Focal Dystonia

Ergonomics and Posture for Classical Guitarists, Aches and Pains, Injuries, etc...
jmaulz

Re: Focal Dystonia

Postby jmaulz » Fri Jan 27, 2012 11:25 pm

Here's the link to Liona Boyd's experience with FD:
http://www.guitarplayer.com/article/liona-boyd/158

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benessa
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Re: Focal Dystonia

Postby benessa » Sat Jan 28, 2012 2:15 am

I don't think you can label any one technique as causing focal dystonia. It's almost always a combination of several factors, which in any other player could have no adverse effects. There's also possibly a genetic connection. For me, I believe it was excessive practice of tremolo technique, but not everyone who practices tremolo to extreme acquires focal dystonia. Certainly other elements were involved. I did learn chunking from Italian teachers, but their other students didn't get focal dystonia. I did use extensors, playing flamenco, but other flamenco players who practice tremolo don't get focal dystonia.

Intense relaxation is a part of a possible cure, but anyone who saw me play before would never had said I had a tense or stressed technique. As any advanced player learns, playing an instrument requires a relaxed tension or a directed relaxation, and most players cultivate this without any problem. One issue with focal dystonia is that it comes to you without warning. There's no pain or nodes involved as with tendonitis, so you don't know what is happening, detrimentally, until it is too late.
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Re: Focal Dystonia

Postby lagartija » Sat Jan 28, 2012 3:10 am

benessa wrote:One issue with focal dystonia is that it comes to you without warning. There's no pain or nodes involved as with tendonitis, so you don't know what is happening, detrimentally, until it is too late.

:shock:
That's pretty scary. So there is no way to know if you have a brain with (what I think Solomon described as) "excessive plasticity" that will start to fuzz the brain map of your hand.
I see your point about it not being just one thing, and that others may use the same training technique without harm.

It reminds me of the problem some people have with carpel tunnel, in that some slight bend in their wrist while playing will cause a problem, but others born with greater clearance for the nerve, will not have problems no matter what they do. Maybe some day, they will have a test for this type of plasticity and at least one might have a chance of taking greater care if the danger were known. :| At the moment, it is the scary thing hiding in the musician's dark closet.
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benessa
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Re: Focal Dystonia

Postby benessa » Sat Jan 28, 2012 4:06 am

lagartija wrote:
benessa wrote:One issue with focal dystonia is that it comes to you without warning. There's no pain or nodes involved as with tendonitis, so you don't know what is happening, detrimentally, until it is too late.

:shock:
That's pretty scary. So there is no way to know if you have a brain with (what I think Solomon described as) "excessive plasticity" that will start to fuzz the brain map of your hand.
I see your point about it not being just one thing, and that others may use the same training technique without harm.

It reminds me of the problem some people have with carpel tunnel, in that some slight bend in their wrist while playing will cause a problem, but others born with greater clearance for the nerve, will not have problems no matter what they do. Maybe some day, they will have a test for this type of plasticity and at least one might have a chance of taking greater care if the danger were known. :| At the moment, it is the scary thing hiding in the musician's dark closet.


That was nicely put. The funny thing is that, unlike tendonitis or carpel tunnel, focal dystonia is not really an injury. The brain is trying to help the hand by changing what it sees as excessive repetitive movement towards more efficient movement as a unit. And we're all so ungrateful for this magical transformation of our nerve signals. There's no helping some people.
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Re: Focal Dystonia

Postby Blondie » Sat Jan 28, 2012 3:32 pm

benessa wrote:I don't think you can label any one technique as causing focal dystonia. It's almost always a combination of several factors, which in any other player could have no adverse effects.


I agree that there are risk factors but I would say that certain techniques, or rather practicing certain techniques in a certain way, are themselves risk factors. It is interesting to see the problems that rock/metal guitarists get with FD in their fingering hand, for example, almost unheard of in classical players because we do not use the specific techniques they use and have an altogether more independent and more relaxed left hand. With CG players it is virtually always the right hand that is affected and where the highest load is put on the sensory motor system.

Whether the same combination of risk factors would trigger FD across different players remains to be seen, it would be virtually impossible to control all the variables to test this.

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Re: Focal Dystonia

Postby benessa » Sun Jan 29, 2012 7:56 am

Blondie wrote: It is interesting to see the problems that rock/metal guitarists get with FD in their fingering hand, for example, almost unheard of in classical players because we do not use the specific techniques they use and have an altogether more independent and more relaxed left hand. With CG players it is virtually always the right hand that is affected and where the highest load is put on the sensory motor system.


This little tidbit of information about rock guitarists getting FD in their LH is new to me and very interesting. And of course, now that it's been pointed out, it does seem obvious.

And you're correct that there are certain techniques which are more likely than others to cause FD, e.g. tremolo and arpeggio.
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Re: Focal Dystonia

Postby Blondie » Sun Jan 29, 2012 9:27 am

Yes when players visited the FD forum with FD in the left hand I used to ask them if they practiced a lot of Holdsworth/Satriani/Van Halen left hand big stretch legatos, it was surprising how often it came up. Well actually not that surprising to me, I used to play rock guitar and it makes perfect sense - hand held rigidly with a wide stretch, all notes played rapidly in sequence with fingers fixed in position. You have to practice it a lot to get it right and have to put tension into the fingers to get the notes to snap out cleanly.

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Re: Focal Dystonia

Postby pogmoor » Wed Jul 31, 2013 1:30 pm

I got the August 2013 edition of Classical Guitar magazine today and noticed an article from the guitarist Apostolos Paraskevas entitled A Classical Guitarist's Story of Recovery from Focal Dystonia. It's a part 1 article, so there's evidently more to follow. What he has said so far sounds good sense to me so it could be a worthwhile read for anyone troubled by this problem.

He seems to have tried a number of treatments with no success and then decided (oversimplifying somewhat) that he needed to go back to the beginning and retrain his right hand (the one affected) in all the movements needed to pluck the strings - as if he was a beginner guitarist again.
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Re: Focal Dystonia

Postby ronjazz » Sat Aug 03, 2013 6:58 pm

I have found that using the little finger on the RH can greatly aid recovery, at least for me. Charles Postlewaite's method of Right Hand Studies for 5 fingers, published by Mel Bay, is the guide.
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Re: Focal Dystonia

Postby benessa » Tue Dec 31, 2013 10:10 pm

Here's the link to my latest blog post re: focal dystonia. I have had some success in retraining, but haven't written about that yet. Hopefully I'll have a post up within a few weeks with the details of my retraining.
http://www.kateclassicalguitar.com/we-are-not-alone/
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Re: Focal Dystonia

Postby benessa » Fri Jan 03, 2014 9:23 pm

Okay, one more post down, and I'm almost current with my condition. I hope to have some real details and helpful exercises in my next post, but that may not be for another month. I'll try to get on it before the semester gets hectic!
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Re: Focal Dystonia

Postby ronjazz » Sun Jan 19, 2014 9:35 pm

Interesting, Kate, I study body-mapping with Jerald Harscher, mostly by Skype but also an occasional face-to-face, and in two full years of regular sessions, I have been pronounced cured of the dystonia, and I am currently well into retraining. I recommend VERY HIGHLY the works of Philip Hii, who has developed an approach of relaxed, light, loose playing that has been very productive for me. Also, I have observed many fine players resting their a fingers very lightly on the 1st string when doing rapid pim or pmi figures on the inner strings, this has been another cool discovery, which I have extended to resting my little finger on the 1st string while playing pima and its combinations on the inner strings. Resting very lightly, I emphasize, really just touching. This has enabled me to rapidly regain pretty good speed, triplets at 150 and higher on a good day. I do practice 4-6 hours daily, very relaxed, allow no build-up of tension in either hand. I am currently on hiatus from performing for 6 weeks in order to get a running start in building a new hand, as it were. Check out Philip Hii!
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Re: Focal Dystonia

Postby ronjazz » Sun Jan 19, 2014 9:37 pm

Blondie wrote:
benessa wrote:I don't think you can label any one technique as causing focal dystonia. It's almost always a combination of several factors, which in any other player could have no adverse effects.


I agree that there are risk factors but I would say that certain techniques, or rather practicing certain techniques in a certain way, are themselves risk factors. It is interesting to see the problems that rock/metal guitarists get with FD in their fingering hand, for example, almost unheard of in classical players because we do not use the specific techniques they use and have an altogether more independent and more relaxed left hand. With CG players it is virtually always the right hand that is affected and where the highest load is put on the sensory motor system.

Whether the same combination of risk factors would trigger FD across different players remains to be seen, it would be virtually impossible to control all the variables to test this.


I think that the major reason is tension buildup. Releasing tension is the key to avoiding dystonia.
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Re: Focal Dystonia

Postby Blondie » Tue Jan 21, 2014 2:10 pm

Hi Ronjazz good to hear of your progress.

FD is such a deeply personal thing, especially finding our way out of it. If someone with FD is moving forward then they must be doing something right. I have a few questions about your post, these aren't meant to sound critical but I'd be interested in your thoughts. I have had several sessions with Jerald too, BTW.

ronjazz wrote:Interesting, Kate, I study body-mapping with Jerald Harscher, mostly by Skype but also an occasional face-to-face, and in two full years of regular sessions, I have been pronounced cured of the dystonia, and I am currently well into retraining.


-What do you mean by you have been 'pronounced cured'? It sounds like some kind of independent assessment but if so what and by whom?

-Following on from that, you go on to say you now well into retraining, which I find confusing. If you are cured why are you retraining?
The way I have see it is that the only successful way to recover from FD and move freely again is by retraining, in other words retraining is the route to recovery and re-establishing normal movement - yet it sounds like you are saying you recovered and then retraining is like a subsequent step?

ronjazz wrote:Also, I have observed many fine players resting their a fingers very lightly on the 1st string when doing rapid pim or pmi figures on the inner strings, this has been another cool discovery, which I have extended to resting my little finger on the 1st string while playing pima and its combinations on the inner strings. Resting very lightly, I emphasize, really just touching.


I used to do something similar and I can see why it helps with early retraining as any tactile point of reference for the fingers is going to help address the confusion in the nervous system when you have various unintended finger contractions. There is an interesting and detailed post from a pianist on the web who devised his own retraining routine (and fully recovered) which involved keeping non playing fingers touching the keys.

I went from the approach you describe to touching down a finger very lightly and removing it prior to playing, say, a specific arpeggio pattern and then eventually learning to play that pattern freely.

The issues I would have with the approach you describe in the long run are-
(i) Firstly that anchoring A, however lightly, inhibits flexion of M and anchoring C inhibits flexion of A.
(ii) Secondly, whilst it may help initially, it could become a crutch and if you are playing on the top strings you cannot do it.
(iii) Thirdly, FD is such a messy condition - the plasticity that gets us the condition is the same plasticity that enables our recovery which is the same plasticity that might cause a recurrence of symptoms in some form. I have always likened the process of recovery to squeezing the air out of an inflatable bed, as you focus on one area and push out the air, pretty soon a bubble pops up somewhere else. I'd be concerned where that planting might lead.

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Re: Focal Dystonia

Postby guit-box » Thu Jan 23, 2014 5:44 pm

What Ronjazz was saying is there are world class players who DO brace fingers on the strings sometimes. Here is Manuel Barrueco playing Asturias and bracing his a finger on the first string.

Youtube


I've seen others doing it as well. There is a Pepe Romero master class on youtube where he is working with a student playing the concerto aranjuez and he recommends bracing a finger in a section.

The main thing I take away from this, however, is not that bracing a finger is good or bad, but that we should always question and cross examine anything that is taught. It's important to make sure that what someone teaches is what they actually do when performing--not just while demonstrating. If it is taught that bracing fingers is always bad, and world class players use it for some techniques, then to me, making a blanket statement that bracing a finger is bad or will cause tension is much less credible.

Another example of this: I was taught early on to focus on playing from the knuckle joint, and there are many examples of this kind of teaching where the middle joint and tip joints are not addressed at all or simply called "helper joints". But after closer examination of world class players when they are doing fast activities like scales, arpeggios, and tremolo show them using a lot more middle joint than knuckle. This is even true of the players who recommend focusing on playing from the main knuckle--you can see them playing more from the middle joint and tip joints during performances. There's also advice that moving the finger phalanges in opposite directions will cause muscle against muscle tension, but you can see concert players flexing the middle joint and moving the proximal phalange away from the palm simultaneously. There's also what I would call a phobia about pulling up with the finger, but again I see most every concert player playing with some component of pulling up (perpendicular to the soundboard) when they are playing difficult or fast free stroke passages--and they don't get a bad sound, even though teachers say this will give a thin or fret slapping sound. I've posted around 50 videos of concert players right hands on the youtube channel listed above if anyone is interested in seeing for themselves.

Do any of these observations cure focal dystonia? Of course not, but I've had some success retraining my hand by changing my view point on a lot of technique that I believed was correct for over 30 years of playing. If the only legitimate treatment for musicians with dystonia is to retrain yourself how to play by using the brains neuroplasticity to find new pathways, then I think making sure you're using the best and most correct movements is critical. Traditionally accepted guitar pedagogy has some inconsistencies that can be seen when observing what hands are doing in slow motion. We didn't have the ability to look at what concert players were actually doing in close-up, slow motion videos 20 years ago, but now with youtube it's fairly easy.
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