The pianist and injury, part i- do common precautions do more harm than good?

(This first part will focus mostly on general pianists' attitudes to physical activity with the hands- exposing how a distorted myth regarding Robert Schumann has created completely unjustified paranoia that urgently needs to be countered. In a second part I'll also go on to explore why I believe the relaxation school may have actively contributed to making injuries increasingly common place- with proof of how the extensor muscles are generally worked considerably harder when trying to channel arm energy through a passive hand)

Introduction 

Firstly, I'll provide a couple of scenarios outside of piano playing, to set the scene.

Picture a tennis player who does no physical exercise apart from playing tennis. He aims to play to a high level and thus must often push his physical capability close to its limits, when holding a racquet in hand. However, don't fear. He won't be at risk of injuring himself. After all, he never goes to the gym, he consciously avoids all forms of stretching and flexibility based work, and he never warms up physically other than by actually playing games of tennis.


WHAT???!!! Let's rewind for a moment, for that's clearly the most deranged logic conceivable. This is not why he would be safe, rather it's why he is going to be actively prone to injury! To play top tennis, you must clearly CONDITION your body for the demands of the real life game, not exclude it from doing everything other than tennis. You don't get to have an incredible serve through avoiding all else!

If you're already complaining that music is an art and not a sport, I'm afraid I saw you coming.

In my second analogy, we have a ballet dancer. She never does any form of physical activity other than rehearsing the ballet routines that she is working at. After all, she must protect her physical apparatus from injury. She never works at flexibility prior to dancing nor does any form of non-artistic exercise to get started. Better to avoid such risks. This is exactly why it's safe for her launch into the splits at a moment's notice (as long as it has artistic context in a genuine routine), without any physical warm up.

WHAT???!!! Let's rewind again. This time you don't get to frown on a sport for being "different" to art, yet it's still abundantly clear that the whole premise is absurd to the very core. Anything that helps the body develop comfortable flexibility is clearly part of performing effectively and with safety. Alongside ballet practise itself, it's common for top dancers to do all manner of body conditioning- including flexibility and possibly even some degree of strength based work (especially for male dancers who may have to carry a partner's full weight). They don't serve their art by turning their noses up at anything that doesn't have artistic context. They work to keep their bodies limber and flexible specifically because it prepares them for the physical demands that they must meet during their art.

Finally, we have a pianist who is building up towards music college auditions. He never does any technique exercises beyond the odd scale, because he is too pure an artist to dirty himself with such matters (and he once heard a famous teacher say all drills are dangerous and should thus be avoided). He deliberately avoids all forms of "unnatural" hand exercise away from the keyboard. After all, everyone knows that Schumann damaged his hand beyond repair with some weird contraption. Other than practising his programme of difficult music, he keeps his hands fresh by resting them and avoiding activity. He has minimal risk of injury, because his hands do little other than musically artistic piano playing.

Now, this is the one where a great many pianists would nod in agreement, rather than shout "WHAT???!!!!". If so, why? If you do go on to continue thinking that's a good attitude, after having read this post, then very well. However, I have to insist that you at least stop to ask some serious questions. Now, there are also radically opposite stances- including pianists who obsess over an idea of extreme finger "strength" and genuinely overdo work on forceful exercises towards that end. I have no wish to promote that branch of extremism. However, the stance outlined above seems to have become widely accepted as if it were basic common sense, rather than the opposite pole of equally extremist madness. Did you notice how consistent it was with the previous examples? Somehow, something I'll call "pianist's logic" seems to have allowed this to be taken seriously within our field. Oh, and in the end, ironically enough that pianist does get injured by a "contraption"- an especially hazardous one, that subjects his poor hands to outlandish demands found nowhere in the natural world. It's called a "piano".

The Schumann myth

Before proceeding, yes I was indeed being facetious for the sake of a cheap gag. It was, however, also for the sake of making an incredibly serious point. This is where "pianist's logic" has come to differ from the default stance of virtually any ordinary human on this planet. Show us a little rubber band and suggest stretching it back and forth for thirty seconds (for the sake of building flexibility) and most of us will run for the hills, while screaming something incomprehensible about Robert Schumann's injury.

"Contemplate the possibility of facing such a wild risk as moving our fingers against incredibly mild resistance? No, thank you. Do you realise that I'm a pianist?".

But what if you ask us to engage them against the larger mechanical resistance of piano keys, for the continuous 30 mins+ it takes to play a Rachmaninoff concerto (featuring incredibly rapid runs, as well as vast physical stretches that must be taken with commanding ease while the hand bears the mass of the moving arm)?

"Sure, no worries mate."

 Contrast against any "ordinary" person and they're usually of sound enough mind to stretch that elastic band without fear, while quite probably expressing far more doubt about playing the piano like the clappers.

Who is right here? Well, how many people have you heard of whose career ended due to an injury associated with using an "unnatural" device (other than the piano itself)? If this were the gameshow "Pointless" and you knew of any tale other than that of Robert Schumann, you'd certainly be on to a winner. Compare to cases of pianists who were injured merely by playing their instrument and we have undeniable reams of evidence. Leon Fleisher and Gary Graffman are two famous examples among a huge number of piano based injuries. Glenn Gould too had a period of being severely afflicted. It's time to seriously reevaluate why the piano gets the "get out of jail free" card, while we are quick to call danger on all external exercises- which no ordinary person nor qualified physiotherapist would be faintly concerned by. Of course, I'm not saying we should ban piano playing based on the possibility of injury. The point is that it's completely irrational for us to issue blanket bans on almost anything else that involves significant hand activity and then happily spend hours at the "unnatural contraption" which has definitively been at the heart of many injuries.

Anyway, here's evidence of the fact that the old Schumann tale is almost certainly nothing more than a wildly distorted myth:

http://www.pianisttopianist.com/?p=10

http://focaldystonia.co.uk/#/robert-schumann/4563923100

Schumann may not have been wise to use the machine exactly as he did, but the severity of his problems already existed. Don't misunderstand, I'm not specifically saying we should all run to get a device like Schumann's, and then pull the crap out of our fingers, with expectation of becoming virtuosi. However, we should stop to ask questions before tarring all hand exercises in general! Where is the meaningful evidence for the crippling long-term injuries that can supposedly afflict those who dare to exercise their hands away from a piano? If there is any substance, I extend an invitation to anyone to point me to it. As far as I can see, it seems that we've been duped en masse, by scaremongering. Evidence suggests that the true worry is injury from playing wrongly, not from any complementary exercises. The pianist's paranoia about everything under the sun (except for pianism itself) does not seem to have any footing in reason at all. It lives in a legend, that somehow evolved into being taken as gospel.

Back in reality, it's widely accepted in science that engagement of muscles against comfortable levels of resistance is actively conducive to flexibility and general health- far more so than abstinence from activity. The only meaningful questions should be about what is a reasonable range to work within. In cases of significant existing injury, complete rest may sometimes be wise. However, even then a physiotherapist may well prescribe gentle work against low resistance- thus encouraging blood flow to assist healing. It's a remarkable situation, really. The very same exercises which are safe enough to be given by medical professionals to the significantly injured (to help restore function via gentle rehabilitation) are being denounced by a horde of medically unqualified pianists as too "dangerous"for the healthy. The idea that hands which perform extreme gymnastic activities at a piano must be protected from such simple exercises exists in the world of "pianist's logic" and nowhere else. Look around and you'll certainly see plenty of evidence of injury through repetitive activities like piano playing, typing and the like. But the Schumann legend seem to be both the beginning and end of the "evidence" behind this overblown hysteria about any kind of alternative hand exercises.

The evil of Stretching?

For some reason, Chopin has been pretty universally portrayed as the antithesis to Schumann- a pianist who respected the hand in its natural form and would never have considered trying to alter its natural state. Well, I'm going to have to shatter this myth too. Did you know that Chopin developed flexibility between his fingers by sleeping at night with wine corks wedged in between them? So much for the poster boy for leaving physical development to piano playing and nature alone...

http://online.wsj.com/article/SB122670581542929769.html

Now, it may be that Chopin changed his mind on this type of thing, but it's impossible to say with certainty that it had no effect on him. I'm not going to recommend going to such extreme lengths, but I'm certainly not going to rule out more gentle stretching exercises. When it comes to small handed pianists, people regularly cite Alicia de Larrocha as proof that they can flourish like any other. While this is spot on, what seems to be forgotten is the fact that she was obsessive about stretching her hands and actually managed to develop enough flexibility to strike a tenth. Weirdly enough, I've literally heard the same people who put her forward as an example to those with small hands, going on to argue that you should never stretch at all. Sometimes they even argue against basic legato. If someone wanted to construct a conspiracy by which to prevent those with small hands from ever transcending their slight disadvantage, they could scarcely do much better. Yes, there will be things which just aren't possible and which cannot be usefully forced. A whole lot of stuff can be coaxed, however. It's incredibly unlikely that de Larrocha would have reached the level she did, had she just decided that there was nothing she could do to improve on what nature gave her. People who treat their small hands as innately incapable (and a thing to be carefully protected from all challenges) are not going to come close to what she achieved. Also, even large hands need training. A large hand is not automatically flexible or limber, in much the same way that a tall person isn't automatically a professional level basketball player. There are good ways to train and bad ways. But it's a gross oversimplification to decide that piano playing counts as good, while everything else must be assumed bad.

Skepticism vs cynicism/"Hmm"vs "NO!"

The origins of this article were triggered by a post in a Facebook group for piano teachers- regarding *brace yourself* finger weights. Given the extreme nature of the responses that post received (displaying "pianist's logic" in full force), I will clarify at the outset that the only thing I wish to promote is the value of an open mind- that neither fully excludes nor fully accepts anything without reasonable cause. Skepticism is healthy. That's where we ask questions and seek further information, rather than accept any claim at face value. Uncertainty is healthy- where we recognise that we have inadequate information to give a final judgement. Cynicism, however, is not healthy. That's where we make a snap dismissal of anything that differs from the limits of our experience/assumptions- thus shutting ourselves in a cage and removing all possibility of someday being pleasantly surprised by a new discovery.

Anyhow, these finger weights were met with a torrent of casual dismissals (some arguably libellous in nature). I won't name or quote anyone, but I will summarise the prevailing nature of the responses. Other than myself, nobody had even cared to enquire about the size of the weight involved, before being ready to pass judgement. Needless to say, the Schumann references came thick and fast- only a couple of which tried to debunk the myth rather than spread it. Yes, one man got injured almost two centuries ago (in a tale of very dubious details) so from there onwards every conceivable mechanical device (except the piano) is to be assumed cripplingly unsafe for a human hand. Among a very large number of responses, I saw very few people who were raising questions or seeking to understand more deeply. Anyway, in the end one of few curious posters looked up the actual weight. It starts at...

10 GRAMS!!!!

As a skeptic rather than a cynic, I find it astonishing that the default assumption would be that putting 10g (!) on a finger will probably cause injury. Pop a pound coin (you'll have to Google your own closest equivalent if you're not in the UK) on the back of a finger and that's the corresponding level of mass and indeed danger that would be involved. I won't even tell you to do so "at your own risk". If you want to take me to court under the grounds that you injured yourself with that coin, all I can say is that you're welcome to try (although you'll need a bloody good lawyer). Remarkable claims demand remarkable evidence. The idea that a finger cannot handle 10g (one hundredth of a kilogramme!!!!) without probable injury is a truly remarkable belief indeed. Particularly given that the very same people who call danger are typically happy to preach the joys of setting the whole arm's weight upon the hand!

Most remarkable of all, the discovery that that merely 10g of mass are involved changed nothing in the tide of opinions! I was assured that the difference is that the arm's more substantial weight is "natural" and thus can't cause injury- in spite of applying radically greater forces. Conversely, I'm led to believe that as 10g is "unnatural", it will therefore become injurious. If you're happy with that as an explanation, then we certainly do live in a world in which facts no longer matter. In my second part of this post I'll go into detail as to how arm weight schools really can cause significant strain, when excess weight bears down on an underperforming hand. I can assure that 10g won't, however.

Anyway, it's not that I even recommend these weights. Rather, I was struck by what the response says about attitudes in general. As one poster mentioned, Liberace's rings were probably heavier than 10g.  You don't become an accomplished pianist by having the biggest and most rock solid finger muscles, but neither do you become one by wrapping yourself in cotton wool and 
living in fear of anything untried. Here's Tzimon Barto:

As a devoted bodybuilder, it's said that after a concert he could easily bench-press the piano for an encore. I think that's only a joke but, regardless, do you imagine that if you asked him to bear the weight of a coin on his finger, he'd back off in case his hands were crippled beyond repair? Or that he'd accept, only to be forced to cancel all concerts for the rest of the season (as a payback for such naïvely reckless bravado)? Other concert level pianists who are also into olympic style weight lifting include Leon Bates and Gen Hirano. I must stress, my point is not that you should lift colossal weights. But this gives some perspective on how utterly pathetic it is for a grown pianist to fear either a rubber band or the mass of a coin upon a finger.

Come back to our ballerina, or gymnast now. Sure, they might not be looking to benchpress double their body weight. However, why would they be scared to lift even small dumbells, when they have to execute chains of backflips? Likewise, why should a hand that is getting around virtuoso octaves be troubled by supporting 10g? I might not expect miracles, but injury via 10g is the very last thing that would be on my mind. No hand is going to shatter into a thousand pieces. The fact that fear of 10g reads like more like comedic parody, than observed reality, speaks volumes of how warped our culture has become. Pianists are being encouraged to cower in response to nothing- despite constantly facing serious gymnastic demands at a piano. And then they wonder why those precious little hands end up injured? You don't necessarily need to have remarkably strong hands, but if you want to tackle serious repertoire then you sure as hell need to have them agile and conditioned for activity!

Weights and Hanon exercises

One of the most useful exercises I've done is to practise occasionally with a 1kg wrist weight. I came upon the idea in a book by the pianist Seymour Bernstein. I'm not going to specifically recommend to anyone else, on an unsupervised basis. However, I will describe some of the details.When I play with a small weight on my wrist, it makes any flawed alignments extremely obvious. Holding the wrist either notably high or low would get tiring very quickly, if sustained. Without the wrist weight it can be like boiling a frog. If you don't know the expression, it refers to the fact that frogs can only detect abrupt changes of temperature- which means that you could theoretically boil one alive without them knowing they are in trouble. In much the same fashion, if I were to play a Chopin study with a slightly crooked wrist position, I'd probably both get away with it for a while and not realise that anything is amiss. Lots of slight imprecision of movement (none of which stands out on its own) slowly adds up though. All of a sudden, I'd eventually realise that I'm starting to miss plenty of notes and feeling everything seizing up.

I just about got away with much that kind of thing, in this rather old video of the black key Etude by Chopin.

The dressing gown slightly hides my long-term habit of holding the right wrist upwards, although you will visibly see a few rather jerky "hopping" movements of the arm, where the legato is poor and the arm is not properly supported by clear connection of the fingers. As I remember, although the accuracy didn't go horribly wrong, my forearm was rather tight by the end.
If I had tried the same with the wrist weights on, I'd know about the slight problems almost immediately, through a somewhat amplified sense of instability. I don't actually do it to make my hand work harder during a whole run-through though. Rather than struggle on while tiredness builds, I use the feedback to stop and adjust into easier coordination- where my wrist is properly suspended at length between a stable finger and the shoulder. The idea is to suspend that extra kilogramme without bearing the whole force down directly on the finger. I literally do it to AVOID weighing down hard on the hand, not to encourage it! When you get things wrong, there is indeed a significant sense of the hand being burdened by extra mass- which is why I don't try to plough through whole performances at speed. Instead, I explore sections (both at very slow tempos and fast burst of small units), looking for comfort and stability at all times. As soon as I detect any moment of awkwardness, I stop and fix it. Nowadays I play the same Etude with far less downward arm pressure and far greater ease of movement.

Also, this brings me back to technical exercises. I've heard many of people say that playing Hanon causes injury. If it can possibly do so, it's because your technique is wrong. Anyone with truly good technique should have no problem playing any of them safely. Avoiding Hanon because its dangerous is simply fleeing from your problems without actually solving them. It's far better to intentionally expose the problems (via only brief bursts) and then make corrections. There are few better places to both uncover and fix fundamental movement problems quickly. When I do the occasional Hanon exercise (with weights on or off) what I again almost never do is is run from start to finish. I'm not looking to build strength with endless repetition, but looking from immediate refinements of coordination. Instead I tend to do small bursts quickly (usually a bar plus one note) and then stop to assess how precise and easy the movement was. If I wasn't happy I'll then do it very slowly, checking for smooth sideways arm movement, while the fingers keep a clear legato connection (to stop the weight collapsing downward). If that works I'll probably do a little bit fast again. Eventually I may play through the whole exercise fast, but never to "feel the burn". If it's not effortless and precise I stop and build precision and clarity again. With this kind of focused approach (based on finding and solving slight problems in the movement, rather than drilling mindlessly) you can find the issues which get in the way of free and easy movement and then change things at once. If I find and correct any points of heaviness, with the wrist weights on, I know that I'll still be significantly clearer and lighter in my movements when I take them off again.

I'd have been far worse off had I simply shouted "Schumann!" (like some mindless parrot) when I first read about wrist weights.

Collapsing fingers- a simple illustration of why they occur, why they are harmful and how anyone can quickly learn to prevent them (via the action of extension)

(Nb. I wanted to get this issue dealt with in order to avoid the need for any digressions about how to avoid the problems of collapsing joints, within my next post in the series about core piano technique. For anyone who sometimes suffers collapsed joints, this is an essential precursor to the upcoming post. However, I am deliberately ensuring that it can equally be understood as a standalone post about this important issue, without any need for external context) 

Collapsing fingers are a classic pianist's problem. Particularly with the second finger, it's extremely common to see the joint nearest the fingertip abruptly give way and double back on itself, to form this type of shape:

(many thanks to Azim Akberali for kindly producing all diagrams)

All too commonly, this is put down as being an issue of strength (particularly in young children)- a defeatist attitude that suggests that the answer is simply to ignore it and merely hope that matters will change of their own accord, given time. However, following some recent experiments with a number of students, I've become quite certain that the real issue lies in the coordination of muscular activity and that it's almost entirely about the basic manner in which movement is conceived. Before I go into any further detail about hows or whys, try this potentially very revealing exercise (please read the descriptions before following the video examples):

Firstly, ground a key gently with a lengthened thumb, in order to help the arm gain a touch of support (without either feeling in any way clamped or forced down against the point of contact). Just once or twice, draw the fingertip lightly back towards your palm in mid air (these are the most sensitive joints of all so I have to stress the importance of being gentle- rather than truly "gripping" against perceived resistance). Here, your joints are closing inward. Then attempt to do the same, when sliding the fingertip lightly and easily across the surface of a depressed key, in towards yourself. Do this with absolutely no sense of digging down through the finger with arm pressure. If you feel the key starts blocking your path, lighten up your arm and make room to continue more gently, without getting squashed down!. Note that the knuckles are given room to drift up and become the highest point- which is important for avoiding any sense of burden. Definitely don't do this with the knuckles squashed down!

So, did the tip double back on itself or did it successfully curl in on itself as it did in thin air? Ideally, line up a mirror beside the piano so you can observe yourself properly. Recently, I saw no less than four students who found this task almost impossible, even when being extremely gentle indeed. Instead of curling inward, on each occasion that final joint would abruptly give way and fold considerably back on itself. Logically, this might seem to suggest muscular weakness- given that they were actively attempting to close the finger tip, yet were incapable of doing so? Well, it might seem that way, but now try example two. 

Here, the finger starts curled and the same two joints perform the opposite action of opening out forwards. Again do it in thin air just the once or twice and then experiment with how it feels to gently slide along the surface of a depressed key- initially starting nail down (but again with a sense of a high knuckle), in order to feel the whole range of movement. Of all these four students (who doubled back severely when they tried to grip their finger tips inwards), not a single one experienced that same sudden collapse! They could easily go from a curled position all the way to a very open one (where just a slight curve of the fingertip was still present) without any sudden jerks or any loss of stability. Within a very wide range of angles, there was simply no danger of collapse at all, any more- as long as the student was allowing the finger to lengthen out freely and easily, without the arm jamming it down hard against the point of contact with the key. Now, I don't want to say this will definitely apply to EVERY case of collapse. However, I'd stress that each one of the students who I speak of here had highly flexible joints that had formerly been so "weak" as to instantly double back into positions so extreme that I'd literally have to break my own bones to even begin to recreate the shape. As soon as they replaced the concept of gripping with that of lengthening, their hands started to find positions that looked as effortlessly "strong" as any hand.

 

This could easily seem plain bizarre- and (in spite of having previously thought about these issues in depth) I was actually rather surprised to see these formerly "weak" fingers consistently becoming so capable at once. Why on earth would it be that trying to perform an action that usually closes each individual joint of the finger would uncontrollably collapse the tip in the very opposite direction? Why would the action that lengthens the finger (ie which moves the fingertip away from a rounded position and in the direction of the position seen in collapse) be readily possible without risk of triggering that extra step into collapse itself? The whole thing seems to be completely the opposite of what common sense might dictate, but actually there's a very simple mechanical explanation (simple enough that it can be given purely in common sense terms and without any need for mechanical jargon). 

Obviously, when we perform the curling action in thin air, the finger closes. The problem is that it's not so simple when we're interacting with a piano key (and the more the arm is pressing down through the finger, the less simple it becomes). Consider, firstly, that the joint which acts to close in the finger tip cannot typically be moved separately from the action that causes closure at the finger's middle joint (except by a tiny percentage of people).

The impossible movement of the tip seen there could only be effective at preventing collapse IF it were possible to execute it without the finger's middle joint also getting involved. As you'll almost certainly see if you attempt what is seen in the diagram, however, the middle joint of your finger will begin to curl up too. Consider now what happens if the arm presses down while this is going on. The fingertip is now effectively fixed against a certain point on the key. That means that if the mid joint starts closing up, it is dragging the final joint backwards and towards collapse. If we depict the finger tip and its middle segment as isolated levers it should be completely clear, from these before and after pictures, that any pull from the upper lever is dragging the joint towards our classic collapsed finger position.

Let's translate that back to the fingers themselves  in these diagrams:

and it should now be abundantly clear why the action that might usually close up the finger (away from the piano) will instead be trying to drag the fingertip into collapse. The middle joint and fingertip joints will function just the same as those two levers had. Once the middle joint has started pulling you towards collapse, the more you try to grip from the weak joint that controls the fingertip (in a bid to keep it rounded) the more you ALSO engage the stronger middle joint that is destabilising it. This creates a vicious circle where the harder you should to seek to oppose the collapse, the more actively you contribute to causing it- by working directly against yourself.

Consider now the lengthening action, seen here in a before and after:

(Note that this action still involves the act of closure or 'grip' at the knuckle joint. The difference in what I am speaking about exists exclusively in whether the middle and fingertip joints complement that by opening or by closing. In standard human grip, all joints close in. In this action, the two lesser finger joints instead open out, while the knuckle alone goes into a more closed position. If that sounds complex to you, simply imagine the finger lengthening to match the blue line, or see this post on the finger actions for more information on how to develop a "feel" for this.)

When you are familiar not merely with the hand's most standard gripping action, but also with this complementary lengthening action, it quickly becomes possible to learn to balance on a depressed key without fighting against yourself. By alternating between the action that slips towards you and that which slips forwards, you start to discover a direction of action that exists somewhere between the two. The line of force is actually a touch forward (rather than perfectly straight down), yet not so much as to make you slip or to cause any feeling of instability. Sometimes it's as simple as getting the student to experience both forwards and backwards slides first and then simply allowing them to discover what feels right, without too much rationalising. However, if a student's habits are strongly based around desire to move keys by pulling the fingertips backwards, it may take some time before this rather different conception of movement becomes fully habitual. If so, I advise spending some trying to consciously perceive the slight sense of aiming finger activity forwards, even whilst keeping a key depressed. The feeling is not that you're not actually going to slip, but that you're ALMOST doing enough to cause the finger to start to sliding slowly but steadily forwards. Given time, this slight forward action will start to feel normal and instinctive and the student will stop accidentally retracting the tip in a way that causes collapse. In the end it may still feel like the finger is acting forwards or it may simply feel come to feel "right", in a more abstract and non-analytical sense. Whatever the case, it's worth coming back to explore both directions of the exercise, from time to time (and for each finger- not just the 2nd, that I used to illustrate). Willingness to slide smoothly but freely in either direction gives a wide sphere of experience to your senses and allows various muscles to let go and stop trying to force stability. When you go back to a regular balance point, it often turns out that you can be more than stable enough without actually bringing back those efforts. 

Addendum

What I've written so far will hopefully have both given a rather comprehensive summary of the objective background to collapse and provided a means of conquering it that is both simple and direct. However, I'd also like to follow up with a few additional points regarding some of the issues that have arisen here. One part of this is extremely significant for pianists with small hands. But, firstly, even if you don't have any collapse issues, consider this- are you certain that your middle joint isn't placing a burden on your last joint, by needlessly pulling back at it while you play? Just because a finger doesn't collapse, it doesn't mean that an inner battle isn't going on between conflicting actions of the two joints- if you happen to employ the type of gripping action described.

With that in mind, the exercise is equally worthwhile for those who never experience collapse but who may be hooking themselves too forcefully into the key. If the finger is typically gripping back in towards you during regular playing, the arm tends to have to press down for the sake of stability. This can really burden the tendons and I strongly suspect that a conception of movement that is exclusively based on trying to grip inwards at the tip can contribute directly towards tendinitis.When you add a capacity to lengthen these weaker joints to the more common desire to grip from them, there's vastly less physical effort. Many people speak of curled fingers as being a cause of tendinitis, but I think this is a very misleading simplification. Curled fingers that are acting to curl up further will become burdened. HOWEVER, curled fingers that are gently lengthening in the last two joints (ie uncurling outwards) need experience no such burden. You have to consider both the position and the type of activity that is in progress, to get to the bottom of these issues. Neither gives the whole picture, without consideration of the other.

Consider what happens if you reach this type of open position (as is commonly seen by the likes of Rubinstein, Richter, Gilels and many other great artists- none of whom ever experienced any physical problems that I ever heard about)

Any use of inward grip from those two secondary joints will cause the fingertip to be dragged virtually horizontally, as shown by the red arrow. Unless the arm is forcefully digging down to create friction, that will cause phenomenal instability when the finger moves and compensatory tensions. From such a position, it is far healthier to appreciate the action that lengthens out the very same joints. This completely eliminates any need to hook in via strong arm pressure. Remember that both actions involve the stronger closing action of the knuckle itself. It's just that one also involves a significant burden on the weaker joints, whereas the one that involves lengthening them out makes for a vastly lighter workload (plus a more productive line of motion).

One point of interest to consider is that many pianists and teachers still actively preach the value of drawing the fingertip in towards the palm. While I'm on this topic, I'd like to illustrate how I'm personally 100% convinced that the efficacy of such advice actually depends on the student taking this as a springboard to something altogether different. This paper speaks about fingertip grip in relation to a pianist's health.

 http://www.legacyweb.rcm.ac.uk/cache/fl0026842.pdf

Also, there is an Irish pianist called Roy Holmes who used to have various Youtube videos that claimed that all finger technique should involve aiming to draw the fingertips back towards the palm (I don't know if the fact that they have been withdrawn might suggest that he's since had a rethink). Firstly, if taken precisely as detailed, this approach would be quite functionally impossible for anyone whose fingers collapse easily. Rather than being healthy, it would frequently encourage the joints to slip out into their extremes of motion, via jolting collapses. Some hands just will not suit the approach, due to their individual characteristics. Even for someone whose joints do not collapse, it could still be hard work, for the reasons already detailed. So how could such a thing be promoted in the name of "health"? 

Consider this- if you pull back into a position that is still curved, what happens next? Do you really keep gripping from the fingertip while keeping that key down? If you did, you'd have to hook in for stability against slippage, as illustrated by the last diagram (and the line of attack would also tend to drag the wrist forward and trap it into an uncomfortably bunched up position). I don't believe this could possibly be wise as a baseline for technique. BUT- consider this: what is the most natural thing to do once you've found a curled position? It's to switch to the lengthening activity, for ease of balance. Perverse as it may sound, I believe that approaches which are founded on preaching the importance of gripping from the fingertips work specifically because they create a position where you may start to feel that it's unnatural to grip any longer (ie. the advice actually describes an action that is potentially dubious, yet which prompts you to move into a position from which you may instinctively begin to a get a feel for the totally different action that suits the situation!).

If you can do it without collapse, try sliding your fingers along the keys like in exercise 1 again. After having had the experience of working at both drawing the tips backward and lengthening out forwards, can you feel an instinct that makes you want switch over to the lengthening activity, for balance- in the instant that you decide to stop sliding? If not, try it even more gently against a table top. If you don't perceive it on the piano, it should at least be possible to detect this change on the table top. At this point, either you could hook in by pressing the arm and work pointlessly hard or you can stop gripping from those joints and instead keep the balance via a much more subtle lengthening action (that keeps the key down and preserves the shape of the finger). This is perhaps what some people mean by "and then relax"- which might be more accurately translated to- "and then switch to a different style of finger activity, in order to find easy balance" That may sound wordy by comparison, but not every one will get this on instinct, merely as a result of indirect (or arguably even "contradictory") instructions. I believe that any deeper benefit of the "carezzando" idea is dependent on whether fingertip stroking triggers a position in which literally the opposite activity has to kick in, as part of a major muscular reorganisation. If you're equally used to finger lengthening actions and willing to go on instinct, you may well find a simple and easy balance without thought. However, if you get lost in an artificial premise that your fingertips are "supposed to" grip and devote all attention to doing so, you may very well place an unpleasant and unhealthy burden on your fingers- especially if you attempt to execute rapid-fire semiquavers with these highly indirect scraping actions. The more successfully you should literally adhere to the advice, the more uncomfortable you would likely find yourself- unless you should begin to perceive a change-over, by which the activity switches to the alternative manner of finger activity.

Although I am totally convinced that actions that involve extension are literally essential to the possibility of advanced pianism (and suspect that you could theoretically flourish with virtually no deployment of active fingertip grip), by looking at it from both angles you can learn a great deal. As I said, allowing slides teaches you how to let go of some unwanted efforts. In that respect, the "carrezando" idea can likely have benefits- (as long as you genuinely do it lightly and without "scraping" hard across the keys or "hooking" forcefully into them). What I am not particularly keen on, however, is the danger of implanting a person's mind with the misapprehension that fingertip grip might be one of THE standard ingredients behind pianistic actions, without drawing any equal attention to the important alternative. Unless a person is lucky enough to stumble on a "feel" for the fact that balance is vastly easier via an opposite activity, they may get themselves into all of the problems that are often associated with "curled" fingers- by using both a curled position and further curling activity. Grip is second nature to most humans already- which is probably one of the reasons why children so frequently collapse their fingers by gripping from the fingertip. In most of life, that's our default hand-action. What we are less inclined to have any immediate feel for is the vital role which lengthening actions can play.

On the subject of health, I want to illustrate one further issue, that demonstrates a powerful reason to appreciate why the lengthening action is extraordinarily important for small hands (and which further illustrates why it's a very bad idea to approach pianism solely in terms of the gripping actions, without reference to opening of joints). Lengthen your fingers out as shown before and then practise gripping lightly inward in all joints. Watch your knuckles this time. Do you see the fingers closing in towards their neighbouring fingers when you grip inward in all joints? Do you see how the space opens when you combine the slight lengthening of joints with a knuckle grasp? Here's a demonstration of both (followed by a demonstration of the fingers purely being drawn inwards and outwards, independently of other motions. This is a great exercise for freeing up any long term tensions that may be lurking there).

If you fancy trying to keep that space between adjacent fingers open while gripping, do you feel the sheer level of conflict inside your hand? Muscles are fighting to contradict the action of your very own muscles. All it takes it to add some degree of lengthening in the lesser joints, and you can eradicate this senseless fight (which is exactly what is going on when most pianists strain to reach big chords).

Ask yourself, even if you have a big hand, do you really want to be limited to actions in which you are actively making your hand smaller with every movement you make? Could that honestly be healthy, if taken as a regular pianistic action to default to? Or does it make overwhelmingly more sense to depend chiefly on an action that actively opens your hand out and frees you while you use it? I don't think it's any coincidence that my reach between 2 and 5 has increased from an awkward 7th to an easy octave since I willfully introduced lengthening actions to my technique.  I'm certainly not looking to try to ban actions involving fingertip grip from pianism outright. However, given the compelling evidence in favour of actions that instead utilise extension (which stacks up way beyond the particular collapse issue that this post started out on), this alternative strikes me as the single most worthy action of any studying pianist's conscious attention. I feel certain that those pianists with smaller hands who flourish (unlike the unfortunate many whose fight to reach chords is all too easy to detect in their sound) do so specifically because their technique regularly involves the lengthening action. In my opinion, pianists whose attention is drawn exclusively to the actions of closure are more likely to be hampered by that advice than to stumble on the alternative- and overwhelmingly more likely to suffer injury via the internal battles. When pianism is approached in terms of both qualities of movement, students are vastly more likely to find their own feel for what works.