How to Practise When You Can’t Practise (On Focal Dystonia – final)

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Re-learning and Recovery

(*My apologies for not writing sooner, it has been a very busy time at Uni with many assessments due recently!)

There are some words which (bad) writers of popular science like to throw around in order to sound impressive. Quantum is perhaps among the most frequently abused terms, for instance. Another would be statistically speaking. (Did you really analyse the sample distributions, and compute the variance and correlation coefficients? Didn’t think so). Another buzzword, and the one pertinent to our discussion here, is neuroplasticity. Fortunately, unlike quantum field theory and statistics, we don’t have to pretend to understand neuroplasticity, since there are many cases where it is clearly visible, and I believe its core concepts are readily grasped by the general public. In addition, popular science titles like The Brain That Changes Itself by the neuroscientist Norman Doidge certainly increase public awareness and understanding of this issue. We can observe directly that the brain is capable of remarkable change and adaptation.  One of the most dramatic and convincing examples of this is the phenomenon of “phantom limbs” — the ability to feel pain or itching or other sensations in missing limbs. If you are interested, I will save you from googling for unreliable sources, and link this journal article by Ramachandran & Ramachandran (2000). The important and (at the time) revolutionary idea is that the brain is not a static organ. The brain map can be reorganised — new neural networks can be created, and the physical topography of the brain is susceptible to change. This is reassuring for those with dystonia. It means that there is a possibility of “unlearning” the dystonic movements, and creating new neural pathways to replace the old, misbehaving ones. Many dystonia researchers now recognise re-training as a viable treatment option, and from a musician’s point of view, I believe it is also the most useful and least harmful. Medical treatments can work very well for some individuals — and depending on the severity of the symptoms, may even be essential — but the prospect of taking botox injections several times a year, for example, is not exactly pretty. However, re-training requires considerable time investment and dedication… then again, isn’t this exactly like learning a musical instrument!

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On Focal Dystonia (2)

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As far back as November 2012, I was noticing a strange sensation in my left hand. During a recording session, I noticed that I could not control my vibrato, and especially when the middle finger was involved. However, I simply attributed this to occupational stress, since there was no pain at all. The holidays were coming up, and I would get a good break, so I was not worried. Near Christmas time, when I was already well rested, I decided to do some practice, which was when I noticed that I had trouble keeping the middle finger on the fingerboard. Any violinist can tell you that already this is a strange turn of events. Typically, the middle finger is one of the strongest, and as far as vibrato is concerned, often the easiest finger to use. Actually, what perplexed me the most was the complete absence of pain. (I’m glad to say that I’ve never experienced pain in my musical practice. Violin playing, or indeed, playing most orchestral instruments, is not inherently comfortable, but I think it’s clear that it should never involve pain!). This made me suspect that there was more to it than the usual repetitive strain injury.

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