What is Musician´s Focal Dystonia?

Focal Dystonia is a silent suffering experienced by athletes, musicians, dancers, writers, surgeons…
Musician´s Focal Dystonia is often misdiagnosed and the musician frequently tries many different therapies before they are finally correctly diagnosed.

It is estimated that 1% of musicians suffer from Focal Dystonia and up until now there has been no truly effective treatment for it. Traditional treatments include Botox injections in the affected muscles, with short-term results and risks of muscle damage and muscle retraining. Research has shown that muscle retraining has a limited ability to resolve Musician´s Focal Dystonia.

It is a type of dystonia that affects a muscle or group of muscles in a specific part of the body (thus the term Focal). It causes undesired and involuntary muscular contraction or twisting. Focal Dystonia can affect the muscles of the eyes, mouth, vocal chords, neck, hands and feet…

It means that a highly precise movement becomes impossible to perform, despite all their concentration and effort. What makes it even more perplexing for them is that it often appears all of a sudden. Examples that I have worked with are musicians who can´t maintain their embouchure, who´s tongue is unable to create the beginning of a note, musicians whose fingers go into spasm and fold tightly into the palm of their hand, sports people who´s body suddenly stops moving forward or who can´t release the ball.

The Causes of Musician´s Focal Dystonia

It is commonly assumed that the cause of the problem is in the affected muscle or muscle group. However, whilst the symptoms manifest in the muscles, the root cause is a complex of erroneous neuronal connections. In the part of the brain that stores the body scheme (somatosensory cortex) the structural location of where their brain receives the messages, from individual fingers or from the lips and tongue, overlaps more than in healthy musicians. This leads to the involuntary muscle tensions, spasms and torsions of the muscles that the musician experiences. It also creates dissociation between the musician´s body scheme and the feelings of the body that their brain registers. For example, clients frequently say to me that it is as if their hand doesn´t belong to them.

In addition, scientists have shown that the signals that are sent to activate the muscles fire for longer than normal and that the muscles that normally work together to control the movements are not coordinated. For instance in the wrist there are a pair of muscles that should work together with one muscle contracting while the other relaxes. In musicians with Focal Hand Dystonia both contract at the same time which gives a feeling of stiffness in the hand movement. It seems that this is caused by a dysfunction in the central part of the brain where our habitual movements are stored (the basal ganglia) which sends erroneous messages to the parts of the brain that control our movements and feelings of the body (motor and somatosensory cortices).

Types of Musician´s Focal Dystonia

Musician´s Focal Dystonia can affect any part of the musician´s body in a way that impedes him or her playing their instrument. Common types of Musician´s Focal are:

HAND

Focal Dystonia

EMBOUCHURE

Focal Dystonia

VOCAL CHORD

Focal Dystonia

For instance in Focal Hand Dystonia the fingers will involuntarily curl into the palm of the hand with a high level of tension and the musician is unable to relax them and regain their normal function. Equally with Focal Hand Dystonia the ring and little finger will extend stiffly outwards, lose the precision of its movements or the fingers may feel stuck to the keys or strings of the instrument.

In Focal Embouchure Dystonia the musician the muscles around the mouth or of the tongue enter into involuntary contractions or twisting.

Vulnerability of Musicians to Focal Dystonia

Musicians are especially vulnerable to Focal Dystonia because of the extremely high level of neuronal precision they have developed in their body from the huge number of hours of practice that they have dedicated to it.

Psychological studies have shown that musicians with Focal Dystonia have more anxiety and perfectionist tendencies than healthy musicians. It has been shown how this perfectionism and the self-demanding that accompanies it, is learned at a young age and how it physically affects the brain.

In addition the precision required to play music is closely related to the musician´s emotional expression. One of the core causes of Focal Dystonia is just this combination of highly trained fine motor skills and emotional expression when it is practiced with self-demanding perfectionism.

Common Responses To Musician´s Focal Dystonia

None of these responses are necessary when we understand the causes of Focal Dystonia and how to use Neuroplasticity and Neurogenesis techniques to resolve them, eliminate the symptoms and enable the musician to fully recover the command of his or her body and return to their instrument without Focal Dystonia.

Common Responses To Musician´s Focal Dystonia

None of these responses are necessary when we understand the causes of Focal Dystonia and how to use Neuroplasticity and Neurogenesis techniques to resolve them, eliminate the symptoms and enable the musician to fully recover the command of his or her body and return to their instrument without Focal Dystonia.