Musician's Dystonia - Part 1

Dystonia, Focal Dystonia, Hand Dystonia, Musician's Dystonia...

This will be a several part series on a topic that is very relevant to all musicians, regardless of the type of music that is played.  Before I get started, I just want to state very clearly that I am not a doctor, nor a specialist of any kind, and I can't give any medical advice.  I am only going to be presenting information that I have learned from other sources, and then some of my own experiments.  You are welcome to add your experiences, experiments, links to articles, etc.

First of all, what is dystonia?  It's a type of nerve disorder in which the nerve impulse is still intact and normal, but despite that, the signal gets "messed up" somehow and a musician will have problems moving one or more fingers ONLY WHEN THEY ARE PLAYING music.  Who does it strike?  Piano players, clarinetists, violin players, banjo players -- any musician who plays repetitive passages over the course of years of practice.  It mainly strikes professional musicians, as this is who would have years of lots of practice and performances.  Of course, any amateur musician who plays a lot would be just as likely over the course of many years of playing.

What happens in dystonia?  I don't think it is entirely understood, but here is what I understand from reading.  (I am going to give other medical sources as well for you to do some of your own reading.)  It appears that the brain is ever-learning, ever-changing.  Technically speaking, this is called "plasticity."  When a musician continues to practice over and over again, the brain gets too good at doing certain techniques and loses its ability to "learn" new things.  Some articles have said that the brain tries to do the "open" and "close" of the finger at the same time.  Other articles I have read talk about cramping of the hand, indicating a muscle response from the nerve impulse.  I can verify that my index finger pulls up to my palm and then just stays there, but only when I play banjo. 

How does this present in a musician?  Well, let me give you my own experience.  For the past five years, I noticed that it was getting increasingly difficult for me to play my banjo fast.  It felt like my right hand just never got warmed up.  It wasn't always bad, but certain days it was really bad.  As time went on, it started getting worse and my "bad" days were outnumbering my "good" days.  I can still play slowly and moderately without a great deal of difficulty.  I have no pain, but when I watch my right hand, I see strange things happen.  My index finger pulls up to my palm and then just simply stays there.  What's funny about that is I had no idea that was what was happening until I actually started watching my right hand.  It felt like it was moving to me, but I could see that it wasn't, or that it was moving only very little.  (I will post some videos later.)  My middle finger, to the contrary, moves straight out across the banjo head in a wide arc.  The index finger problem severely affects my banjo playing because it simply doesn't do anything.  My middle finger doesn't really seem to affect my playing much because it still moves, though it is certainly not preserving motion!

It is only recently that there has been given hope for musicians suffering from this.  I am going to post several links here for you to do more reading, if you so desire.  I will also be posting some of my own experiments and some videos, but in a later post or posts.

Here is an excellent article that explores all kinds of information about dystonia in musicians:
http://chambermusictoday.blogspot.com/2008/10/progress-in-treating-musicians-focal.html

Here is a technical paper (very technical) that details a medical study that should be of significant interest to anyone wanting to know more about treatment:
http://www.jneurosci.org/cgi/content/full/29/46/14627

Please feel free to add your own experiences or links as comments.  In fact, I hope you will!