The purpose of this study is to gain a better understanding of the perceived impact of personal circumstances, past and present learning environments, and musical culture on the development of playing-related pain and injury among tertiary string students. The study used a multi-phased mixed-methods methodology with elements of both quantitative and qualitative research. Forty eligible Bachelor of Music string majors at a tertiary music institution in Australia completed questionnaires/interviews twice annually, totalling 181 sessions. Due to attrition of 11, the number of participants decreased to 29 (14 violinists, four violists, 11 cellists) of whom 17 took eight semesters to complete their programmes. Results showed students consistently reported a high incidence of playing-related discomfort/pain. Further analysis revealed key groups of contributing factors, including the Major Study course, orchestral rehearsals, practice, technique and non-playing-related activities. The qualitative data revealed the complexity, subjectivity, and individuality of student experiences and the extent to which they vary according to a number of complex and overlapping risk factors. The research suggests the need for education institutions to adopt a range of preventative strategies as part of a multifaceted approach to addressing the issue of playing-related pain and injury.