The Three Basic Categories of Injury

1. Pain/discomfort that arises in a certain playing situation or passage. In other words, it’s specific to the situation (such as which side of the stand you’re seated on) or to certain demands in the music (repeated passages on the G/C string or sustained ff tremolo, for example).

2. Pain/discomfort that is in the playing generally, regardless of repertoire and situation.

3. Pain/discomfort that is pervasive, where the person experiences chronic pain in daily activities and in multiple parts of the body, sometimes all over. These injuries can be debilitating to the extreme. They may have started with the playing or with an external event.

The Recovery Process

Changing a habit means reorganizing the brain and relearning how we use the body, which is not usually a quick fix. However, when the solution is in line with how the body and brain function in normal activity, recovering from an injury can be remarkably fast, especially compared to the time it probably took for it to manifest. Furthermore, musicians’ innate and highly trained capacity to understand and adapt their playing speeds the process. Once undertaken, most people find the process stimulating and exciting. 

Solving playing-related injuries happens in four stages, all of which involve gaining physical tools and knowledge while moving the brain—changing a person’s concept of how an aspect of playing works, and then locating the specific physical movements involved. There is a general trajectory to the process, but in practice the four stages overlap.

1. Getting the player out of pain/dysfunction through an understanding of the correct physical movements and what those movements feel like in the body.

2. Ensuring that this knowledge and technique can be applied to and meet the specific demands of the music, solving problem passages and situations.

3. Ensuring that the new technique is integrated, so that it can be maintained in the workplace, such as during rehearsals or while teaching.

4. Ensuring that the playing is integrated to the point of stability in stressful situations, such as performances.

A Special Note on Musicians’ Focal Dystonia

The first thing to understand about dystonia is that, like all other playing-related injuries, it is reversible. The neurological component of the condition can make the trajectory more complex and the timeline less certain, but the bottom line is that employing healthy movement patterns creates healthy and functional neural pathways.

The first question many musicians suffering from dystonia have, understandably, is “will I recover completely?” The answer is that, with the correct information and the time needed for the brain to assimilate it, complete recovery is not only possible, it is the expectation. In fact, going through the retraining process usually produces playing that is much more efficient, comfortable, and reliable than even before the dystonia.

The second question is, “how long will it take?” There is no simple answer, as the process is dependent on a combination of factors, including the number of technical “misunderstandings” that have taken root in the brain, how many of them are directly contributing to dystonic symptoms, and how fully the player is able to commit to the retraining process. Additionally, the gravity of the dystonic symptoms does not necessarily predict the timeline for recovery.

The dystonia recovery process is not necessarily an easy one, but it yields innumerable rewards: a renewed career, greater ease and reliability, and a wealth of insight for helping ourselves and others. When playing feels intuitively right, the joy music awakens in all of us can deepen and expand infinitely.