Focal Dystonia Discussion

[eupho]

About 5 years ago I was forced to cancel a faculty recital due to Focal Dystonia. I stopped playing (euphonium) until last year. I took it easy by playing once a week with a community band. Things seemed to be improving until recently. I am experiencing the same type of difficulties when playing with a tuba quartet. Has anyone out there had a similar experience?

[Mudman]

Look up Jan Kagarice, in NY. She has a track record of helping people recover. Also call David Vining at Northern Arizona State University. He recovered, and has some good ideas on the process. His website has some info.

[scottw]

MaryAnn, here on tubenet has posted extensively on the subject--it is worth your while to search out her well-done posts.

[winston]

Look up Jan Kagarice, in NY. She has a track record of helping people recover. Also call David Vining at Northern Arizona State University. He recovered, and has some good ideas on the process. His website has some info.

I wrote part of my Master's thesis on Focal Task Specific Embouchure Dystonia. These are good people to look up. On the medical side - it may be worth contacting Steven Frucht http://www.mountsinai.org/profiles/steven-frucht" target="_blank, and Eckart Altenmüller http://www.immm.hmtm-hannover.de/en/ins ... enmueller/" target="_blank who have both written and researched extensively on this subject.

[happyroman]

Check out Roger Rocco's blog. He suffered from focal dystonia and has written extensively about it.

http://www.rogerrocco.net/search?update ... -results=1" target="_blank

[MaryAnn]

Beware of medical intervention. It very likely will not help and can do harm. Contact Jan Kagarice. She has cured over 300 people (I had a session with her several months ago, and it is well worth it) and the only failure was someone who went back to doing Caruso exercises against her advice. She supplies the concepts, forces you to change your mindset during the Skype or individual session (which may be not a lot of fun; it was not for me, but it was necessary) and depending on how much work you are willing to put into it, you can get completely fixed. PM me for Jan's email address if you can't find it otherwise. Much of the conceptual material she gave me, I have posted here, but the in person session is going to be necessary for most because of the paradigm shift needed. Best of luck.

[MaryAnn]

Others have gotten fixed by Joaquin Farias who has a clinic both in Spain and in (I think) Ontario, CA. His approach is to fix the emotional pathway. Jan's is to fix the mental pathway. None of it has to do with fixing technique.

[Doug Elliott]

I have had excellent results with a number of students who have come to me with that problem. I use a combination of methods, including correcting technique issues since that's what caused it in the first place. Controversial maybe, but every case I've seen has been a result of a lifetime of bad technique, in my opinion. Great musicianship can overcome such problems for a while, but eventually it comes back to bite you.

[ASTuba]

Seth Fletcher, who lives in the DC area, wrote his dissertation for his doctorate on this topic. https://libres.uncg.edu/ir/uncg/f/umi-uncg-1548.pdf is the source for it.

[timothy42b]

I read that dissertation. I noticed something about the descriptions, especially in the case of Fletcher. I hesitated a bit before posting, as I don't want to minimize the seriousness of this for those affected.

But some of the symptoms described, like unclear articulation, poor tone quality in an isolated register, difficulty with lip slurs, are precisely what beginners and amateurs struggle with. (and why I take lessons <grin>)

When these symptoms recur in a professional who has made it past those faults, they could have the same cause or a different one. I'm not sure how you would tell. Either way, from the Fletcher description they seem to have a similar cure, although his case demanded extreme application.

[k001k47]

I have no advice to give, but I do wish you well in your struggles. This type of thing is always hard to hear about.

[MaryAnn]

What has to occur is a change in the brain path used to play, which has gotten corrupted with signals that should not be in it. This can be accomplished in a number of ways. It should be noted that the vast majority of people affected by focal dystonia are high level pros, not amateurs and not kids playing with wrong technique. It is not simple to fix, and if it was simple to fix, it likely was a technical problem and not focal dystonia. I know one person locally who at the very beginning of the problem was able to change his mental focus. But he still has wayward muscle twitches that are visible when he is playing, that do not (currently) affect his playing. I'm hoping it never gets out of control for him.
Do your own research, take the path that sounds best to you, and if that path doesn't work, try another one. The thing not to do is practice harder. It will spiral you into a pit.

[Frank Ortega]

I found this video to be quite helpful.

https://www.youtube.com/watch?v=2pKHuH5L9Js" target="_blank

It explains how the brain is sending too much signal to the embochure and that a distracting element can help.
I find that if I raise my eyebrows in the mid to high register, it disrupts the signal.

I also studied the Carmine Carrusso method with a direct student of his, the great lead trumpet player, Tony Barrero. He rebuilt my embochure and made it stronger than ever.

Best of luck,
Frank

[timothy42b]

It should be noted that the vast majority of people affected by focal dystonia are high level pros, not amateurs and not kids playing with wrong technique. It is not simple to fix, and if it was simple to fix, it likely was a technical problem and not focal dystonia. .

From what I understand, the idea is not that bad technique IS the problem. The idea is that improper technique over a period of years eventually breaks down even though results have been good in the interim.

My father-in-law had recovered from childhood polio but his symptoms returned in later life, that may be related.

Why would amateurs not get it? Their brains should be susceptible to confusion too.

[MaryAnn]

All I know is that the people who actually successfully fix people with dystonia have told me what I said above. Most pros who get it will not let it be known publicly and may suddenly retire for no specific reason. I know of one high level tuba player who had to retire, but am not going to post his name.
If changing technique fixes the problem, then the brain pathway has been changed, and it is changing the brain pathway that fixes dystonia. There are many ways to change the brain pathway, and whatever one a person is successful with, they will then claim that whatever they changed away from is the cause of their dystonia.
I'm not going to argue about it; everyone has their own path to success.

[Donn]

From what I understand, the idea is not that bad technique IS the problem.

The two of you may have been saying the same thing -

...
But some of the symptoms described, like unclear articulation, poor tone quality in an isolated register, difficulty with lip slurs, are precisely what beginners and amateurs struggle with.

i.e., technique likely is the problem, in cases where bad technique is likely.

[timothy42b]

The two of you may have been saying the same thing -
.

Donn,
We may indeed. This is complicated stuff, not easy to observe or measure.

What I interpreted Maryann to say was that if a technique change fixed it, then it wasn't dystonia to begin with, it was just bad technique.

And in some cases that might be true. But the theory is that over time a technique that works but isn't right for your chops predisposes you to an actual dystonia. There may be other things - choice of exercise, perhaps - that predispose you to a dystonia.

With an amateur, we can make the assumption that bad technique is just that, bad technique. That assumption may not be always true either.

[Doug Elliott]

And what is "actual dystonia?"

This thing commonly called "focal dystonia" is only diagnosed by symptoms and there is no clear definition or test for it. Which means the people who are diagnosing it are only guessing.

I maintain that it is the long-term result of bad technique, no matter how well that bad technique was disguised or overcome by fantastic musicianship.

And as such, it's caused by inefficient and incorrect training, not by a neurologic pathway dysfunction.

Overcoming it is difficult because it becomes a phobia, and phobias are notoriously difficult to overcome.

Shaking, as it usually manifests itself, is a completely normal response to fear - fear of playing because you don't know what's going to come out.

[timothy42b]

And what is "actual dystonia?"

I certainly don't know. I was reacting to the suggestion of a neurological component that is different from or in addition to bad mechanics. I guess it was a bad choice of words.

I worked 8 years in mental hospitals and I saw a lot of mouth movement symptoms that were direct side effects of neurotropic medications - the tardive diskinesias, for example. So something along that line is possible but may not relate to musical problems. Some of these symptoms do not clear after medication is discontinued, they are more or less permanent.

It can be hard to replace a habit with a better one. Hank Haney failed with Charles Barkley, if you've ever seen the Haney Project. Hank Haney was a world class golf instructor, thoroughly knowledgable in the mechanics of the golf swing. Charles Barkley was a world class athlete with incredible coordination, awesome work ethic, responsive to coaching, had the time to take lessons and hit 1000 balls a day. But they didn't fix that swing fault. He could do a good looking swing in practice but as soon as he tried to play the old one would return.

[Doug Elliott]

I would like to point something out to those who think the symptoms that are called "embouchure dystonia" are Dystonia.

I said above that I think it is a phobia, or fear of playing.

Even people who DON"T PLAY A BRASS INSTRUMENT have their jaw shake when afraid - try a google search for it - TREMBLING, specifically of the jaw, occurs EVEN IN ANIMALS as a response to fear.

Every player who has come to me with this problem, when I mention "fear of playing" has agreed.
This is not to dismiss it - obviously it is a serious problem that is difficult to overcome.

BUT IT"S NOT DYSTONIA.