Duet for Piano and PC : In a Controversial Technique, O.C. Musicians Teach How to Move in Harmony for Health

Nina Scolnik’s hands move with grace and precision across the grand piano keyboard in her living room. Then she abandons Chopin and slides off the piano bench to settle onto a chair at her dining table, where a computer keyboard awaits.

There she types as if she were playing an etude, then stops to explain the connection she sees:

Whether you’re a butcher, court stenographer, landscaper, concert pianist or computer operator, if you want to cure aching fingers, hands, arms and back, you needn’t resort to splints, wrist rests, stretching exercises or surgery.

Just learn the basic, natural movements that successful pianists have relied on for centuries, she says.

The problem is not with the piano, the computer, the cash register or the meat cleaver, says Scolnik, 41, a piano faculty member at UC Irvine. “The problem is with the way people move. The finger, the hand, the arm must move as a unit.”

And that’s the basic idea of a controversial message emanating from a Brooklyn woman who has taught piano for 50 years. During that time, Dorothy Taubman has spawned thousands of disciples of the Taubman method, known largely within the U.S. piano community. “Blaming the instrument,” says Taubman, 76, “is like saying that writer’s cramp is caused by the pencil.” Or the computer.

Now, Taubman and her colleagues, including Scolnik, are launching a nationwide business to transfer what they know to a realm broader than pianists, flutists or violinists who suffer from what’s called repetitive stress injury or RSI.

Aimed at teaching people how to use computers with techniques previously reserved for musical instruments, the company offers workshops to retrain injured workers and to train those who want to prevent injuries.

As the RSI problem has mushroomed to afflict everyone from secretaries to executives with hurting muscles, tendons and nerves, Taubman and her associates have been approached on occasion by businesses wanting to see if the technique could help. But only recently has Taubman’s institute decided to focus on it.

“There are so many people out there in trouble (who) can’t get help, and this little lady has figured it all out--what the medical profession has not figured out,” says Taubman Institute Executive Director Enid Stettner, who lives in Upstate New York.

To initially spread the word, Taubman is relying on two-dozen faculty members who teach at her institute, held each summer at Amherst College in Massachusetts. During the past three decades, thousands have studied there and gone on to teach thousands more.

Key among them is Scolnik, the principal West Coast advocate of Taubman’s methods. Since the late 1970s, she has been associated with Taubman and has introduced many of her own students to the technique.

As the Taubman consulting firm starts up, to their dismay, one of Scolnik’s former UC Irvine piano students, Greg Dempster of Laguna Beach, has also begun what he bills as the first company “in the country to adapt this approach to the business community.”

From 1983 to early this year, Dempster studied with Scolnik, who introduced him to Taubman’s ideas. “At first I thought this was really snake oil, that this was from Mars,” says Dempster, 34, who completed his undergraduate and master’s work with Scolnik.

But soon Dempster, who had been injured from his earlier technique, became a believer. For a half-dozen summers, he studied with Taubman at Amherst and was a teaching assistant at the institute. He says, “My playing has grown by leaps and bounds.”

As he was teaching one of his own students who worked as a computer operator, Dempster says, “it became obvious that this applied quite directly to computer people.”

Within the past few months, Dempster put together a staff including other Taubman devotees and has already been offering seminars and making a pitch to intrigued representatives of Southern California companies.

Although Dempster knows that the Taubman Institute is miffed with him, he praises Taubman’s genius. “The relationships she was able to figure out and observe in pianists are unparalleled.”

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For her part, Stettner says that it is not that difficult for someone fully trained in the technique to teach it as a preventive approach. But she says “to cure somebody who is injured, you need great knowledge, and we have that knowledge.”

Stettner and Dempster do agree, however, on Taubman’s tenet that moving correctly is therapeutic and pain-relieving.

Dempster makes this exact point at a seminar in a salon at the Irvine Hyatt Regency. He is speaking to a small gathering, including representatives from Orange County businesses interested in this new tactic to combat RSI.

“Correct movement minimizes effort, fatigue,” he says. “If you are not moving correctly, there is a level of fatigue you are operating under.”

As an example, he cites the problem of hitting the keys too hard. “Anybody have an idea of the weight it takes to displace a computer key? It’s about a gram or gram and a half. Your forearm weighs about 15 pounds. So this is always a winning battle.”

At Dempster’s request, his seminar students stand with hands and arms by their sides. Then he outlines another of Taubman’s main ideas. “Notice how your hands hang. No two are alike. Everybody’s hand will look different on the keyboard.

“The natural profile of the wrist, at rest, at your side--that is more or less the profile it should have when it’s moving or performing work. Anytime you distort that, so that any of the joint structure is out of the mid-range arc of motion, you develop problems.”

That means avoid curling your fingers, avoid twisting your hands into positions that would mimic actor Charlie Chaplin’s famous splayed feet antics and avoid stretching your fingers to reach unnaturally.

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To trouble-shoot for these tendencies in his students, Dempster asks one of them, Michael F. McCrackin, Fluor Daniel’s safety manager at its Irvine facility, to sit before a computer keyboard. McCrackin begins to type.

Dempster spots a problem and coaches him to keep his hands in line with their natural curve.

Several years ago, McCrackin said, his company saw there was a problem with RSI--that typing on a computer is different from using a typewriter. “We started throwing things at the problem--wrist rests, articulated keyboard platforms. But we didn’t address how people were using the equipment.”

Ergonomic solutions have been insufficient, he said. And it’s not enough, he said, to tell someone to align the body properly, to keep the wrists relatively straight or to take frequent breaks. Many people, he said, must be completely retrained.

Of the 2,500 Irvine-based employees with the international engineering firm, he said he expects about 300 to 400 fall into the “high risk” category--those needing retraining to cure an existing RSI problem or to prevent one.

“I’m pretty excited by this whole concept. I’m impressed by the level of detail,” he said. Even basic training, he said, would be beneficial. “You don’t need to know how a car works to learn to drive it, to get the proper instruction.”

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To explain what she knows in great detail, Taubman is writing a book and, even sooner, will release instructional tapes.

In an interview with the Piano Quarterly, Taubman once said: “I do not regard my work as a ‘method’ or even a ‘system.’ Rather it is a set of strategies which, I hope, can help establish the foundation for a science of the movement of the fingers, hand and arm.”

The test of that, she said, will be if “it can be applied successfully to a wide variety of problems and that it can be learned and used by others.”

So far, Taubman has by no means been embraced by the musical establishment. In introducing a 1992 interview with her, the journal California Music Teacher called her “perhaps the most controversial figure in piano pedagogy today.” The editor’s note went on to say that Taubman, “after being largely ignored. . .has in recent years won a grudging recognition for her successful treatment of injured pianists who had exhausted all known methods of treatment.”

In a documentary video of her summer institute, “Choreography of the Hands,” musician after musician, including prominent pianists, testify how Taubman helped them.

One flutist, whose right hand was severely troubled before she found relief in Taubman’s teaching, tells the story of how a physician “suggested I find a new profession and start over.” And, Taubman says, the orthopedist “wanted to break every bone in her hand and reset it.”

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In some cases, Garry S. Brody, medical director of the Hand Rehabilitation Center at USC University Hospital, says: “Nothing else works. And you have to do surgery.”

However, he says much is still unknown about RSI. “We’re all struggling to know, No. 1, what’s really behind all this and, No. 2, how to prevent it and how to live with it.”

As far as the Taubman approach goes, he says until scientific studies are done to verify the anecdotal claims, skepticism is in order.

“I would say a couple of months of trial won’t do any harm. But if after a month or two you still have the problem, you’d better look for a more conventional treatment.”

Regardless, he adds: “Nobody ever died from a carpal tunnel problem. It’s not a crippling disease. The problem is the pain.”

To find what common ground might exist with medicine, music and the Taubman technique, an Oakland occupational health physician is starting a research project on injured pianists.

William A. Pereira 45, is undertaking the work as part of degree studies at UC Berkeley’s School of Public Health. A pianist since age 7, he has studied with Scolnik and Taubman. While living in Orange County and working as a physician in the 1980s, he completed a bachelor’s in music with Scolnik at UC Irvine.

“I want to do something to get this information more available to the mainstream in the medical community,” he says.

“From what I know of physiology, the ideas she is saying make complete sense. The motions involved in piano-playing are often invisible. Dorothy’s genius was figuring them out and how they connect with muscles and movement. It was like analyzing a wave form, and she broke it all down.”

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In individual lessons with students, Scolnik breaks it all down, too.

At a lesson at Scolnik’s home, Rebecca Bogart is playing a rapidly paced piece, Moszkowski’s No. 6 in F major. Scolnik listens intently.

In 1990, when Bogart, now 33, was living in the Bay Area, she suffered from acute tendinitis. “I experienced flaming sharp pains on the underside of both arms,” she said. “The onset was dramatic and immediate, right after a concert, when I was lifting some boxes.”

For two years she tried medical treatment, painkillers and resting. She abandoned her new Steinway for her students to play. Not until she went to the Taubman summer institute did she find relief--so much so that she moved to Laguna Niguel to be close enough to take weekly lessons from Scolnik.

As Bogart finishes the piece, Scolnik tells her: “On your A-flat you’re letting your wrist fall.” Bogart nods. Scolnik says, “We’re talking very subtle stuff here.”

And she says, “This is all so much easier to do right on a computer. There is much less involved.” For one thing, she says, “you don’t have to play chords.”

Preventing Repetitive Stress

The study of ergonomics--how people work--shows hand-arm alignment is at the center of keyboard repetitive stress injuries (RSI). Misalignment causes muscles to become overworked, causing stress and fatigue in the hands and arms. In retraining, piano and computer keyboard users learn how to move without causing the injuries.

Signs of RSI

Repetitive stress injuries can have a variety of symptoms including muscle fatigue and pain.

* Puffy skin surface: General sign of stressed or overworked muscle group that flexes fingers.

* Ganglions: Small cysts beneath skin form as result of stressed muscles that flex fingers and hand.

* Finger numbness: May be caused by inflammation of nerves in wrist when muscle that extends wrist rests on hard surfaces.

* Elbow swelling: Could indicate twisting and resulting stress of muscle that rotates wrist when arm is palm down.

* Wrist pain: Often caused by inflamed muscles constricting nerves.

* Forearm ache: Usually indicates inflamed biceps which contracts arm and moves hand side to side.

Top Causes of Injury

The most common poor keyboard postures cause the wrist joint to move beyond its range of motion, which leads to physical problems. The three most common incorrect keyboarding practices and their symptoms:

* Twisting: Long muscles in arms forced to stretch around the elbow, which stresses muscles in hands and arms.

* Symptoms: Elbow inflammation, throbbing in forearm, loss of dexterity of little and ring fingers.

* Over-curled fingers: Continuously flexed muscles that contract and extend wrist cause nerve compression in wrist.

* Symptoms: Pain in wrist or forearm; tingling or numbness in fingers.

* Dropped wrists: Tendons press against nerves in wrist area, weakening the thumb, index and ring fingers.

* Symptoms: Numbness, tingling in fingers at night; swelling of wrist and/or thumb joint.

Posture Perfect

Computer desks and keyboards can be equipped to ensure good posture and proper alignment.

* Arm at 90-degree angle

* Keyboard at elbow height

* Back straight

* Thighs, forearms parallel with floor

Ergonomic Equipment

* Padded wrist rests

* Cushioned keys

* Elbow rests

* Adjustable computer table

* Sliding keyboard holder

* Foot rest

Futuristic Typing

New keyboards are designed to encourage good typing posture. This one, for example, splits in half and has built-in padded wrist rests, encouraging a naturally relaxed position of fingers, hands and wrists.

Typing Test

* Score your knowledge of good keyboard technique with these true-or-false questions:

1. Only the fingers should move.

2. Shoulders should be relaxed and dropped.

3. Keys must be pushed to bottom of stroke.

4. Wrists should rest on edge of table or on wrist pad.

* Answers

1. False: Entire arm should move and get involved in the process. The elbow should act as a stable hinge supporting the forearm.

2. False: Shoulders should be relaxed, but dropped shoulders cause the long tendons to hold the arm in place, stressing the elbows.

3. False: Keystroke is complete through the top two-thirds of the motion. Finger muscles should be at rest at the bottom.

4. False: Resting the wrist on table edge can cause nerve damage. Use pads as guides for proper alignment, not as pillows.