31. My hands/wrists/thumbs/shoulders etc. hurt (are very tensed)! What should I do?

This question is not related to the functionality of PianoCareerAcademy.com – but because I receive it (and other similar ones) all the time, I decided to address this issue here in the FAQs as well :).

If you’re experiencing hand/wrist/elbow/shoulder tension, discomfort or pain (or if you have developed a hand injury), you have to begin by identifying the cause of your problem – and the first step is determining if your pain/discomfort/tension is piano-related or not. The fact that you’re a pianist doesn’t automatically mean that your hand/wrist pain is caused by your practice! For example, your hands/wrists might hurt because of a medical condition (such as arthritis), or you might be recovering from a surgery, or maybe you’re experiencing the side-effects of a trauma (which had nothing to do with your practice), or maybe you have developed a RSI (repetitive strain injury) as a result of some activity you perform at work. If this is the case, you should speak to your doctor, and you could also look into holistic healing options (such as a healthy balanced diet, a progressive exercise program tailored for your specific needs etc.).

If your problem is piano-related, however, the answer is very simple: in 99% of the cases, hand injuries (such as tendonitis) and pain/discomfort are a result of an incorrect playing habit (and the resulting tension).

Correct piano playing does not cause pain and injuries!!!

If you’re in pain when you practice, there’s a big chance that you’re using the old-school finger-only approach (playing from the separate movement of your fingers, with stiff arms and wrists – which is counterproductive and dangerous, leading to tension, fatigue and pain), instead of involving the entire relaxed arm in the playing process (which allows you to achieve maximum results with minimum efforts – and play with comfort, freedom and brilliance).

Therefore, in order to make sure that tension (and the resulting pain) does not occur, you need to change your playing habit and learn how to play correctly, by using ergonomic principles such as whole-arm action and weighted playing, arm/wrist relaxation combined with finger&hand strength (and all the other elements of correct posture/key attack that I describe in my tutorials).

Other causes of piano-related hand/wrist pain (we can group all of them under the category incorrect practice):

1. Irregular practice.

It means that you’re not practicing at all for a couple of weeks – and then you practice several days in a row, many hours per day.

Piano endurance is like physical fitness: if you practice only from time to time, chances are you will experience at least some fatigue (because your muscles/tendons are not used to this type of activity). In time, fatigue can degenerate in tension, pain and injuries.


  • consistent practice;
  • after a longer break, resume your practice gradually!

2. Not taking any breaks in your practice.

This is the other extreme – practicing too much, every single day, without allowing your muscles (AND your mind) to rest and recharge.

By the way, in the Members Area you will find a detailed video tutorial entitled When to Take a Break in Your Practice?

3. Repetitive practice.

It means working on the same type of uncomfortable patterns (such as octaves or chords) ALL the time, without alternating them with other, less ‘stretched’ patterns.

The bigger the stretch – the higher the risk of tension. If you add exaggerated repetition to the formula? You risk developing a RSI! Yes, even if you’re doing your best to play without tension, with relaxed arms and wrists! Unilateral and unbalanced practice equals incorrect practice (and no amount of wrist relaxation will help you here!).


  • work smart, in a balanced and harmonious manner!
  • always warm up with easier scales/exercises before playing difficult passages;
  • alternate octave fragments/pieces with works where compact hand positions are predominant;
  • listen to your sensations and take a break (or work on another piece) at the first sign of discomfort;
  • choose your program wisely, making sure that it comprises pieces of different styles/genres/tempos/patterns (you will find super-detailed information about the structure of a professional piano program in the Members Area).

4. Too much fast practice.

The exam/concert is approaching, and you dedicate your entire practice time to playing the piece(s) in the final tempo, from beginning to end, many times in a row, hoping to increase your confidence and technical ‘security’… Does this scenario seem familiar?

Unfortunately, too much fast practice has the opposite effect: instead of increasing your technical stability, it has a negative impact on your control, coordination, rhythmical evenness AND expressive awareness, leading to mechanical playing and loss of quality due to so many ‘automatic’ repetitions – and it can also cause muscle fatigue, tension and pain (especially if the fast ‘tests’ are done in state of anxiety and with a negative attitude – as I will explain below).


  • slow, detailed, mindful practice is the foundation of a healthy practice habit!
  • the tempo of a piece should be increased gradually, one step at a time and one little fragment at a time;
  • even in the last practice stage (1-2 weeks before the performance), the ratio of slow/fast practice should not exceed an aprox. 60%/40%!
  • alternate ‘fast tests’ with slow practice (to avoid fatigue, mechanical playing and loss of quality);

… and you will find out more (and learn how to practice a piece correctly, in a step-by-step manner – including when and how to increase the tempo, how much slow practice is needed for every practice stage etc.) by watching the tutorials available in the Members Area ;).

5. Psychological tension, anxiety & a negative attitude.

Do you often practice in a state of anxiety? Are you afraid that you’re not good enough, that you’re not making enough progress? Do you tend to get angry with yourself, and to push yourself past your limits (not listening to your body, forcing yourself to play through pain and discomfort)? Are you always in a hurry, worrying that you don’t have enough time for all the tasks that need to be done?

These attitudes and ‘mental habits’ can be very destructive!

Our emotions and states of mind are always reflected by our body. Mental tension causes involuntary muscular tension, which can lead to increased fatigue, pain and even injuries (not to mention all the other negative consequences!).


  • learn how to manage stress and reduce anxiety (this is a journey in itself – but worth every single step!);
  • be aware that a negative attitude can only hold you back – being extremely counterproductive (therefore getting upset with yourself – or your teacher, parents, siblings etc. – is not practical at all! LOL);
  • a calm, centered, positive attitude is the best productivity accelerator!
  • be compassionate with yourself: it’s ok to make mistakes, to have bad days, to be tired or unmotivated – as long as you keep moving forward and don’t give up!
  • don’t practice with a negative state of mind, or in a state of ‘inner hurry’: if you can’t get past an anxiety attack (or another unpleasant emotion), it’s better to skip your practice altogether (and resume it when you feel calmer and more focused).

6. Practicing pieces that are too difficult for your current level.

This is actually the ‘disease’ of our century – and I come across this problem every single day!

We live in a fast era, we look for ‘fast-food’ solutions and we want to become virtuosos in only several months! LOL This is obviously impossible – just like it’s impossible to improve your health by eating fast-food: piano playing is a lifetime commitment, and great results require A LOT of patience and correct practice.

So if you’re a beginner or yearly intermediate (having only 1-4 years of piano experience) and you’re attempting to practice advanced pieces such as Bach’s Preludes & Fugues, Liszt’s Etudes, Rachmaninoff’s Preludes (this list can go on and on!), you WILL experience fatigue, tension and pain!

Why? Because your pianistic ‘apparatus’ is not fit/strong/flexible enough (yet!) for conquering such high mountaintops (not to mention that your overall musical awareness/knowledge is not deep enough for understanding the complexity of these masterpieces)!

Can you do a yoga handstand only after several months of training? Can you paint a masterful landscape after only a couple of drawing lessons? Can you be a professional pilot after only 3 flying lessons? Of course not!!!

Similarly, you need a lot of practice and experience in order to play La Campanella or the Winter Wind Etude (or even a slow Nocturne by Chopin) – and you cannot skip any step of this process.

Solution: be patient and take it one step at a time! A gradual, progressive approach is actually the fastest way to move forward – saving you lots of time and effort in the long run (while a ‘hurried’ approach will only set you back, causing injuries, frustration and forcing you to take breaks until you finally give up on your piano dreams). My Video Course for Beginners (described in FAQ No. 17) and the step-by-step Scale & Arpeggio Course (FAQ No. 19) are based on this progressive approach – and you can also find lots of repertoire recommendations for all levels in the Members Area (they will guide you through the ‘labyrinth’ of the enormous piano repertoire, so that you always know what pieces to practice next!). ;)


And, the MEGA-cause (that comprises all the causes listed above): lack of correct information!!! Why are you practicing by using the finger-only approach in the first place? Because you don’t know any better, and because you have never heard of the whole-arm action principle! Why are you practicing pieces that are too difficult for your current level? Because you are impatient :P – but also because you have no idea that you should do otherwise! This list can go on – and the solution is obviously professional guidance (from an experienced teacher) – in real-life or online :).

This was a very simplified answer to a super-complex question which involves many different physical and psychological elements (in different combinations) – but the good news is that all the ideas mentioned above are explained in detail, from scratch, in a step-by-step manner, in the hundreds of video tutorials available on PianoCareerAcademy.com.

You’re always welcome to join our community – and you can also learn more about the ergonomic technical foundation of piano playing by watching/reading my free tutorials:

How to Deal with Piano Practice Related Hand Injuries and Muscle Pain?
The 5 Basic Elements of a Correct Piano Posture
The Piano Posture and The Energy of the Sound
The Secrets of a Correct Piano Key Attack
The Key Principles of Correct Piano Practice: A Step-By-Step Holistic Guide

People also ask me: What exercises do you recommend for getting rid of piano-related tension/pain?

This question is probably inspired by the fact that I have published several workout/warm-up tutorials for pianists such as this one: Wrist, Arm & Shoulder Warm-Up for Pianists.

However, if you’re asking this question, you have probably misunderstood the purpose of my workout tutorials: they were NOT designed to help you get rid of incorrect-playing-related hand injuries – they were designed to make you stronger and more flexible, therefore facilitating your practice, speeding up your piano progress and improving the overall quality of your life.

I will remind you that piano-related hand injuries are caused by an incorrect playing habit. Therefore, how can you solve this problem without addressing the cause??? Wouldn’t it be silly to keep playing in a tensed incorrect manner and then do some exercises to counteract the damage – instead of not causing the damage in the first place? Wouldn’t it be much smarter to learn how to play correctly, in a safe ergonomic manner? :)

Doing exercises for getting rid of piano-related pain is just like taking a pill when you have a headache – it might make you feel better for the moment, but it will not cure the problem itself because it does not address its cause! In solving ANY piano playing problem, we have to begin by identifying the cause (like I explained in the beginning of this answer). Then, you should obviously exercise – but for the right reasons!

Another metaphor: imagine that it’s nighttime and you have lost an earring in the grass; you know the approximate place where it fell – but because that place is very dark, you’re looking for it somewhere else (under a streetlight, for example), because it’s more convenient this way. Of course you’ll not find it under the streetlight – your earring is in the grass, and this is where you should look for it!!!

And yet another one: you’re a heavy smoker, but after smoking each cigarette, you’re drinking a green smoothie (or go for a run etc.), thinking that this will counteract the damage. Yes, it might counteract some of it – but wouldn’t it be smarter to quit smoking, and then complement this decision with diet/exercise?

I hope that this answer will help you to understand the basics of managing piano-related injuries – pointing you in the right direction and helping you to take the first step towards your recovery ;).

Good luck, practice correctly and stay healthy!