Pianist with dystonia
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Posted by: pianogirl ®

10/08/2003, 19:00:19

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I developed a focal dystonia some 3 years ago after a music festival over the summer. I really have no idea how it happened, just one day I couldn't play anymore. My problem is that my right hand thumb curls in into the palm, I have no control over it. It tenses up so much that I couldn't play a simple chord or a scale that any 5 year old could do. After going to numorous clinics and doctors we found out that I have dystonia and it was really difficult since for the longest time I didn't know what it was and still, I had to manage all the work at the conservatory, which was dreadful. I'll try to practice, I couldn't keep myself infront of the piano for more than 5 minutes since it was too frustrating and depressing. I would always end up coming out of the practice room with tears and anger. It made me seriously depressed and almost suicidal since I've always dreamed of becoming a concert pianist and I can't imagine a life without piano. I took a year off from school and thanks to my encouraging teacher then, I started to practice again little by little and managed to audition for graduate schools.
NOw, the symptom is not getting any better or worse but I think I am finding ways to deal with it on the keyboard. Somehow flattening the fingers help and I try to use as much contact on the keyboard as possible. I try to keep a constant but gentle pressure on my thumb against the keyboard, free my arms and my shoulder, but not too much that it's totally relaxed, and I am working on strengthening my finger tips so they'll grip the keys. Eating and sleeping well does help too, and I try to to forget taking vitamins.
I think the best way to deal with this is to have possitive attitude, and be happy. It is a medicine to any kind of disease or disorders. I have concerts and competitions coming up and I think I can do as well as the others who doesn't have any problems.






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Re: Pianist with dystonia
Re: Pianist with dystonia -- pianogirl Top of Thread Archive
Posted by: Leif S. ®

10/17/2003, 13:53:10

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Dear PianoGirl,
I totally share your pain. I know exactly how how feel -- I used to try to continue to "practice" repertoire, and within two minutes, I would be overcome with frustration, trying to figure out exactly why every time my third, fourth or fifth finger plays, my thumb lifts and my second finger flexes at the hand joint into the keys, making it impossible to lift or not play.
My symptoms came on suddenly in 1997, when I was practicing the Tocotta from Ravel's Tombeau de Couperin for five to six hours a day in preparation for a recital. So STUPID! What I would do to go back to those few weeks and redo them! After a couple of weeks of this ridiculous schedule, I noticed that my second finger was all over the place, and my third finger was curling involuntarily (I've since realized that the third finger was simply my body/mind's way of compensating for what is happening with my second finger, and I've only recently realized that my thumb's lifting is not so much me compensating but is really involuntary).
I am happy to report that I have made a fair amount of progress -- very, very slowly (it's now six years later!). All the progress that I've made has come from training myself to relax at the exact moment that I feel the cramping/urge to flex. One thing I noticed about your post was that you feel you have more control when your thumb is touching (with some pressure) the keys. I too have noticed that I have almost total control of my second finger when I am touching it with my left hand -- as if touching sends a signal to my brain reminding it of where my second finger is. From this (and this is after years of obsessive experimenting), my latest exercizes have been geared toward training my brain to be aware of the orientation of all my fingers as I slowly move them -- not only telling my second finger to relax when it feels the urge to flex, but thinking "okay, your second finger is here -- feel how it is an independent finger, not attached to your third finger". I do think it is helping -- and I have not given up the idea that I will eventually improve enough to play as well as I know that I can.
Good luck with the competitions! I'd love to hear (a) what you are playing and (b) what sort of exercizes, if any, you are employing.
Best,
Leif






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Re: Pianist with dystonia
Re: Re: Pianist with dystonia -- Leif S. Top of Thread Archive
Posted by: pianogirl ®

10/17/2003, 18:11:28

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Dear Leif,

It's so nice to know that there are so many people that are going through and over coming this problem. I totally agree on exercising the brain and to be aware of the orientation and independance of the fingers.

To answer your questions..
a) I'm playing bach partita no. 1, Beethoven sonata op. 110 and the e flat major one.. I think it's op. 81, Debussy Images book 1, Rachmaninoff concerto no. 2, some chamber music pieces, and I am also accompanying singers.

b) I'm constantly doing "mental" excersices on the piano whenever I practice, I try sending signals to each of my fingers and muscles indivisually.

Here are some of the exercises I do to deal with it and it seems to help.

Playing staccatos. - I'm woking on strengthening my whole hand and fingers tips and developing indivisuality back. It works with Bach suites which doesn't have much complex fuges. I repeat practicing until I am absolutely sure of which fingers I'm using and reassuring that until I'm mentally really confortable. I don't think too much about relaxing the hand when I'm doing this, but rather relaxing the wrist and shoulder, and not to forget that the arm must move.

Standing on one finger. - Play a note with a finger and try to relax the rest of the fingers. When it is too hard, I allow my left hand to hold my finger tip ( and only the finger tip) of the finger that is holding the note, until the hand decides to relax.

Tap the key - with one finger at a time. This has to be quick and light and hand has to be relaxed as possible.

Lifting hand and arm slowly from the keyboard. - I tense up I don't think much about it, so I lift my arm up slowly, slow enough that I feel the balance between the gravity and the lifting force. I could apply this on my playing and it helps a lot.

I find it better to pick a piece to practice than to do etude type of repetitive excersise because first of all we have to spend much more time learning a piece, we wouldn't want to waste much time doing something we won't be able to play or perform eventually, second, we could make etudes off of any piece of music anyway and third, it feels better to know that you're actually working towards making actual music and I think your brain knows.
These are the things that I think about when I practice. I use these techniques depending on the pieces, using one or multiple combinations when needed.

1. It helps to have pressure against all the fingers against the keyboard, especially the one with dystonia even when the fingers are not actually playing the notes. Using just the weight of the hand.

2. Occasionally it help to use the whole arm weight, and to feel the five finger tips against the keyboard indivisually when playing big chords which require a lot of control before playing. I experiment on which direction should I lean towards to that is most comfortable for my hand - is it downward towards my thumb side or towards my pinky side, or should I focus more towards my third finger?

3. On some legato passages I flatten my fingers and try to imagine using the weight and the force fron the knuckles. When doing this, I grip the keyboard with my fingers inwards as much as possible, so that it has a sticking sensation. (Not too much that the arm is tense).

4. I also experiment on angles with the forarm. Sometimes it's better for me to angle it inwards.

5. I move my forearm, and free it to move as much as needed.

So! These are some of the things that I thnk about.. after some obsessive experimenting, that are working for me. I'm sure there are some more that I apply that is useful, but I can not think of anything else on top my my head at the moment. SOmetimes when nothing seems to be working and the dystonia seems at the worst, practicing internalizes after some time. After a week, day or two, or even after a short nap, I don't have to think much about coordination, or be obsessed about it, and at times I can play it perfectly fine. I got to the point that sometimes I even forget I have it, especially when I'm performing, or when I'm getting some kick off the adrenalin. It's funny. I don't practice when I'm too tired or simply when I don't want to. But I find the most important thing is to keep practicing and not giving up.
Good luck to you too! Pianogirl

If anybody have any exercise they do that seems to help, I would love to know.








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Re: Pianist with dystonia
Re: Re: Pianist with dystonia -- pianogirl Top of Thread Archive
Posted by: Leif S. ®

10/28/2003, 18:27:31

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Dear Pianogirl,
Sorry to be so slow to reply. I have been very busy at work.
Anyway, thank you for your very thoughtful message. I read it with great interest. First, it is encouraging that someone afflicted by this condition can still play such demanding repertory. What I would do to learn the Rachmaninov second at this point! I used to play "Les Adieux", which I believe is the E-flat major sonata you were referring to, but now that would be out of the question.
Second, I appreciate learning what you find helpful. I think the exercise you call "standing on one finger" looks (especially) really good, even for a pianist who doesn't suffer from focal dystonia. If you focus on letting the weight of your arm be conducted through your finger, without any "pressing" (i.e. pushing from the tricep) but rather with pure relaxation of the arm (i.e. letting gravity do 100% of the downward force), and then don't let your finger tips collapse while relaxing the rest of your hand (i.e. so that your finger tip is counter balancing the weight of your arm), your body can learn to play with arm weight to achieve a nice full sound by playing from the surface rather than by "hitting" the keys. So many pianists haven't learned this basic and fundamental lesson. Playing this way also allows you to play as loud or as soft as you want (for example the opening chords of the Rach 2 are controlled through arm weight, and the crescendo is the result of each chord being the product of slightly more arm weight -- not through "pushing the keys harder"). It's how all the great pianists play.
This weight exercise through one finger has helped my FD a lot as well, but it hasn't totally fixed everything. Lately, I've been having a LOT of benefit from the following exercise: As I mentioned, my problem is that, when I play 3, 4 or 5, my second finger flexes at the hand joint and hugs my third finger, and my thumb tightens and lifts. So, I've been lifting all my fingers from the hand joint (as if I was waving "hi" to someone), but letting my thumb drop so that it is not extended (as if was playing). Then, I slowly flex my fourth finger from the hand joint (as if it now too is going to play) and try to have my thumb and second finger be unaffected, NOT by stiffening them, but rather by not letting them cramp. It's a total mental exercise. It has helped a fair amount in the last few months. I do the same thing for my 3rd and 5th fingers as my fourth, but it has especially helped with the fourth. Also, I can do this exercise both at the piano or away (for example, on a table or desk). I'm guessing that, whatever one's coordinational difficulty one is having, one can extrapolate from this exercise and find it beneficial. At least I hope that is the case.
I really find this problem to be a lonely one, don't you? I mean, I just LOVE the piano. It's so much of who I am. And yet, I feel like I can't play for anyone any more -- and there is really no short, simple way to sum up why I can't. There's no sound bite for focal dystonia, and no one knows what it is.
But, anyway, I really do survive based on hope. If someone said to me: there's no chance of this ever getting better, I really don't know what I would do. But, I TRULY believe that it can be fixed. I've personally experienced a great deal of improvement. The brain can be retrained. Look at stroke victims, etc.
Anyway, I'm rambling. Hope your competitions are going well.
Best,
Leif






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Re: Pianist with dystonia
Re: Re: Pianist with dystonia -- pianogirl Top of Thread Archive
Posted by: Leif S. ®

11/03/2003, 17:26:08

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Re: Pianist with dystonia
Re: Re: Pianist with dystonia -- Leif S. Top of Thread Archive
Posted by: pianogirl ®

11/04/2003, 23:08:21

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Hello.
My comeptition went well, I am pretty happy with the way I played. I guess it could have been better if I wasn't so nervous, but I still can't help thinking about loosing complete control of my dystonia hand expecially with something exposed as Bach and I know that I need to control every single note. It is just too difficult to play the piano when I start thinking too much, so I try to let it happen and believe in the body and mind. It takes a lot of courage.
Lately I have been meditating and imagining that my dystonia hand is moving without any problem. It is definately helping me since when I go back to the piano it is much better already. There is so much that our body can do and we sure do not know the limits of our abilities. I am now pretty convinced that with strong will, hard work and optimism is going to help us overcome this.. atleast when we're playing the instrument. ( I could play rach 2 fine but I really can not type with my right hand... yes it's really strange).






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