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Abstract Aims: This doctoral thesis sought to develop new understanding of antagonistic muscular co-contraction (AMCC) in the context of piano playing, to aid pianists facing playing-related challenges. Background: Playing the piano skillfully is an exceptionally complex task. Pianists are confronted by considerable obstacles when developing and maintaining their playing. Debate about the physiological mechanics of proper piano technique has continued across pedagogical and scientific fora for centuries, including disagreement over AMCC. A scientifically sound and pedagogically viable understanding of proper piano technique is overdue — which must clearly account for muscle activity, including AMCC’s effects and proper role. Methods: This thesis justifies its novel, integrative methodology by determining that prior scientific and practical inquiry has been unable to properly comprehend the complex phenomenon of AMCC, partly due to persistent theory-practice gaps. The thesis leads this novel approach by adopting and harmonizing previously untried methods. Chapter II’s scoping review establishes a science-based theoretical model of AMCC, which is applied and expanded in Chapter III’s systematic critical review of pedagogy. Chapter IV then generates a practice-led model and integrates this with the prior expanded model, culminating in a unified theory-practice model of AMCC in piano playing. Chapter V observes pianists’ AMCC via surface electromyography (sEMG), empirically validating key areas of this unified model. Results: The thesis’s unified model thoroughly and verifiably characterizes AMCC’s nature and effects on piano playing. AMCC is a fundamental contributor to human movement with broad and unique consequences, including a dualistic capacity for major positive and negative effects both on sensorimotor task performance and musical expression — but prior AMCC research and pedagogy are fragmentary and often flawed, frustrating prolonged efforts at understanding and harnessing its potential. Conclusion: This thesis synthesizes multifarious perspectives on AMCC, arriving at a unified model of AMCC’s nature and effects on piano performance. Skilled, healthy piano playing requires considerable AMCC, due to its capacity for substantial, transcendent, and uniquely beneficial effects on the exceptional challenges of piano performance — but this AMCC must be implemented dynamically and organically within the broader context and expressive function of musical performance, otherwise quickly becoming harmful rather than facilitative. The thesis concludes that pianists can and should train, use, and maintain AMCC, which itself varies significantly between and among individuals — thereby illuminating clear avenues for future pedagogical transformation. These findings constitute a compelling resolution to centuries of debate, misunderstanding, and inconsistency regarding AMCC.