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From a physiological standpoint, playing scales and chords at the piano is not terribly different from typing a memo, a novel, or a report at a Personal Computer. Modern computer users can learn a lot from pianists about how good technique can help maintain physical comfort and longevity in their work.

Since the early Renaissance, when harpsichords became more widely available in Europe, musical keyboards have been commonly in use. By the 19th century, most middle and upper-class households owned a piano. Computers are ubiquitous in the 21st century, and while newer on the scene, present some of the same physical challenges to users as musical keyboards. How do you use one and avoid problems such as Repetitive Strain Injury (RSI)?

Many doctors and physical therapists believe that RSI can be prevented. A number of the suggestions for healthy keyboarding presented here are drawn from the Musical Wellness movement as related to piano performance, especially from the work of Prof Barbara Lister-Sink (Salem College in Salem, North Carolina), and her DVD Freeing the Caged Bird. Developing Well-Coordinated, Injury Preventive Keyboard Technique.

It is generally understood among pianists that in order to play comfortably, avoiding RSI, one must:
1. Use good posture: sit up straight!
2. Develop kinesthetic awareness: notice how you are using your body;
3. Practise efficient muscle use.
The same principles apply to healthy keyboarding at the computer keyboard.

Good Posture

The diagram on the first page of a beginner's piano method book, and the diagram in Mavis Beacon Teaches Typing and the diagram at the start of your computer manual all basically say the same thing: Sit up straight! This is fundamental to avoiding RSI at the computer or at the piano. According to Dr Emil Pascarelli, in his book Dr Pascarelli's Complete Guide to Repetitive Strain Injury, "The most frequent physical finding in patients seeking care for RSI is postural misalignment. I found this in almost 80 percent of my patients."

Why is sitting up straight so important? Because when we sit up straight, we allow the natural curves of the spine to support the weight of the head. The human head of an adult weighs approximately 3.6 kilograms (8 lbs. U.S.).

The human body has a wonderful, built-in support device via the spine, with its three natural curves – the curve of the neck (cervical spinal region), the curve of the middle back (thoracic spinal region), and the curve of the lower back (lumbar spinal region).

Why is that significant? Because the spine does not generally get tired when we sit with good posture. If we sit up straight, in relaxed good posture, the head is balanced above the strong spine. If we don't sit up straight, we force our neck and upper back muscles to hold up that 3.6 kilogram weight. Forced to stay contracted, holding up the heavy weight of the head, those neck and upper back muscles get tired, stiff, and sore, which often leads to RSI.

Sitting up straight at the piano or in an adjustable computer chair with good lumbar support can help users avoid muscle pain and avoid RSI. It is desirable to get a piano bench or computer chair that has an adjustable seat height.

Kinesthetic Awareness: Extensors and Flexors – Comfort of Arms and Hands

Most pianists agree that it is important to be seated on the bench at a height that allows you to play the piano with your arms parallel to the floor. If the pianist sits too high on the piano bench, and is forced to angle the forearm down to reach the piano keys, it hurts because it puts stress on the extensor muscles, the muscles on top of your hand and forearm. Computer users similarly stress the extensor muscles if they type from a height that forces them to angle their forearm down to reach the computer keyboard.

The opposite of stressing the extensor muscles by reaching down, is stressing the flexor muscles, the underside of the hand and arm, by reaching up at a steep angle to play or type.

The optimum arm position for typing or playing the piano is with the arms parallel to the floor. When your arms are parallel to the floor instead of angled down or up, neither the extensors nor the flexor muscles get overly tired. They simply balance each other out.

It is approximately 72 centimetres from the floor to the top of the piano keys on the Steinway in my studio. I prefer to adjust my piano bench so that it is 55 centimetres high, which allows me to sit comfortably, with my arms parallel to the floor.

It is approximately 65 centimetres from the floor to the top of the keys of my computer keyboard. I prefer to adjust my computer chair so that it is 46 centimetres high, which likewise allows me to sit comfortably, typing with my arms parallel to the floor.

Depending on the length of your torso and the length of your arms, you will need to adjust the height of your piano bench or computer chair accordingly to find the height at which your arms will be parallel to the floor. One size does not fit all.

Efficient Muscle Use and Longevity

It can be instructive to watch video footage of an accomplished concert pianist such as Artur Rubinstein at the keyboard. Watching Rubinstein play the piano is like watching Fred Astaire dance. He makes it look easy. Terrific posture, elegant freedom of movement, no wasted motion, no unnecessary tension in the arms or wrists. Rubinstein played many of the most difficult pieces ever written for the piano, technically challenging music requiring great speed, power, and dexterity. He started performing as a young child, and continued concertizing until he was almost 90. Yet his manual dexterity never waned. His arms didn't 'wear out' from virtuoso piano playing.

His longevity as a pianist is a testament to the benefits of good posture and efficient muscle use for all keyboardists, both musical and computer users.

Athletes study footage of themselves, game tapes, to learn about ways to improve their performance. Musicians record their work onstage for the same reason. We can benefit from examining ourselves 'in action' at the keyboard. If you don't have the resources for videotaping yourself at work, just ask a friend to take a digital photo of you after you've been typing for about 15 minutes. Look closely at your posture. Where can you make improvements?

What about Laptop Computers?

Be aware that according to doctors and physical therapists, laptop computers are the least ergonomic of any computer. The problem is that on a laptop, the keyboard and screen are too close to each other. The machine was designed for portability, not for ergonomics. The only healthy way for a person to use a laptop is to set it up on a computer desk like a desktop computer: plug an external keyboard into the laptop, and set the laptop on a monitor stand so that the screen is at eye-level. Then you can work comfortably for hours.

Sitting hunched over the laptop with the computer resting in one's lap results in distorted posture, making it increasingly likely that the user will experience neck, back, and arm pain. Setting the laptop up on a high table, and stretching your arms up at an angle to reach the keyboard is no better, because it stresses the flexor muscles and puts pressure on the sensitive area of the carpal tunnel. You will never find recommendations for either of these posture distortions in respected resources on how to avoid RSI.

Summary

In Poor Richard's Almanac, Benjamin Franklin wisely observed: "An ounce of prevention is worth a pound of cure." Prevent injuries before they start by making a habit of using good posture and ergonomically designed tools at your desk. Consider piano lessons to develop the muscles in your hands and arms. Forget that myth about 'No pain, no gain'. It has absolutely no place in healthy keyboarding.

Bibliography

Books and Articles

Damany Suparna and Bellis Jack. It's Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals. Simax, Philadelphia, PA, United States. 2000. www.RSIRescue.com.
Friess Steve. Laptop design can be a pain in the posture. USA Today. April 12. 2005.
Lister-Sink Barbara. Freeing the Caged Bird. Developing Well-Coordinated, Injury Preventive Keyboard Technique. Produced and Directed by Barbara Lister-Sink. 150 min. Wingsound, International. Winston-Salem, NC, United States. 1996. DVD.
Norris Richard. The Musician's Survival Manual: A Guide to Preventing and Treating Injuries in Instrumentalists. International Conference of Symphony and Opera Musicians. San Antonio, TX, United States. 1993.
Pascarelli Emil. Dr Pascarelli's Complete Guide to Repetitive Strain Injury : What You Need to Know About RSI and Carpal Tunnel Syndrome. Wiley & Sons, Hoboken, NJ, United States. 2004.

Web Sites

Bruser Madeline www.artofpracticing.com
Musical Wellness Bibliography www.mtna.org/mwb1.htm