Violin Injuries – Top Six Postures That Cause Pain

by Grace Cheung, PT

Musician Injuries often happen because playing your instrument, whether it is the violin, piano, cello, guitar, flute, drums or even the glockenspiel, is REPETITIVE and ASYMMETRICAL.

Often times, changes in technique, practice habits, instrument set-up, posture, and other life changes can contribute to injury. You may want to examine whether there have been any changes lately and whether they were introduced quickly versus gradually.

Here we have a novice violinist demonstrating six postural habits that can contribute to hand, arm, neck and back pain.

1. Arm Position
A good violin teacher will notice when your hand or wrist is not in an optimal position. However, when playing for a long time, sometimes very subtle changes in position can occur in the forearm, wrist or finger positioning in either the bow or string hands. Repetitive use of a muscle or joint when it is in a non-optimal or neutral position can lead to overuse and eventual repetitive strain injury. A Musician Injury Scan can help to identify these variations in posture and prevent injury.

2. Neck and Jaw (TMJ) is Bent to the Left
Here we see the neck is bent to the left. Now, a good music teacher would be fairly quick to correct this posture by bringing the head to as straight as a position as possible. However, it is unavoidable as a violinist to not use the left neck and temporomandibular joint (or jaw) muscles more than the right. A right side bend stretch is one thing a violinist can do to alleviate this left neck and jaw muscle overuse. If you missed our exercise tip sheet from the last post, look here.

3. Right Shoulder Girdle Slump
Pain in the right shoulder, neck and upper back is not uncommon amongst violinists as well. Often times the shoulder blade, or scapula, can be slumped and pulled up and forward from overuse of the upper trapezius and pectoral muscles, and weakness of the lower scapular muscles.

4. Lazy Back
Below we see a loss of the spine’s natural curves. There is an increase in kyphosis, or forward curve, throughout the back. In the low back, we see a loss of lumbar lordosis, or backward curve, along with a pelvis that is tilted back. Playing with these postures in a prolonged fashion contributes to muscles and ligaments being stretched in the back, leading to weakness and eventual pain with overuse in this non-optimal posture.

5. Swayback
Here we see in standing another common posture. The head is forward, the upper thoracic spine is slightly back, the pelvis is pushed forward, the hips are extended and the knees want to lock into hyperextension. All sorts of potential problems here from the spine down to the knees.

6.Non-Violin Related Postures

Another thing to consider is what your posture is like the rest of the day, when you are not playing violin. Below is a common posture we see with our smarthpones and devices. This posture, when held prolonged, can contribute to headaches, neck pain, back pain, and arm pain and even numbness and pins and needles.

Grace Cheung is a physiotherapist who specializes in treating musicians and performing artists. She is also a musician and plays violin, piano, guitars and is now learning the cello. Grace is co-owner of Go! Physiotherapy Sports and Wellness Centre.

Musicians Injuries

I have just posted a new exercise sheet for common muscles that get overused but musicians, especially string players. Check it out on our website here.

Check back here soon, as we will soon be posting some more info about common musician injuries!


Musicians Injuries Go Physio

You’ve Got to Move it, Move it!

I am really appreciating Dr Mike Evans’ informative videos on how movement and exercise can help us live better. Check out this video here.

Why do I love it so much? Because a good majority of people I see in the clinic come in with aches and pains, not necessarily because of their sport, but because of their lack of it. Our bodies were not meant for so little movement that our sedentary lifestyles offer. One thing I do to make myself to work a little harder is to use a heavy steel framed bike when I bike to work!



Got a good workout this weekend not just

Got a good workout this weekend not just snowboarding down but also hiking up. #springskiing

Back Care and Incontinence During Pregnancy and the Reproductive Years

For Mom, the whole experience of pregnancy and giving birth is a time of great physical and mental adjustment as she adapts to the new challenges of motherhood. She expects perhaps to experience some aches and pains during pregnancy, especially once she can no longer see her feet, or turn over in bed!

Pregnant women often have to modify the level and type of activity to prevent physical strains yet maintain the original fitness goals to feel fit and ready to deliver. For example. exercising while lying down on the back should be limited after 16 weeks of pregnancy to avoid pressure on the uterine artery. Elevated pregnancy hormones result in increased laxity of the pelvic ligaments (essential structures that usually stabilize the pelvic bones) which creates a looser pelvis ready for the expansion needed for babyʼs delivery. However, this looser pelvis is also potentially, a less stable pelvis at a time when the core muscle group (which usually acts as a ʻback-up stabilizing systemʼ) is also functioning at a mechanical disadvantage. In the later stages of pregnancy, Mom will experience increased fatigue due to the greater demands of pregnancy on the
cardio-vascular system. In addition, during subsequent second or third pregnancies, the physical demands of daily life are greater as Mom continues to care for older siblings. She may already be experiencing some residual symptoms of back ache or incontinence which have been left unresolved since the previous pregnancies.

Good posture, biomechanics and back care, as well as the correct type and amount of exercise, are very important to prevent or minimize the aches and pains of pregnancy. Eager to regain their pre-pregnancy toned-up body, new Moms frequently return much too soon to the exercise regimens that they participated in prior to pregnancy without allowing more time for more progressive low-level strengthening and stabilization first. They may return to high impact activities too early causing further damage to an already traumatized pelvic floor. Repeated bending to pick up toys or to lift older sibling from the crib or bath, carrying baby in a car seat or on her hip while multi-tasking around the home, are all examples of potential physical stressors. Sitting slouched for prolonged periods to settle baby or to nurse can also cause neck and back ache. It may help to raise baby up closer by laying him/her on one or two pillows. If an older sibling wants to see what Mom is preparing in the kitchen, perhaps have the child stand on a chair (away from the cook-top!) rather than lifting him/her up. If they want to have a cuddle, try suggesting that Mommy sits down first and have them climb on your knee. If the child is able to climb in to the car seat, then allow him/her to do so, even if it takes a few minutes longer. Walking with a baby in a carrier secured against Momʼs body in front
(for an infant) or behind (for a toddler) can be less strenuous than carrying a child in Momʼs arms.

Return to Activity

In the early post-partum period, it can be difficult to know when to get back to exercise. What type, how much and how soon can be difficult to gauge. Our bodies typically take at least 6 weeks to heal from any trauma that occurred during the delivery. Specific core stability and pelvic floor exercises, ball and water-based exercises can be excellent choices when under the direction of a doctor or physiotherapist. Higher impact activities can cause or worsen symptoms of incontinence or leakage of urine, a condition which is
very common during, after pregnancy and can be persistent for some Moms throughout the rest of their lives. It is a treatable but sometimes embarrassing condition that many women do not feel comfortable talking about. It is recommended that if Mom experiences these symptoms that she seeks the assistance of a specialized
physiotherapist who can examine and direct her in learning bladder control and teach specific exercises to regain pelvic floor muscle strength. This is essential to help her to resolve incontinence. A detailed physiotherapy exam can also reveal pelvic asymmetries, instabilities and inadequacies in the core muscle function that could cause Mom on-going pain and difficulty in returning to the physical activities that she most enjoys, including the daily tasks of motherhood that her new role demands. It only makes sense to treat these problems early! Your physiotherapist is there to assist you.

Susan Deslippe is a physiotherapist at Go! Physiotherapy Sports and Wellness Centre in Vancouver.

For more information on Vancouver physio visit Vancouver Physiotherapists at Go Physiotherapy!

20 to 30 minutes of daily exercise gives you the best return on investment

Good things should be shared. So here are 9 minutes of education and empowerment (given by Dr. Mike Evans) for your day. Enjoy and be well.


Grace Cheung is a physiotherapist at Go! Physiotherapy Sports and Wellness Centre in Vancouver.

For more health tips, please visit Vancouver Physiotherapists and Physio Vancouver.

Measure your heart rate pulse on your iPhone

There is an app for almost anything nowadays isn’t there? Why am I not surprised that there is actually an iPhone app that can measure your heart rate?

Check this out:



Grace Cheung, Physiotherapist, Vancouver, Canada.

For more health tips, please visit Vancouver Physiotherapists and Physio Vancouver.

Go! Physiotherapy Sports and Wellness Centre, Vancouver

Olive Oil: Why cooking with it may be bad for you


Last night I had dinner with a friend who is a food scientist at UBC. I learned this health tip while we dined on a delicious clam and chorizo white wine pasta dish: when cooking, don’t cook with olive oil.

Olive oil has gained a lot of attention this past decade, with a general increased interest in cooking, culinary arts and health and wellness.

Did you know that olive oil has high amounts of unsaturated fats? In fact, it’s high content in monounsaturated fats is why we’ve been told olive oil is good for us. However, when high amounts unsaturated fats are heated, as in with cooking, many double bonds in its chemical make-up turn into radicals. These radicals, when roaming free in the body, create reactive compounds that can damage your cell membranes, and are responsible for many chronic degenerative diseases.

That being said, olive oil is great for drizzling and preparing non-heated dishes. However, cooking with canola or corn oil might be a better choice.

Grace Cheung, Physiotherapist, Vancouver, Canada.

For more health tips, please visit Vancouver Physiotherapists and Physio Vancouver.

Go! Physiotherapy Sports and Wellness Centre, Vancouver

How to burn fat and save money (and appreciate street art all at the same time)

I came across this photo of a clever piece of street art by Peter Drew from Australia.

He has a good point!

Exercises after breast surgery

This is a great resource for those who are recovering from surgery after breast cancer. You can download the PDF here from the Canadian Cancer Society. For more specific exercises and questions, please book an appointment at Go! Physiotherapy Sports and Wellness Centre.