Focal Dystonia of the Hands: Info for Guitarists
Holy Moly! Focal Dystonia! Of all the bum cards you could be dealt, this one is the bummer of the bunch.
After all the hard work you put into your playing, all the hours and days spent honing this craft, imagine losing it all. Imagine your hands not working anymore. Imagine doctors not having a clue what to do about it. Imagine how tragic, distressing, frustrating and heartbreaking something like this could be. Then double it.
Focal Dystonia is one of those silent maladies that is all around us that we rarely hear about. My musical coach has it (though he staved it off for 15 years since he first got serious symptoms. More on that later.) And I have been surprised how often I am contacted by guitarists (typically advanced players, well-studied) suffering from the effects of Focal Dystonia.
What is Focal Dystonia?
Disclaimer: I am not a medically certified anything. I don’t even know CPR. If you suspect you may have focal dystonia, widen your research to beyond this guitar blog!In a nutshell, focal dystonia is an affliction where your brain sends your muscles too many commands at once. The result is a total traffic jam of muscle movements, which creates a clinching spasm.
Instead of playing an arpeggio pattern, say, PIMA, You instead have a cluster of fingers all at once. Like this:

Nice and tidy

All jumbled together
Focal Dystonia Treatments
People and doctors are experimenting with many different cures and treatments. (surprisingly, Botox is a common treatment! Though the effects are temporary.)
One treatment, that could also help as a preventative, is practicing slow, exaggerated movements.
For this, you would break down all the separate motions that go into a stroke, such as an arpeggio, or I and M alternation. Then you would play each in turn, slowly, exaggerating the follow-through.
(I was happy to learn that my methods for I and M alternation, and for playing arpeggios, jive well with this, because I suggest breaking down the movements to begin with. I got lucky on that one!)
This is how my coach was able to continue performing publicly for 15 years after first diagnosing his focal dystonia. He went back to square one, and practiced slowly, examining and retraining every movement involved with basic technique. Never underestimate the power of patience and a serious work ethic!
Re-visit your basic technique
For us all, this is one more reason to slow down and focus on good technique. If you haven’t in a while, this would be a great time to set aside a practice or two to re-visit your basic movements, and re-train any non-optimal habits you may find.
Here is a lesson on fundamental movement.
Here are 5 common mistakes guitarists make.
Here is the course on arpeggio technique.
Here is the lesson on I and M alternation.
Other resources
Other avenues that may prove helpful:
1. The Alexander Technique – I have studied this for years, and it is probably the absolute best thing I have ever done for my daily quality of life and bodily health. It’s not easy to talk about unless you have some experience with it, but it’s well worth the investment for lessons. (For US residents, make sure you get an AmSAT-certified teacher. There are others, but the AmSAT standards are miles higher. If you are not in the US, I am sure you can do an internet search for a teacher nearby.)
2. Body-Mapping – Body Mapping teaches the basic fundamentals of movement. Some people compare it to the Alexander Technique, but that would be like comparing a story with an actual experience. It’s a whole different thing. Still, Body Mapping is quick and cheap to learn (AT is not) and is valuable for what it is. It is simply intellectual knowledge, whereas AT teaches through bodily experience (i.e. you could learn all about a peach, or you could learn about a peach while actually eating one.) If you get the opportunity to take a Body-Mapping workshop, I would encourage you to sign up.
3. The Poised Guitarist – Thanks to Sasha Ahuja for turning me on to this guy. He’s a guitarists who used Body-Mapping in his teaching, and specializes working with people with focal dystonia and repetitive stress injuries. There are some great videos on his home page that are worth a watch.
4. Do you have others that belong on this list? Let me know, please, either via a note or in the comments below.
Conclusion
If you have focal dystonia, you have my complete sympathies, and I encourage you to stay patient and dedicated to slow practice.
If you are all clear, I encourage you to thank your lucky stars and periodically return to fundamentals and basics.
Do you have any experience or knowledge on focal dystonia? Please share it below!

Hi, I’m Allen Mathews.
I started as a folk guitarist, then fell in love with classical guitar in my 20’s. Despite a lot of practice and schooling, I still couldn’t get my music to flow well. I struggled with excess tension. My music sounded forced. And my hands and body were often sore. I got frustrated, and couldn’t see the way forward. Then, over the next decade, I studied with two other stellar teachers – one focused on the technical movements, and one on the musical (he was a concert pianist). In time, I came to discover a new set of formulas and movements. These brought new life and vitality to my practice. Now I help guitarists find more comfort and flow in their music, so they play more beautifully.
Click here for a sample formula.
I have to say, two practices later [after a video review] with the new position - the difference it's made in my playing is... unbelievable, really. It's like many months of improvement overnight.
Everything is so much more secure, left-hand stretches are easier, I feel like I'm getting way more volume for the same effort, the tone is noticeably better all along the neck, and the list goes on.
Thank you!
~ Alexander Mosolov
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Thanks for your on-going support. I never expected such a personalized approach when I signed up.
~ Harlan Friedman
-Harlan Friedman
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