In this programme, I aim to integrate all the most relevant aspects of current research with my own specially devised exercises, based on my observations and experience of working with pianists with dystonia. These exercises have not been scientifically evaluated, but have shown to be of significant benefit to pianists with dystonia.

 

Inspirational practice

 

You may need to rethink your role as a pianist and your priorities to ensure that your practice methods do not exacerbate the symptoms.

 

• Aim for a good balance between work and relaxation.

• Rethink your practice methods and allow more regular breaks during practice.

• Above all avoid mechanical finger-work practice which is divorced from emotional engagement. Have a clear musical image of everything you play so that technique can flow in response to the emotional content of the phrase.

 

Technical retraining

 

With each pianist with dystonia I create an individualised programme depending on the specific nature of the problem. A programme typically consists of around eight to ten weekly or fortnightly sessions. In the first session I assess the most urgent technical problems and suggest exercises which are tailored to the pianist’s specific needs. New exercises are introduced in each subsequent session, so that the pianist remains motivated and inspired as the technique is gradually modified.

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The main purpose of the exercises is to teach the body (and brain) a new repertoire of ergonomic movements which reintegrate the fingers with the rest of the body. Each movement has a very direct effect on the sound, which offers immediate feedback via the improvement in quality of sound.and musical expression. Each new movement should be learnt at a speed and dynamic level at which the dystonic movement does not occur. Practised thoroughly, the new movements become habitual and so powerfully embedded into the subconscious that they replace the old dystonic movements.

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Piano exercises

 

I have found the following exercises the most relevant for pianists with dystonia. All are explained in more detail in The Complete Pianist.

 

‘The Roskell Parachute touch’ – this is particularly important for pianists with curling fingers, as the fingers are trained to open out, rather than bend. Focus on playing on the fingerpad, rather than on the fingertip in this exercise.

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‘The Parachute touch in chords’– the whole arm is integrated into each movement so that the load is shared. Fingers are supported by the arm in everything they do.

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‘Evenly curved fingers’ – many pianists with dystonia play with a distorted hand position. The hand needs to play in its natural position, with fingers evenly curved.

 

‘Releasing the non-playing finger’ and ‘Note endings’ are particularly helpful for pianists with fingers which lift involuntarily.

 

Scale technique – focussing on integrating the fingers with the arm, especially when passing over the thumb.

 

Re- aligning the hand – The hand is retrained to work around its natural alignment, with the third finger in a straight line with the forearm. A supple wrist allows the forearm to take each finger to its note, so that the playing finger is always in line with the forearm.

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Rotation – rotation movements re-integrate the fingers with the arm and are useful training for pianists with dystonia.

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General posture exercises – many pianists with focal dystonia have a tense overall posture, which can be improved over time with help from Alexander Technique, Feldenkrais or Yoga (See Yoga for Musicians DVD).

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Incorporating other techniques

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I incorporate elements of the Mirror treatment and Slow-down exercise treatment into each exercise. Each exercise is learnt initially with the non-dystonic hand, as it is important that this is working with a healthy technique from which the other hand can ‘learn’. It is then introduced to the dystonic hand in mirror image, at a slow tempo (initially a mirror box may be used). The tempo is only increased very gradually and never beyond the stage where the dystonic movement re-occurs.

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