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The human body is a musician's most important instrument. 

The late Canadian pianist Glenn Gould, one of the world’s most gifted interpreters of J.S. Bach’s music, hunched over the piano and disconcertingly contorted his body as he played.
Early 20th-century composer and pianist Sergei Rachmaninoff canceled engagements because of horrible pain in his hands.

What these virtuosos probably had in common were injuries caused by misusing—and misunderstanding—their bodies, says Lisa Marsh, director of the Coordinate Movement Program at PSU. She teaches pianists and other musicians the right way to play their instruments. With body awareness, a musician can bring out the potential of the instrument.

Without it, the instrument can become a kind of torture device.

“Show me your arm,” Marsh says to me as I interview her for this article. “Show me where it begins and ends.”

I’m sitting with my classical guitar resting on my knee. I’m a rank amateur, but I know a little bit about how playing an instrument inefficiently can trigger aches, fatigue, and shooting pains. When I’m in a bad position I can get radiating jabs that go all the way up my spine, and I’ve had to ice my left wrist at times after long practices.

I extend my arm and state the obvious: It starts at the wrist and ends at the point of my shoulder.

Wrong. Marsh, who was a registered nurse for 19 years, brings out a life-size skeleton model of the human torso. One of the problems with how most musicians view their bodies, she explains, is that they isolate their component parts. Pianists, for example, will keep their arms and shoulders rigid and make their fingers do all the work. Doing this over a period of years can produce tendinitis, carpal tunnel syndrome, and chronic back and neck pain simply because the pianists lock up the rest of their bodies.

“You should think of your arm as including your wrist, your hand, and all the way up through your clavicle and scapula,” she says.

When she shows me how this relates to my guitar playing, I suddenly feel looser and more mobile. I drop my left shoulder more than I’m used to in order to access more of the neck. I’m conscious of my chest muscles at work. I can more easily reach that last quarter inch with my little finger. Marsh gives me other suggestions about angling my instrument, putting a pillow between my thigh and guitar—little things that work the kinks out of my body and my playing.

And when you work the kinks out of your body, your music improves.

“Sound is movement, whether you’re singing or playing an instrument,” she says. The freer the movement, the better the sound and the greater a musician’s expression of artistry.

Marsh estimates that about 40 percent of musicians are disabled in some way or affected by pain or injury. The numbers are hard to pinpoint, she says, because most musicians play without telling anyone they’re hurting.

“Orchestras usually don’t offer disability coverage. If you have to lay off because of pain, they fire you,” she says.

Pianists and violinists tend to have the most problems, Marsh says, and women tend to suffer more than men. The bulk of the classical piano repertoire was written by men with big hands. To replicate the big sounds of composers such as Rachmaninoff and Liszt, you have to have hands with a lot of stretch. One solution Marsh offers is to selectively eliminate notes from certain chords to allow the player to perform those pieces without undue agony. Dropping a note from a chord is no big sin, she says unapologetically. “These composers would want their pieces played regardless.”

Violinists tend to have a lot of neck problems—not surprising when you see how they hold their instruments. Some of those problems can be alleviated by adjusting the chin and shoulder rests to bring the head more in alignment with the rest of the body, yet few violinists take the trouble to do that, she says. Consequently, they also don’t stand in a balanced way; they arch their backs, forcing the knees to lock and the lumbar spine to bend forward.

“They have no concept of what’s holding them up. It’s the grand design of the skeleton that holds them up,” she says.

Ben Thauland, a trumpeter with the Portland Youth Philharmonic and PSU Orchestra, acquired a whole new sound after taking Marsh’s class and learning to relax. “I was skeptical going in; it sounded like a yoga class. But after the second week I noticed that my sound opened up, especially in the upper registers,” he says.

Michael Miersma, a singer with the PSU Chamber Choir, says Marsh coached him on the proper use of his arms and legs in a way that helped him release tension and breathe better—all of which improved his singing in subtle but unmistakable ways.

Marsh’s teaching of body awareness was revolutionary for piano teacher Eileen Knox. “When I was trained, I was told to warm up with scales,” she says. Now she warms up with walks and a gym workout. The result is a disappearance of the carpal tunnel syndrome in her arms that had plagued her since the fourth year of her career.

Pain is something that Marsh, 51, knows from firsthand experience. In her compact Lincoln Hall office, which contains a desk, a couch and two baby grand pianos, she explains how a lifetime of making music put her on the injured list. She began playing piano at age 7, and spent years playing classical piano, both solo and as part of ensembles. She has been the principle keyboardist for the Columbia Symphony Orchestra for the last 10 years, and has played dozens of large and small concerts on her own. She was even a rock singer in the 1980s with a group called Metro Dog, a punk band made up mostly of OHSU medical students.

In 1994 Marsh developed constant pain in her right shoulder while practicing hour upon hour for a difficult solo piano recital. She survived the recital, but the experience led her on a quest to learn as much as she could about the role that body mechanics plays in musicianship. What started as independent research grew into eight summers of study at the Taubman Institute of Piano in New York. Its founder, Dorothy Taubman, is a pioneer in identifying the prevalence of injury among pianists, and has been teaching musicians how to play pain-free for more than 50 years.

Meanwhile, Marsh became acquainted with Barbara Conable, a Portland musician and teacher who, along with her cellist husband William Conable, is an expert in how musicians and singers use their entire bodies—their skeletal, muscular, respiratory and nervous systems—in making music. “They believed that if students understood the structure and functioning of their bodies, they would perform better and use fluid, natural movements at their instrument, reducing the possibility of playing with pain,” Marsh wrote in the October 2005 issue of Clavier.

Barbara Conable encouraged Marsh to create a program at PSU that combined musicianship and anatomy. The result was actually two programs: the three-term Coordinate Movement Program that’s primarily for pianists, and a one-term course called Body Mapping, for musicians and singers of all kinds. The longer class picks up where the shorter one leaves off, but they both have a common premise: If you want to make the best sound and do it for the long haul, you have to think of your body in a whole new way.

Now Knox, who spent a year learning from Marsh, is imparting this whole-body awareness with her young students. As she sits with a pupil at the piano, she, too, will drape a skeleton arm on top of the student’s own arm to make a point. “Once you see how the joints were meant to work, you never want to go back to the old way of playing.”