Peer-reviewed epidemiological and clinical research on pianists using the conventional keyboard has demonstrated a link between small hand spans and pain and injury.

This link is supported by recent studies in the US which compare performance and health outcomes for pianists using keyboards of different sizes. A pianist moving to narrower keys is, in effect, getting ‘larger hands’.

Female pianists run a much greater risk – approximately 50% higher – of pain and injury than males. Some studies have found that  70-80% of female pianists are affected by playing-related pain or injury at some stage during their lives.

Children and teenagers have also been found to suffer from pain and injury related to piano playing. Piano teachers have a duty of care in this regard – a mismatch between hand size and the repertoire taught can be a factor.

See also: http://smallpianokeyboards.org/pain-injury-and-performance-quality/

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