BackgroundMusculoskeletal pain is a common issue in both pianists and choral conductors. Choral conductors, unlike orchestra conductors and pianists, rely heavily on expressive hand gestures, facial cues, and upper-limb movements (rather than a baton) to communicate, which potentially increases their risk of musculoskeletal strain. Piano students often report neck, shoulder, upper-back, and wrist pain due to prolonged arm extension, rapid octaves, and uncoordinated head movement. Choral conductors frequently experience shoulder and trapezius pain from holding arms raised and making forceful gestures. In both groups, the arms are held in abduction relative to the trunk, which strains the rotator cuff, trapezius, and neck muscles. Building on our presentations at ISME 2024, APSMER 2025, and ISPS 2025, we emphasised the importance of head-arm coordination, discussing arm torque, head-arm coordination, and musculoskeletal pain in pianists and conductors.AimsThis presentation examines the correlation between musculoskeletal pain and body movement in pianists and choral conductors, aiming to (1) identify the common prevalent pains, (2) determine the specific movement patterns associated with these pains, and (3) develop scientific and natural physical education strategies on body coordination for pianists and choral conductors.MethodA questionnaire survey (N=30) is conducted to assess the prevalence of musculoskeletal pain among piano and choral conducting students and teachers in Chengdu, China. We use an OptiTrack motion capture system with 6 infrared cameras to analyse hand, arm, and upper-limb movement in pianists (N=15) and choral conductors (N=15). The collected data are examined through biomechanical and ergonomic calculations to pinpoint inefficient and asymmetrical movement patterns that contribute to musculoskeletal discomfort, providing evidence for the study of physical education strategies.ResultsOur findings indicate that wrist, elbow, shoulder, and neck pain are the most prevalent discomforts among pianists and choral conductors. Through motion capture analysis, we observed that pains are closely linked to specific joint movements. By clarifying the relationship between movement and pain, we propose targeted physical education strategies that align with natural biomechanics to enhance efficiency and reduce the risk of injury.ConclusionsThis study explains why and how pianists and conductors develop wrist, elbow, shoulder, and neck pain by linking it to specific movements. It clarifies the movement patterns causing pain and integrates biomechanics and ergonomics into practice. The findings improve understanding of occupational risks, aiding injury prevention.