Orpheus wounded: The experience of pain in the professional worlds of the piano

Conclusions

None of the three worlds within the field of professional piano playing has adequately confronted the problem of pain, partly because its causes and treatment could be easily assigned to another world. The medical world could blame pain on “misuse”; the virtuoso world on lack of “genius” or “hard work”; the pedagogical world on “bad teaching” or “lack of talent.” Each world, for its own reasons, has managed either to skirt the problem of pain outright or to develop techniques and languages that fail to offer general remedies, or worse, exacerbate the amount of pain pianists endure. In the meantime, market competition in a shrinking concert market has increased, together with audience dependence upon charismatic virtuosity. The more compact virtuoso world, populated by ever larger numbers of hopeful pianists, creates intense competition in which the causes stimulating pain multiply.

A number of factors have inhibited both the private and public acknowledgment of pain. First, there are the demands of maintaining a professional career as a pianist. It has been difficult if not impossible for concert artists to admit they are in pain, because it would threaten their careers. Second, there is the romantic image of pain: the belief that pain is necessary and inevitable in order to be a virtuoso. This factor is related to a culture of mastery (or masculinity): the ideal of a stoical master in control of his body, able to surmount such mundane obstacles as pain.Footnote 1

Third, the emotional identification of the young prodigy with their teacher; the belief that the teacher is giving the young pianist a precious skill, potential career as an artist, and would not allow unnecessary pain. Psychologically it is difficult to challenge teaching maxims that lead to discomfort. Instead, musicians in pain blame themselves.

Complementary factors are leading to a growing ability to acknowledge pain. First, what might be called a “culture of femininity” emphasizing awareness of the body may be increasing. It is interesting to speculate whether women teachers are more likely than male teachers to emphasize that playing should be “comfortable.” Are women pianists less likely to suffer pain than male pianists because of less commitment to the ideal of control, power, and mastering pain?

Second, the rise of the world of performing-arts medicine itself provides a refuge, a safe place where pain can be legitimately acknowledged. Medicalization takes pain out of the virtuoso world and “neutralizes” its emotional and professionally charged character, whether or not the doctors have solutions.

Third, the diffusion of awareness that pain is not one's individual problem, as such examples as Gary Graffman and Leon Fleisher have become publicly acknowledged. However, once acknowledged, there may be a contagion effect. Is it possible that the reported incidence of pain is a result of a kind of “mass hysteria”? This possibility raises a knotty methodological issue: How much can we trust subjective reports of pain? Once people are asked if they have physical problems, they may become aware of them. Or, the individual may “discover” or “remember” an analog to parental or teacher abuse. Such an attempt to explain away the discovery of widespread pain as hysteria seems highly unlikely.

If injuries to hand and arm can be shown to be caused by keyboards, not just pianos, but computers too, then legal institutions may get involved in this complex story. Here we are dealing with a future possibility, but an ominous one. Repetitive stress injury (RSI) has been charged by persons suffering pain after long hours on the computer, and more than 2,000 suits have been filed against makers of computer equipment.Footnote 2 The U.S. Occupational Safety and Health Administration in October, 1994, announced a plan for rules that would “make it harder for employers to claim they didn't know about the problem.... For the delicate muscles and tendons in the fingers and wrists, rapidly pushing buttons [or piano keys] thousands of times an hour can be just as stressful [as driving screws or slicing carcasses in a meat-processing plant].” The Time magazine article blithely explains the consequences of these stresses as creating “tiny tears in the muscles and tendons, which become inflamed. If the tissues aren't given time to heal properly, scarring can occur.”Footnote 3

That the hand motions required for the piano and computer keyboards are essentially the same, in terms of body physiology, has been finally realized. A book giving concrete instructions on how to “play” both types of keyboards safely and efficiently was published in 1995, although the author, a concert pianist, focusses upon computers, with an accurate eye on a far bigger market for the book.Footnote 4

It is curious in a society like ours that technical solutions have not been explored at all as a cure for pain. Interviews with members of manufacturing companies at the National Conference on Piano Pedagogy in October, 1994 indicated that there is practically no work being done in this area. Even though certain technological solutions readily present themselves (as they do in the computer industry, for example), having to with changing the physical arrangement of the keyboard, nothing has been seriously considered.Footnote 5 Neither have pedagogical learning routines in electronic keyboards reached the sophistication that is now technically possible. This lack is fortunate (and perhaps not accidental) because Steinway and Baldwin might become subject to suits on exactly the same grounds as IBM has become liable.

If pain is still slipping through the cracks among the various worlds constituting the field of professional piano playing, it is because in each of these worlds there are forces at work either producing pain or explaining it in individualistic terms. The pervasive experience of pain is an unintended consequence of the mutual actions of the institutions involved in creating and propagating piano music in our culture. Unintended consequences put stubborn difficulties in the path of change precisely because there are no concrete intentions or interests at stake that are producing the problem. As the examples above show, however, the mere recognition of pain as a reality pushes for a mutual opening up and interaction among these only partially overlapping worlds. If the issue of pain among pianists becomes forcibly raised - well beyond academic discourse and professional “interest groups” - in the broad community of piano playing and the even broader realm of the media, each of these institutional worlds faces deep challenges. At this moment it is impossible to know what might happen if the issue of pain is finally confronted as a joint problem for these social worlds. Within physiological limits, the issue is whether knowledge exists or can be acquired about how to play the piano in a way that will minimize the occurrence of pain.Footnote 6

We have been concerned with the institutional and individual processes that both cause pain and stand in the way of obtaining a suitable cure for injured pianists. As we have shown, the institution with which pain is traditionally associated in our culture - medicine - plays only an accompanying part in this story. As David B. Morris notes in his recent work on the cultural embeddedness of pain. “Certainly we can take comfort in assuming that pain obeys the general laws of human anatomy and physiology that govern our bodies ... however, the culture we live in and our deepest personal beliefs subtly or massively recast our experience of pain. The story of how our minds and our cultures continuously reconstruct the experience of pain demands that we look beyond the medicine cabinet.”Footnote 7

For the sociologist, what is most theoretically and substantively compelling about the relatively esoteric tribulations of pain-ridden performing artists is precisely how, within the experience of emotional and physical distress, deeply individual physical states and emotions cannot be separated from institutional pressures and constraints. And not only does the scourge of pain among pianists shatter the dichotomy of individual versus institution, it also provides a palpable example of how pain in our culture exists in the shadow of multiple social worlds.Footnote 8

Notes

  1. 1.

    Byron Janis “recounted instances in which the pain was so intense as he started to warm up that he could not imagine enduring the performance. But after a few minutes it went away. ‘You just play through it,’ he said, “and this is what kept happening” (New York Times, ibid.).

  2. 2.

    This issue is so new there is no scholarly literature on the topic. Our information is derived from Time Magazine, 24 October 1994, 61. A few months later, plaintiffs lost a suit against IBM and Apple Computers claiming that “computer keyboard makers should be held liable for repetitive stress injuries such as carpal tunnel syndrome, which most experts agree have no single cause.” Attorneys for the plaintiffs intended to appeal (San Francisco Examiner and Chronicle, 12 March 1995).

  3. 3.

    This issue is so new there is no scholarly literature on the topic. Our information is derived from Time Magazine, 24 October 1994, 61. A few months later, plaintiffs lost a suit against IBM and Apple Computers claiming that “computer keyboard makers should be held liable for repetitive stress injuries such as carpal tunnel syndrome, which most experts agree have no single cause.” Attorneys for the plaintiffs intended to appeal (San Francisco Examiner and Chronicle, 12 March 1995).

  4. 4.

    The author, concert pianist Stephanie Brown, describes the “dangerous angle” (which piano pedagogue Dorothy Taubman labels “twisting”), and several other fundamental mistakes in holding and moving the hands (“clawing,” “scratching,” “curling”). Brown has codified a number of principles about hand position and movement which are beginning to be regarded as “common sense” among piano pedagogues. The book received enthusiastic blurbs on the cover from several neurologists and hand therapists, including Dr. Frank Wilson (cited earlier). See Stephanie Brown, The Hand Book (New York: Ergonome Publishers, 1995).

  5. 5.

    Several alternative keyboards have been invented, but none has been adopted. Dr. Otto Goldhammer, for example, invented exchangeable keyboards, with five different widths of keys, to be used in music schools so that “every pupil plays on a keyboard fitted to his hands” (Gat, Technique, 272).

  6. 6.

    In response to the discovery of widespread pain, some actions are indeed being taken. Professor Gail Berenson, Ohio University, in a private communication (January 3, 1995) says that “several universities [are] incorporating new courses into the music curriculum that teach musician wellness strategies in a preventative effort.” She directed a workshop on “Comfort in the Performance Spotlight” in June, 1995, with faculty members Dr. Thomas Mastroianni of Catholic University of America (a teacher of a “wide range of courses dealing with musician wellness”) and Dr. Richard Norris, Medical Director of the National Arts Medicine Center. We might note that a recent addition to the repertoire of interest groups on the internet is one called “sorehand,” headquartered at the University of California at San Francisco, which is accessible by the following command: listserv@ucsfvm. ucsf.edu. In the message area one writes: subscribe sorehand [enter your name, no brackets].

  7. 7.

    David B. Morris, The Culture of Pain (Berkeley: University of California Press, 1991), 2.

  8. 8.

    An interesting and important topic for study would be a comparison of the conditions under which pianists suffer pain with similar or different conditions for other occupations that require repetitive and stressful motions of the body: dancers, skiers, swimmers, and boxers, to name a few. Some of the same problems of linking pedagogical techniques with the incidence and causes of injury exist for sports: “... a direct link between injury and training methods is seldom made.” See William A. Sands, et al., “Women's gymnastic injuries: a 5-year study,” American Journal of Sports Medicine 21/2 (March, 1993): 271. For a study of boxers with a similar theoretical framework to ours, see, for example, Loïc Wacquant, “The pugilistic point of view,” Theory and Society 24/4 (August 1995).

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Alford, R.R., Szanto, A. Orpheus wounded: The experience of pain in the professional worlds of the piano. Theor Soc 25, 1–44 (1996). https://doi.org/10.1007/BF00140757

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Keywords

  • Carpal Tunnel Syndrome
  • Widespread Pain
  • Time Magazine
  • Musician Wellness
  • Piano Playing