Ouch?  No!!  Try Pain Prevention!

If you are experiencing pain as a result of playing the hammered dulcimer or autoharp, OR if you want to make sure you never play in pain, OR if you are a doctor or therapist looking for practical ways to help an injured dulcimer player or autoharpist (or any other musician), I offer this web page to help you begin investigating and reversing the situation.

I am neither a doctor nor an injured musician.  My interest in playing the dulcimer and autoharp, and in teaching others to play these instruments, began decades ago with learning how to produce musical sound.  Little did I know when I began researching the functions of musicality for the hammered dulcimer in 1986 that they would include healthy playing movements, but they make sense.  Studies in Body Mapping now augment my focus on musicality by including how to avoid discomfort, pain and/or injury.  I also regularly discuss injury and movement issues with medical professionals and movement specialists to clarify causes of pain.  These discussions sharpen my observations of hammered dulcimer players and autoharpists (and musicians of other instruments!) at play, while developing viable solutions to playing the hammered dulcimer and autoharp pain-free.

I hope what’s here will help you or someone you know continue to play the hammered dulcimer and/or autoharp with joy and abandon forever!

DISCLAIMER: This page is meant to serve as a guide towards identifying potential cause(s) leading to discomfort and pain; it is not an ultimate diagnostic tool.  To narrow the field towards a specific cause and a thorough plan of action for reversal, see your doctor before engaging a movement specialist or a musician who plays your instrument and is knowledgeable about training healthy playing movements.


Generalities About Making Music
First, See Your Doctor
Easy Fixes?
Accepting Retraining of Learned Habits
Identifying Causes:

         ergonomics:   Hammered Dulcimer      Autoharp
         Some Basic Body Movements:   Hammered Dulcimer     Autoharp

Avoiding Confusion
Fixing the Mess!
Practical Applications

This page was first released into Cyberspace on Tuesday, June 20, 2006 at 5:10pm MST and was last updated on March 19, 2015.


I had the privilege to attend the presentation given by Lucille Reilly, titled Beyond Diagnosis: Retraining the Hammered Dulcimer Player, at the 24th Annual Symposium on Medical Problems of Musicians and Dancers in Aspen [now Snowmass], Colorado.  I was extremely impressed with Ms. Reilly’s analysis of the biomechanics, anatomy and alignment that is necessary for the dulcimer player to safely and effectively play the instrument….Her understanding of what is necessary, both from the anatomical and ergonomic perspectives as they relate to the playing of this instrument, is outstanding.       —Michelina C. Cassella, PT Director, Department of Physical Therapy and Occupational Therapy Services, Children’s Hospital, Boston, Massachusetts

“Lucille Reilly has a rare gift of intuiting connections between problematic action and causation.”       —Joseph H. Winston, M.D., New Jersey

Lucille’s conclusions are consistent with my long-term personal study of soft-tissue and neural-muscular injury (I suffered serious, non-music-related accidents in 1990 and 1998).  Her insights and discernment have boosted my musicality on the hammered dulcimer, brought me greater expressive freedom with the dulcimer and other instruments, and aided my general recovery as well.       —Scott Reeder, hammered dulcimer player Music for All Seasons, New Mexico, USA

Thanks, Lucille.  This is good stuff.       —Kathy Durant, dulcimer player and teacher, Maryland, USA

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Generalities About Making Music

  • “You can play any way you want.”  “There is no one right way to play.”  While these are popular statements in folk-music circles; they are often misapplied to the techniques of music-making (see next point).  But both quotes refer to the creative realm of making music, once logical techniques–the glue of music-making, if you will–are mastered.  If you experience discomfort or pain when making music “any way you want” in the technical sense, you have found a wrong way to play.
  • Movement differs from technique.  Technique is a method of finger or hammer order, covering and uncovering certain holes/valves on wind instruments, bow-stroke direction/length, etc.  Movement, on the other hand, mostly involves what goes on in between strikes/fingerings, etc.  There is no guarantee that healthy, free movement automatically comes with the best technique the finest teacher can give us.  (Before I realized the importance of movement, my students didn’t play as well as they could have, even though I was doling out sound technique they could hang their hats on.)  Further, technique influences movement: To the intuitively lucky musician, the stroke or finger order that comes from “playing any way you want” may also permit moving well, but when the stroke or finger order is awkward or haphazard, movement can become awkward or non-existent, making beautiful phrasing and other musical results harder to come by.
  • The more the entire body (including the arms) moves as a coordinated whole, the freer the movements are.  Conversely, directing movement towards one body part (such as thumbs, fingers or wrists, often recommended in the interest of avoiding mistakes) can invite rigidity leading to discomfort, pain or injury.
  • Every musical instrument is a mirror, reflecting whatever the musician puts into it.  When the music sounds resonant, the musician is playing freely.  When the music sounds tense, tinny, or thin, it is the result of excess physical tension in the musician.  Therefore, making music is a 75-25 proposition: 75% player and 25% instrument, not the other way around.  Remember this before you look around to replace your current instrument with a “better” one!  You may already own the gold you think you don’t have.  An instrument’s sound always improves when the musician knows how to move well.

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Why do some people hurt when they play, while others do not?  Is it luck?  Heredity?  Giftedness?  Something else?  Here are a few thoughts:

  • Heredity: A physiatrist once shared with me that a “rectangular” wrist is less prone to Carpal Tunnel Syndrome than a “square” wrist.  That’s because a rectangular wrist posits its bones in a wider arc (or tunnel) to surround the median nerve.  To determine your wrists’ shape, lay a ruler across the back of one wrist and look at the measurement, then hold it upright alongside the wrist and make note of that measurement.  If both measurements are the same or very close, you’ve got a “square” wrist; if they are markedly different, your wrist is rectangular.
  • Familial influence: Over-tensed, everyday movements can be unknowingly passed from one generation to the next, and considered to be “the way it’s done.”
  • Music making: How can some people can practice or jam for hours and not hurt, while others feel pain after a few minutes?  (It’s so unfair!)  After all, you would think that players who hammer or pick fast would eventually play in pain.  Not necessarily.  I jam at all tempos for hours, and stop only because it’s time to get some sleep, not because I ache.  Is it luck?  I don’t think so.  I’ve been keen on moving well since my early teen years.  Those who don’t hurt after playing at lightning speed may move well without realizing how they do it.  If you play lots of fast tunes and experience discomfort/pain, watch yourself play to find out why you hurt.  The wonders of modern technology now give us many ways to video ourselves via cell phone, mobile device or computer.  My favorite “device” is a 12×12-inch mirror from a crafts store placed on a music stand (no worries about battery life).  A note to dulcimer players: You will surely make a lot of mistakes while looking in the mirror instead of at the strings.  Do your best to focus on what you see more than on what you hear. Someone who plays slow tunes all the time may never play in pain—but then again, they may be playing slowly because of the limitations imposed by awkward movements.  Every time someone tells me they prefer to play slow tunes, I can only imagine that they must be moving awkwardly.  So knowing how to move in between striking the notes is key to moving freely and well.
  • Finally, some hammered dulcimer players and autoharpists may claim those areas I have labeled here as being potentially injurious are off-base because they’ve been playing the way they have “for years with no problems.”  They would do well to consider the previous points in this section.  Maybe they’ve been playing a certain way “for years,” but what kind of music, how often, and for how long at a stretch?  Could it also be, because these players have never tried other approaches to compare to what they’ve been doing all along, that they do not know whether or not they play in pain?  For example, until I raised my autoharp four inches above my lap atop a hip pouch, I had no idea how much needless tension I had been working against in the entire right side of my body–for 16 years!  It’s easy to believe in “comparison shopping” after that kind of positive experience.  It can take courageous willingness to entertain a new approach and listen to your body as well as your music-making, but I encourage you to try.  Accepting the possibility that a new approach may afford greater ease of playing than whatever was dreamed up or taught can be a fantastic learning experience.  The point to remember is this: how we make music is not about “no pain, no gain.”  It’s about no pain, period.

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First, See Your Doctor

If you suspect that playing your instrument is causing bodily pain anywhere—in the wrists, along the arms, through the back, even behind your knees—get a check-up from your doctor first to rule out unrelated, organic causes (previous injury from an unrelated accident, cancer, congenital issues, and so on).  As this page can only suggest generalities, every case is different and is best evaluated by a medical professional before you investigate further.

If your doctor decides your pain is “mysterious” (and, for example, nothing shows up on an X-ray to support the thought of arthritis), perhaps moving awkwardly when playing your instrument is the cause.  Talk with your doctor about movement retraining, and who out there might be able to help you with ergonomics, techniques and movements.

If you choose to work with a dulcimer or autoharp instructor, find someone who has developed the skills necessary to observe you at play and help you retrain basic habits.  The last thing you want is new tunes with a focus on right notes. One of my doctor friends says he is fine about a patient seeing a non-medical professional who can help him/her overcome a problem.  (It is unlikely that health insurance will cover music lessons, but you can always ask your trainer.  Perhaps s/he and your doctor can confer about how to go about getting coverage.)  A handful of weekly lessons with an instructor knowledgeable in movement issues can be worthwhile towards helping you get on track.

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Easy Fixes?

Everything in the following list has been bantered around the block more than once, with reasons pro and con offered:

  • Stretching exercises, massage and acupuncture: Certainly okay, but if you move awkwardly while playing your instrument, all the good these therapies are supposed to do will cancel out at the onset of playing.  “Shaking out” gently when you play can do much the same thing, and it won’t cost you a dime.
  • Drugs: Non-steroidal, anti-inflammatory drugs (NSAIDs for short) offer temporary relief, but not a cure.  Do you really want to spend the rest of your life taking NSAIDs for your music-making?  Revising the injurious playing habits to eliminate the pain offers a stronger, more permanent way to reverse injury.  And as I said earlier, the instrument’s sound always improves when the movement does.
             I would not take a NSAID before performing a concert, playing at a jam session, practicing, especially without the benefit of retraining in place.  The NSAID will mask the pain, but any awkward movements you continue to nurture without retraining may do further damage because the pain is “gone.”  To this end, pain can be a worthwhile indicator, especially when retraining.  Every time you play, you will feel the pain go away, which will tell you that you are healing!
            If you must take a NSAID (after all, they will reduce inflammation), try to save it for inactive times, such as when reading a book or at bedtime.
  • Ice/Heat: Like NSAIDs, do you really want to ice or heat a body part before every practice session or performance?  (I’d rather use my pre-performance time to focus internal energy on details related to the concert program.)  Use ice or heat as directed to assist retraining in progress, rather than as a “band-aid” to cover up unaddressed, awkward movements.
  • Cortisone and BOTOX shots: If either of these are recommended, tread slowly and do some homework first.  Movement specialists are concerned about these therapies because of potential side effects.  Consider cortisone or BOTOX as very last resorts, especially as they may require repeated doses in the future.  Consider retraining your movements first to see if it improves your situation.
  • Surgery: Consider surgery as a very, very last resort.  If yours is an extreme case, this kind of intervention may be required.  You’ll need to decide how extreme it is.  Again, tread slowly and do your homework before agreeing to a procedure.  If you opt for surgery, look beyond it, too.  You may still need to retrain your music moves following any general physical therapy.

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Accepting Retraining of Learned Habits

Injured musicians of all ability levels can be tentative about undergoing revision of now-failed, learned habits cultivated over months or years.  For the self-taught musician, pain can also strike a blow to one’s sense of pride as certain invented techniques show themselves to now require “unventing.”  And on a gut level, hurting from playing your musical instrument can seem embarrassing or even stupid, but it’s still very real.  If you’re hurting, you have found a wrong way to play that needs revising, even if you were taught to play that way. You do have another choice: you can decide to live with the pain.  If that’s the case, especially if music is your life’s work, then I would consider what will happen when the pain worsens to a point where it hurts so much that you cannot play any more.  Sadly, a few among our ranks have stopped playing because of pain.  I believe firmly that this doesn’t have to happen.

The main questions injured musicians ask are:

  • Will I need to learn how to play all over again?  To a point, yes.  Some habits will be fine, while others will need to change.
  • Will I be able to play my repertoire again?  YES.
  • How long will it take?  No idea.  Some aspects can change immediately, while others require guidance over time.  As one example of immediacy, several years ago one of my students began to feel back pain playing the hammered dulcimer.  When he struck the courses furthest away, he intuitively stood to play with one foot slightly ahead of the other for balance.  This was fine—except it was the wrong foot!  When he put his other foot slightly ahead, his back pain went away immediately.  I can’t guarantee a similar “cure” in every case, but sometimes instant relief can be realized once the student engages in exploration or receives a little practical information. On a personal note, I suffered a computer injury in front of my left shoulder some years ago.  Thinking it was an old bicycle injury returning to haunt, the truth came to the fore during a week-long Body Mapping course I attended: I’d conjured up a faulty approach to typing computer keystroke commands (it seemed so incredibly clever!).  The first two weeks were the hardest because I had to stop and think every time a command came around.  It took 4½ months for the pain to go away, but it did go away, and I’ve had no problems since.
  • You will probably play a lot of wrong notes at the onset of retraining because you’ll be thinking more about the How of playing than the What.  Fear not!  Music is much more than about right notes (you should hear the beautiful wrong notes my students routinely play!).  I promise you that your repertoire will come back with a bonus: your instrument will gain resonance and gorgeous tone when you can play with physical freedom.

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Identifying Causes

Okay, so you’ve decided to retrain.  (Good for you!)  What follows is a troubleshooting guide of pain-causing culprits (listed under Ouch), followed by the usual solutions I offer to my students.  My recommendations are based on teaching and observing hundreds of students.  Note that my solutions are briefly described, requiring further details to really make them work.  You can always contact me for help, too.

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ergonomics is a great start, gaining more steam in folk-music circles these days.  Just remember that it is only a start.  Techniques and movement factor in to complete the healthy playing picture. Below are some ergonomic areas you can check.

Hammered Dulcimer

The dulcimer’s course spacing

The closer the courses are (measured from the top string of one treble course to the top string of the next treble course above or below it), the smaller the body movements can be (as noted by the occupational therapist of an injured dulcimer player).  This spacing is often found on “miniature” dulcimers small enough to carry onto an airplane.


The optimum course spacing is anywhere from 7/8 of an inch, to 1¼ inches.
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Seating (for those who sit to play):
  • A high stool, with feet placed on its rungs, impairs balance.
  • Any chair that sets the dulcimer too high to the forearms (elbows close less than 90 degrees) or too low to the forearms (elbows open almost all the way).
  • Maybe: A folding chair whose seat typically slants away from the dulcimer.  Notes: Ergonomic chairs for other instruments (bass, percussion, etc.) are designed for musicians of specific instruments and aren’t necessarily universal to everyone.  Also, a chair labeled “ergonomic” may not be worth the expense.  Along these lines, there are no ergonomic chairs for the hammered dulcimer that I know of.
  • A folding percussion stool with a depression in the middle of the seat cushion causes the spine to perpetually hunch forward.
  • A chair or chair-height stool with a flat seat, or whose seat slants slightly towards the dulcimer.  The slant opens up the hip joints and feels great.
  • Seat height factors in.
  • Sit on a chair that sets your lap either level or slanting slightly down towards the knees.  See the dulcimer’s Height section for help with set up.
  • Set your feet flat on the floor and under your knees for balance.
  • If you have to sit on a folding chair whose seat slants backward, sit on the front four inches.  Your back will be off the chair back and well forward of it.  Note: Old, wooden folding chairs aren’t balanced the same as metal folding chairs; they tend to flip forward when you sit on the front end.  Don’t wind up on the floor!  You can always level a backwards-slanting chair seat or slant it forward by setting equally high stack of magazines or books under both rear legs.
  • The artist’s stool, available at large craft-store or your local hobby shop, is a narrower, more affordable (albeit less comfortable) version of the old rotating piano stool.  If you’re good with woodworking or know someone who is, make a larger, more comfortable seat and cushion for an artist’s stool for seating that will work anywhere.

Click here if you need to return to ergonomics for autoharp.

  • I do not understand how any dulcimer player can survive a tilt of 30 degrees and greater.  For example, when I played my dulcimer at 40 degrees of tilt as part of a personal dulcimer-stand study (see the Comment following the “Aaah” section below), I experienced excruciating pain in my upper arms after only ten seconds of hammering.  I also felt like I was going to choke.
  • When standing to play, tilts of 5 degrees and less don’t work, either.  The knees lock, immobilizing the rest of the body.  When sitting to play, a dulcimer at this very slight tilt becomes so low that it eliminates adequate space for the player’s legs underneath.
  • Playing the dulcimer at a negative tilt so that the audience can see the hammers: Maybe this is a wonderful visual gesture for the audience, but take care of yourself first.  Negative tilts lock the knees, something that’s not so good for one’s back.
  • Maybe: Non-adjustable dulcimer stands having one tilt available.  If the tilt is within the ranges listed in the “Aaah” section, you are very, very lucky.

The tilt ranges I recommend for the most free and easy playing are:

Standing: 10-15 degrees               Sitting: 20-25 degrees

When tilt is combined with height (see next section), these ranges generally work for everyone, regardless of personal height.

Comment: The above tilt ranges are the result of an informal dulcimer-stand study I performed in 2006.  The study began with standing to play, first by tilting the dulcimer to 40 degrees.  From there the tilt decreased in 5-degree increments through zero to -5 degrees.  (Note: Stand height changes with tilt; see Height for more.)  At each tilt, I played all of the major scales on my 15-15 dulcimer followed by five tunes that collectively took my hammers all over the dulcimer’s strings.  I then repeated the same process for sitting to play.  All the while, I tuned in to how my body felt.  I wrote down those sensations, noting which tilts allowed the most bodily freedom and resonance.  An inclinometer quickly measures tilt, although this carpenter’s tool is a little pricy unless you teach and can use it a lot with students and workshop attendees.  If you need to check yourself once or twice, my paper Tilt Tool, which includes instructions for assembly and use, is an inexpensive alternative.

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  • Any “high” height that points the forearms decisively upward perpetually.
  • Any “low” height that opens the elbows enough so that the forearms perpetually slant down: the “drag” of forearm weight is felt. Note: the steeper the tilt, the higher the dulcimer, and vice versa.
  • I recommend these set-up distances between a stationary hammer head’s striking surface and the center course:

Standing: 3 inches            Sitting: 0 inches

  • These findings coordinate with hammer action that comes mainly from the arms (not by manipulating the hammers down and up by flexing the wrists or thumbs).   Note: Both measurements are approximate!  If you are very tall or short, or your hammers are shorter or longer “than normal,” you may find more comfort by allowing for more or less set-up distance.
  • A fully adjustable parlor stand in both tilt and height will help you experiment (you may not want to purchase one as a mainstay because it is heavy to carry around at festivals).  If you can, borrow an adjustable stand to determine the height that’s best for you, then you can build a lightweight stand to those specs or have someone build it for you.
  • Before you determine height, be sure to include shoe heels and/or chairs.  High heels and/or thick soles, even when sitting, change the lap’s orientation.
  • To set height, have a friend or family member close by to help, and hand this person a ruler.  Hold both hammers over a course in the center of the treble bridge (this is usually the G-D treble course), with forearms parallel to the floor and elbows directly underneath your shoulders.  If your hammers overshoot the G-D course, take a small step backward from the dulcimer, or move your chair backwards just a little.  Now ask your helper to hold the ruler vertically over the center course and then measure the distance between the hammers’ strike surfaces and the course.

Note: The dulcimer’s new height as described here may not “feel better” at first.  Expect it to feel different for a little while—sleep on it, in fact!—and you may find soon find it to be quite freeing.

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BONUS: String View

Once tilt and height are established as described above, your next goal is to be able to see the strings’ crossover point between the main bridges so that the treble and bass strings “angle towards” each other; see the photo below.  If the strings look parallel, even though you have set the tilt within the stated ranges, you may be standing or sitting too close to the dulcimer.  (No, you may not need glasses for depth perception.)  Step back some until you see the strings angle; they will also cross-hatch between the bridges.  This makes it easy to tell treble and bass strings apart. If backing away creates other string-vision challenges, see your eye professional. Angled strings may look odd at first, especially if your dulcimer’s tilt made a radical shift downward, but their benefits are being able to see a lot of strings at once (great for negotiating large leaps) and opening/freeing the arms.

I can’t thank you enough for all the dulcimer stand information.  I came home [from the workshop you taught in Albuquerque, New Mexico] and immediately *fixed* my two dulcimer stands.  I feel much better….The new [tilt and height] makes playing so much easier, not to mention more accurate.  I didn’t realize how much I was “fighting” the dulcimer’s set-up.  Thank you for everything!!

—Harriet Marvin, beginning (not rank any more!) dulcimer player

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  • Hammers with handles whose top sides are curved.
  • Double sided hammers, unless both sides of the handle are flat or very slightly curved
  • Holding the hammers “any way that’s comfortable.”

Comment: What’s the problem with hammers having a deep curve on the top side of the handle?  After all, if top-side curves on the handles are all you see out there, they must be okay, right?  I plead for a little research and development: Look at how the hand holds this handle.  The top-side curve forces the thumb to approach the hammer at an angle to the shaft because a “nub” on the back end of the handle is in the way.  As a result, the hammer is usually held by the tips of the index finger and thumb.  This may not seem like a death grip to those who use it, but in reality the thumb is placed under significant, unnecessary tension.  It needs to add pressure so the hammer won’t go flying!  When the hammer goes down and up in play, the already rigid thumb resists flexibility, inviting discomfort or pain in the thumb itself, the wrist, anywhere in the arm, and/or the upper back.  Furthermore, the sideways thumb approach invites players to manipulate the hammers down and up with the thumbs or wrists (see Movement for more).  This is also part of the reason why a dulcimer can sound sharp and tinny.  Wonder no more why a slender object weighing only 8 grams can cause injury!  It’s happened more times than I care to know about.


Note: This section assumes the player has “normal” hands and fingers. Some adjustments will need to be made to accommodate arthritic hands.

  • The handle is flat on top.
  • The handle may be flat or curved on the underside.
  • A rigid shaft: the hammer finds flexion in the circular hammer hold (described below).
  • The hammer heads are single sided, which means you can’t flip the hammers over to strike the strings with a different surface.  Buy a second pair if you need a different sound.
  • A circular hold: All fingers, with sides gently touching to support the thumb, curve easily around in a circle when viewed from the top and are free to adjust when you need them to.  The view from above will look like anything from a triangle with straight to bulging sides, depending on your hand’s girth.  Look for a bend a little larger than a right angle at the first knuckles down from the wrist (at arrow in the drawing below right).  In this hold, the handle rests between the creases on the index finger.  About half of the thumb lays atop the handle in line with the shaft.  The thumb’s fleshy pad secures the handle over the middle of the index finger so it won’t go flying.  In this way, the hammer becomes a natural extension of the forearm.








  • Move the forearm–not the wrist!–down and up so that the hammer swings down and up on its own. Aside from the circular hold magnifying dulcimer resonance, subtle finger and wrist adjustments create dynamics, rolls, and other musical effects.

Hammers with flat-topped handles can be found here.

  • A flat-topped handle isn’t a cure-all.  It can still be held by the digit tips with the thumb approaching it at an angle, but at least the circular hold is possible.
  • The circular hammer hold can feel radically different (not to be confused with “uncomfortable”) if you’ve been playing for a while, so feel free to contact me for an in-person or Skype/FaceTime lesson to help you get going.  Setting up the hold is fast, although it takes a little getting used to.

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Most of what follows applies to holding the autoharp upright and sitting to play, except where otherwise indicated.


See the seating description for Hammered Dulcimer.  (If you stand to play, click here.)

Rest points for the autoharp

Leaning the autoharp against the button arm (usually the left arm) immobilizes the string arm.


When sitting to play and the autoharp is situated upright, the autoharp rests securely on these three areas (to be elaborated upon shortly):

  • The autoharp’s lower treble corner (the corner nearest the shortest string) bears weight on the lap or a filled hip pouch (see below).
  • The upper chest (localized to the top side of the left* breast on women)
  • The left* side of the jaw.

*Or “right” if playing a “left-handed” autoharp.

Note: Anatomical differences in men and women require different set-ups.  Viewed from either side, a lean man can play the autoharp upright at dead vertical and have the strings relatively close by, but the “anterior protrusion” of women (and some men) requires the autoharp to lean against the upper body at a forward slant in order to gain similar “in-touch-ness” with the strings.


Using an arbitrary body part as a reference point (like the top of one ear).
Wondering if your arms are too short to get around the autoharp.

Comment: The best autoharp height for each player is established by upper-arm length.  While aligning the top bass corner of the autoharp with the top of the ear may suit one player, it cannot work for all.  After I set up an autoharpist who was 4’8” tall, the top bass corner of her standard-sized autoharp was two inches above her head!  A bodily reference point is okay for you once you’ve established a workable set-up.  Just remember that the next autoharpist’s reference point is bound to differ.


The hip pouch: For many years, I raised my autoharp to my arms by crossing my left leg over my right.  That all changed in 2006 when the hip pouch holding my wallet and car keys transformed into an essential autoharp-support accessory.  Ever since, I have played with legs uncrossed and both feet solidly on the floor.  Perhaps the best part when I first used the hip pouch was all the tension that released over the entire right side of my body that I didn’t know I had.  As a result, my string hand’s endurance increased. Raising the autoharp is my consistent cure for those who say they have short arms.  (The odd part of this statement is that, as of this writing, everyone I’ve set up has longer arms than I do, and I’ve had no problems getting my arms around an autoharp!)  For more, see Arms below. Hip pouches vary in size and design.  Check your local thrift or charity shop for bargains.  Features to look for:

  • A curved lid, with the zipper, not a seam, curving along its edge.
  • A capacity for ¾-1 pound of peanuts in the shell.  The CD in the photo below offers a general idea of pouch size.  (The lid’s size at its widest point from front to back is 3 1/4 inches, excluding the black zipper tapes.)
  • A belt long enough to surround you with a LOT of room to spare.


When you find a workable hip pouch, fill it almost to the top with peanuts in the shell.  Use real peanuts; Styrofoam peanuts flatten!  You can also use large, dry legumes, although the amount may be 1 1/2–2 lb.  If you don’t mind the weight, fine; just be sure to keep the pouch away from water sources.  When filled, look for a shallow well in the center of the lid Loosen the pouch’s adjustable belt so that it can be slung very loosely over the hips.  With the clasp latched, I can slip mine off over my hips.  (You may or may not be able to slip yours off your hips, but this is just to say that the belt may need to be much looser than you think.)  If the belt is too short for generous loosening, thread a strong twine or rope or an old necktie through both loops of adjustable webbing near the clasp, then secure with a square knot (right over left, left over right).

If the autoharp needs to be higher than the hip pouch can raise it, place a folded hand towel on your thigh, under the pouch (not under the autoharp).  Fold the towel various ways to create the number of thicknesses you need. The hip pouch doesn’t work for everyone, but it works for most, even if its only drawback is that you have to sit to play.


Holding the autoharp upright with the strings perpendicular to the floor.


How to wear the hip pouch and place your autoharp atop it: Center the pouch on your left thigh (or right, if you play “left-handed”) and then shift it a little towards your center.  Set the autoharp’s bottom treble corner atop the lid.  This corner will probably slide away from you, towards the zipper, which is fine.  The zipper tape will act as a brake, preventing the autoharp from falling off (that is, as long as the lid and zipper are curved and the pouch is slightly underfilled).  Now tilt the autoharp so that its angled side (where the tuning pins for the higher strings are) runs perpendicular to the floor.


Lap playing (arms crossed or uncrossed): Experiment with turning the autoharp at different angles on your lap, instead of positioning it so that the strings are horizontal to your body and your view and strumming feels easy.


Attach a guitar strap to the top and bottom bass corners to hold it securely.  Be sure the strap is loose enough; depending on your girth, the bass side of the autoharp may or may not contact the front of your body.

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Playing with the elbows and upper arms against and/or next to the sides of the body.  This strategy bends both wrists at right angles to point the digits of both hands toward the strings.  This is the biggest reason why some autoharpists claim their arms are too short for playing the autoharp.


By opening the joints in both shoulders, you can easily surround the autoharp with both arms comfortably, so that the fingers can play/depress all over it.  The elbows will naturally stick out some, but this is necessary in order to feel open and free.  If expanding your physical space takes up too much room in a crowded jam session, sit or stand at an angle to the jamming circle, instead of head-on (maybe I’m dating myself: do the Hokey Pokey and put your right or left elbow in!). If the autoharp still seems too wide for your arms, the autoharp may need to be higher.  Raising the autoharp with a hip pouch underneath can help here.  Note: Players with large hands may think moving the string arm is unnecessary.  Regardless of physical size, all autoharpists need to move our arms when we play in order to feel free and avoid playing in pain.

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Fingers of both hands

Moving only the fingers shown by the symbols on the page. What’s wrong with that?  See…


Use the symbols to tell you which fingers make contact with the strings via the moving string arm.  As for the button hand, its fingertips do make contact with the chord-bar buttons, but it’s sending energy towards the chord bar with the button arm that lowers the chord bar to the strings.

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Standing to play the autoharp

Until the same kind of set-up as for sitting can be replicated when standing to play, here are some thoughts: Straps that form an X across the player’s back generally set the autoharp too low to the upper arms.  The autoharp also weighs down on both shoulders, impairing arm freedom. Using a single strap may lean the autoharp on the button arm, impairing that arm’s freedom, along with immobilizing the rest of the arm above it. Shoring up the autoharp from below frees both arms completely.

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Some Basic Body Movements

Being technically sound with hammer order or autoharp fingering does not necessarily guarantee that a musician will move well. What technique does do is set up a musician to move well when s/he is aware of the need for body movement while playing. Here are some basic movements to check:

Hammered Dulcimer


Stopping between strikes: This happens when:

  • each hammer takes its own turn to strike the strings.
  • the hammers are manipulated down and up by the wrist and/or thumb.
  • the same course is struck by the same hammer and the notes are short in value.
  • alternating strokes all the time despite the music’s rhythm.
  • One hammer and arm rebounds up while the other falls to strike.  Both hammers and their respective arms move at the same time; they don’t take turns.  This also means developing skills in looking ahead to the next playing pattern, and the next.  If you play slow tunes only, or want to play faster and can’t, this movement adjustment can be liberating.
  • Coordinate stroke order with the music’s rhythm.  I’ve written all of this down in a book, which is well explained there, but for starters, I’m talking about stroke order played this way…


…instead of this way:



Playing from the wrists: stresses the wrists while immobilizing the arms.  Playing close to the strings often points to flexing the wrists to make the hammers go down and up (see previous point).  The rationale here is to assist striking the right courses, but aside from freezing most of the body to play and compromising overall sound, close proximity to the strings can make it easier to miss, especially when large leaps are involved.

Fingers and thumb: If these do all the work, you may not only find some pain there, you’ll have to find another way to access dynamic range (soft to loud).


Consider geometry: When playing the dulcimer, the shortest distance between two points is: [an upside down parabola] The arc’s size is relative to tempo: smaller when playing fast.

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The string hand
  • Strumming alongside the chord bars makes the upper string arm unnecessarily overactive, engaging too much movement at the shoulder.
  • Strumming from the wrist offers a short range of motion, encouraging strain.  A short range of motion may come from the string arm leaning on the autoharp.
  • Pinching exclusively with one finger tires that finger.  Short, fast notes can feel forced.
  • Pinching with the middle finger and plucking with the index finger: The middle finger must curl to lower the index fingerpick to the strings, perpetually crunching the string hand.  This is especially true in “chord-and-release” playing on a diatonic autoharp, where the string fingers often play many short notes.
  • Pinching with the middle finger also tips the string hand over at the wrist, creating ulnar deviationwhich stresses the hand.  (Note: When playing the autoharp upright against the chest, it is impossible to see ulnar deviation when looking down at the string hand.  The best way to see it is by playing in front of a mirror.)
  • Curling all fingers towards the palm after pinching so picks clear vibrating strings: Fingers do all the moving from an immobile arm.
  • Rotating the string forearm after a strum or brush so the picks clear ringing strings: Points all picks away from the strings.  This won’t necessarily hurt you, but aside from usually evoking a louder zing at the end, you create more work for yourself than necessary.
  • Playing without fingerpicks makes the fingers curl towards the palm to access hard material on the backs of the fingers. Button hand: Depressing many chord buttons with the thumb.
  • Once the autoharp is tilted as described, a simple down-up strum over a wide arc is more easily performed.  Most of the movement comes from the forearm going up and down, as a result of bending the elbow.  The rest of the arm is needed in smaller ways, as you can see in the thankfully “fuzzy” photo below, where I’m strumming away during one of my solos in a concert.  Notice the range covered by both the forearm and the hand.  My elbow and upper arm look quieter, but they are not static.  That’s because my body is also moving while I play.  When strumming with the forearm, my wrist is free enough to respond naturally to the forearm movement, and my thumb’s sole function is to support the pick.  Neither thumb nor wrist forcibly flex to create playing action.  They don’t have to, because my forearm does the strumming.


  • Strum with string arm off the autoharp: Lifting it as little as 1/8 inch will do.
  • Wear fingerpicks.  As a folk guitarist picking nylon strings with my nails, I didn’t want to wear fingerpicks to play the autoharp, either, but I barely feel them when the tips extend no more than 1/8 inch beyond my fingertips (trim your nails).  Given the large pinches we sometimes need to play over a 9-inch width of strings, it’s impossible to equate autoharpist moves with guitarist moves.
  • Mix the finger order up, and include the ring finger in the mix.  Coordinating fingering with the music’s rhythm is a great way to activate the arm.
  • Let your string arm lift the picks away from the strings so that all fingers can remain gently curved.  Allow all picks to point towards the strings as you raise your string arm from the shoulder joint.
The button hand
  • Resting the button arm on the autoharp.
  • Thinking that the fingers alone, without the rest of the arm, depress chord bars.
  • Curling the fingers excessively to depress the chord bars.
  • Using the thumb to depress the chord bars.  This not only puts pressure on the side of the thumb, it can also set the hand in ulnar deviation at the wrist, freezing it.   (Note: When playing the autoharp upright against the chest, it is impossible to see ulnar deviation when looking down at the button hand.  The best way to see it is by playing in front of a mirror.)
  • Button placement: Consider which chords you play most.  After the major chords, if you hover around seventh chords a lot and minor chords very little, perhaps having the seventh-chord buttons in the row nearest the bass strings is worthwhile, with the minor chords nearer to the treble strings.  If you play a lot of minor chords, put that near the bass strings with the sevenths near the treble strings.  Whenever you go for the most-used chords, the button fingers will  have a slight curve in them as they move up towards your nose and those chords.
  • Start telling yourself that it’s the arm that depresses chord bars.  The button fingers, like the string fingers, are simply contact points.
  • Lift your button arm off the autoharp; 1/8 of an inch will do.   Now you can use the joint way up in the shoulder to navigate all of the chord buttons.  For example, when I want to depress a seventh chord in the row nearest the treble strings, swinging my button elbow out some opens the shoulder joint, pivoting my button hand to take the ring finger down to the seventh chord almost effortlessly.
  • Use the index, middle and ring fingers to depress chord bars, setting the wrist neutral.
  • Save the thumb for that occasional, large reach.  Activate the joint in the shoulder to rotate the hand to move from V to V7.

(For a YouTube video showing autoharping movement, click here.)

In conclusion, the more your entire body is involved in playing, the freer it is to move (remember: when we can’t move, we can’t play), and the rounder the autoharp’s sound becomes.

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Avoiding Confusion

One question that’s been coming my way lately at festivals where I teach: “One workshop instructor says to do it this way, then another instructor says to do it this way.  How are we supposed to know which way to do it?  It’s very confusing!”  The answers to this question echo what has already been discussed all over this page:

  • Listen to your body; and
  • Listen to your instrument.

When you are presented with two ways of doing the same thing, consider it an opportunity to compare X to Y (perhaps also to Z, if you are doing something else).  Do what the instructor tells you in each workshop, and then go back and forth between that and what you already do, tuning in to how each method feels and sounds.  When you like how you feel and/or what you hear, then the instruction received could well be a keeper.  (I am reminded of the autoharpist who shouted during a workshop I taught about fingerpicking without one’s fingers, “My pain is gone!”  Talk about finding a keeper!)  If you continue to struggle with an instruction, then consider whether you are doing it as intended or if it is just plain crazy-making, remembering that just because something feels different, it isn’t necessarily “wrong.”  (Really, folks, we need to stop placing value judgments of “right,” “wrong,” “correct,” “proper,” etc., on how-tos.)  There is always unfamiliarity that comes with performing a certain action differently, but if the instructor returns a positive difference in his or her own playing and you know that’s what you want, ask the instructor to show you more about it.

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Fixing the Mess!

This page has described the most common causes of pain that players have presented to me, with snapshots of their solutions.  When someone emails me with a detailed description of their pain that I am asked to troubleshoot, I can generally come up with at least seven things that may be at its root.  Unfortunately, a description is never enough; I need to observe that person at play in order to tailor solutions that address his or her specific situation. If you cannot find someone in your locale, contact me.  I will either connect you with someone in your area who can help, or you and I can meet in person or on Skype or FaceTime (it is possible to flesh out a lot via these technologies).  Also available for out-of-towners: B&B lessons for five days in my home.  We can find and move forward on viable solutions to give you a jumpstart on whatever retraining you need so that you feel happy every time you play.  You’ll be fed well and toured around the area, too!

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Practical Applications

None of the everyday tasks listed below involve playing the dulcimer or autoharp, but you may discover a common thread to how you make music the next time you perform one of them. Click here to tell me about more good ones to add to the list.

  • Driving a car: Ironically, all of my students hold the steering wheel with their upper arms positioned vertically against their bodies, generating lots of tension.  When the forearms turn up and out even a little, the upper arms naturally want to take the elbows away from the body some, too.  Yes, you have enough room in the driver’s seat to drive with elbow room.  And you’ll still have a secure hold on the steering wheel.
  • Whisking an egg: Assuming your whisk has a thin enough handle (mine is 3/8 inch in diameter), hold it as you would a pencil.  No death grip here; let the end of the whisk swing a bit as your forearm moves back and forth quickly.  You’ll whisk an egg in no time.
  • Typing at the computer: Oh, boy, this one’s a biggie.  Although loads about this topic can be found online, here are my salient points:
    • Set the keyboard level or to a -5-fegree tilt away from you, as recommended by ergonomists.  (I know that sounds weird, but -5 is very slight.)
    • Throw away the wrist rest.  Somebody made a lot of money with this injury-producing gadget.  Resting your wrists means typing with your fingers only.  Your arms need to give them a way to rebound and absorb those constant shocks!  Treat typing like playing the piano; your arms need to move!
    • “Pigeon-toe” forearms and hands to open up the shoulder joints naturally (free the shoulder joints as for Driving a car above).  Let the hands pigeon-toe, too; don’t bend the wrists to set the fingers perpendicular to the keyboard. Pigeon-toeing is helped when…
    • The fingers curve slightly. Do not curl them.  I’m looking down at my hands as I type this page.  Granted, everyone’s hands are shaped differently, but perhaps what I see right now will be helpful. My index fingers and pinkies look almost straight, but they are really very slightly curved and feeling free.  My middle and ring fingers curve a little more, so that all fingertips and the outside of both thumbs meet on the keyboard.  AND my hands emanate from neutral (unbent) wrists.  If all fingers are closer to flat (thanks to the wrist rest just thrown away), push your chair away from the keyboard some (assuming your computer isn’t resting on your lap right now, of course).

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    The Internet offers of plethora of sites that can inform you further.  Still, use caution; as with anything else on the Internet, there is plenty of “hocus-pocus” out there, too.  To save time, I recommend visiting the following sites carrying really fine information.  Should you make contact with a site’s owners, please let them know that I sent you:

    All Sense Press: www.allsensepress.com

    Andover Educators: www.bodymap.org.  Includes some great articles about the effects of body mapping in music performance, and will take you to still other links.

    Performing Arts Medical Association: www.artsmed.org.  A good place for physicians to connect and discuss the problems of performance-related injuries

    And check out the following books:

    Conable, Barbara, What Every Musician Needs to Know about the Body, Andover Press, Portland OR, www.bodymap.org, 2000.  An easy, informative read, lavishly illustrated and with good humor.

    Conable, Barbara, and William Conable, How to Learn the Alexander Technique, Andover Press, Portland OR, www.bodymap.org, 1995.  An in-depth version of What Every Musician…, above.

    Pascarelli, Emil, Dr. Pascarelli’’s Complete Guide to Repetitive Strain Injury, John Wiley and Sons, Inc., Hoboken NJ, www.wiley.com, 2004.  Dr. Pascarelli probably knows more about this subject than anyone else.  While much of it deals with computer use (also good for us dulcimer players to know about) he does address musicians, too.

    Reilly, Lucille, Striking Out and Winning! A music-maker’s guide to the hammered dulcimer (revised 2nd edition), Shadrach Productions, Denver Colorado, 1992.  The hammer hold, movement and striking methods described here were put to the test in 2005 and passed.  You won’t find a more complete source anywhere else that helps the hammered dulcimer player play freely with fabulous resonance.

    All of the above will encourage you to keep playing!  I hope you do.

    Thanks to Kay Hooper, certified Alexander Technique specialist and licensed Andover Educator, for reviewing this page and offering sound advice during its preparation.

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    Copyright 2006, 2007, 2008, 2014 Lucille Reilly.  All rights reserved.  No portion of the contents on this page may be reproduced for mass production without permission of the author; however, links to this page from other web sites are welcomed and encouraged.

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