You may often think about protecting your harp’s health: Is the humidity okay? Is the temperature ideal? Is it time for a visit to the harp doc?

But how often do you think about your own harp health? A harpist’s life is often sedentary, which can cause our posture to deteriorate and increase muscle tension. Stress—whether from the harp or elsewhere—adds to this by generating undesirable tightness. While we harpists may not be considered athletes, our instrument demands strength and balance. The harp requires intense mental fortitude and robust finger dexterity. It also necessitates a strong and flexible body both to play and move, especially where pedal harps are concerned. Regardless of what kind of harp we play, all of us fall into the same pattern of repetitive motions with our arms, hands, and fingers. 

How do we break out of those repetitive patterns? One answer is cross training, which functions as a way to exercise other muscle groups than those a person normally utilizes. It can provide many preventative measures to avoid pain and discomfort. We talk to three physical therapists who share their expertise and show us additional ways to establish helpful habits and increase the longevity of your time with the harp. 

Common problems

Musicians are no strangers to the possible symptoms of repetitive playing or lack of physical care. Tendinitis, muscle trigger points, and poor spinal alignment are unfortunate but common complaints. Cathy Sheetz, P.T., D.P.T., is a part-time lecturer in the Doctor of Physical Therapy program at Chapman University and a physical therapist (PT) in Orange County, California. She notes that sitting on a bench and extending your arms out for long periods of time can cause postural strain, which in turn can harm the cervical spine (the neck) and the thoracic spine (the upper back). She also mentions that muscles can either become too elongated and stretched out or they can spasm and cause more tightness, which causes more waste products to build up in the muscle fibers. Dr. Bonnie Lasher, P.T., D.P.T., R.Y.T., a PT and yoga instructor also in Orange County, adds to this the issues that chronic repetitive motion presents. “It’s the chicken and the egg relationship with connective tissue and musculature where, when you start to have something that’s either elongated too frequently or shortened too frequently, one tissue impacts the other. Treating both is really important to normalize that length and tension relationship once again.” Additionally, she recognizes that the asymmetric nature of the harp poses a problem. 

Jessica Baum, M.M., M.S.P.T., speaks to this well; she is a PT in the Boston area and a professional violist. She has worked with many aspiring artists as a performing arts PT at the Boston Conservatory at Berklee and Berklee College of Music. She says she experiences the same asymmetric challenge with the viola. While she says she believes harpists and violists are lucky to play these beautiful and unique instruments, they are not without physical challenges. “They happen to have a unique ergonomic challenge to them, which is that your arms are asymmetrical when you’re playing the instrument.” She notes this can cause the right shoulder to come up higher and the neck to tilt to the left side. The asymmetry can also affect the shoulder blades, with one shoulder blade coming further away from the spine than the other, a diagnosis Baum recognizes as Scapulothoracic Dyskinesis. Baum suggests that technique choices can cause issues with the wrist and elbow in which the ulnar nerve is compressed, creating cubital tunnel syndrome. The forearms and hands are also at risk from daily activities we take for granted, like tuning the harp. 

Hidden concerns

The connection between playing the harp and physical issues in your back, shoulders, and arms isn’t surprising. But other possible side effects can crop up that you may have never imagined, such as pelvic floor and bladder issues. They may seem tangential to discuss, but Lasher sees them often in musicians, especially in those who either teach for long periods of time or have studio recording sessions in which bathroom breaks are dictated and few and far between. Regimented bathroom breaks lead to dysfunctional cycles in the brain-bladder connection. “Education is super important in [the musical] population to make sure people understand that you can create dysfunction by sticking to certain structures like that,” Lasher says. She recommends countering those behaviors outside of teaching hours or rehearsals so those negative patterns are broken up and addressed. “If you start to recognize, ‘Oh, I’m using the bathroom 15 times a day when I am just at home,’ perhaps you’ve started to retrain your nervous system in such a way that is less functional and less optimal for yourself.” With this and other symptoms, all three PTs stress the individuality of the body. Every harpist’s body is different and will encounter its own set of challenges and need its own personalized solutions. 

An ounce of prevention

For many dedicated students, amateurs, and professional harpists, the show must go on, no matter the physical consequences. Fortunately, there are many positive and simple ways to prevent injuries from occurring and become a healthier harpist along the way. That’s where cross training comes in. Lasher provides the following analogy: “If you consider your body a bank account and whatever you’re doing as a chronic movement throughout the day as a withdrawal from the bank account, what you need to do is make deposits, which would be essentially whatever is the opposite motion…if you’re in a chronically forward flexed position leaning over a piano, let’s say, then doing exercises where you’re working on back extension would be more ideal.” She suggests harpists, who often rotate and lean in one direction, use rotational spinal motions and shoulder opening exercises to counteract the strain of being in a playing position. Baum also mentions the importance of moving your body parts in the opposite direction of the way they engage to play your instrument. “This is a general rule for all instrumentalists when they take a practice break,” she says. “For example, harpists will have a tendency for the upper back to rotate right while playing. Rotating the upper back gently to the left during a practice break is very helpful.” She also advocates for breaks that do not involve electronics, because, not surprisingly, scrolling through Instagram does not encourage optimal posture, nor does it provide a true respite from playing the instrument. 

As demonstrated above, these “bank deposit” exercises need not be anything extreme or intense. In fact, the opposite is often more beneficial—small changes can make an enormous difference in a safe way. All three PTs emphasize the need to take frequent breaks in order to stretch and change posture. “I know that sometimes when you’re in a concert, you can’t take a break,” Sheetz says, “but in your daily life and practicing routine, it’s always really good to take a break every 30–45 minutes.” She points out that even during a performance it is possible to do imperceptible pelvic tilts, shift your weight from side to side on the bench, or even pump your ankles to promote blood flow.

Take a deep breath

One of the simplest things she recommends? Breathing. Deep breathing is something everyone can do, regardless of where they are or what they are doing. Lasher talks about this as belly breathing. “One of the things I discovered once I became a PT was how few people really know how to breathe—it’s somewhat shocking!” To get in touch with your breathing, Lasher suggests you lie down on your back and place one hand on your chest and one hand on your stomach below your belly button. As you slowly inhale and exhale, you should be able to breathe where there is only a noticeable rise and fall in the hand on your stomach, while the hand on your chest remains relatively still. “If you’ve ever watched a baby breathe, that’s honestly the best thing to try and mimic,” Lasher shares. “Their chests don’t really move when they’re sleeping; you just see that little belly lift and fall.” Baum identifies the somewhat hunched position musicians inhabit as the reason it can be challenging to take a deep breath. Good, balanced posture is crucial to being able to breathe in a way that assists your body. 

Breathing properly can alleviate general anxiety as well. “If you can get out on stage and breathe through some of the anxiety, you’ll feel a lot more comfortable. And if you know places in your body you want to release and practice playing your instrument with those parts of your body released, you’ll feel a lot more comfortable,” Baum says. Sheetz points to research that shows if you are anxious, your muscles tend to be tighter, which can lead to overactivity in the muscles and may eventually cause pain. Breath control plays a huge role in getting oxygen to the right place, helping musicians perform well in stressful situations. 

Get moving

Not surprisingly, exercise can also assist in this area. “One of the ways to mitigate performance anxiety is to exercise,” Baum says, noting it does much more than keep nerves at bay. Baum encourages harpists to think of their bodies as an extension of their instruments. “I’m sure that you take very good care of your harp, right? I take very good care of my viola. If I think of my body as part of my instrument, then I need to take care of my body as well.” She believes exercise plays an enormous role in injury prevention. Cardiovascular exercise—exercise that gets your heart rate up—works especially well as a healing tool. “Once your heart starts beating faster, it’s pumping blood throughout your body. If you have any little bit of strain or pain from playing, the blood is traveling to those tissues while you exercise and promoting healing. Often, when any part of the body is inflamed, the blood gets trapped there, and it can’t get out and it prevents the fresh blood from coming in. When the fresh blood comes in, that stagnant blood goes out, and that is a very strong preventative mechanism for injury in musicians,” she explains. Sheetz also advocates for cardiovascular activity. “The American College of Sports Medicine recommends that people get 150 minutes [of exercise] a week for good cardiovascular health…” She adds that getting the cardiovascular system pumped up helps move oxygen and proper nutrients to the muscle fibers, which in turn prevents muscle spasms and pain. But Sheetz acknowledges that time commitment can be challenging for musicians with a busy schedule. She suggests even 10 minutes of stretching or 20 minutes of cardiovascular activity daily will help immensely. Baum devised the following exercise regimen: one day a week of body awareness (which could include gentle yoga, body-mapping, Alexander Technique, Feldenkreis, or a similar practice), two to three days a week of strengthening work (with a caution to musicians to be careful with upper body exercises because they already experience great stress on that area), cardio on alternating days from strength training, a daily stretching routine, and one day of rest. “Exercise in general is so good for your overall health…if there was a pill that did what exercise does for people, everybody would be taking it.” While that pill does not exist, the benefits from exercise do.  (Scroll down for Sheetz’ stretching sequence.) 

Walking is another wonderful cross-training activity to help keep harp muscles happy. Lasher recommends a 20–30 minute daily walk if possible. Baum is also a big fan of walking. “All you need is a pair of sneakers and you can go outside,” she says. “It’s good for your mental health, too.” In addition to walking, Sheetz champions Pilates, another activity with many benefits, including the necessity for participants to engage their core muscles, which supports correct posture. Pilates’ holistic approach to movement integrates all parts of the body and encourages them to move as one. Synchronized breathing correlates with the movements to promote ease and a consistent rhythm. Yoga is another favorite with the PTs. Baum and Lasher recommend gentle and restorative yoga, practices where the emphasis is on posture, alignment, and stretching. Yoga releases muscle tension and builds strength. Its focus on equilibrium within the body counteracts harpists’ asymmetrical position at their instrument. Deep breathing as part of yoga promotes a calm and centered balance throughout the body. Baum also finds barre classes to be excellent for musicians. “The focus is on endurance,” Baum says. “In general, isometric exercises that use a low weight with a high number of reps are most useful for building stability and endurance.” Thanks to YouTube, hundreds of free exercise classes are available online, though it is important to always attempt new movements cautiously and find a teacher who explains how to participate in a safe way. While walking, yoga, and Pilates are all fantastic options, it is more important to pursue an activity in which you are interested. “If you make an [exercise] routine, it’s got to be something that you enjoy,” Baum says. Find an activity that works for you and brings you joy in order to institute healthy habits. 

Feeling the difference

While the experts attest to the power of exercise, stretching, and body awareness as important cross-training tools for maintaining physical and musical wellness, do they really make a practical difference in the lives of harpists who try them? Lauren Arasim, a music instructor and freelance harpist in Riverside County, California, discovered some unexpected benefits. During her harp graduate studies at the University of Arizona, she joined the archery club for fun. The activity had surprising results. “It opened up my posture and strengthened my shoulders,” Arasim says. “When I got into archery, it made me think, what am I doing [with my body]? What can I do that’s the opposite?” She realized the principles mentioned earlier in the article of practicing opposing motions from her position at the harp. Both Arasim and Amber Mecke, a music instructor and freelance harpist in New Jersey, recognize body awareness as an important tool. “Alexander Technique has been the most beneficial [method] for me in reducing excess tension while I play,” Mecke says. Jane Soh, a harpist in Singapore, shares how she learned body awareness through working with a PT to heal from a rotator cuff injury that was unrelated to harp but affected how she played. “I don’t think I thought about my instrument in an unhealthy way before, but the PT [I worked with] did show me how my body favored certain ‘rest positions’ that weren’t really balanced and seemed to coincide with harp-related positions.” She observes that becoming more physically fit in general and learning specific exercises to combat any aches or discomforts helped her feel healthier overall and improved her harp playing. 

Mecke also made a helpful distinction between playing pedal harps and lever harps: “Pedal harps generally have more tension on the strings (unless you have a concert-tension lever harp), and the instrument itself is much larger. Because I am shorter and smaller, I have to reach and stretch more when playing lower strings and tuning or moving the instrument. However, on a smaller instrument (lever harp), there is more of a tendency to hunch over and to ‘make yourself smaller’ to fit the instrument, rather than staying open.” Her observation connects directly with Baum’s advice to adjust your instrument to your needs. Regardless of what size instrument you play, your body’s connection with it will vary depending on your physique and environment. Your body might be tempted to adapt to “fit” your instrument because it is malleable—but always make the instrument work for you. 

The possibilities of physical therapy

While most exercise activities are free, physical therapy is a privilege that many cannot afford, especially if it is not covered by health insurance. Musicians know this to be a painful truth. The tips offered by professionals in this article will hopefully help you take care of your body in order to prevent injuries. However, there may be times when it is necessary to see a specialist. If you are using whatever prevention tools you can but you still have consistent pain, it is worthwhile to visit a PT, even if it may not be feasible long-term. Sheetz recommends scheduling one or two visits and sharing your specific goals with your PT so they can create a personalized program for you at home and show you how to perform exercises correctly. 

Lasher agrees. “Even if you can only go to a single session, it’s good to get an assessment. You can be very clear with your PT: ‘I don’t have the time or the funds right now. Is there a way to assess this specific issue I’m having? What can I do for self-management?’ You can always follow up as needed.” She mentions that you may be surprised to find that an area of pain may not actually be the root cause of the issue. 

Take a break

Sheetz points out that if you experience muscle spasms, it may be important to see a PT so you can “break up the cycle” because the muscle spasm may continue if there is no intervention. Other times, though, it simply may be the exhaustion of musician life catching up with you. “Despite our best efforts, injuries happen,” Baum says. “But I will say from my years of working in a busy performing arts medicine clinic, sometimes, like athletes, musicians just hurt everywhere. We had a big orchestra concert or we just gave our master’s recital or something that required a lot of effort and everything hurts. And in that case, it’s usually just that you need to rest. You need to maybe take some anti-inflammatory medication, do some stretching, do some massage.” But Baum cautions harpists not to wait too long to address any sort of persistent pain. “The closer to the time you get the injury that you treat the injury, the more quickly it’s going to go away.” If possible, she recommends seeing a specialist who is experienced in working with musicians, and if you experience any sort of nerve-related symptoms such as tingling or numbness, see a medical expert right away. 

Stretching and sitz baths

Prevention is key to avoiding any sort of injury, and, thankfully, maintenance is far less expensive than trying to fix problems. Lasher recommends several harpist-specific stretches—the deep squat, the happy baby pose, and others—to counter-stretch those muscles that are contracting long-term while you are playing. In general, she encourages harpists to think about re-balancing the shoulders and opening up the hips. For an upper body stretch, she suggests holding one arm out at 90 degrees with the palm facing outwards and fingers pointing up towards the sky. Gently tilt your head towards the arm, then away from it. Reverse the process with your other arm. Baum suggests stretching out the hip flexors, the pectoral muscles, and the hamstrings, as those often become tight for anyone who sits for long periods of time. She also recommends thoracic rotation stretches, which you can easily do in a seated position at your harp. Sheetz favors pelvic tilts and shoulder girdle exercises. She suggests attempting a tabletop position on all fours with the focus on making sure your shoulder blades feel balanced and your core is engaged. Baum sums up the importance of stretching. “If I could somehow reach all the musicians in the world to tell them something, it would be [to share] strategies to prevent injury.” 

A relaxing activity can go a long way, too. Lasher encourages you to treat yourself to a sitz bath. Run your bath water at a gentle, warm temperature. Combine two cups of Epsom salt, one-half cup of baking soda, and toss in your favorite essential oil for added enjoyment. A 20-minute soak is great for muscle relaxation and can be an intentional form of self-care. 

Physical awareness

As you learn more about your body and how to play the harp in a healthy way, educate others. If you are a harp instructor of any kind, start teaching your students about their posture and relationship to the instrument at a young age—no one is too young to learn to take care of themselves. Ensure you are literally supporting yourself as well. “If patients have a tendency to slump and they rest a little bit more on their tailbone, it can lead to pelvic floor dysfunction or just generalized pain with sitting,” Lasher explains. She recommends investing in a separate cushion with a gap where the tailbone rests to encourage flexibility in the spine. She also suggests checking your posture in a mirror or taking photos of yourself at the harp to analyze the health of your position. 

Of course, physical therapy and cross training aren’t required to play the harp well. I have heard harpists mention in the past that a need for those might signify a lack of proper technique. But just as football players sometimes take dance classes to improve fluidity or coordination, harpists can utilize a plethora of exercises and stretches to avoid injury and build bodily strength. You might incorporate a little something every day or perhaps focus on exercising a few times a week. No matter at what level, intentional movement away from the harp with guidelines in place will improve your overall health, and it could even transform your playing into a more confident, positive, and pain-free experience.


Stretching Sequence

Stretching is a key element in cross training to be the healthiest harpist you can be.  Try this sequence of stretches for 30–60 seconds at a time (as you feel comfortable) to release muscle tension and build strength.

 

Prioritize Your Posture

Sheetz encourages harpists to learn good postural control—awareness of your position can have a major impact on your overall health. Relax your shoulders, shift your posture every so often, focus on core control, and improve strength in your shoulder girdle because your arms are extended out in front of you. Baum drew similarities again to her experience with viola. “I always studied with very tall men who had a very different physique from what I have,” she notes… “I didn’t fully understand that as someone who’s shorter and female and has a longer distance between my shoulders and my jaw, I was going to have to set things up a bit differently. Basically, you want to set up your environment to promote good posture.” She mentions a variety of external factors you can adjust: the height of your chair or bench, the slope of your seating, the kind of shoes you wear, the placement of your music stand, and the point at which the harp rests on your shoulder. These adjustments in micro-increments ensure that the instrument is coming to you, rather than you adapting to the instrument. 

Awareness of your position can have a major impact on your overall health.  Sheetz encourages harpists to learn good postural control. She recommends the following to assist with this: 

Relax your shoulders
Shift your posture every so often
Focus on core control
Improve strength in your shoulder girdle (this helps with our constant arm extension as harpists) 

Adjustments in micro-increments ensure the instrument is coming to you rather than you adapting to the instrument. Baum mentions a variety of external factors you can adjust.

Height of your chair or bench
Slope of your seating
Kind of shoes you wear
Placement of your music stand
Point at which the harp rests on your shoulder