Small-handed pianists are at a higher risk of injury due to greater wrist abduction, extension and deviation than  larger-handed players.

Large chords, octaves and arpeggios repeatedly force small hands out of an ‘anatomically neutral’ relaxed position. Further, small hands are at a biomechanical disadvantage due to the need for increased hand movement in getting to the keys. These factors mean loss of power, speed, accuracy and tonal control, in addition to the greater risk of pain and injury.

Muscles and joints operating near the middle of their range rather than close to their limits will have a greater range of dynamic response. This means that those with large hands are more likely to be operating within the optimum range. On the other hand, those with small hands are more likely to be operating at the extremes and therefore less efficiently.

Having to stretch further imposes increased muscular tension on those with smaller hands. This results in increased mental effort to keep playing, as well as a progressive loss of power and control. Ability to focus on musicality is thus compromised. 

The aging process also has a degenerative effect on hand function, so young pianists who cope well with the conventional keyboard may encounter increasing difficulty with age. Many older pianists report that narrower keys increases their comfort and extends their playing life for many years.

‘The three factors of hand width, finger length and finger abduction, …., will explain a surprisingly large number of technical difficulties that are often wrongly attributed to defects of coordination or studentship‘. (Otto Ortmann, 1929)

 ‘Fine dynamic gradation with the fingers in extreme stretches is physiologically impossible‘. (Otto Ortmann, 1929)

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