I once worked with a pianist who came to see me because she was suffering from pain in her neck and shoulders. I’ll call her Ann. Before her first lesson, Ann explained to me that she had just finished a graduate degree in piano performance, and that she wanted to pursue a career in performance and teaching.
“Unfortunately, though, the pain in my shoulders is really beginning to get in the way,” she said. “It’s been there off and on for a few years but now it seems to be getting worse. I’m pretty sure it’s related to my playing – and I know that I have to address it before I can take the next step with my career.”
During her first lesson, I noticed that Ann had a lot of extra tension in her shoulders and neck and around the base of her skull (the area behind her ears). That tension was affecting the alignment of her head, neck and spine: her head tended to go back behind the vertical and her shoulders were raised. I pointed out those patterns to her and then we talked about them.
“Those patterns of tension actually mean that the cloud has a silver lining,” I told her. “They’re a problem with a solution. The Alexander Technique offers you a way to reduce the tension and realign your head, neck and spine. We can hypothesize that the tension is causing your pain. If it is, then the change process will obviously result in less pain.”
I explained to Ann that the change process would take some time. She would have to undertake a reeducation process in which she unlearned some old habits and replaced them with more efficient habits. That process would require practice and repetition. She said that she had some sense of what would be involved. She’d had group classes in the Alexander Technique at music school, and she had friends who’d taken private lessons and benefitted greatly. So she was willing to give it a try.
Here’s how I thought about Ann’s situation and the process she was embarking on. When a person first learns a new activity, for example playing the piano, there are actually two sets of skills. First of all, there are the technical skills. She learns how to read music; she learns where to put her fingers on the keys; if she’s playing with an ensemble, she listens to the other instruments and plays with them; and so on. Obviously in Ann’s case, she was already expert in all of those areas.
The thing is that there’s another set of skills involved in playing the piano. The pianist has to use her body efficiently so that she can carry out those technical tasks. Because so few teachers and coaches talk to their students about how to use themselves, I sometimes refer to those skills as silent skills. But of course those skills are anything but silent if the pianist is experiencing pain, as Ann was, or if she’s having trouble with her playing because of excess tension.
Let me get back to Ann and her story. The good news was that she found the Alexander Technique extremely helpful. She turned out to be very motivated and she spent a lot of time practicing what she was learning during her lessons. As a result, she was able to address her underlying patterns of tension and realign her head, neck and spine.
As a result of her practice, Ann’s pain gradually but steadily improved. Unfortunately, though, one key problem still remained. Whenever she tried to play the piano, she noticed that her tension and pain would come back. So I arranged to give her a lesson at her house, where she had a piano. That way I could observe her when she was playing.
At the beginning of that lesson, I noticed that, when Ann began to play, she raised her shoulders and her head went back behind the vertical. Her upper arms also began to get tense. Of course those were the same tendencies that I’d noticed before – but they were more pronounced when she was playing.
“The way to deal with those tendencies in your playing is to give yourself breaks,” I said. “You can take the same approach that you took when you changed your approach to walking, standing and sitting. You can pause before you start to play, in the middle of your playing, or after you play. The pause will allow you to give your directions, realign your head, neck and spine and subtract some of your excess muscle tension.
“When you’re working on this,” I added, “it’s best to pick a piece of music that’s not too complicated, or one that you know well. You can even do scales. That way you’ll be able to focus more on yourself than on the music.”
Then I broke down the approach for her. I asked her to sit at the piano and take a two-minute break. During that time, I did some hands-on work on her head, neck and spine and on her arms. While I was doing that, I encouraged her to give her directions. Once she was in a more neutral state, and her head was going forward and up so that it was more aligned with her spine, I told her to go ahead and play again.
After a few minutes of playing, it became clear that Ann’s tension was beginning to coming back so I suggested to her that she could take another short break. We did some more hands-on work and she gave her directions – until she was once again in a more aligned and neutral state. Then she tried playing again.
We repeated that process several more times before the end of the lesson. Each time her shoulders started to get tense, or her head went behind the vertical, I encouraged her to pause so that we could do more hands-on work. At the end of the lesson, I asked Ann if she had any questions.
“This lesson has been really helpful,” she said. “I do feel a small difference in the level of my shoulder and neck tension. I’m not as tense as I thought I’d be, even though I’ve been playing off and on for the last hour. I feel hopeful – and I have some really specific things I can work on now.”
“I’m impressed at your willingness to do this very basic work,” I said. “It takes a lot of humility – especially when it comes to an activity that you’re expert at.”
“I guess pain is a great motivator,” she said and then she paused for a moment and thought about the whole thing. “It’s true that I know a lot about playing the piano,” she went on, “but I’m definitely not an expert when it comes to my muscle tension. I don’t always know when it’s coming back. It seems to happen so fast. And when it does come back, it’s difficult to get it to release. But again, I’m very happy with the changes that are beginning to happen as a result of these lessons.”
When Ann came for her next lesson, I asked her how it had gone during the week. Had she been able to apply the Alexander Technique to her playing?
“I did work on the things you suggested, but it didn’t go quite as well as when you were helping me,” she said. “I have to tell you, though: I discovered something really strange. When I sat at the piano and didn’t play, or even if I just went into the piano room, I noticed that my shoulders would get tense. I was kind of surprised by that.”
“That’s a great discovery,” I said. “And by the way you’re not alone. That’s true for everyone. Our habits are as much mental as they are physical. If we have a habitual pattern that’s developed in response to an activity like playing the piano, all you have to do is think about the activity and the pattern will get triggered.”
After that, Ann developed a powerful, step-by-step way of addressing her habits. She would start by going to the piano room and standing in the doorway. Then she would notice that, just because she was in the same room as the piano, her head would start to go back and her shoulders and neck would “get ready to play,” as she put it.
Once she noticed those tendencies, she would pause and give her directions. After she had realigned her head, neck and spine and returned to a more neutral state in her shoulders, then she would walk over and stand next to the piano. Here again, her shoulders and neck would get ready to play. So she would pause and start the process of giving her directions all over again. If she succeeded in returning to a more neutral state, then she would go ahead and sit down at the piano. If not, she would go back and stand in the doorway and give her directions from there.
In other words, she developed a series of steps that gradually led to playing the piano. Once again, the first two steps involved standing in the doorway of the piano room and then standing next to the piano. The third step involved sitting at the piano but not playing. Then she would sit at the piano and put her hands on the piano and not play. Then she would play a single note. And so on. Each time she went to a new step, she would pause and give her directions. If she succeeded in realigning her head, neck and spine, she would go on to the next step. If not, she would go back one step and start over.
After Ann had undertaken that reeducation process for a few months, she was able to play with much less pain. Gradually with more practice, she was able to maintain her new way of playing not only when she was playing scales but also when she was playing pieces of music. She was very pleased with those breakthroughs and with her overall progress.
But she still had one question for me.
“There’s one thing I’m still not sure about,” she said. “When I play passages that are loud or that require a lot of intensity, I can feel my shoulders jumping into action again.”
I told her that she was raising an extremely important question. How does a musician create volume and intensity in her playing without overdoing and getting tense? The answer is that a pianist or string player creates more volume not by doing more in her shoulders and arms, but rather by creating a clear contact in her fingers – and then supporting her hands through her head, neck and back. On the other hand, singers and players of wind instruments increase their volume not with more tension but with more air.
Recall from Chapter 9 that the musician can organize her head, neck and back in an optimal way so that they become a framework of support, and so that they increase her strength. Then she can play with more or less volume and intensity, depending on the requirements of the music. This does take some practice, though. She learns to do less in her shoulders – and at the same time she increases the amount of direction, or internal movement, in her head, neck and spine. To be specific, she directs her head to go forward and up while her back stays back and lengthens and widens.
I worked on this a lot with Ann during her lessons. With time and practice, the organization and direction in her head, neck and back increased, while the stress and tension in her shoulders decreased. Then she found that she could play as loudly or as softly as she wanted without triggering the old pattern in her shoulders and arms.