ARTHRITIS AT THE PIANO AND WAIT, WHAT? ROTATION?

  

     In a forum for pianists, a physical therapist remarked that one of her clients, a doctor, had been advised to stop playing the piano because of painful arthritis. There ensued much discussion about whether or not piano playing causes, exacerbates or alleviates symptoms. My advice in these circumstances is—keeping in mind that I am not a medical doctor—first get a thorough evaluation from medical experts. After that, proceed gently using methods that do not interfere with the body’s natural design.

     My response to the poster was: “Your client should find a teacher who understands how the playing mechanism works. In brief: The fingers do not act by lifting away from the hand, but rather operate as a connected unit with the hand and forearm, through a forearm rotation. This particular action is a natural, quick and easy one and has proven to be therapeutic. It's not possible to play the piano without it; trying to thwart it causes injury. There is a series of DVDs published by the Dorothy Taubman Institute that might be a good starting point. Avoid at all costs exercises by Czerny, Hanon and the others. They are at best a waste of time and at worst can create a misunderstanding of what is needed to play.

     One possible approach for this pianist would be to explore how the forearm works. She could try this: Lift the arm up from the elbow and notice the hand is in a karate-chop position with the heel of your hand facing the keys. In order to play at all we have to turn (rotate) the forearm toward the thumb. When this movement is not understood, it is possible that unnecessary tension will exacerbate the arthritis symptoms. This rotation gets the forearm behind the finger that is playing and is the source of power and speed. But it is only a tool. We move laterally up and down the keys using other mechanisms which I don't have time to describe here. We play the piano with our fingers in alignment with the wrist hand and arm. Also, it is a mistake to think of originating a movement from the wrist because then the fingers, more often than not, turn to wet noodles.



      It was suggested that she study Czerny and Hanon, which many people use with enthusiasm. My feeling is that if you know how to play them technically, then you don't need them. Their premise is that we train for endurance and physical strength similar to the way weight-lifters train. This is a fallacy. We train refined muscles for coordination. A small child is "strong" enough to play the piano. Repetition training of the sort advocated by the authors of these exercises falls too easily into the category of mindless rote.

     I think it's more important to examine how this arthritic pianist moves at the keyboard, rather than the issue of what repertoire to play. In general, though, she may want to take care not to extend her hands to extremes. That is, avoid stretched intervals, particularly octave positions with a minor second in the index finger. And of course, if something causes discomfort, don't do it. Since she's a doctor, she may have an advantage.

     Some pianists argue that they don't use forearm rotation, so I repeat: Lift your forearm up from where it hangs at your side. Lift from the elbow. Do nothing else. Your hand will not be in a playing position. In order to be in a playing position you must rotate your forearm in the elbow axle toward the thumb. This is the first example of forearm rotation as an UNDERLYING TOOL. It is only one of many refinements we use. It is not  the only way to play the piano. But you can't play without it. Moreover, understanding forearm rotation as an underlying tool contributes to an efficient and fluent technique.          

     

     In all fairness, I think I understand where the rotation doubters come from. They can see applications in Alberti figures because that’s rather obvious. If they play naturally and with ease and if they had facility at an early age, it is difficult for them to understand what is underneath and why it's important for people with less natural facility to discover for themselves what works. 
     I also can understand why they might think movements originate from the wrist. In a well-coordinated technique in which lateral movements are incorporated—walking arm and shaping—the wrist moves in ovate gestures, giving the appearance of being the motor behind the fingers. The piano is played with the fingers in collaboration with the wrist. It is not useful to think of initiating the movement from the wrist, but rather allowing the wrist to participate. This takes some deliberation. And unless a pianist is willing to give it thought, the understanding will never come. 
     So I say to pianists faced with arthritic pain, find ways to use the playing mechanism in the manner to which it was born. That is, use it according to its design. Never mind the rotation doubters. It’s possible to make music at the piano from many different points of view, or from no point of view at all, the latter approach being the most common. I choose to make use of knowledge. This knowledge can be therapeutic.

TROUBLE SHOOTING:WHAT’S THE DIAGNOSIS?

       I hope I don’t break any hearts when I say that the piano is a machine. In an earlier chapter we learned that someone thought of the piano as home to a choir and organ, at which time I expressed my preference for the Philadelphia Orchestra string section. Fanciful imagery can be helpful, perhaps necessary, when developing a musical purpose. It’s important to keep in mind, though, that we achieve our musical purpose by means of the expert operation of a system of levers, dampers and hammers, setting into motion more than 12,000 individual parts, a physicist’s dream. If you think of it this way, the piano operator must be a very skilled machinist, a mechanical wizard possessed of a remarkable number of refined motor skills. Oh wait. That’s actually what we’ve been discussing.

     For a moment, let’s think of the operator as a machine, too, a living machine made up of, well, you know what, mostly water. What I think of as the piano playing mechanism, the fingers, hands and forearms—the heart of our operator’s machine—is, like the piano or any other machine, subject to malfunction. If the piano develops a buzz or a hammer misfires, we run through our checklist of possible problems, or in my case, call the technician and rely on him to diagnose and repair the problem. If the problem is not the piano’s mechanism, but rather the human’s mechanism, what then? Warning: Metaphor shift. We call the doctor, describe the problem and wait eagerly for a prescription.

     Working in the way I’ve been describing in this volume is really a diagnostic approach, a term coined by Taubman and particularly apt. Knowledge is our doctor, or until that knowledge is secure, the teacher who has knowledge is the doctor—this book can be the doctor’s aide. If something in the technique malfunctions, if there’s what I call a bump—a note is not completed, as in transferring of weight—then our interior doctor has to pull out his stethoscope, as it were, and check us out. But, and this is enormously important, he doesn’t then write prescriptions for every known medication. He offers the correct one(s) for the particular problem. This is why I don’t tell students to play Czerny etudes in preparation for that problem passage, or play the passage in every possible rhythm, or play it 1000 times everyday or just play it slowly. These are vague, general corrections, the equivalent of throwing all medicines at the patient in the hope that one might work. There are many down sides to that general approach, chief among them the likelihood of causing other problems with the unnecessary medications. Remember, first do no harm.

    To read the checklist and find more answers, see Piano Technique Demystified, the book.

THE DILEMMA OF THE DAINTY HAND: PLAYING ON THE EDGE

The octave-challenged hand, when confronting the grimacing sneer of a piano keyboard, seems to shrink to its smallest self in sheer anticipation of being held to the rack for a round of torture. The feeling of being pulled and

stretched is a familiar one to those with a less-than-octave reach. It is therefore imperative for those possessed of such a hand to be well tuned to its reports from the dungeon.

When asked about physical requirements for piano playing, my usual answer is that the minimum hand size is an easy octave. By that I mean the hand should be able to reach an octave without feeling extended to its extreme. Even better, the hand should be able to play an octave and include a minor second between thumb and first finger without feeling stretched. But experience has shown that, with extra consideration, the smaller hand can be quite successful at the keyboard. And when there is a burning desire to make music, how can I not try to help. 

My adult student brought the final movement of Beethoven’s C minor sonata, op. 10, no. 1, which, though not in a class with, say, the octave-crazy Liszt Sonata, still has some pesky passages for the smaller hand. Find out how to avoid lockjaw of the arm and learn the solutions to this problem in Piano Technique Demystified, the book.

ERRATA
Dear Readers: Many thanks for your support and for your interest in my new book. The first group has sold out. Alas though, human error rears its head—mine. If your volume has the typo in dilemma on page viii of the contents  (spelled dilema), then please print out the following paragraph and attach it to page 51. Somehow, previous incarnations of this example found their way into the final version. Words are like that...

These errors have been corrected in current editions.

Final paragraph of page 51:

Speaking of taboos, consider this: Despite what you may

have heard, the fifth finger may cross over the thumb and the

thumb may cross over the fifth finger, particularly in the playing of

dominant seventh arpeggios. But I do this whenever convenient,

now that I know how. Have a look at the end of this melisma of 48

notes in Example 9-1 below. Notice the editor’s fingering at the

high point turn around, from F and descending. Try the 1-4-3-2-1

combination as shown in the example with an added slur line.

When I first played this as a teenager, not knowing any better, this

is the fingering I used. Very uncomfortable and not really fluent.

Now try 1-3-2-1-5 on the same group of notes and continue as

marked in the top fingering. The thumb is the mechanism by which

the hand moves rotationally from one on D-flat to five on a white

key, C-flat. Yes, cross five over one, one being the thrusting agent.

The book is now available at Amazon, including the LOOK INSIDE feature. It is also available at  Create Space E-Store. As you may have surmised, the book was inspired by the posts in this blog, though many of the articles have been considerably expanded and illustrated. There are also several new sections, namely, a chapter on the co-dependence of the hands, a not-to-be-missed concluding "putting it all together" chapter and a chapter of teaching moments. I'll be interested to have feedback on any aspect of the book, especially those teaching moments, whether or not they are useful. It is time-consuming to devise these, but if they are useful I'll do more.

For those of you who want to get a head start, my book is available now at Create Space E-Store, which is an Amazon company. Amazon.com will have it within the week. Remember, the first reader to notify me of any typos may have a free piano lesson if feasible. Or choose a limited-edition, signed photo similar to the one posted in this blog under "Off Topic." I'll soon have a link to my portfolio, where you can take your pick. If you find an error in my book, just click on the contact button above and let me know the page number and location and leave your contact information. I decide if it's a valid error.