If you have experienced the symptoms of “musician’s task-specific focal dystonia” (sometimes referred to as “MD”, for “musician’s dystonia”; or simply “FD”, for “focal dystonia”), you know all too well the feelings of despair, bewilderment, frustration and hopelessness that come with this debilitating condition.

Most unfortunate, many musicians with FD don’t even know that they have it. They simply know that they have an inexplicable loss of the fine motor control most specifically necessary to playing their instrument. If you’re a brass instrumentalist, it’s typically a loss of control over the the muscles directly involved in tone production (embouchure dystonia), and if you’re a woodwinds instrumentalist, it is either in the embouchure or the hands. (As a saxophonist, my focal dystonia is in my left hand, which is known as “hand dystonia”.)

If you play a string or percussion instrument (including piano), the manifestations of dystonia might be in your hands, or wrists and arms, or even in your neck. (The neck can also be another place that is affected for wind instrumentalists and singers.)

This description of task-specific focal dystonia given by the National Institute of Health is concise and accurate:

“Musicians Dystonia is a movement disorder, most often referred to as a neurological condition. Part of a larger group of focal dystonias known as “task-specific”, MD is characterized by an unexplained loss of fine motor control in the parts of the body that are most directly involved in the skilled, learned movements necessary in playing a particular musical instrument.”

And more specifically for hand dystonia:

“Some of the most common symptoms of musician’s focal hand dystonia are: unexplained loss of finger coordination/control , unwanted flexing (curling) of fingers, a diminished differentiation between fingers (two or more fingers acting as if they are “smeared” together into one), fingers feeling “stuck” onto the keys, strings, etc., rigidity/lack of control in the wrist, and cramping of the hand due to the compensation of the dystonic fingers.”

And for embouchure dystonia:

“Embouchure dystonia manifests itself in an unexplained loss of control of some of the mechanisms of the air stream involved in playing a wind instrument. The most common symptoms of embouchure dystonia are: tremor/spasms in the facial muscles while playing, loss of control of the corners of the mouth, loss of control of the tongue and other ‘voicing’ mechanisms in the mouth, such as the soft palate, tongue, and throat muscles, as well as the jaw. As in hand dystonias, musicians with embouchure dystonia often complain of their facial muscles, lips, tongue and/or jaw as feeling ‘stuck’ (i.e., unable to move freely).”

If you suspect (or know through a diagnosis from a neurologist specializing in focal dystonia) that you have MD, I’m here to tell you that there is hope. There are ways of improving this condition. I know this to be true because I have learned to manage my condition to a degree that has allowed me to return to a highly satisfying and consistent level of skill as a saxophonist and improvising artist. I have also been able to help a handful of other musicians (both with embouchure and hand dystonia) learn to effectively manage their condition, as well.

The consensus among neurologists is that there is no “cure” for MD. I don’t disagree with this, as I don’t think that MD is a “disease”, i.e., something with a “measurable” pathophysiological element (no measurable neurological damage). Instead, I think of MD as a neurological “condition” that has been acquired unintentionally over time, possibly through unhelpful habits of attention that are cultivated in the practice room and in performance.

In a sense, it is something your brain “learns” to do (unconsciously) as a result of frequently repetitive movement patterns. (This is sometimes referred to as “Mal-adaptive plasticity” in neuroscience). And anything that is learned can be unlearned, at least to a certain degree.

My work is in helping you to unlearn the patterns that perpetuate the dystonic symptoms, thus helping you access the healthier pathways that support and improve your functioning on your instrument. This is not a quick fix, nor a “simple” task, but rather, a flexible and dynamic approach to helping you find your way back to satisfaction on your instrument through exploration, activities and new cognitive concepts.

Even though the symptoms of Musician’s Dystonia only “appear” in the muscles most directly involved in playing a particular instrument, it is, for all practical purposes, a “whole body/whole person” phenomenon. In other words, the pattern of reaction manifests itself throughout your entire physical being (posture, movement, breathing, quality of attention, emotions/feelings, etc.) Improve how you react in this “whole body/whole person” way and you indirectly begin to subvert the old dystonic pathways.

That’s where my work comes in. Using the principles of the Alexander Technique, I can help you become aware of, and prevent or lessen, the “whole body/whole self” habitual patterns that are manifesting themselves as dystonic symptoms. I’ll also use these principles to help you develop more constructive habits of attention, so you can begin to develop the calm, clear and dynamic quality of attention that supports and encourages improvement.

I have studied extensively (and continue to study) the science related to task-specific focal dystonia, including neurophysiology, cognitive neuroscience and kinesiology. I carry a fairly extensive working knowledge of the anatomy and physiology of the bones, muscles, joints, etc., with a particular focus on facial muscles, vocal mechanisms, the breathing apparatus, and the structures of the hands, arms and shoulder girdle. It is my aim to provide you with the knowledge, skills and strategies to effectively address your condition.

I feel deep empathy for any musician who has focal dystonia, and always proceed with kindness, respect, honesty and hope. This is truly my passion. I do this work both in person and remotely. Please know that protecting your anonymity is a top priority for me. I aim to create a safe, open and caring environment for you to improve and grow. My fee for this work is based upon an “ability to pay” sliding scale. It is my aim to make it affordable to all who need it. I also offer a free initial consultation for you to see if my approach would be a good fit for you.  Please contact me to learn more.

Here is a link to the Focal Dystonia Research Foundation’s page on musician’s dystonia.