Violin and Viola Players – Highest risk for Pain!

String players have the highest risk for Performance-related musculoskeletal disorders (PRMD’s). Rates frequently reach as high as 88%. PRMD’s include issues like neck pain, shoulder pain, shoulder impingement, carpal tunnel syndrome, wrist pain, and back pain.

Violin and viola players are at the highest risk for injury among performers in the symphony.

Violin and viola players are at the highest risk for injury among performers in the symphony.


Musicians who play instruments that reinforce asymmetrical postures and movements, like violin and viola, are more susceptible to injury. High volume repetitive stress, often accompanied by extreme mental focus and stress, contribute to string players’ vulnerability.

A literature review spanning 16 years and published in the journal Medical Problems of Performing Artists Published in 2018 strongly supports this premise.

Reducing Risk in Violin and Viola Players.

As frustrating and annoying as preventive measures and cool down sessions may be for musicians, like athletes, they must attempt to reduce the risk of career dampening injuries.

Below are a few steps to help prevent injury that require no help. These should not be skipped:

Warm-up. A gentle warming up of your body and instrument should preclude serious practice or performance.

Take breaks. Pause between songs or sets to shake your body out and interrupt the repetitive, asymmetrical strain on your body. Stretching and mobility exercises of the neck, shoulders, wrists, and arms should be given priority.

Sleep on your back. Reducing stress on your neck and shoulders by sleeping in the most neutral supine position will aid in recovery and reduce the risk of ancillary tension. Playing is stressful enough. Violin and viola players must work to reduce tension, restriction, and harmful neuromuscular patterns often caused by side and stomach sleep positions.

Limit screen time. Much like sleeping on your stomach, looking down at computers, phones, and tablets add strain to one’s neck. This strain makes you more vulnerable to PRMD’s of the neck. These include neck strain and pain, tension headaches, cervical spine neuropathy, rotator cuff tension and pain, and a handful of others.

Be aware, act fast, get better.

Listen to your body. If your gut instinct says something bad is or has happened, seek professional help immediately. Neck and shoulder problems kill professional music careers. The structural, biomechanical, and neurological implications of PRMD’s in violin and viola players can be serious! Surgery is impractical and often risky. Seeking non-invasive therapies early on may eliminate the need for invasive procedures later on.

Dr. Lou with Blackberry Smoke

Dr. Lou Jacobs is a chiropractor – acupuncturist in Portland, Maine who has been specializing in the health and injuries of musicians and their crews for 20 years. Dr. Lou is available for telemedicine consultations for music-related injuries and health problems. Among those he has permission to mention, Dr. Lou has worked with Mumford & Sons, The Pixies, Steve Vai, Tommy Emmanuel, Ziggy Marley and the Melody Makers, Blackberry Smoke, Gogol Bordello, Trey Anastasio, and Edward Sharpe and the Magnetic Zeros. PHOTOS


Musculoskeletal Demands in Violin and Viola Playing: A Literature Review
Nadine Rensing, Heike Schemmann, Christoff Zalpour 
From: Medical Problems of Performing Artists: Volume 33 Number 4: Page 265 (December 2018)