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may not be accurate
by Chiara Strabioli and Camilla Refice
A practical warm-up and cool-down protocol for safe, sustainable traverso practice.
In historically informed performance, we often speak about the body — breath, gesture, balance, articulation — yet we rarely address the physical sustainability of our daily practice in concrete terms.
Traverso playing demands fine motor control, asymmetrical hand positions, prolonged static postures, and repetitive micro-movements. Without a conscious approach to preparation and recovery, these demands easily lead to overload.
This Practice Pill does not propose a generic fitness routine, but a musician-specific protocol developed through lived experience and clinical expertise. Its goal is not to “fix” problems after they arise, but to integrate body awareness, prevention, and care into everyday traverso practice — just as naturally as tuning, warming up the sound, or choosing fingerings.
In historically informed performance, we often speak about the body — breath, gesture, balance, articulation — yet we rarely address the physical sustainability of our daily practice in concrete terms.
Traverso playing demands fine motor control, asymmetrical hand positions, prolonged static postures, and repetitive micro-movements. Without a conscious approach to preparation and recovery, these demands easily lead to overload.
This Practice Pill does not propose a generic fitness routine, but a musician-specific protocol developed through lived experience and clinical expertise. Its goal is not to “fix” problems after they arise, but to integrate body awareness, prevention, and care into everyday traverso practice — just as naturally as tuning, warming up the sound, or choosing fingerings.
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Would you ever ask an athlete to run the 100 meters without warming up?
Would you imagine a football player not stretching after a match? And yet, this is exactly what we musicians do all the time. We begin practicing without warming up our bodies; after endless rehearsals we carefully clean our instruments in every detail, but we do nothing to release the tensions accumulated in our hands. Too often, we fail to realise that the music we make is produced with our body — or we realise it too late, when a problem has already appeared. Just as we take care of our instruments, we should take care of our bodies — perhaps even more, since we cannot buy a new one. |
My encounter with Camilla Refice
During the years in which I lived with tendinitis — sometimes disappearing, sometimes returning — I went through several phases of bodily research, drawing information from many different fields (for example, dance).
I greatly developed my proprioceptive awareness, and this certainly benefited my playing. However, all my intuitions regarding my hand problems were empirical, and therefore insufficient to lead to a spontaneous resolution.
Two years ago I experienced another severe episode, perhaps the worst one, characterised by repeated relapses. I was in a very difficult moment of my flutistic life.
Then, one year ago, I was fortunate enough to meet Dr. Camilla Refice — a specialist in musicians’ hand health… and even more: a hand specialist who is also a flutist.
This encounter was crucial not only for evaluating and treating the pathology, but also for giving structure and coherence to something I had sensed was necessary, but had previously approached in a vague, unspecific, and improvised way.
I now have something extremely valuable: a targeted and specific exercise protocol for warming up and cooling down the hands.
During the years in which I lived with tendinitis — sometimes disappearing, sometimes returning — I went through several phases of bodily research, drawing information from many different fields (for example, dance).
I greatly developed my proprioceptive awareness, and this certainly benefited my playing. However, all my intuitions regarding my hand problems were empirical, and therefore insufficient to lead to a spontaneous resolution.
Two years ago I experienced another severe episode, perhaps the worst one, characterised by repeated relapses. I was in a very difficult moment of my flutistic life.
Then, one year ago, I was fortunate enough to meet Dr. Camilla Refice — a specialist in musicians’ hand health… and even more: a hand specialist who is also a flutist.
This encounter was crucial not only for evaluating and treating the pathology, but also for giving structure and coherence to something I had sensed was necessary, but had previously approached in a vague, unspecific, and improvised way.
I now have something extremely valuable: a targeted and specific exercise protocol for warming up and cooling down the hands.
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Safe Practice Sessions: what to do, when, and for how long.
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** Preventive focus ** We would like to emphasise that this exercise protocol should not be performed only when problems arise, but also — and especially — as a preventive measure. We must start taking care of this crucial aspect of instrumental practice while we are still healthy. For this reason, in this Practice Pill we would like to present a basic protocol for approaching traverso practice sessions safely. |
Video Series 1 — Warm-up exercises
Perform the following exercises in this order: “hooks,” “beaks,” “fists”.
Each exercise should be carried out slowly for about one minute, or alternatively for 20–30 repetitions.
Perform the following exercises in this order: “hooks,” “beaks,” “fists”.
Each exercise should be carried out slowly for about one minute, or alternatively for 20–30 repetitions.
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Video 1.1 "Hooks": fingertip extension and flexion exercise.
This exercise activates the extremities of the hand that must be ready to touch a key or to close a hole.
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Video 1.2 “Beaks": flexion of the base of the fingers.
This exercise activates the base of the fingers that serves to create the correct grip on the flute.
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Video 1.3 "Fists": finger complete closure.
This exercise allows for more overall warming of the hand.
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Video Series 2 — Muscle Stretching Exercises
Each stretching exercise described in this series should be held for approximately one minute and repeated several times if necessary.
Each stretching exercise described in this series should be held for approximately one minute and repeated several times if necessary.
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Video 2.1 Stretching of the finger flexor muscles.
The finger flexor muscles are essential for closing the tone holes and pressing the keys. To stretch them: extend the arm forward, grasp the fingers with the other hand, gently pull them back, and hold the position.
You will feel the stretch along the underside of the forearm. |
Video 2.2 Stretching of the finger extensor muscles.
The finger extensor muscles are the “antagonists” of the flexors and are responsible for lifting the fingers from the holes and keys to the appropriate height. To stretch them: extend the arm forward, grasp the fingertips from underneath with the other hand, gently pull them back, and hold the position.
You will feel the stretch along the upper side of the forearm. |
Video 2.3 Stretching of the hand intrinsic muscles.
The intrinsic muscles of the hand are necessary for maintaining proper hand shape and balance on the instrument. To stretch them: place your hands in a “prayer” position, bend the fingers of the hand you want to stretch into a hook shape, then press against them.
You will feel the stretch in the palm of the hand and the wrist. |
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Video 2.4 Stretching of the thumb.
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The thumb, which is fundamental for supporting the instrument, requires a separate stretch that can be summarized in two positions:
• With the other hand, push the thumb backward and you will feel a stretch along the finger. • Using the fingers of both hands, bend the thumbs into the palm and flex the wrists downward. Be cautious, as this stretch may cause discomfort on the upper side of the thumb. This is a normal reaction that will improve if you maintain the stretch. |
Video Series 3 — Nerve Stretching and Neurogliding Exercises
This series of exercises gently stretch and glide the nerves, almost instantly relieving those annoying sensations of fatigue or tingling in the hand or upper limb.
This series of exercises gently stretch and glide the nerves, almost instantly relieving those annoying sensations of fatigue or tingling in the hand or upper limb.
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Video 3.1 Stretching and neurogliding of the Median Nerve.
Compression of the median nerve at the wrist, or “Carpal Tunnel Syndrome”, is the cause of tingling symptoms in the first three fingers and half of the 4th finger of the hand, which occur when the upper limb is overused. The position to stretch the median nerve involves opening the arm outward, extending the wrist, and pointing the fingers downward, then tilting and turning the head to the opposite side. Hold this stretching position for a minute. Then, move your head and wrist from side to side in a converging or diverging direction, that is the “neurogliding”.
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Video 3.2 Stretching and neurogliding of the Ulnar Nerve.
The ulnar nerve shows signs of irritation when tingling appears in the half of the 4th finger and little finger. Compression of the ulnar nerve occurs primarily at the elbow, or “Cubital Tunnel Syndrome”, and this symptom is caused by overuse of the upper limb. The position for stretching and neurogliding the ulnar nerve involves closing the upper limb at the ear, with the head tilted to the opposite side. Hold this position for a minute, then move the head and upper limb from side to side.
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Video 3.3 Stretching and neurogliding of the Radial Nerve
The radial nerve shows signs of irritation when tingling occurs on the upper forearm and the back of the hand. This symptom is caused by overuse of the upper limb. The position to stretch and glide the radial nerve involves opening the upper limb at the shoulder, twisting the upper limb inward with the head tilted and turned to the opposite side.
Hold this position for a minute, then move the head and upper limb from side to side and turn the wrist clockwise and counterclockwise. |
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Closing reflections and warnings
With this Practice Pill, we hope to draw the attention of musicians at every level to this aspect of instrumental practice, and to provide a useful tool for establishing a working routine that respects the body’s needs and the health of the hands. It is essential to learn to listen to one’s body — especially to sensations of fatigue, and even more so to pain. Respecting one’s limits is fundamental. If discomfort arises: What to do: suspend intensive practice if possible and consult a specialist, such as a hand therapist or hand surgeon. What not to do: avoid “do-it-yourself” treatments, do not evoke pain, and do not fixate emotionally on the symptom. |
Click on the image below to download the Healthy Hands Protocol here:
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** For teachers **
We would like to draw teachers’ attention — at every level — to the importance of a healthy relationship with the body, and to respecting sensations of fatigue and especially pain.
> Pain is not a good sign, never!
Teachers should not underestimate discomfort reported by students related to instrument holding, technically demanding passages that cause hand strain, or tension in the neck, shoulders, etc.
Students should be sensitised to listening to their bodies, and to understanding that pain is not a sign of effective practice, but of overload.
> Learn to have a healthy relationship with the body
It is particularly important to suggest home-practice methods that respect the student’s age and level. Proprioceptive awareness varies greatly with age, and students must be guided in recognizing signals of fatigue and overload.
The protocol outlined here can serve as a useful guide to help a student with structuring practice sessions, especially regarding warm-up, the need for rest and short sessions, and cool-down routines.
> Proprioceptive awareness
Protocol exercises execution should be adapted to the student’s proprioceptive abilities: fewer exercises performed well are preferable to many exercises done inaccurately.
In my teaching experience with pre-adolescent students, for example, I have observed that exercises in which the hand is not visible are often performed incorrectly due to limited proprioceptive awareness. In such cases, it is better to simplify or even reduce the exercises and perform them under the teacher’s supervision.
We would like to draw teachers’ attention — at every level — to the importance of a healthy relationship with the body, and to respecting sensations of fatigue and especially pain.
> Pain is not a good sign, never!
Teachers should not underestimate discomfort reported by students related to instrument holding, technically demanding passages that cause hand strain, or tension in the neck, shoulders, etc.
Students should be sensitised to listening to their bodies, and to understanding that pain is not a sign of effective practice, but of overload.
> Learn to have a healthy relationship with the body
It is particularly important to suggest home-practice methods that respect the student’s age and level. Proprioceptive awareness varies greatly with age, and students must be guided in recognizing signals of fatigue and overload.
The protocol outlined here can serve as a useful guide to help a student with structuring practice sessions, especially regarding warm-up, the need for rest and short sessions, and cool-down routines.
> Proprioceptive awareness
Protocol exercises execution should be adapted to the student’s proprioceptive abilities: fewer exercises performed well are preferable to many exercises done inaccurately.
In my teaching experience with pre-adolescent students, for example, I have observed that exercises in which the hand is not visible are often performed incorrectly due to limited proprioceptive awareness. In such cases, it is better to simplify or even reduce the exercises and perform them under the teacher’s supervision.
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I am Chiara Strabioli, an Italian flutist from the Castelli Romani, near Rome, where I currently live, play, and teach. I studied and played the modern flute a great deal before I encountered the traverso. I was fascinated by the description of fork fingerings and how they gave different colors to the tonalities. I absolutely wanted to hear it live. I heard Barthold Kuijken in concert in Rome, playing Bach’s Partita in A minor—and my path was decided!
I studied traverso first with Claire Genewein, and then with Barthold Kuijken and Frank Theuns in Brussels. I have played with La Petite Bande, the Accademia Barocca di Santa Cecilia, the Accademia Montis Regalis, Atalanta Fugiens, Gli Originali, among others. Since 2009 I have been part of the Cappella Musicale Enrico Stuart, with whom I recorded Boismortier (2019), Haym (2022), Babell (forthcoming), and we are currently working on another Telemann disc to be released soon. I also like to carry forward a more experimental solo project, Suoni Raminghi, in which I use the traverso in unusual ways, playing in open spaces or in acoustically singular locations. As a flute teacher I work, nowadays, mostly with teenager students. I have a flute teaching post at the Public Music School (Scuola Media ad Indirizzo Musicale) in Palestrina, near Rome. Chiara on Facebook and YouTube |
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I am Camilla Refice, an Italian flutist and physiotherapist specialising in musicians’ health, hand injury prevention, and posture-related disorders affecting instrumental performance. I serve as principal flute of the Wind Orchestra of the Santa Cecilia Conservatory in Rome and as adjunct lecturer in Body Awareness and Expressive Techniques at the “Licinio Refice” Conservatory in Frosinone. In Fiumicino, near Rome, I run a physiotherapy practice dedicated to the treatment and prevention of hand overuse syndromes and performance-related musculoskeletal conditions in musicians.
I hold degrees in Flute Performance and Contemporary Music Interpretation (with honours), as well as a degree in Physiotherapy and postgraduate training in Postural Re-education and Hand and Upper Limb Rehabilitation. My concert activity spans orchestral and chamber repertoire from Baroque to contemporary music. I actively organise masterclasses, publish scientific articles, and lecture at national and international conferences on injury prevention, hand rehabilitation, posture, and body awareness for instrumentalists. Camilla's website Camilla on Facebook and Instagram |
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