Over the decades of specializing in the health and injuries of musicians, I have encountered a number of upright bass players with a variety of issues. Bass players are necessary. We can’t have them dropping like flies for injuries that are easily treatable without the use of drugs and surgery.

Like most other instrumentalists, upright bass players are prone to several common injuries, primarily due to the physical demands and repetitive nature of playing the instrument. Here are the most frequently reported injuries, most of which are classified as Playing Related Musculoskeletal Disorders or PRMD’s:

1. Shoulder Impingement
Shoulder impingement is a prevalent injury among upright bass players, particularly affecting the shoulder of the upper hand. This condition is caused by repetitive stress and the compromised position of the shoulder while navigating the neck of the bass. Symptoms include severe pain, difficulty lifting the arm, and restricted movement[1]. The pain is often on the outside or front of the shoulder, and lifting your arm out and above your head will often trigger it.

2. Repetitive Strain Injury (RSI)
RSI is common in both the picking and fretting hands of upright bass players. It results from repetitive movements that cause micro-tearing and inflammation of the tendons. Symptoms include tingling, numbness, burning sensations, and pain during or after playing[4][5]. Again, this will usually manifest as a tendonitis, or muscle strain. Inflammation will be painful, and can lead to permanent damage to the tissue.

3. Tendonitis
Tendonitis, or inflammation of the tendons, is another frequent issue. It often affects the hands, wrists, forearms, elbows, and shoulders. This condition is typically caused by overuse and can lead to significant pain and reduced mobility[5][12]. Bicipital tendinonitis, forearm tendonitis or tendonitis in any of the other dozens of tendons in playing related muscles could be implicated in a painful, inflammatory, tendonitis situation.

4. Low Back Pain
Low back pain is a significant concern for upright bass players due to the weight of the instrument and the physical strain of carrying and playing it. Poor posture and the need to transport the bass can exacerbate this issue, leading to chronic back problems[10][13]. Dr. Lou is a chiropractor who has been working with spines of all kinds for over 22 years. Pull yourself together and call. Chiropractic care is safe and effective and you don’t have to stop playing during your care. You can keep doing what you love, in fact, it’s recommended.

5. Nerve Compression
Nerve compression, particularly in the neck and shoulders, can occur due to the weight and positioning of the upright bass. This condition can cause pain, numbness, and tingling in the extremities[4][9]. Think Carpal Tunnel Syndrome. Often times changes in bony structures that are unrelated to playing will lead to nerve compression (arthritis). This is a good example of a problem feeling like it was caused by playing but was only triggered by playing…or even something else.

6. Focal Dystonia
Focal dystonia is a neurological condition that causes involuntary muscle contractions. It can affect the hands and fingers, leading to loss of motor control and coordination. This condition is less common but can be debilitating for musicians[3][9]. There is a wonderful book called The Focal Dystonia Cure by Ruth S.L. Chiles that addresses this very condition.  “I recommend this book highly” ~Dr. Lou

7. Spinal Conditions
Spinal conditions, including persistent neck and lower back pain, can result from the physical demands of playing the bass. The weight of the instrument and the need for mobility on stage can contribute to these issues[4]. These issues may be easily addressed by a chiropractor. Waiting to see if it goes away on its own is not recommended. Problems, causes and other dysfunction may still remain even though you don’t hurt. If pain goes away, is the cause just on vacation? Additionally, the longer a problem persists, the harder it will usually hit later. Don’t like surprises? Predict the future by creating it through educated action steps.

Prevention and Management

To prevent and manage these injuries, bass players are advised to:
– Maintain proper posture and alignment while playing[2].
– Limit the use of the left-hand thumb to reduce tension[2].
– Perform regular warm-ups, stretches, and physical exercises[15].
– Use ergonomic equipment, such as well-designed straps and stools[13].
– Seek professional medical advice and treatment when necessary[1][4][12]. Call Dr. Lou from anywhere in the world and tele consulting will be made available to you if your issue qualifies for tele care.

By adopting these strategies, bass players can reduce the risk of injury and maintain their physical health while playing.

Dr. Lou Jacobs in Portland, Maine has worked as a chiropractor and acupuncturist  for some of the world’s most famous musicians. He was interviewed for a published article in Guitar Player Magazine in 2023, and offers online consulting for musicians with playing related musculoskeletal and nerve disorders. Dr. Lou may be reached at (207) 774-6251, he is available to consult with patients anywhere in the world. 

Citations:
[1] https://www.drloujacobs.com/upright-bass-shoulder-pain-double-base-shoulder-pain/
[2] https://www.bassgearmag.com/stand-down-or-sit-up-posture-issues-all-bassists-must-deal-with/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758983/
[4] https://www.painfreenyc.com/for-musicians/guitar-bass-players/
[5] https://www.notreble.com/column/health-fitness-for-the-working-bassist/
[6] https://diginole.lib.fsu.edu/islandora/object/fsu:176405/datastream/PDF/download
[7] https://www.reddit.com/r/Bass/comments/zzr5vz/is_it_normal_to_get_injuries_from_playing_bass/?rdt=58158
[8] https://forums.musicplayer.com/topic/38548-bass-playing-a-health-hazard/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718408/
[10] https://www.basschat.co.uk/topic/199036-double-bass-player-injuries/
[11] https://www.reddit.com/r/doublebass/comments/18fbace/bass_affecting_health/
[12] https://stringsmagazine.com/how-to-identify-and-fix-common-string-playing-injuries/
[13] https://www.thestrad.com/double-bassist-leon-bosch-on-avoiding-back-and-finger-injuries/1921.article
[14] https://www.talkbass.com/threads/health-related-issues-to-playing.594399/
[15] https://music.humboldt.edu/sites/default/files/music/Avoiding%20discomfort%20and%20injury%20in%20young%20string%20pla%20copy%20%281%29.pdf
[16] https://www.talkbass.com/threads/injuries-via-double-bass.860368/
[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797213/
[18] https://www.johnsonstring.com/resources/overuse-injuries.htm
[19] https://www.youtube.com/watch?v=sDEM1IdpBzM
[20] https://www.violinist.com/discussion/thread.cfm?page=2902