Strategies for small-handed pianists.

When pianos were first invented, they were similar in size to harpsichords. Hand size was rarely a limiting factor throughout the eighteenth century because the keys were short and narrow and the repertoire usually contained intervals no larger than the octave. However, at the beginning of the nineteenth century, the piano gradually expanded in range and key size. The use of cast iron frames led to an exponential increase in string tension, resulting in heavier and deeper actions that exacerbated problems for small-handed players. Nineteenth-century concert pianos typically featured actions with 6 millimeters of travel depth, requiring 23 grams of weight for full key depression and string tension in the middle register that ranged from 12 to 15 grams. (1) By the end of the century, string tension had risen to 80 kilograms in the middle register, resulting in a heavier action with 9 millimeters of travel depth, requiring 45 grams for full key depression. Today's Steinway grands feature even heavier actions and larger hammers: 90 kilograms of string tension and 10.5 millimeters of travel depth, requiring 50 to 60 grams of key depression weight.

As the piano evolved, a "one-size-fits-all" mentality prevailed. Small-handed pianists resorted to using mechanical devices that purportedly stretched the hand, usually requiring the participant to force fingers over sized wedges. For example, the "Hand Extender," designed by Frederick Crane of Massachusetts in 1899, featured a threaded rod located between two finger slings, which could force apart any pair of fingers (not necessarily adjacent) for extended periods of time. All these devices were ineffective and had the potential for seriously damaging the hand.

Many important piano teachers including Erno Dohnanyi, Alfred Cortot, Isidor Philipp, Heinrich Neuhaus, Otto Ortmann, Louis Kenmer, Adele Marcus and Josef Hofmann commented or wrote about the problems of small hands. Some pedagogues prescribed relatively benign treatments such as kneading and massaging the joints and fingers or soaking the hands in hot water to loosen joints. Others recommended regimens that were clearly dangerous--finger gymnastics for strength conditioning, lifting weights with the fingers and exercises that stretched the fingers apart. Typical exercises prescribed by Dohnanyi, Johann Pischna and Marcus advocated holding down the notes of a widely spaced seventh chord, lifting only one or two fingers, and then sounding those fingers as loudly as possible while keeping the elbow close to the body and the wrist low.

These highly questionable "remedies" continue to be widely prescribed, contributing to the numbers of piano students who sustain serious physical injury. Studies indicate that more than half the musicians with health-related injuries are keyboardists, and the afflicted are disproportionately female. (2) We have encountered many gifted students with small hands who have had to overcome great difficulties when playing standard-sized keyboards. Their special needs frequently are ignored, misunderstood or underestimated by teachers who have never had to personally grapple with issues of hand size. Children in the beginning stages of piano lessons also are at risk. Diagnosing physical discomfort in young students is difficult because problems related to small-handedness are compounded by incoordination stemming from a lack of fine motor control. It is imperative that we educate ourselves about the risks of small hand size so we can help our students develop healthy and appropriate coping strategies.

Anatomic Generalizations

In 1988, Christoph Wagner measured the hands of pianists from many angles in an attempt to correlate certain hand shapes with pianistic success. Wagner was not able to identify a single hand type as a predictor of success at the instrument. Instead, Wagner's measurements indicated that people with many different hand sizes and shapes played the piano with at least some success. (3)

Playing the piano poses some risks for players of all hand sizes. Epidemiological, biomechanical and ergonomic studies have determined that degree, repetitiveness and forcefulness of wrist motions are factors in the development of tendinitis, carpal tunnel syndrome and other nerve entrapments. When the wrist is flexed, the median nerve is compressed between tendons or fluids in the carpal tunnel. (4) Wrist pressure in the average person increases by a factor of two to ten with passive flexion or extension. (5) The greater the degree of any active wrist motion, the higher the carpal tunnel pressure. Furthermore, a study conducted by In-Seol Chung showed that pianists use a much greater range of lateral wrist motion than that which falls in the functional range. (6) This is the case whether pianists are performing technical exercises or repertoire. Since increased carpal tunnel pressure has been theoretically linked to the development of carpal tunnel syndrome, all pianists should exercise extreme caution when positioning the wrist.

Small-handed players are at markedly higher risk because greater degrees of lateral wrist motion, flexion, extension and deviation are required than for a player with larger hands. Additionally, large chords, octaves and arpeggios repeatedly force the smaller hand out of "anatomic neutral," an ideal position that can be identified when the hand is hanging in a naturally relaxed state at the side of the torso in perfect alignment with the wrist. In this position, the hand retains a naturally compact shape, and the tendons and muscles controlling the hand have maximum flexibility. Any deviation from this anatomically neutral position results in some flexion or pulling with the tendons and muscles.

This observation is underscored by Naotaka Sakai's study that examined the playing of octaves, chords, fortissimo and presto passages, arpeggios and staccato passages in relation to frequency of performance injury. (7) Within the context of this study, the playing of octaves and consecutive large chords accounted for 77 percent of the documented injuries. Sakai hypothesized that the reason for the resulting injuries was that both octave and large chord playing required marked spread between the thumb and little finger along with stabilization of the wrist joint. Sakai further stated that hand size was likely a major factor in the occurrence of injury in the study, since his study participants all had relatively small hands. Having a small hand certainly requires a greater degree of thumb and little finger spread in the playing of octaves and chords in comparison with a larger hand.

In addition, small-handed players require more frequent hand shifts when playing widely spaced melodies or accompaniment patterns than players with larger hands. Distances at the keyboard seem magnified. When jumping from one note to a distantly placed note, small-handed players should use their arms to find the notes and refrain from reaching with the fingers. This necessitates much practice purely for the sake of accuracy.

The following sections deal with four issues particularly relevant to small-handed players: legato playing; fortissimo playing; playing octaves, large chords, and arpeggios; and fingering. We propose practical solutions in these areas that will alleviate discomfort and reduce the potential for injury.

Legato Playing

Much time and energy are expended in traditional piano study to produce a beautiful legato. Unfortunately, many pianists labor under the erroneous assumption that legato depends on physical connections between notes, for example, "holding down one note until the next one plays." In practice, this view often leads to holding down one note while the next one plays. Dorothy Taubman recognizes this physical contradiction, saying:

Legato is not necessarily a physical connection but an aural effect, a sweetness of sound, determined by the character of touch. It is achieved by thinking of connecting tones rather than fingers, ... (by) melting one tone into another with shaping. Forcing connections and creating unnatural stretches are often implicated in injury. (8)

The difference between staccato and legato playing is a matter of degree. Legato playing utilizes basically the same finger touch as staccato playing, with each key being held slightly longer by the finger and with larger connected motions being made by the arm. A beautiful legato is a product of phrase shaping and dynamic development, produced by larger guiding motions of the hand and forearm. The key is still released between successive tones when playing a legato passage! The amount of space between notes determines whether a passage sounds legato or staccato. The larger the space, the more separated or staccato the resulting sound. Attempting to physically connect one note to the next with the fingers alone can result in "keybedding," in which force continues to be applied to the key even after it has reached its maximum depth of travel. Keybedding places undue strain on muscles, tendons and joints.

The pedal plays a large role in creating a musical perception of legato, and for small-handed pianists, it is indispensable. It can be used to avoid keybedding or to connect a series of tones or chords. It also can be used at 1/4 or 1/2 depth to create a coloristic wash of sound.

Pedagogical Strategies for Producing a Healthy Legato:

* Refrain from forcing physical connections between the fingers. Avoid traditional legato octave fingerings (1-3, 1-4, 1-5), using 1-5 exclusively in conjunction with the pedal.

* Join widely spaced notes and melodies with the pedal instead of with the fingers.

* In contrapuntal passages where two voices are placed in one hand, release inner or less important voices early to relieve hand stretches.

* Avoid pushing into the keybed at all times.

Fortissimo Playing

All pianists with small hands eventually struggle with the problem of how to produce a big sound without unduly taxing the body. Many pianists incorrectly assume that vertically crashing down on the keys with increased weight is the solution. Unfortunately, increasing weight carries several potential difficulties. First, the resulting sound is harsh and uncontrolled. Second, keybedding tends to result, a wasted effort since the hammers have already contacted the strings. A third side-effect of trying to use too much weight is that the muscles in the upper back, shoulders and neck tend to tighten in response to the unrelenting and excessive force applied by the forearm and upper arm. In addition, using too much force on the thumb can lead to eventual osteoarthritis and joint deterioration of the basal thumb joint.

When playing fortissimo, pianists should remember that volume is not a function of weight alone. As Ortmann recognized, volume is a product of both force and speed. (9) Of the two factors, speed is the more easily controlled for pianists with small hands. Moreover, instead of using consecutive vertical strokes, pianists need to initially impart weight into the key and then transfer it across the keyboard. Overinvolvement of the upper arm muscles, especially the biceps muscle group, can negatively impact both force and speed. Instead, forearm rotation can be used. This motion, also called "pronation" and "supination," is the strongest motion in the upper half of the body and one of the fastest.

Forte is not an absolute value. Rather, dynamics represent a range of values from soft to loud that vary from piece to piece and player to player. Long passages of sustained fortissimo are very difficult to bring off physically and tend to be musically static as well. Thus, it is in the best interest of small-handed players to insert subtle dynamic fluctuations within lengthy fortissimo passages, dropping the sound back when musically feasible and gradually rebuilding the fortissimo.

Pedagogical Strategies for Producing a Healthy Fortissimo:

* Avoid fixed and rigid hand positions.

* Since volume is a product of both force and speed, work to increase key speed through free fall and rotation.

* Insert dynamic fluctuations within long fortissimo passages to allow for muscle recovery.

* Volume often is built from the bass. Avoid overemphasis of the melody to the exclusion of the supporting bass parts. Maximize the bass through longer pedals to increase the overall dynamic level.

* Adjust fingering so strong fingers (1, 3, 5) are used whenever possible, even on the black keys. If a weak finger must be used, align the forearm behind it.

* Find many resting places in the music (ritards, rests, breaths and so on) to alleviate fatigue.

Octaves, Large Chords and Arpeggios

Octaves, large chords and arpeggios are all formations that seemingly call for large hand stretches. They are frequent sources of trouble for small-handed pianists, especially when played rapidly and consecutively. However, there are ways to minimize, or even completely avoid, stretching with the hand or fingers. Retention of a naturally compact hand through early release of selected notes and judicious use of staccato touch is a potent technique.

Many chords and arpeggios, particularly full first-inversion triads (for example, E-G-C-E) and full seventh-chord inversions, present special challenges for small-handed players because of stretches between inner fingers. In an arpeggio, these stretches can be eliminated by releasing the note preceding a large "stretch" as soon as possible and propelling the compacted hand over the remaining notes.

When playing passages of octaves or successive chords, tendonitis and other hand injuries often can be averted if players will carefully voice to one note of an octave or chord, not dispensing equal weight to all notes. The nonfavored note or notes should be released immediately after playing, and the hand should be returned to its naturally compact position as soon and as often as possible. It is vitally important that uninvolved fingers not be held suspended above the keys, but rather allowed to remain in contact with the keys. As long as the joints of the inner fingers remain loose, no sound will result. Many players with small hands find the best motion for playing octave scales is a "rebound" motion in which the hand descends on the keys with the weight of the forearm behind it. The wrist remains loose and the hand is pushed upward as the key rebounds. The visible manifestation of this motion is a hand that appears to be "flapping" up and down at the end of a loose wrist.

Physical difficulties with large chords are compounded as speed and volume are added. Repertoire containing large chords barely within the reach of the hand is best avoided. Stretching the hand limits the mobility of the inner fingers and can strain the tendons. In cases where stretches cannot be avoided, the fingers can be moved into position by the forearm and the hand returned to a compact shape as often as possible. AS discussed previously, playing with the hand fully extended for long periods of time can lead to injury. Rearrangement of problematic chords or omission of doubled notes is worth consideration. Again, the ideal is to maintain an anatomically neutral position of the hand and wrist as often as possible.

Pedagogical Strategies for Playing Octaves, Large Chords and Arpeggios:

* Voice to one side of an octave or one note in a chord, releasing nonfavored notes immediately after playing to relieve hand stretches.

* Avoid suspending uninvolved fingers above the keys.

* Maintain a supported arch in the hand even though fingers are relatively flat, but avoid stiffening the hand into a claw.

* Use a rebound motion for octave scales or chains of chords. In a succession of chords, small moments of rest can be inserted between each and every chord. Compact the hand as often as possible during these periods. Such periods can be so short as to be virtually imperceptible to the listener. Use the damper pedal for legato if necessary.

* Use the sostenuto pedal to sustain notes, if appropriate.

* Judiciously omit notes or rewrite chords in passages that prove intractable. Address large stretches between the thumb and fifth finger as well as stretches between inner fingers of the hand, such as full first inversion chords and seventh chords.

* When playing broken octave passages or arpeggios that incorporate large intervals, keep the hand soft, "find" the notes with the forearm and release notes early if possible. Avoid reaching for notes with the fingers.

* Long fortissimo octave passages can be redistributed between the hands (Example 1).

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Fingering Principles

Not all the fingers are created equal. Each finger is equipped with its own flexor tendon that controls flexion toward the palm. The flexor tendons are attached in the same way to each of the four fingers of the hand. In sharp contrast, the extensor tendons controlling the lifting of the fingers from the palm are attached in a manner that greatly limits the strength of some fingers. This is easy to see when you make a loose fist and try to raise each finger independently of the other fingers. This understanding of hand anatomy underscores the importance of avoiding keybedding to minimize stresses on tendons.

The extensor tendon that controls the fingers originates at the elbow. As it passes through the wrist, it divides into three main strands. The first strand is connected exclusively to the second finger. The second strand is in line with and connects with the third finger. The third strand connects to the fourth finger, with a small branch extension that connects to the fifth finger. The tendon controlling the fourth finger also is connected to the third finger by another branch. Therefore, the extensor tendons of the third, fourth and fifth fingers are interconnected. Both the fifth finger and thumb have their own extensors and also are stronger because of their position at the end of the hand, where they can be supplemented by forearm rotation. The second and third fingers also are relatively independent since they have their own strands of the extensor tendon. However, the fourth finger cannot move independently since its extensor is bound to other strands on each side. The fingers are by design unequal in strength, and attempting to strengthen the small muscles and tendons controlling the fingers may likely contribute to injury. One strategy that will help in coping with finger inequality is to line up the forearm behind the finger playing the note, or behind the finger playing the more important voice, in the case of some chords. Joints should stabilize the bones of the finger at the moment of impact so the weight of the forearm is transmitted directly to the key. Using these two techniques in combination actually gives quite a bit of strength to all the fingers and to the fourth finger in particular.

Choosing appropriate fingerings is extremely important. As we noted earlier, since pianists vary with regard to hand shape, fingerings that work for some may prove totally inadequate for others. Ortmann tested a passage from Beethoven's Op. 57 fingered in two different ways (see Examples 2a and 2b). He found that small-handed players preferred the fingering that used smaller hand spans represented in Example 2b, even though more frequent shifts were required. (10)

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In general, fingerings that utilize stronger fingers are more effective. Traditional scale fingerings may work well in linear passages but need not be slavishly observed. Small-handed players also need to minimize stretches involved when playing large chords. This may mean leaving out notes of a chord or even transposing notes from one octave to another. However, there are times when musical concerns may over-ride physical ease. For example, dividing up the chords of the opening of Beethoven's Op. 111 between the hands may increase accuracy and comfort, but at the expense of dramatic intensity.

Pedagogical Strategies for Fingering:

* Be aware of individual differences in hand shape. Just because something doesn't look like a stretch doesn't mean it doesn't feel like one.

* Keep the hand compact.

* Tailor fingerings to fit the demands of the music. For example, use the thumb to express tenor melodies or in passages requiring maximum power.

* Refinger to minimize hand stretches. For example, substitute 1-5 for 1-4 or 1-4 for 1-3 when appropriate. Fingerings can be broken into smaller units even if they necessitate more frequent shifts. Example 3 shows Cortot's refingering of Chopin's Op. 10, No. 1 etude. (11) Often, notes can be redistributed between the hands to eliminate tenths (Example 4), to eliminate stretchy arpeggios (Example 5) or to eliminate leaps. If stretches cannot be eliminated, create brief moments of rest for muscle recovery. Example 6 shows an extensive refingering of Schumann's Wild Rider better suited to the smaller hands of children.

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* Do not slavishly adhere to traditional scale and arpeggio fingerings, especially in repertoire written after the mid-nineteenth century. The thumb may be used on black keys in many musical contexts.

* Redistribute notes to eliminate stretches between interlocked hands (Example 7).

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* Redistribute notes with trills (Example 8 and 9 (12)).

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* Refrain from reaching for widely spaced notes. Pick up the hand and let the forearm guide it to its new position.

Workable Solutions

While there are clearly no easy answers for teachers of small-handed students, an awareness of their special needs is an essential first step to finding workable solutions.

* Do not use exercises or devices that claim to strengthen the fingers or increase hand span. They are completely ineffective and can cause serious damage to the hand.

* Telling a student to "relax" is not helpful. Be as anatomically specific as possible in your observations and instructions.

* Exercise caution when recommending repertoire. Repertoire containing extended fortissimo passages, large chords or stretches barely within reach of the hand should be modified or avoided entirely.

* Encourage students to maintain an "anatomic neutral" position of the hand and wrist whenever possible. Avoid the exaggerated dropped wrist position often seen in young players.

* Listen to your students if they complain of pain or fatigue. Encourage healthy practice habits.

* Do not assume that a student's inability to master a passage is due to a lack of talent or insufficient practice. Educate students about the inherent risks of small hand size, empower them to find their own solutions and encourage experimentation with fingerings, note omissions and redistributions.

* Support the universal adoption of the 7/8-sized keyboard. Inventors Chris Donison and David Steinbuhler have developed a sophisticated computer system to cut keyboards whose octaves are one white note smaller than is standard. This keyboard "levels the playing field" for small-handed pianists, allowing them to negotiate stretchy passages with more power and accuracy, play previously inaccessible repertoire and avoid injury. A "D.S. Keyboard," attached to its own action and key frame, is easily interchangeable with a standard-sized keyboard, making its purchase dearly feasible even at conservatories and schools of music.

* Cultivate an aesthetic appreciation for different styles of performance. Louder and faster is not necessarily better.

By recognizing the individuality of students and by utilizing a problem-solving rather than a prescriptive approach, we can assist students in avoiding injury and in promoting healthier means of music making.

NOTES

(1.) H. J. H. Fry, "Overuse Syndrome in Musicians: 100 Years Ago," Medical Journal of Australia 145 (December 1986): 623.

(2.) Nancy S. Grant, "Arts Medicine: When Practice Turns to Pain," Keyboard (February 1988): 90; Ralph A. Manchester, "Medical Aspects of Music Development," Psychomusicology 7, No. 2 (1988): 149; Alan H. Lockwood, "Medical Problems of Musicians," The New England Journal of Medicine 320 (26 January 1989): 222; and Hunter J. Fry, "Prevalence of Overuse (Injury) Syndrome in Australian Music Schools," British Journal of Industrial Medicine 44 (1987): 37.

(3.) Christoph Wagner, "Success and Failure in Musical Performance," The Biology of Music Making: Proceedings of the 1984 Denver Conference, ed. Franz Roehmann and Frank Wilson (St. Louis: MMB: 1988); C. Wagner, "The Pianist's Hand: Anthropometry and Biomechanics," Ergonomics 31, No. 1 (1988): 97-131.

(4.) Robert M. Szabo and Michael Madison, "Carpal Tunnel Syndrome as a Work-Related Disorder," Repetitive Motion Disorders of the Upper Extremity (Rosemont: American Academy of Orthopedic Surgeons, 1995): 426-427.

(5.) R. H. Gelberman et. al., "The Carpal Tunnel Syndrome: A Study of Carpal Canal Pressures," Journal of Bone and Joint Surgery 63A (1981): 380-383.

(6.) In-Seol Chung and others, "Wrist Motion Analysis in Pianists," Medical Problems of Performing Artists 7 (March 1992): 5.

(7.) Naotaka Sakai, "Hand Pain Related to Keyboard Techniques in Pianists," Medical Problems of Performing Artists 7 (June 1992): 63.

(8.) Audrey Schneider,. "Dorothy Taubman: There is an Answer," Clavier (September 1983): 19-21.

(9.) Otto Ortmann, The Physiological Mechanics of Piano Technique (Toronto: E. P. Dutton & Co., 1929; reprint, 1962): 192.

(10.) Ortmann, Physiological Mechanics: 278; quoted in Patricia Eger, A Study of the Problems Encountered by the Pianist with Small Hands and a Compendium of Practical Solutions (D.A. diss., Ball State University, 1982): 124.

(11.) Thomas Manshardt, Aspects of Cortot (Northumberland, Great Britain: Appian Publications, 1994): 90.

(12.) Eger, Study: 156.

Lora Deahl is associate professor of piano at Texas Tech University Her publications have appeared in the International Journal of Musicology and The College Music Symposium. In 1995, Texas Music Teachers Association named her Outstanding Collegiate Teacher of the Year.

Brenda Wristen directs the piano pedagogy and keyboard skills programs at the University of Nebraska-Lincoln. She is the author of numerous journal articles and conference presentations, and an active clinician and adjudicator.