Physiotherapy, Ergonomics, Alexander Method; how they help in the life of a musician.

Physiotherapy musical

Whether we are musicians or not, we all reach a certain age in which the monotony of our lives hurts us in our health and not only with illnesses, also with physical discomforts that prevent us from developing an activity with a good rhythm. Back pain, cervical, limbs … all this is due to a continuous overload, which hurts us in our daily lives.

Well I choose this topic to raise awareness of how we can prevent many of these pains, I will be focused on the musicians, but everything I say below applies to any field.

Physiotherapy, its different fields and the most used techniques:

The word physiotherapy comes from the Greek word”physis → nature” and “therapéia → treatment”. It is a branch of health, which is responsible for solving the problems of physical pain through the use of various techniques.
Within physiotherapy there are many branches that few people know, when we talk about physiotherapy suddenly comes to our mind a massage to remove tensions but it´s not only that.

This branch of health frames several fields which I will name below:

  •  Physiotherapy in muscle-skeleton pain: It treats problems of cervical, lumbar, sciatica pains …
  •  Rehabilitation in traumatology and orthopedics: It occurs after fractures, immobilizations …
  •  Sports physiotherapy: Occurs when the injury occurs practicing sports, most usually they are sprains or overloads. Here is the famous tennis elbow.
  •  Therapeutic gymnastics: Above all, it is used to prevent any fracture that may occur, we use the mezieres and williams methods, of which I will talk more going along with the alexander technique.
  •  Postural hygiene: Used to prevent injuries or prevent relapse.
  •  Neurological physiotherapy: Treating diseases of the central nervous system and those of the system peripheral nervous system, such as multiple sclerosis, hemiplegia, facial paralysis …
  •  Geriatric physiotherapy: Used in the elderly, who suffer many physical pains by which their movements are slower and clumsier, or even in some cases produce immobility.
  •  Cardio-respiratory physiotherapy: Occurs when a person has respiratory problems, such as asthma.
  • Children’s physiotherapy: Used when there is some type of childhood pathology, such as PCI (Cerebral Palsy Infantile), dystrophies, psychomotor delays … In turn, within these fields different techniques are used, and these techniques are the following:
  •  Massage therapy: This is perhaps the best known, pain is treated through massage.
  •  Osteopathic manual therapy (Osteopathy): With this technique the body is studied in a global way, treating pain from the exact point and also its surroundings.
  •  Kinesiotherapy: Electrical means are used to treat pain. One of the most used are the currents.
  • Thermotherapy: Pain is treated by heat waves.
  • Cryotherapy: Pain is treated with cold.
  •  Manual lymphatic drainage
  • Mechanotherapy: Mechanical means are used. Different machines which help the movement.
  • Dry puncture: They use needles which act directly in the focus of the pain.

Having made mention of physiotherapy in general we are going to talk about another aspect no less important: Ergonomics or Human Engineering or Human Factors.

What is Ergonomics?

This term refers to the study of biological and technological data that allow adaptation between man and machines or objects; that is to say, the ergonomics is proposed that the people and the objects work in harmony. For this purpose, it is dedicated to creating tools and utensils whose function is to satisfy the welfare and needs of people. Therefore, it reduces injuries and illnesses linked to the use of artificial technologies and environments. An ergonomic object is one that offers comfort for those who use it. For example:

 There are people who spend many hours sitting because their work is an office. What ergonomics does is design specific chairs for this task or adapt the computer keyboard for greater comfort. If ergonomics were not applied, surely these people would suffer back pain among many others.

Thus, responsibility for ergonomics is that the wheelchair is as comfortable as possible taking care of aspects such as the height of the chair and its inclination, the width or distance between footrest and seat, etc.

 Also for those who perform their tasks standing, ergonomics have created anti-fatigue mats. Focusing on music, they have made an ergonomic cushion which can be adapted to any chair for those who do not feel comfortable with conventional and It is adjustable.
We also find chairs for orchestras that are ergonomic, which offer greater comfort. But I have to say that as far as music is concerned, ergonomics do not act too much.

We need to highlight what would be an ergonomic posture for the violinistic practice as well as the main errors that are committed and lead to injuries:

  1. We must distribute the weight between the two feet.
  2. The waist must be aligned.
  3. The violin is placed on the left shoulder, taking care not to put the arm forward or head to hold it.
  4. The head will be placed on the beard, it must remain straight.
  5. The left hand should not hold the violin, but it should be held by the head and the clavicle, without cervical tension. But neither should we get confused and relax the arm too much, it should be very high, without the arm resting on the body or the elbow being too low.
  6. The fingers remain rounded above the strings. And the arm pivots around the thumb-index contact point.
  7. When holding the bow, the thumb, wrist and shoulder should remain relaxed and watch for tension.

Below we quote the main mistakes we make and we will have to keep an eye on them to avoid future injuries:

  1. Tilt the head too much or rotate it by holding the violin with the chin.
  2. Back tense or in bad posture.
  3. Raise the right shoulder.
  4. Left elbow attached to the body or violin in line with the body. (The violin must be left in front of us)
  5. Left hand tense or big toe in extension of the last phalanx.
  6. Right hand rigid or without the little finger stabilizes the bow.

Forward I will write some methods used for the correction of harmful postures such as, for example, the alexander method and the Williams and Mezieres method mentioned above.

Alexander Method:

The Alexander technique is:
→ The art of making good use of oneself, having control over oneself gives the ability to cope with activities for which we tense, such as playing an instrument, dancing, walking, sitting .. .
→ A simple method of body education; the objective is to find the balance and the natural freedom of the body to be able to move more easily.
→ A way to understand how the body is designed to let it function properly. → A reeducation to establish good coordination between body and mind.
→ A slow but safe learning process … we must take into account that what we do is erase the comfortable habits that we have acquired to give way to others that are not so comfortable but that is the correct way to develop them, Clearing the error and learning again is a slow process.
→ A way to learn to interact with the “other” but without losing ourselves, we must learn to be more present and aware in the space in which we are and that we share with others.

This technique is not an exercise program or a treatment, it wants to teach us to become aware of ourselves, how we move and choose how we want to move. Make good use of ourselves to prevent pain or illness. Who specializes in this is a non-therapist teacher and those who come to him are students, it is a reeducation.

Williams Method:

Williams proposes flexion exercises, insists on the stretching of the abdominal muscles to avoid the spinal displacement. The sequence of these exercises allows to recover the physiological profile of the column.

Mezieres Method:

This method was developed in 1947 by Francoise Mezieres, is a physiotherapeutic technique that treats the patient through a postural work based on exercises of stretching and body perception in a globalized manner. Rebalances the different muscular and joint chains, improving posture and relieving pain.

This treatment aims to return the mobility of the muscles and joints in a progressive way, balancing the breathing, stretching the muscular chains retracted, improving in turn the corporal conscience.

Main injuries to musicians and how to prevent them.

After having exposed these techniques to prevent pain, we will following talk about the main injuries that musicians dealt with and which often prevent us from carrying out an interpretation successfully or in some cases the suspension of the practice during a period of time.

Muscle contraction, myofascial trigger points, neutral entrapments such as cramps, tingling … somatic dysfunctions that are vertebral pathologies, arthritis / osteoarthritis, focal dystonia (mobility does not respond quickly to a function controlled by the brain). To all these injuries, are exposed musicians or any person who makes a physical effort (out of the ordinary).

If we are aware of what we do wrong and how to avoid it, we can prevent these injuries.

Since we started our tutors as well as they teach us about technique, the time that we need to study and the sacrifice that musical practice requires, they should also transmit to us how important it is to be in harmony with a physical and mental practice.

To avoid injuries we must follow several tips that will help us feel better about ourselves:

1. Before studying we should perform at least 15 minutes of stretching without the instrument, working on the most problematic parts of the body, such as the back, neck and arms for example.
2. We must distribute the study in sessions, it is recommended that they do not exceed one hour and we take a break of 15 minutes in which we return to perform a shorter stretch and do breathing exercises to avoid tensions and relax.
3. When we are practicing with the instrument, be aware of our body at all times, and if we notice in tension release and relax. As time passes this will become automatic.
4. When we finish the study, perform the stretches at the beginning.
5. Go to a physiotherapist to prevent, we do not need to hurt anything.
6. Control the posture when walking and when sitting.

Many people ask if doing sports would be a good option to combine it with an artistic life and here we give three very good options that also help us to prevent injuries and better control of our body position.

One of the sports that we can practice is swimming, this one helps us with back pain and prevents them.

Yoga and Pilates are also recommended, to prevent injuries you have to stretch and there is nothing that makes stretching better than practicing these sports; besides when you go to the doctor and you explain the pains that you have and that you dedicate to music the first thing that recommends you more than anything else are these guidelines and that you practice these sports regularly.

Another important aspect that helps us not to prevent but to keep us in shape and feel better with ourselves is food, in a way a person with a balanced diet that includes everything: fish, vegetables, meat, pasta… will help us to reduce the risk of injury that an unhealthy person could have. If we take a good protein diet with vitamins we will be more attentive when it comes to studying and we will focus more on all aspects. Everything in life determines us, that’s why it is very important to strike a balance between study, sport, food and sleep.

About all we need a good hydration, which will help us maintain healthy joints for a lifetime. A good hydration allows all the nutrients we eat to move correctly to feed our tissues and give the ability of the articular cartilage to withstand the pressure and recover after the loads.

With this article I hope that people, especially young musicians with a long life ahead, will become aware that apart of the mind we need to look after our body habits. We need to be aware of everything mentioned above since we started to play an instrument. Speak with your teacher about body position and what to do to improve it.
As we start to play an instrument when we are young we still do not finish the development of our body so we will grow up with the instrument, it is very important to have a good posture from the beginning, otherwise, it will bring us physical health problems in the future.

As Viola M Frymann said “The human being is not the physical body, the emotions or the spirit. These are instruments that allow you to act in the physical, emotional and spiritual world and we have the obligation to study the anatomy and physiology of these instruments if we want to treat the human being as a whole “.


Avila red. Formación para tratar los trastornos musculoesqueléticos de los músicos. (2020)

Rediscover Ease. Alexander Technique. (2020)

PMC. Physical therapy management of performance-related musculoskeletal disorders in musicians. (2020):


 González Portillo, T. (2016). La guía del músico profesional. España: Gran Pausa.

 Kleinman, J; Buckoke, P. (2013). The alexander technique for musicians. London: Bloomsbury.

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