Comparing Violinists’ Body Movements While Standing,

Sitting, and in Sitting Orientations to the Right or Left

of a Music Stand
Claudia Spahn, Prof Dr med, Dipl Mus,1 Céline Wasmer, Dr med, Dipl Mus,1,2
Franziska Eickhoff, Dr med,1,3 and Manfred Nusseck, Dr rer nat1

OBJECTIVES: For violinists, it is common practice to play while
standing or sitting. When playing in an orchestra, generally
two persons share one music stand, with one sitting to the
right and the other to the left of the stand. The present study
investigated specific movement patterns while playing in
these different positions. METHODS: Using a posturographic
device and 3D motion capture, the body weight distributions
and specific body movements of 19 violinists were analyzed.
RESULTS: Results showed unbalanced weight distributions
while sitting in front of or oriented to the right of the music
stand compared to the almost even distributions while stand-
ing or oriented to the left of the stand. Analyses of movement
patterns showed significant differences between standing and
sitting, mainly in the upper body parts with less movability
while sitting. While sitting in front of or oriented to the right
of the music stand, the right bowing arm showed more
restricted movements compared to other positions. CONCLU-
SION: The playing positions are discussed with regard to possi-
ble physiological stress and health risks. The study empha-
sizes the importance of different playing positions and offers
starting points for discussion of postural influences and sensi-
ble handling of the instrument in performance and practice
for violinists. Med Probl Perform Art 2014; 29(2):86–93.
I n concert situations, it is well established that solo per-
formances by violinists are played in the standing posi-
tion, while in orchestras or chamber music ensembles, the
string players are predominantly sitting. Practicing and
teaching situations are mostly performed standing upright.
For this, if a music stand is used, it is placed in front of
each player. In orchestral arrangements, however, two
players generally share one music stand. This situation
results into two additional playing orientations, to the
right and to the left of the music stand (Fig. 1).
The instrumental literature for the violin does not
detail the relevance of these different playing positions. In
the book of violin method by Szende,1 there are some sug-
gestions for playing in standing or sitting positions. For sit-
ting, he recommends an equable weight balance by resting
the full body weight over the complete seating surface of
the chair. The left foot should be wholly leveled on the
floor, while the right foot is loosely positioned beside the
chair. In the upright position, the player should have a
symmetric posture with the body weight evenly distributed
over both legs. The center of gravity can thereby easily be
adjusted through the smallest body and muscle move-
ments, even in apparent rest.
Specific sitting orientations in front of the music stand
are not mentioned in any violin school that we know of. If
it is mentioned, mostly the correct adjustment of the stand,
such as the height and the position to the conductor, were
advised.2,3
In the scientific literature of the last decade, there has
been an increasing interest in the systematic analysis of
movements of musicians, especially among violinists.4–7
Using modern 3D motion recording systems, several differ-
ent fields of music performances and movement skills of
musicians have been investigated. Visentin et al.5 empha-
sized that scientific research about courses of movements
gives important information for instrumental teaching
methods and for preventions of playing-related health

From the 1Freiburg Institute for Musicians’ Medicine, University of

Music and University Clinic Freiburg, Freiburg, Germany; 2Univer-
sity of Basel Psychiatric Clinics, Basel, Switzerland; and 3Department
of Cardiology, Municipal Hospital Braunschweig, Braunschweig,
Germany.

Address correspondence to: Prof. Dr. med. Claudia Spahn, Freiburg

Institute for Musicians’ Medicine, University of Music and University
Clinic Freiburg, Breisacherstrasse 60, D-79106 Freiburg, Germany. Tel
0049 761 270-6161, fax 0049 761-270-6169. claudia.spahn@uniklinik-
freiburg.de.
FIGURE 1. Positions of violinists sitting to the right and left
© 2014 Science & Medicine. www.sciandmed.com/mppa. of a music stand.

86 Medical Problems of Performing Artists

problems. However, there is no literature on the compari-
son of body movements of violinists in different playing
positions and orientations to a music stand.
As a methodological background for this study, the work
of Shan and Visentin4 was examined. Using a 3D motion
analysis, they measured the arm movements of eight profes-
sional violinists and three semi-professional violin students.
Their results showed that the left arm, which is grasping the
instrument, stays in a nearly static position. The analysis of
the right arm (bowing arm) showed rather similar move-
ments in the shoulder and the elbow across the musicians,
whereas the right wrist (holding the bow) showed very indi-
vidual motion patterns. Based on these results, the current
study included analysis of the right bowing arm and the
movements of the back, since these anatomical regions are
expected to show the largest effects of while playing in dif-
ferent positions and orientations.
The goal of this study was to systematically compare
arm and back movements and the body weight distribu-
tion of violinists while playing in upright and sitting posi-
tions, as well as sitting oriented to the left and right of a
music stand. The study is motivated by the fact that the
different movement characteristics of these basic playing
positions for violinists have not been considered in
research or in instrumental teaching literature yet,
although they play a very relevant role in concert or solo
performance practice.
METHOD
Participants
Nineteen violinists (16 females, 3 males) participated in the
experiment and gave their informed consent. All players
were right handed. Their mean age was 23.6 years (SD 2.8).
All of them had a minimum of 10 years of experience on
their instrument (mean 15.9 yrs, SD 3.5) and were either
students at the University of Music in Freiburg or mem-
bers of a (semi)professional orchestra. People with current
health problems related to the instrumental play were
excluded from the study.
Procedure and Design
For all participants, body weight distribution between the
right and left body parts, movements of the right bowing
arm, and movements of the back were measured while
playing in the four different conditions. Body weight distri-
bution was recorded using a posturographic device, and
the movements of the arm and back were measured by a
3D motion capture system.
Movements of each participant were recorded in three
ways: 1) with the posturographic device, 2) with a 3D
motion recording of the back, and 3) with a 3D motion
recording of the right bowing arm (see description below).
Due to limited technical equipment, the three measure-
ments were recorded individually in three separate ses-
sions. In each data collection session, the violinist per-
formed the same music piece while playing in four differ-
ent conditions: 1) standing, 2) sitting, 3) sitting oriented to
the right of the music stand, and 4) sitting oriented to the
left of the stand. This resulted in 12 recording trials per
participant.
Participants were instructed to play the first six bars of
the prelude “Präludium und Allegro” in E minor by Fritz
Kreisler. Fingering, position changes, and dynamics were
given in the scores and were discussed with each partici-
pant beforehand so that all players performed in a similar
way. They played with a metronome and the tempo was set
at 80 bpm. Each trial took approximately 20 to 25 seconds.
For the standing and sitting positions, a music stand
was placed directly in front of the player at a distance of 50
cm and was adjusted to eye height. For the sitting to the
right and left of the music stand, the stand was also placed
50 cm in front of the player and was then moved 30 cm
from the middle position to either side. The height of the
chair was adjusted to produce a 90° angle between the par-
ticipant’s thigh and trunk.
After the experiment, each participant was asked to fill
out a questionnaire. It included general personal informa-
tion, i.e., gender, age, study semester, and questions about
playing and practice behavior. They were asked about
their average practice time, common playing position (sit-
ting/standing) during practice, in concert, or during les-
sons, the preferred playing position and orientation
(left/right to the music stand), and why they prefer this
position and orientation. Last, the participants were asked
if they had a current playing-related health problem and if
so to briefly describe the kind of problem.
Equipment
Posturography
For body weight distribution measurements, a standard
orthopedic posturography platform (PDMS-S, Zebris Med-
ical GmbH) was used. This device records pressure disper-
sal on its surface and calculates the center of mass and the
distribution of weight between a person’s right and left
sides. With the WinPDMS software, the dataset can be
summarized into mean values over the complete measure
duration. This can be shown as percent distribution
between left and right sides or as curve progressions of
each individual side. More details about this method can
be found in Bloem et al.8
In the standing position, participants stood without
footwear on the platform, and pressure distribution
between the right and left foot was recorded. An ideal
weight distribution in perfect balance is given by 50.0% on
each foot. For the sitting positions, the platform was
placed on top of a chair. Pressure distribution was there-
fore measured using the tuberosity of the ischium on each
side (hereafter referred to as sitting bones). Body adjust-
ments for weight balancing can only be made with the
upper body parts. An ideal distribution was assumed to be
a 50.0% weight distribution on each side.
June 2014 87
 FIGURE 2. Marker positions and angles, from the back (a) and side view (b).

3D Motion Recordings RESULTS

Recordings of body movements were made using an opti-
cal 3D motion capture system with two digital camcorders
and the software Peak Motus 9 (Peak Performance Inc.,
Denver, CO, USA). Optical markers were placed on spe-
cific positions on each participant (see Fig. 2a and b). The
software calculated marker positions in a 3D coordination
system. The sampling frequency was set to 50 Hz.
For an optimal motion analysis, two different recording
views were used: 1) from behind the participants and 2)
from the side. The view from the back gives insights into
the movements and flexibility of the back and shoulders as
well as the hips (Fig. 2a). Nine different marker positions
were chosen: the back of the head (protuberantia occipi-
talis externa, 1), right (2) and left (3) end of the shoulder
(acromions), neck lordosis (C4, 4), thoracic kyphosis (T6,
5), lumbar lordosis (L3, 6), proximal os sacrum (7), and 7 cm
next to the right and left posterior superior iliac spine (8, 9).
In the side perspective, the movements of the right
bowing arm were recorded (Fig. 2b). For this view, six
marker positions were chosen: right shoulder (acromion,
1), right olecranon (2), right ulnar styloid process (3), mid
bone of the fifth finger of the right hand (4), lower border
of the costal arch (5), and right anterior superior iliac spine
(6). With these markers the following angles were calcu-
lated: the right and left head angles, shoulder angle, neck
lordosis angle, thoracic kyphosis angle, both hip angles,
elbow angle, and wrist angle of the bowing arm.
Posturography
The mean body weight distribution in the standing posi-
tion showed a perfect distribution of 50.0% (SD 6.8%) on
each side (Fig. 3). In the sitting position, however, there
was an overcharge on the left sitting bone with 62.1% (SD
23.3%). Both playing positions were significantly different
from each other (t=2.389, p=0.028).
Weight distributions in the two sitting orientations with
respect to the music stand showed that when the musician
is oriented to the right of the music stand, there was more
weight allocated to the left sitting bone with 60.0% (SD
16.7%), while for musicians oriented to the left of the music
stand, the distribution is approximately even with 44.5%
(SD 17.9%) on the left side (Fig. 4). The distributions in
both sitting orientations were also significantly different
from each other (t=3.367, p=0.005). Due to technical inac-
curacies during these measurements, only 14 participants
were analyzed.

Statistical Analysis

For given normal distributions of the dataset, parametric t-

tests were used, whereas where normal distributions were
not found, non-parametric Wilcoxon tests were used. Both
tests can be identified by the letter (either t or z, respec-
tively) in the statistical reports. The threshold for rejecting
significant difference was set at p = 0.05. All statistical FIGURE 3. Mean body weight distribution between standing
analyses were made with the program SPSS 20.0 (SPSS and sitting positions on the left (dark bars) and right sides (light
Inc., Armonk, NY, USA). bars) of the music stand (*p<0.05, n=19).

88 Medical Problems of Performing Artists

 quality of the data was inadequate for detecting all neces-
sary marker positions accurately. For motion analysis com-
parisons, maximum, minimum, and mean values of all
angles over the full trial times were used.

Comparison Between Standing and Sitting

Differences in mean angle values (standing and sitting

FIGURE 4. Mean weight distribution on the left (dark bars)
and right (light bars) sitting bones between sitting positions to
the right and left of the music stand (**p<0.01, n=14).
The weight distributions of both sitting orientations
were tested against the ideal distribution (50.0% on each
side). For the orientation to the left, no significant difference
was found (t=1.141, p>0.05). With the musician oriented to
the right of the music stand, the weight distribution showed
a trend to be different to a balanced distribution (t=2.216,
p=0.054). Additionally, the comparison of left and right ori-
entations to the frontal sitting position (Fig. 3) showed that
the sitting orientation to the right of the stand was not sta-
tistically different (t=0.525, p>0.05), whereas sitting oriented
to the left of the music stand varied significantly (t=2.853,
p=0.014) from that for the frontal music stand.
Motion Analysis
In total, only 16 participants could be analyzed from the
3D motion measurements. For the other recordings, the
positions, frontal music stand) for selected body angles are
summarized in Table 1. No significant differences were
found for the right and left head angles, the neck lordosis
angle, and the wrist angle of the right hand. Thus, these
are not included in Table 1.
The mean maximum values of the shoulder angle,
which is the angle between right shoulder, neck, and left
shoulder, were significantly different between the two posi-
tions. The mean value of 139.7° in sitting position was 7.4°
lower than in standing position (147.0°). In contrast, the
mean minimum value of the same angle in sitting position
(113.4°) was 16.2° larger than in standing position. The
values were not significantly different. It leads, however, to
the conclusion that the range of motion of the shoulder
angle was smaller in sitting position than in standing posi-
tion. The calculation of the range of motion between the
maximum and the minimum angles showed that there was
indeed a significant difference (z=2.327, p=0.020) between
standing (49.8°) and sitting (26.2°).
The mean angle of the thoracic kyphosis in the stand-
ing position (151.2°) was significantly lower (by 5.5°) than
in the sitting position. The mean maximum and minimum
values were also significantly different, but in both cases
the angles in the sitting position were larger than in the
standing position. Therefore, the range of motion did not
differ between both positions, but the total value of angle
was different.

TABLE 1. Mean differences of angles between standing and sitting positions (n=16)
Difference,
Angle in degrees SD Significance

Shoulder angle Maximum 7.36* 12.03 t=2.447, p=0.027

Minimum –16.21* 46.68 z=2.068, p=0.039
Mean –2.25 6.59 n.s.
Thoracic kyphosis Maximum –2.66* 5.43 z=2.585, p=0.010
Minimum –23.09* 48.88 z=2.223, p=0.026
Mean –5.56* 8.85 t =2.512, p=0.024
Lumbar lordosis Maximum –3.99* 7.16 t =2.157, p=0.049
Minimum –5.45 42.31 n.s.
Mean –2.61 6.61 n.s.
Hip angle Maximum –8.44 34.78 n.s.
Minimum –28.13 53.29 t=2.111, p=0.052
Mean –9.66 24.56 n.s.
Elbow angle Maximum 15.47* 17.25 t =3.588, p=0.003
Minimum 0.25 8.62 n.s.
Mean 4.34* 5.72 t =3.037, p=0.008
Asterisks (*) identify significant p-values.

June 2014 89
 TABLE 2. Mean differences of angles for sitting to the right and left of the music stand (n=16)
Difference,
Angle in degrees SD Significance

Right head angle Maximum –5.61 15.89 n.s.

Minimum 5.20 26.15 n.s.
Mean –9.33* 10.29 t=3.512, p=0.003
Left head angle Maximum 2.24 12.33 n.s.
Minimum 1.24 50.74 n.s.
Mean 7.62* 9.23 t=3.196, p=0.006
Neck lordosis Maximum –3.61 9.49 n.s.
Minimum 3.60 49.48 n.s.
Mean –4.80 8.97 t=2.073, p=0.057
Thoracic kyphosis Maximum –1.66 4.22 n.s.
Minimum –0.13 18.34 n.s.
Mean –3.41* 5.56 t=2.374, p=0.032
Elbow angle Maximum –17.16* 28.29 t=2.350, p=0.034
Minimum 2.30 12.19 z=1.874, p=0.061
Mean –3.33 10.18 n.s.
Asterisks (*) identify significant p-values.

The maximum angles of the lumbar lordosis in the
standing position were slightly significantly lower than in
the sitting position. The hip angle is the angle between
right iliac crest, lumbar lordosis, and left iliac crest, which
is a recalculation of left and right side angles into a single
hip angle. Only the minimum values of the hip angle
reached marginal significant difference between standing
(78.6°) and sitting (106.8°) positions.
For the right bowing arm, the mean elbow angle in sit-
ting position (69.5°) was significantly different to the angle
in standing position (73.8°). The maximum elbow angle in
the sitting position (109.2°) also showed a significantly
smaller angle than in standing position (124.7°). A compar-
ison of range of motion for the right arm showed a signif-
icant difference (t=2.535, p=0.023) in amplitude between
standing (79.6°) and sitting (64.1°) positions.
Comparison Between Sitting to the Right and Left
of the Music Stand
The comparison between the sitting orientations to the
right (right-side) and to the left (left-side) of the music stand
showed significant differences only in the head angle, the
neck lordosis angle, thoracic kyphosis, and the elbow
angle (see Table 2). No significant differences were found
in lumbar lordosis, shoulder angle, and hip angle.
The mean values of both head angles differed signifi-
cantly between right-side and left-side. The values of the
right head angle on the right-side (94.1°) was 9.3° smaller
than that on the left-side (103.4°). Correspondingly, the left
head angle from right-side orientation (126.1°) was larger
than the one to the left-side (117.9°). The total head angle
determined by adding the values measured on both left
and right sides was on average about 220° and did not
differ between the two playing orientations.
The angles of the neck lordosis were significantly differ-
ent between both orientations. The neck in the right-side
orientation (151.9°) was 4.8° more curved than in the left-
side one (156.7°). Additionally, the thoracic kyphosis
showed a significantly smaller angle on the right-side
(154.0°) than on the left-side (157.3°). The conclusion of
these findings suggests that the upper spinal column has a
stronger flexion when the player was oriented to the right
of the music stand than to the left of it.
Mean elbow angles were 70.9° to the right-side and 74.2°
to the left-side of the stand. Therefore, the bowing arm was
on average about 3.3° more bent when the player was ori-
ented to the right of the music stand. Maximum values of
the elbow angle were statistically different, with a 107.9°
angle right-side and a 125.2° angle left-side. A significant
difference was also found between the minimum angles of
the elbow, where the angle right-side (49.3°) was larger than
left-side (46.9°). From this it follows that elbow range of
motion is generally smaller when a player is oriented to the
right of the stand than to the left. The calculation of the
range of the elbow angles yielded a significant difference
(t=2.236, p=0.042) between the motion amplitude of 58.6° in
the orientation right-side and 78.1° left-side of the stand. In
summary, these findings show that the orientation to the
right of the music stand results in more restricted mobility.
Questionnaire
The analysis of the questionnaire showed that the partici-
pants clearly preferred a standing posture to a sitting one
(16 out of 19). They argued that they have a larger moving
space for the bowing arm and for the whole body, feel
greater body stability, and have a better ability to concen-
trate in a standing position. Eleven participants practiced
in standing positions. The others changed to a sitting posi-

90 Medical Problems of Performing Artists

tion after a while or when they felt tired. All participants
reported to playing in a standing position during lessons
and in sitting positions in concerts.
In the sitting position with orientation to a music stand,
16 of the 19 participants preferred the right-side of the
music stand. The reasons given were: a better feeling while
playing; perceiving a larger range of motion, especially in
the bowing arm; a feeling of less muscular tension; and
habitual familiarity with this orientation. Arguments for
the preferred orientation to the left of the music stand
were the feeling of a smaller body rotation and the greater
comfort to look at the conductor.
Sixteen out of 19 participants reported to having had at
least one health problem related to instrumental playing.
They described problems as a pain in the back (n=9), in the
lumbar region (n=9), or in the os sacrum (n=8), tenosynovi-
tis (n=8), or pain in the shoulder and elbow (n=3). A delib-
erate change of playing positions in relation to the music
stand for health reasons was not performed. There was no
correlation between having a playing-related health prob-
lem and the preferred position or orientation.
DISCUSSION
Standing vs Sitting
Posturography
The posturographic measurements showed a nearly bal-
anced weight distribution between the right and left foot in
the standing position, whereas in the sitting position the
left sitting bone was more heavily loaded than the right
one. Playing the violin, however, demands an asymmetric
body posture due to the instrument which rests on the left
shoulder. The left arm holds the instrument and can only
make restricted movements in the sagittal plane, whereas
the right arm performs large movements to guide the bow.
A pressure distribution with an overload on the left
side can therefore be explained by the bowing movements.
Similar to having a supporting and a playing leg in the
standing position, the surplus load on the left side might
be compensated through the left trunk side to keep this
side stable. With that adjustment, the right side would
then be flexible enough for the bowing during perform-
ances. This flexibility is necessary for performing bow
changes and string changes that occur several times in the
whole piece, especially at the change from bar 4 to bar 5
between G-string and E-string. Other authors also men-
tioned the importance of the freedom of movability of the
right body side.4
In the standing position, the necessary flexibility of the
right arm can easily be achieved through a freely movable
pelvis. In the sitting position, the total movability of the
trunk is restricted by the contact of the pelvis on the chair.
Therefore, the imbalance in the sitting position is proba-
bly due to the asymmetric instrumental posture, the
restricted movability of the pelvis, and the limited possibil-
ity to fully balance between the two sitting bones.
Motion Analysis
The 3D motion analysis showed that the angles in the tho-
racic kyphosis, the minimum values of the shoulder and
hip angles, as well as the maximum angles of the lumbar
lordosis to be larger in the sitting position than in the
standing position. Comparatively smaller values were
found in the maximum shoulder and elbow angles for the
sitting position than for standing. At the same time, the
range of motion in the shoulder and elbow was smaller in
the sitting than in the standing position.
The values of thoracic kyphosis indicate a balancing
behavior of the unilateral weight load of the violin
through movements in the back. However, the results
showed a stronger curved back in the standing than in the
sitting position. A clear interpretation of the angle
changes is limited due to the setting used in the study. A
reduction of the corresponding angles can lead to an
increase of the natural spine curvature in terms of a phys-
iological spine lordosis or kyphosis or a lateral scoliotic
back curvature. The similar range of motion of the tho-
racic kyphosis in standing and sitting positions, however,
shows that over the complete playing time, the general
back curvature was kept even, to which the playing move-
ments were attached.
While large movements of the whole body are easily
performable in upright position, in sitting position the
lower trunk is nearly motionless. Therefore, the back area
between flexible and inflexible trunk segments is heavily
used. Muscles, joints, and ligaments in the spine column in
this area encounter extreme shearing forces from the
movements in the upper trunk parts. It is not surprising
that nearly all participants mentioned problems in the
back areas in their history after an orchestral perform-
ance. Other studies also showed that back pains in the
area of the lumbar portion of the spine are quite common
for violinists.9
The larger maximum and mean values of the elbow
angles in the standing position compared to the sitting
position provide evidence for generally larger amplitudes
of the elbow joint. This can be seen in the extension of the
forearm and the larger range of motion in the elbow
during playing and the up- and down-bowing. In the sit-
ting position, however, the elbow was more bent. Here, the
arm is, even by playing at the tip of the bow, obviously less
extended than in standing position.
On the contrary, Seidel and Lange9 described that opti-
mal force effort and accuracy of movement are given espe-
cially in the middle position of the joints and through a
medium elongation of the muscles. An excessive extension
in the elbow joint in the standing position, similar to an
extreme flexion, does not meet the ergonomic range of the
upper extremity. The use of the muscles beyond their opti-
mal range of performance, however, cannot be avoided
while playing the violin due to the close head position of
the instrument and the resulting unnatural posture and
motion patterns.
June 2014 91
 Right vs Left of the Music Stand
Posturography
Pressure distributions of the posturographic measurements
showed that when sitting in an orientation to right of the
music stand, the body weight rests mainly on the left sit-
ting bone (60.0%), while to the left of the stand the weight
is primarily on the right sitting bone (55.5%). Hence, rela-
tive to the music stand, the contralateral body side is
slightly more loaded.
In total, the body weight is distributed somewhat
equally in the orientation left of the music stand: both sit-
ting bones are evenly loaded, whereas in the position to
the right to the stand, the sitting bones were considerably
unbalanced.
Considering that the human body is a closed system, a
weight overload on one side results inevitably in an asym-
metric body posture. As the sitting position implicates
already an increased burden on the lumbar intervertebral
discs,10 an asymmetric posture in this position leads to
additional physiological stress. Moreover, in the sitting
position, the body weight rests nearly completely on both
sitting bones.11 To adjust unilateral weight strains in this
position, the body can only use the upper body parts.
Apparently, this balancing is easier in the orientation to
the left of the music stand than to the right of the stand.
Possibly the trunk rotation to turn to the music stand pre-
vents some movement adjustments.
Nevertheless, proper evidence for the reasons behind
the different weight distributions in both sitting orienta-
tions cannot be found using the posturography alone.
With this method, however, it became clear that a differ-
ence in the weight distribution due to the sitting orienta-
tion relative to the music stand exists.
Motion Analysis
The detailed analysis of the body movements showed that
the head angle is about 10° smaller in the orientation right
of the music stand than to the left. Therefore, the head is
more tilted when oriented right of the stand compared
with left of the stand and to the standing position.
The spinal column in the area of the neck lordosis and
the thoracic kyphosis is less bent in the orientation to the
left of the music stand. Also, the range of motion of the
spine is larger when sitting left-side. Both findings lead to
the assumption that a less curved body posture is assisted
by larger movability. The violin performance on the left-
side of the music stand is more physiological than on the
right of the stand. In addition, the symmetric head posi-
tion also indicates an ergonomic body posture in the ori-
entation to the left of the music stand.
Furthermore, the elbow joint showed a larger range of
motion on the left-side than on the right-side. The arm
was more extended, as shown by the higher mean values
of the angle. The analysis also showed that the movement
amplitudes on the left-side of the music stand matched the
92 Medical Problems of Performing Artists
motion range of the standing position, while the restricted
range of motion on the right-side of the stand corre-
sponded more to the frontal sitting position.
The more bent posture of the right arm and the
restricted movability by playing right of the music stand
could be provoked due to the rotated trunk. On this side
of the music stand, the player has to turn left to see the
score. The right arm seems to adapt to this rotation. On
the left-side of the music stand, the left body side turns
slightly to the right, in which the movability of the right
arm can stay unchanged.
These results provide many reasons for a more bal-
anced sitting position left of the music stand. Interestingly,
these findings contrast with the subjective statements of
the participants: in addition to the standing position, the
preferred sitting position was the orientation right of the
music stand. Compared to the findings, they argue against
a larger range of motion and a better body posture. More-
over, performance on the right side of the music stand was
described as more familiar and therefore as more comfort-
able. It is possible that certain kinds of psychological fac-
tors, such as the hierarchy in the orchestra or the visibility
to the audience, could cause the preference. More research
is needed to address the influence of these factors.
Velocity of the Bow
To achieve consistent rhythmical and musical playing per-
formances in the standing and sitting positions, in the sit-
ting positions the restricted elbow motion range should be
compensated for elsewhere. This could be accomplished
through movements of other joints of the right arm, such
as the shoulder or wrist. Movement analysis data, how-
ever, showed that neither the shoulder nor wrist per-
formed different activities in both positions.
Otherwise, smaller amplitudes of the elbow angle indi-
cate a sparing use of the bow length. This, however, leads
to a reduction of the bowing velocity to maintain the given
tempo. The angle velocity of the right arm is given by the
elbow angle over time. For this, the mean angle range
between up and down strokes was used. As the time was
constant through the metronome and the stroke behavior
was identical for every player, these angles represent the
velocity. In the standing position, the value of the velocity
(v=57.8°/s, SD 31.7, n=14) was significantly higher than in
the sitting position (v=35.3°/s, SD 17.4, n=14; t=3.351,
p=0.005). Therefore, it can be assumed that the player has
to use more pressure for the bow in order to keep the same
dynamics of sound quality. This behavior, however, could
affect directly the health of the shoulder and back muscles.
CONCLUSIONS
The results of this study showed clear differences in the
movement patterns and the body weight distribution to be
related to the position and orientation of the violinist rel-
ative to his or her music. Body movements in the standing
and sitting positions as well as in the orientations right
and left of the music stand differ significantly from each
other. Data analyses showed that the sitting position in
comparison to the standing position—both in front of the
music stand—and the sitting position in orientation right
of the music stand in comparison to left of the music stand
encourage more restricted and potentially physiologically
problematic movement patterns. Due to the commonly
reported musculoskeletal problems for string players (for a
review see Ginsborg et al.12), these results suggest that pos-
sible health problems may be among others related to the
playing position. More research is needed to clarify the
degree to which these factors, playing position and orien-
tation, contribute to risk of musculoskeletal injury.
The presented findings clearly recommend conscious
consideration of the different playing positions, especially
for professional players. Consequences for the playing
practice could be the variation of the playing positions in
order to practice the flexibility of the motion system. In
orchestras, specific exercises could be integrated for pre-
vention of disadvantageous motion patterns. In summary,
this study emphasizes the importance of considering the
playing positions and seating orientations as a matter of
fundamental vocational health and wellness for violinists.
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