More on FD.
The homunculus is a body map of brain power devoted to process touch receptors. You will see from a representative model that the hands and fingers of the homunculus achieve huge proportions. Unfortunately the abnormality of the normal homuncular organization of the finger representations becomes hard-wired with FD and is therefore very difficult to normalise.
Whatever barriers you build to block dystonia it will always find a way in. For example, some sufferers find that they can deceive dystonia by sensory tricks - like wearing a latex glove. The trick may work and dystonic reaction deceived. But the relief is only ever temporary (a minute or so) since your dystonia will find a workaround to plague you once more. Likewise, altering your seating position, angle of wrist, position of arms and hands may all improve your playing, but only for a very short time. I daresay you will try all this in the early stages, but to save you heartache I can guarantee that they will not work. Some people have even spent years in fruitless experimentation. Neither will dystonia 'dry-up' if you do not play for a year, ten years or even longer.
Useful ideas to take on board include playing below the threshold of dystonia. This means playing slowly (and I do mean slowly) and softly to the point where dystonia does not intervene and then gradually building up from level zero. One Asian concert pianist in the USA has recovered using this technique. A traffic light scenario is also useful. Here you stop at the point where dystonia intervenes, relax, refocus and carefully move on. With practise the 'bump' may be shortened to the point where it becomes imperceptible. The point of these techniques is to encourage and register clean signals and clean movements.
However, the best method of recovery (in my opinion) is to take the CIMT/SMR route. This will effect change where change is really needed - in the brain. If you are patient enough (and tough enough) to undergo therapy for the requisite time then there is no reason why your condition should not significantly improve. Retraining then becomes much more viable, but you will probably have to abandon most of your present neural pathways. In short, effect a complete change in technique and approach as I have done. Hard as it sounds there is no going back once you have FD. It?s too late for that.
At least we live in a more enlightened era of medical knowledge. Not so long ago the condition was dismissed as hysteria and sufferers more likely to be referred to a psychiatrist then a neurologist. Science-based approaches to treatment have come a long way in the last twenty years and the prognosis for FD better with it. Take heart and remember that
Hopefully my brutally frank prognosis is tempered by enough positives to see you through.
QUOTE(Hammerklavier @ Dec 18 2010, 06:12 PM)
Hello,
I have been having terrible problems with the performance of my right hand when at the piano. It has been a problem for three years and in the last 12 months, has become increasingly worse. During the past 6 months, it has deteriorated so much that I can now barely play. I have been to see a hand specialist and have been told that I have Focal Dystonia. Having researched the condition and discovered that quite a few musicians are afflicted with this condition, including some very well-known performers, I thought I would ask and see if any Forum readers know anything about it or have had experience of it and most importantly, suggestions on how to overcome it
I have to see a Neurologist as a next step and have been told that I am likely to face a long and arduous path in attempting to overcome it.
Thank you.
Glad to hear that you can still play at least a little. Some musicians end up completely crippled and cannot play a single measure cleanly. Sounds like you are 'fortunate' enough to know what the problem is early on when remedial action is easier.
Good luck tomorrow.
I would advise you to temporarily stop playing with immediate effect. Believe me, no amount of ?practise? will help: indeed it will only worsen the situation, making any sort of recovery more difficult. Your doctor/neurologist should also check that you do not have mechanical problems as well - such as Carpal Tunnel Syndrome. Most FD sufferers also have one or more mechanical problems on top of FD, often as a result of frustrated attempts to play.
I sympathise for you. We are told that FD is a greatly feared condition, but most musicians have never heard of it - unless it affects them. Then it consumes their lives. I can empathise too because I was diagnosed with FD six years ago.
As you probably now know there is no cure for FD and it has ruined many careers in music. However, while not curative there are palliative or remedial techniques that help. Some musicians may resume professional playing, although they are a minority.
It is thought that FD, a neurological condition, arises from the smearing of digital representation in the somatosensory cortex of the brain. With practise and specialisation these areas expand and begin to overlap. Confused signals are sent by the brain, so that there is a lack of coordination and muscles simultaneously flex and extend - hence the term musicians? cramp. If a pianist then your ulnar digits are probably affected (4th and 5th fingers). Efforts to train these anatomically restricted fingers - by such destructive means as Pischna or Hanon, or endless repetition of a difficult piece - probably cause the smearing.
One remedial technique is derived from Constraint Induced Movement Therapy (CIMT) used for stroke victims, and is often referred to as Sensory Motor Retuning (SMR). Here an analysis of movement is made to identify the compensatory movements the body makes to overcome dystonic flexion. These movements are immobilised so that the dystonic digit(s) is forced to work with a healthy one - and all other movement is eliminated. This process is repeated systematically with other digits over a year and gradually retunes digital representation with varied degrees of success. All pianists and string players register improvement.
Another option are injections of botulinum toxin (Dysport or Botox) into the flexing muscle using a scanner. This interrupts neural transmitters and stops flexion. The effect is temporary and injections are required every three months. Also, by paralysing a muscle or muscle-group your playing will still be affected, albeit for different reasons.
Yet another technique is movement retraining, which takes an holistic approach. Or heightening sensitivity with the afflicted digits by reading Braille.
Acupuncture, massaging, faith-healing, meditation etc will not work. Massaging may alleviate stiffness, but will do nothing to alter the brain. It is purely palliative.
The best option is to use everything available in combination. MSR does work in time, and should be followed by retraining using a different technique. That, at least, is my recommendation.
I can play again, but with a vastly different technique that relies chiefly on intrinsic muscles. The tone is much smaller and the balance remains fragile: I still spend an hour each day on CIMT/SMR. The main point, however, is that there is still life and hope after diagnosis. Be kind to yourself.
I hope you find ways to continue enjoying music.