokovich and by the second to last page,

my hand feels ready to fall off.  I have too play the piece soon and in a recent

rehearsal, I couldn't finish a run through because it hurt to much.  I would

appreciate any help!  S. K.

Of course, It is difficult if not impossible to diagnose Sarah Koo's

problem completely, sight unseen. However, it is obvious that she plays in

a way that generates a great deal of tension. I believe that the first step

in solving her problem is to evaluate the way she uses her body when she

plays. She needs to learn more about her body's natural impulses, so that

she can adapt her technique to these impulses, rather than forcing her body

into unhealthy patterns.

Most pain is related to poor body balance. Faulty alignment, immobility and

pressing are the main causes of such imbalance. Body imbalances create

muscle tension which can accumulate layer upon layer, leading to the kind

of pain and loss of control that Sarah Koo is experiencing. Clearly, she

clutches and presses her bow, but I would guess that this is just the tip

of the iceberg. If your body is out of balance and/or any part of your body

holds tension, you tend to clutch and press.

One of the most fundamental causes of tension and pain among cellists, is

faulty sitting. (This is why cellists have the  highest incidence of back

problems of any group of musicians.) Many pain problems that appear in the

hand, arm, shoulder, etc. are not initiated at the site of the pain, but

are the result of a chain-reaction related to the way cellists sit and hold

their instruments. A solid, mobile and balanced base of support is

essential to healthy and efficient playing. For further information on

seating problems of musicians, see

Anyone can Increase awareness of their body's natural impulses. It is not a

difficult task. If you are alive and can breathe an feel, you have all of

the equipment you need. The next step is to ask your body a few questions.

Your body will give you the right answers if you ask the right questions. I

suggest checking out "New Directions in Cello Playing" for examples of some

right questions. Your body's answers will provide the tools which will

enable you to identify the sources of your tension. I have worked with many

musicians who were able to overcome problems similar to Sarah's with this

approach. Naturally, it would be helpful if Sarah could find a teacher who

could guide her though this process.

Best regards,

Victor Sazer

With all due respect to Victor Sazer, who has many good things to say, I

would STRONGLY urge Sarah to get to the nearest music medicine clinic for

evaluation and a treatment program tailored specifically for her.  Time is of

the essence here, since the tissue damage can become irreversible in time,

and this had been going on a LONG time.

Jack Winberg, M.D.

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