View Full Version : Focal Dystonia

Thomas Zöller
05-08-2004, 07:45 PM
Hi there!

Has anybody suffered from a focal dystonia in the piping scene that you know of?

Best wishes,
Thomas Zöller

Wade Reeser
05-09-2004, 06:22 PM
I am fairly sure that our own Chris Hamilton (Tone Czar) suffered from focal dystonia. I believe it stopped his piping for awhile but he successfully rehabbed himself and is currently playing both in grade 1 band and open solo competiton.

Chris Hamilton
05-10-2004, 06:14 PM
Yes, that's correct. It destroyed my solo career and eventually I stopped piping altogether for three years (no solos for eight years). But, like a phoenix, I'm back. I still have problems, but I manage to work around them and disguise them reasonably well. Most people are very surprised when I tell them I have this affliction.

I have met many other pipers who have suffered similar and worse affliction by Focal Dystonia.

The keys (according to the Arts Medicine specialist who helped me):

1. Change your repertoire - avoid tunes that have movements that are problematic.

2. Change your technique - move your hands around, get comfortable, get leverage, do what it takes to make it work.

3. RELAX - don't try to force anything, that only makes it worse.

There are drugs available, but they're of limited use and may or may not help.


Kevin F. Gilstrap
05-11-2004, 12:43 PM
I believe that Hamish Moore also suffers from this.

Chris, what were the early symptoms? What was it that sent you to the doctors?

Thomas Zöller
05-12-2004, 01:45 PM
Hi there!

Thank you Kevin, Christopher and Wade for your answers!

If anybody knows more, PLEASE post.

All the Best from Glasgow,

Chris Hamilton
05-12-2004, 02:12 PM
Originally posted by Kevin F. Gilstrap:
I believe that Hamish Moore also suffers from this.

Chris, what were the early symptoms? What was it that sent you to the doctors? That's correct, Hamish does. Some other famous names as well.

The problem started in the summer of 1987. I was warming up to compete in the Professional MSR at a local games, and I was practicing "Abercairney Highlanders", and suddenly, without warning, I could NOT play the first phrase -- long Low A, quick B, grip to C -- without the B finger moving involuntarily halfway through the dotted 8th note A. This literally did not happen the day before or at any other point in my 15 years of piping prior to this. I was known for my excruciatingly clean and crisp fingerwork.

And the odd thing was, no pain. I thought, "Carpal Tunnel? Where's the pain?"

From that humble beginning it began to affect anything involving the B finger, mostly A-B-C or A-B-D with a grip, throw, or doubling (especially with a long A / quick B). I could mitigate it somewhat by adding a D gracenote on the quick B, but of course that goofs up the timing and the accenting. I couldn't even play "Scotland the Brave" !!!!!

I went to an orthopedic surgeon. He examined my hand and told me that there is nothing wrong with it. Perfectly normal.

Normal? I couldn't play simple things that used to be auto-pilot!!

No clue, no cure, nuthin'

After a year of this I gave up on solos. After 4 years I gave up piping completely (though I will say that a nagging spouse (not The Lovely Heather, mind you) and general burn-out had a lot of influence there as well. I was out of piping almost entirely from fall 1991 to fall 1994.

In 1994 I began to play again (got "the bug"!) and for the first week the problem did not appear. It was gone! Then it returned ... ugh ... in spades.

One day in late 1994 or early 1995 I read an article in the Piper & Drummer by a Dr. Patrick Potter. He's an orthopedist and piper. He talked about carpal tunnel and similar hand injuries. At the end of the article he alluded to something he called "focal dystonia" or the pain-free sudden loss of previously skilled motor movements. So I found his number and called him up, and he recommended a friend of his, a specialist in my area. He said this guy was the BEST.

I saw a Dr. Norris at the National Arts Medicine Center. He watched me play, watched video tapes of me playing before the onset of the problem, and watched videotapes of "normal" pipers. He said this is common among guitarists and pianists. His theory was that between my odd grip on the chanter (my thumbs are double-jointed, so I have a claw-grip on the bottom hand), my heavy computer work, and piping, this was not unexpected. The B finger is not designed for fine motor movements, it's designed for power and gripping. Making it do all these detailed minute movements on the pipes (or other instrument) is very unnatural.

Overuse, stress, something had to blow. It's essentially a muscle or group of muscles saying, "We don't really want to do this anymore, you guys go on without us, we'll just stay here and watch TV."

He mentioned Bo-Tox treatments but advised against them - much pain, little gain, lots of frustration.

His advice is in my earlier post - relax, change technique, change repertoire. And, STAY POSITIVE, DO NOT FORCE IT. He also cautioned me -- only ONE professional musician that he'd treated was able to return to his prior level of performance. If I were fortunate I'd get some of the dexterity back.

Well, it took a while ... and a lot of struggling, but once I knew WHAT IT WAS (ie, there IS a reason for this, it's not some mysterious lightning bolt or the Olympians rolling dice) I was determined.

And here I am today. In late 1996 I returned to the solo circuit, tentatively, and soon I was back in form. I continue to compete with reasonable success on the Professional circuit, and am actually known for my strong clear technique. I play with a Grade One band, front rank and all that, and have played at The Metro Cup, the USPF and other venues. I'm no Alasdair Gillies, but I don't suck.

And most people are unaware there is any problem at all. Believe me, the problem is there, but it's much less than it was, and I hide it well. Kind of having long dust ruffles on your bed to hide the trash underneath!

I've met other pipers who've had it worse than me - had to quit piping completely and such.

Whew, I didn't mean to write this much!

The moral of the story is, as David Soul sang, "Don't give up on us, baby, Lord knows we've come this far ...", or as Stalin said, "Not another step backwards!", or as General Anthony McAuliffe said, "Nuts!!!"

Now how many people do you know that can connect David Soul, Stalin, and McAuliffe in one sentence?


Kevin F. Gilstrap
05-12-2004, 05:36 PM
Remarkable story, Chris, with a happy ending to boot! Very encouraging to us all! Thanks!

05-12-2004, 06:56 PM
Chris, thanks for sharing your story and optimistic outlook on FD. My story is similar, but, without the same positive result (at least not so far).

I was a retread. Poorly trained as a youngster; I was retreaded thanks to the kind and patient efforts of Chuck Murdoch. He turned me into a passable grade 1 amateur player good enough to carry a corner in the Manchester Grade 2 band when we were winning everything. It was fun and challenging, but, nothing like the quantum leap that was necessary when I graduated to Worcester Grade 1. As you know, more music means more practice. Originally from Massachusetts, my desire to play with Worcester was a childhood dream from the time when I was an eleven year old wannabe and I was willing to do almost anything to get into that Worcester circle and stay there.

When my chance came, I worked hour after hour daily. I taped band sessions and played full band practices with cassette and headphones every day. My playing improved and I found my way into the circle (albeit: always looking over my shoulder) with lots of tutoring from Blair and James Kerr and others. At the peak of my career in the Worcester years I was reclassified as an open player by EUSPBA. I never competed as an open player. It was just about that time when I noticed a “stiffening” in my top hand. James always said if my bottom hand work was as good as my top hand I might have someday been a real piper! I got worried but not enough to really do anything about it as I was not interested in solo piping at the time and my band playing was good enough to keep me in the circle.

It started with an inability to play a clean g gracenote between short F and E after High A and progressed ultimately to clawing, inability to cover holes and (lastly) uncontrollable twitching (so that I play grace notes at inappropriate times) and can’t keep to even the simplest of tunes. Like you, I stopped playing altogether and did not play for nearly ten years. When I came back the problem was nearly gone and actually did not resurface for about a year. It progressed slowly over a couple years but, eventually, I experienced the worst of the symptoms described above.

I too went thru a variety of doctors and misdiagnoses. I wonder how many players have quit because they were told they had arthritis? You and I connected briefly several years ago, but, I was never able to locate your doctor who had moved to New England. I finally found an excellent specialist at Brigham and Women’s Performing Arts Clinic in Boston. Same message, no cure, no drugs (other than the evil botox); common problem for other musicians/few success stories. My doctor did offer some plastic rings that fit over the affected fingers and restrict the clawing. They helped for awhile, however, these didn’t help the twitching which I think is one of the later and more insidious symptoms.

I heard about Hamish Moore (noted in an earlier post) and learned that his FD problem was the same as mine (top hand) and I understand what he did was to shift up one finger so that the index finger is now the useless one and the pinky takes on the role of the E finger. He did not answer my email and so I only have this second-hand. I recently got a copy of his Stepping on the Bridge CD and I understand this was done after he converted fingering. It brought hope.

I was pleasantly surprised when I tried this technique and noted that I was no longer twitching, no longer having trouble covering holes. My clawing has disappeared; I am struggling with execution of taorluaths and crunluaths and some doublings, but, the more I practice using this technique the better are the execution of these movements. I will never be an open player, but, at least I can now play some simple tunes and I have some hope that I will be able to listen to myself play someday without breaking down out of frustration and despair. I am hoping this is a permanent solution and that the FD won't creep back into this latest attempt to avoid this dreadful disease.

This technique reminded me of a story I heard about John Burgess. I understand he came to Toronto somewhat late in life to perform in a concert and was being kidded by the local pipers as being an old man with arthritic fingers. The story goes that he took them into the back room of the armory where he planned to warm up and began playing jigs and hornpipes to the amazement of the young turks and then he took it one step further by switching hands and playing the same jigs and hornpipes left handed. Their mouths dropped and then he played the same selection again switching in mid-performance from one to the other. So...perhaps there is hope-even for us old dogs!

Sorry, I guess I went on for too long too. I hope I didn't bore anyone to death. This is a serious problem with pipers and musicians in general and the more we get out into the open with it the better off we will all be I am sure.

Thanks again for sharing. Yours was an uplifting story.

Chris Hamilton
05-12-2004, 09:21 PM
Oops, on further reflection I'm deleting Stalin from my "inspirational comments" ...

Apart from being a extraordinarily not-nice guy, his INFLEXIBLE stand-fast policy nearly destroyed the Soviet Army in 1941 (granted his tenacity in 1942 on the Volga was monumental).

Anyway, in dealing with crises of all types, FLEXIBILITY is needed (I'm a Libra, so I'm all things to all people :D )

Flexibility regarding repertoire, technique, and expectations. For instance, if your affliction means you can't play Tune X in competition, then don't play it! If you can't execute a grip from a quick B to C, then try a plain G gracenote. Maybe it's not acceptable for competition, but in a band or non-competitive setting, it works fine. And flexibility to relax and accept your changed situation.

So, adapt and evolve, that's what I was trying to say.


Chris Hamilton
05-12-2004, 09:47 PM
Hi Jim,

Keep on truckin' ...

The doctor in question is Richard Norris ... and here's a link to his book:
The Musician\'s Survival Manual (http://www.mmbmusic.com/MMB/musSurvival.html)

Video and Contact Info (http://www.cello.org/Newsletter/Articles/videoreview.html)

Try a Google search on "richard norris dystonia" and you'll find a lot of info.


Chris Hamilton
05-12-2004, 09:53 PM
Originally posted by Kevin F. Gilstrap:
Remarkable story, Chris, with a happy ending to boot! Very encouraging to us all! Thanks! Thank you, Kevin. I have been very fortunate in that I've been able to play again.

Which reminds me of a favorite quote:

Spock -- "Random chance seems to have operated in our favor."
McCoy -- "In plain, non-Vulcan English, we've been lucky."
Spock -- "I believe I said that, Doctor."

:woohoo: <<<<---- Note that this seems to be an evolved Tribble - note the recently sprouted limbs! I guess the poisoned grain didn't kill them, it just made them adapt! Like we dystonians must adapt.

And I'm perfectly sober as I write this - imagine me after a couple of cold ones. :wink:


05-13-2004, 02:36 PM
Hi all,

I got the following out of a paper entitled "Focal Dystonia: Current Theories". It can be found at the following link;

I apologize for the length of the post, and it's probably more technical than most people care for. You have to endure a lot of medical terms, etc., and alot of doesn't necessarily apply to musicians, but it provides alot of insight as to what the perceived causes are and possible ways of treating focal dystonia.

A couple of excerpts from the paper that I found interesting as it relates to musicians include;

(on pg. 5) "The symptons displayed by musicians depend upon the type of instrument played, rather than hand dominance. For example, dystonia occurs more frequently in pianists and guitarists, particularly in the 4th and 5th fingers of the right hand for pianists, and in the 3rd finger of the right hand of guitarists."

(also on pg. 5) "The hand is a biomechanical instrument; its proper functioning depends on the functional integrity of the nervous system, joints, muscles, and tendons. In a group of 14 musicians with focal dystonia, Wilson et. al. (1993) found a relation between the limitations of passive and active abduction ranges of the central digits of the hands; ... They concluded that a specific biomechanical condition in the hand can interfere with movements that are required of musicians while playing an instrument."

and it goes on ...

"They found that connections between tendons restrict the movements of the connected fingers in typical ways, for example, by causing conjoined movements of the fingers, as tendons of one finger pull with them tendons of the other. These restrictive movements suggest that biomechanical limitations may constitute a risk factor for developing focal dystonia."

(and on pg. 7) "Furthermore, increasing the duration and intensity of practicing or playing aggravated the dystonic symptoms. These results are consistent with the idea that some aspects of focal dystonia are associated with peripheral nerve damage."

OK, OK, enough of the depressing stuff ... the paper goes on to address treatment approaches. For example,

(pg. 25) "A novel treatment approach ... is based on the principle of "constraint induced movement therapy" in stroke patients. In this approach, patients are encouraged to used the partially paralyzed limbs while movement of the non-affected "healthy" limbs are actively constrained (such as placing them in a splint or cast) ...

"In musicians with focal dystonia, this approach has been applied with some success. The finger that is considered to be "compensating" for the dystonic movement is fixed, while the "dystonic" finger is required to carry out repetitive exercise. Improvement was reported in 8 of 11 patients. There was considerable short-term improvement, however, long-term improvements were not so common."


"Based on the assumption of cortical dysplasticity (neural consequences of rapid, repetitive movements leading to central somatosensory degradation) being the main pathology of focal dystonia, a prospective treatment trial on a mixed group of patients with focal dystonia was conducted (Byl & McKenzie, 2000). The authors used various methods of sensory re-training and visual mirror feedback in addition to physiotherapy for strengthening the hand muscles. The patients improved significantly in obtaining motor control, accuracy, sensory discrimination, and physical performance."


As for myself, I struggle with a dystonic (ie. "lazy") pinky finger on my right hand (lower hand). Much like Chris, I'm usually able to hide it pretty well, but it occasionally rears its ugly head with the B finger lifting up while lifting the pinky finger. It's most annoying when the pinky finger is preparing for a birl (double-tap). When it starts acting up, I switch to a slide birl, and the problem goes away. Unfortunately, for me, I've always found the slide birl to require alot more effort (ie. strenuous) than the effortless double tap (which I learned as a kid).


Stuart Cassells
05-13-2004, 04:41 PM
This is all great stuff folks!!!!
This is the help and support which makes bobdunsire.com such an excellent site!!!

Jim, could you elaborate on the following as to how this could apply to a piper and what exercises could help

"The authors used various methods of sensory re-training and visual mirror feedback in addition to physiotherapy for strengthening the hand muscles. The patients improved significantly in obtaining motor control, accuracy, sensory discrimination, and physical performance."

What do they mean by sensory re training? How could that apply to pipers?

Thanks very much

05-13-2004, 05:08 PM
I'm not sure what they mean, but the reference in question is as follows;

Byl, N.N., & McKenzie, A. "Treatment effectiveness for patients with a history of repetitive hand use and focal dystonia: A planned, prospective follow-up study", Journal of Hand Therapy, pp 289-301

Now as far as who Byl, N.N. is ... I tracked her down on the Internet and I believe it is Nancy Byl, who is a professor at University of California San Francisco (UCSF) - San Francisco State University (SFSU). You can usually write to the author to get a copy of the paper.

You might also refer to the following web site for information about her work.



05-13-2004, 08:40 PM
Just hearing about this scares the hell out of me. The question I have is, is this largely the result of too much practice, poor technique, genetic susceptibility, or some combination of all of these?

Chris, how much were you practicing before this happened? How has your practice schedule changed as a result?

I never feel like I practice enough, but seeing this, I wonder if the trick is to make the most from the relatively least amount of practice.

Kevin F. Gilstrap
05-13-2004, 08:44 PM
Originally posted by Chris Hamilton:

And I'm perfectly sober as I write this - imagine me after a couple of cold ones. :wink:

Chris If you're planning on coming to KC again for Winter Storm IV, I'll buy the first round! :thumb:

05-16-2004, 05:11 PM
Nice info Jim. I will follow up. Scotchboiler, I was practicing at home at least three hours a day and more often it was like five hours a day and then there were the several band practices each week. If your not eating, drinking and sleeping bagpipes, you probably don't need to worry.

I am sure the beer and whisky consumed after each pracitice didn't help, but, I can't blame the mother of all nectars for this problem (like so many other problems in my life). I really think it was the practicing that did it.

I am interested in the notion that Jim set forth about the hand being a biomechancial instrument. I did notice is that my eczema (heavy duty stuff on my top hand) started at about the same time as my FD and I have always wondered if there was any relationship. Anyone else with this disease also have eczema? Mine is so bad that the skin cracks and bleeds from time to time and there is little I can do but wait it out.

Isn't it amazing that we do open heart surgery robotically, cure some forms of cancer and we still don't know the answer to eczema or FD. These days, it would seem to be within the realm of our scientific knowledge base!

Matt Buckley_dup1
05-17-2004, 05:43 AM
Originally posted by jd3214:

I heard about Hamish Moore (noted in an earlier post) and learned that his FD problem was the same as mine (top hand) and I understand what he did was to shift up one finger so that the index finger is now the useless one and the pinky takes on the role of the E finger. He did not answer my email and so I only have this second-hand. I recently got a copy of his Stepping on the Bridge CD and I understand this was done after he converted fingering. It brought hope.Hamish's FD came on very soon after recording of
Stepping on the Bridge. At the 1995 Vermont SSP School, it came on with a depressing vengence, and many of us watched, painfully, as Hamish's playing deteriorated.

By 1999 Hamish was experimenting with use of the left-hand pinky in place of the ring finger, and by the summer of 2000 he was able to make his public debut of the new fingering style at my wedding. :thumb:

As many of you are probably aware, Hamish is now playing regularly with Fin by using the pinky. He does amazingly well with it.

Matt Buckley_dup1
05-17-2004, 06:10 AM
Originally posted by Chris Hamilton:

The B finger is not designed for fine motor movements, it's designed for power and gripping. Making it do all these detailed minute movements on the pipes (or other instrument) is very unnatural.This is a very important point, one overlooked by many pipers. My wife is a Feldenkreis (TM) practicioner - a disclipline that addresses fine motor movement, repair post-stroke, and related issues. She has stated, many times, while watching me play that pipers are asked to do with their hands/fingers many things that are very unnatural and possibly even harmful, the ring fingers in particular on both hands.

My problem became evident over a year ago when my instructor, Donald Lindsay, noticed an odd twitch whenever I used my left-hand ring finger, a twitch that seriously affected my GDEs and tourluaths (Hey Chris - remember those gawd-awful tourluaths two years ago at Manchester?). A year later, I've made tremendous progress, with the assistance of Donald, my wife and a couple of other sources. A few things to be aware of:

1. DON'T FORCE IT!!!!! Less is more. The second the problem movement begins,
stop. Switch tunes, switch movements, take a break, or use a substitute movement. The important thing is to stop.

2. Find an appropriate substitute. . For me, on those days when my ring-finger is not cooperating, I substitute my index finger. That means that GDEs become GDGs, and my tourluaths end with G gracenote rather than an E. But the sound is very similar, and blends in well with the band. I can now play jigs at 100 bpm using, amazingly, GDGs.

Alex the Prophet
05-17-2004, 07:27 AM
Hi all,
I don't actually suffer from the ilness but I know someone who does and my dads line of work gives me access to a lot of info.
I thought I would write down some of the stats I have heard or read about from good souces which haven't been posted.
Susceptibility to FD is linked to age. It seems that you are extreemly unlikely to develop it if you are under the age of 30 (read near impossible). In most cases it affects people in mid-life. You also need to be quite a serious musician as is obvious from the previous posts. You won't get it through anything less than near professional level of play/practice. From what I have read FD is basically something that can affect anyone who is doing anything at a certain level: sportsmen, surgeons, artists etc (but it goes under a different name in other fields sometimes). Its just that musicians are a high risk group. We are nutters. Medically. No one comes close to the kind of stress dedication and intensity that musicians get to (exept certain athletes for which the problems are similar). So your chances of developing it are in between 1-200 and 1-500 if you fit the mold: in mid-life and very good. Its not really sure wether or not there is a genetic susceptibility but generally speaking pretty much evering does to a certain degree.
As for the actual cause of FD, its thought and verified in most cases that its a problem with the brain. Basically the part of the brain that is supposed identify parts of your body has merged or blurred the "image" it had of you hand/fingers. This can lead to random ability to lift a finger i.e. you want to lift your ring finger but it doesn't move 40% of the time or an other finger moves instead because your brain has no knowledge or partial knowledge of your finger existing. Or maybe it thinks that your ring finger is your middle finger or the other way around etc. This is also why it varies so much and is therefore difficult to diagnose.
So to cure it you would have to totally re-educate your brain to move your hand and fingers. Its a bit like starting over. Exept psychologicly much more demanding.
I think that the visual mirror feedback part of haganjp's post elluded to therapy involving sitting in front of a mirror and playing with your good hand to give your brain the illusion that your bad hand works. A lot has been tried to help it. Because its the nervous system's failure, the symptoms are lightened by wearing gloves or in some way reducing the sensation of playing. Unfortunately, it seems that for the minute the only shot at getting back to former glory for the people affected is through years of rehabilitation and dedication. Thankfully some make it.

Hope this helps someone,


Chris Hamilton
05-17-2004, 10:38 AM
Originally posted by AVettas:

Susceptibility to FD is linked to age. It seems that you are extreemly unlikely to develop it if you are under the age of 30 (read near impossible). In most cases it affects people in mid-life.I was not quite 26 when it started. However, between my odd claw-grip on the chanter, heavy computer work, and piping in general, I was "bound to get it" as my doctor said.


Alex the Prophet
05-17-2004, 11:33 AM
Ah ok. Good to know how accurate these articles and books are. :wink: (either that or you are a very special person :cool: )
Thanks for that,


Chris Hamilton
05-17-2004, 05:58 PM
Originally posted by AVettas:
(either that or you are a very special person :cool: )
The One and Only! :D

I am unique, there's no question. Eccentric, unique, it's all the same!


Thomas Zöller
05-24-2004, 07:47 AM
Hi guys!

I have researched a bit on the internet as well, and came across some names that might be useful:

First of all, there is a German Prof., who treats musicans with focal dystonia in various ways. The interesting thing is, that he studied both music and neurocology, so he knows what a musicians go through when they suffer from this. His name is Altenmüller - a contact can be obtained from http://www.hmt-hannover.de/sys/subnavi_forschung.htm

Then, there is a Dutch guy called van de Klashorst, who founded the Dispokinesis therapy. I have recently had contact with one of his students (cellist), who fully recovered from focal dystonia. You might have to file for this guy on the net - I do not have a contact yet. Anybody interested might email me in a couple of weeks.

Furthermore, an American lady called Barbara Conable, which you can contact via the homepage www.bodymap.org (http://www.bodymap.org) - there is also an article published on focal dystonia on this webpage.

Finally, there is a guy in France called Phillippe Chamagne, who succesfully seems to treat with a body therapy, which seems to be comparable to Alexander technique - no contact again so far.

Hope this is of interest!

I would appreciate, if more people who have any kind of experience with this subject matter would join the discussion and share of information

Best wishes,
Drones up,

Alex the Prophet
05-24-2004, 08:22 AM
Yes, I think the Alexander Technique could be a good way to start. Wether you have focal dystonia or not actually. It will definately get you playing properly. Its way too hard to put into words what they (Alexander teachers) can do for you but I suggest that you try it.


Steve Brittain
05-26-2004, 07:34 AM
Although I am unaware of any hard evidence (such as functional MRI or PET scan) to prove this model, I think acquired focal dystonia can best be thought of as a problem with the programing of motor control circuits in the brain. In other words after multiple repetitions (particularly forced repetitions) there is a change in the way the motor control neurons interact which results in unwanted ?dystonic? muscle contractions. Once those new pathways for motor control are established, it is very hard to reestablish a new ?correct one?.

It is very position and movement-specific. For example I have friend who has dysonia in one hand when playing the fiddle but not when using the same fingers for playing his guitar or flute. The implication of this is that by altering how you play a certain tune (substituting different movements or even fingers such as mentioned in some of the earlier posts) you can work around the problem and make good music. The risk is that if you aren't careful how you use the new movements, you may develop a second dystonia involving more that the original finger.

One way to at least temporarily ?unlearn? the dystonic movement is to stop doing it altogether, such as happened with Chris. I read of an interesting and radical approach to this aspect of the therapy, in which musicians had the misbehaving arm put in a cast for a month so that they couldn't move the fingers and hand at all. When the cast was removed, there was of course atrophy of the muscles. The hand had to be retrained but when it was, the dystonia was gone in almost all of them.

Again the risk is that if you are not very careful with how you retrain the hand, the abnormal movements may be relearned, because those abnormal neural pathways are presumably still latent in your brain. This is where I think a Feldenkrais or Alexander practitioner could potentially help a lot as their's is a very different and more ?mindful? approach than standard physical therapy.

So no easy solution, but with a fair bit of mindful work and following the advice mentioned in several posts of relaxing and not forcing, it may be possible to keep making music.

take care,


Thomas Zöller
06-01-2004, 03:33 AM
Hi Steve!

"Although I am unaware of any hard evidence (such as functional MRI or PET scan) to prove this model, I think acquired focal dystonia can best be thought of as a problem with the programing of motor control circuits in the brain."

Altenmüller, a German professor for neurocology has shown, that in the brains of people with focal dystonia, the usually seperated regions controlling the fingers (5 in each half of the brain) have merged, and that therefore the brain can not distinguish between those fingers anymore.

"I read of an interesting and radical approach to this aspect of the therapy, in which musicians had the misbehaving arm put in a cast for a month so that they couldn't move the fingers and hand at all."

Where did you come across this article?!

Best Wishes,

Barry Conway
06-01-2004, 10:26 AM
I have been diagnosed with Focal Dysdonia.

At first, this problem was missed diagnosed as a tendon problem. Because rest did nothing to help this, surgery was recommended. I had the surgery and it didn’t help.

As it turns out, the pain in my forearm was being caused by an attempt to control a dysdonic finger. (ring finger, right hand) after much practice, I learned to move the finger somewhat laterally instead of up and down. This required a lot of work but, I was able to continue playing.

Last summer, I noticed the problem staring on my left hand. It hadn’t gotten to the point of affecting my playing but, I could see the involuntary twitch starting.

After an EMG, I was diagnosed with Focal Dysdonia and referred to Dr David Childress at Brigham’s & Women’s Hospital in Boston. After an e-mail exchange, he referred me to Dr Richard Ledderman at the Cleveland Clinic as they work together on the study of Focal Dysdonia in musicians.

I was asked to be part of a study. The idea was to splint the dysdonic hand and allow the brain to rewire itself. This was an option I liked as it was not invasive. (Splint from fingers to elbow) I had the splint on for 6 weeks last fall. This hasn’t done much to cure the dysdonic finger and also caused some problems with flexibility in my fingers.

Also being done is a process where all fingers are immobilized except the dysdonic finger. Daily, the dysdonic finger is exercised for 2 hours. Initial findings are good but, the closest place they are doing this treatment is in Chicago.

I was referred to a specialist for Alexander technique. This deals with re-posturing as well as approaching movements in a different manner. I didn’t pursue this as I was told it takes a great deal of timeto go through the process. With three kids, a business to run, and the season approaching, I thought I’d try Botox.

I had my first shot of Botox the first week in May. It seems to have helped quite a bit. So far, I’m very happy with the results.

Barry Conway

Thomas Zöller
06-04-2004, 03:47 AM
Hi Barry!

How is your left hand affected and which fingers are?

How is the treatment with Botox done? Are there any side effects?

What did you do when you retrained yourself to move your finger of the bottom hand laterally; how long did this take you to relearn?

Best wishes for your treatment!!


Barry Conway
06-04-2004, 09:01 AM
Ring finger on right hand started some time ago. Ring finger on my left hand less than one year.

Botox was injected into the muscle groups that control the contracting or bending of the ring finger on my right hand. (Injection into forearm and the palm of my hand---the injection into the palm hurt quite a bit)

To retrain my hand? Just practice and concentration and trying to survive.

Thanks..the treatment seems to have done a lot of good.


06-04-2004, 11:44 AM
For those actually diagnosed with this...how did they arrive at the diagnosis? What were the key indicators? I've always put my finger problem down to possible arthritis, maybe tendon damage or carpal tunnel, but the "feeling" never really fealt like any of those to me. Now I'm wondering if this might be the problem. started in my late 20's. I was fantatical about practicing and competing.

me - right hand, ring and pinky -- have a tendency to move as one at times. result...crappy birls ( I used to make machine gun birls!) tap drag style.

Steve Brittain
06-04-2004, 03:54 PM

The diagnosis is largely made by observation; though it can be confirmed with EMG testing. (This involves inserting a needle into various muscles and measuring the way they contract). With dystonia there are unwanted abnormal or extra movements/muscle contractions which occur while you are trying to use your hand. It may feel like a spasm or cramp in the muscle and the finger/hand/etc. will not do exactly what you want to to. In fact it may do something different or beyond what you want it to.

With arthritis you are more likely to have pain and stiffness and with a pinched nerve tingling, numbness and possibly weakness.

It is something that your local neurologist would (hopefully) be able to sort out for you.

take care,


06-07-2004, 12:37 PM
Thanks for that Steve. Your description sounds more in line with what I experience. I never really had it checked out becuase I couldn;t explain what the "feeling" or the result was. My doctor not exactly knowledgeable or interested in musician related problems. It really became a problem when I reached open level and I quit competing competely and then quit playing for a few years. After reading what some of you have written, I may look into further diagnosis and treatment.

Susan D
04-18-2014, 10:27 AM
Hello, I can completely relate to the symptoms that have been described here by all. Mine started probably 20 years ago and progressively got to the point where I felt like a fake player due to the adapting I had to make on my top hand. That is where my dystonia affected my playing. Anything that required a g gracenote became impossible. High A's also became almost impossible. Like someone else said, I couldn't even play Scotland the Brave correctly. I kept thinking, how can I have gone so far backward to a point where I sound like a beginner.
It was stressing me out, made me want to skip chanter practice around the table, hide when I played my pipes, and just feel really bad about my playing. I am an amateur player at best, not gifted, and was pretty lazy growing up with my practice time, however, I managed to become a decent band player. I left piping when I got married and had my kids, and 7 years later I returned. It was like I had never left, in fact I felt I played better than I ever had. Then slowly after about 2 years I started to notice that I was having difficulty with my top hand. I put it down to not practicing enough. On the problem went, and proceeded to just get worse and worse. The clawing, lack of control, sometimes I would play 2 gracenotes instead of 1 when I could get them out. If I spent a couple of hours before heading off to band practice, it would help somewhat but by the time I got there, it was as if those 2 hours had never happened. I chose to step back and finally look for a solution. I haven't played in going on 4 years now. It took a while for the referral's etc, but I finally saw a specialist who wanted to try botox if I was willing. I was willing, as I really wanted this to go away. It's expensive and had to pay for it myself as not covered, so $200 an injection. Ouch. Several botox shots later, at times having no strength in my left hand to even pick things up, we concluded that it wasn't working. I have resolved that not playing is not an option, so I am going to tackle it again, and see what happens. I don't really hold out much hope, but we'll see. I'm inspired though to read some of the threads on here from folks that have had success figuring out their own rehab. I will endeavor.
All the Best.

Jay Close
04-18-2014, 11:06 AM

Sorry to hear of your dystonia. It sounds too familiar.

I went back to the College of Piping Green Book in an effort to re-teach myself to play but have had only moderate success. I've done some postural things that seem to help.

I can still blow good tone and know how it's all supposed to sound so I've been trying to carve out my own niche in the local bagpipe scene. I work with reeds and bagpipe maintenance within the band and play in the back rank. I even have a couple of private students who respect my limitations.

You may need to reinvent yourself as a piper, but I'm sure you can still contribute.

Maybe we need to start an informal "pipers with focal dystonia" support group!

Best of luck.

04-18-2014, 02:09 PM
Susan, although I was never formally diagnosed, I stopped playing for about 12 years because my birl disintegrated with many of the characteristics described in this thread: little finger locking on the chanter or not moving; B finger lifting too, etc. I have overcome it sufficiently in the last two years largely by adopting the approaches discussed by Chris Hamilton & others. In my case I switched to a tap & drag birl (used to play a "7" birl) and ditched my entire repertoire. Also had some hypnotherapy. I did all this before I found the descriptions of dystonia and how to deal with it.

I am now competing and winning prizes, although I have to be careful with the hand and always try to keep it relaxed. If I get a hint of the problem I stop. You can't play through this sort of thing, it gets worse.

I hope you can find some ideas to try from all the advice here.

04-18-2014, 02:20 PM
Hi Guys,

I have just finished reading a book that might interest those who are suffering.
I don't know if it will help or not and it is from an unusual source.
The writer behind the Dilbert comic strip suffered from focal dystonia. He seemed to beat it too.

The book is called "How to fail at everything and still win big", even without the relevance of that part, it is a great read.

04-19-2014, 05:08 AM
Focal Dystonia? Wish I had known of this 4 years ago. Always had issues moving my right hand fingers on some of the flourishes but just attributed it to starting late in life, but the ring finger on the left hand wouldn't move when desired and actually started to curl under to the point I couldn't play. Dr. appointments, therapy and eventually surgery allowed to straighten it back out, but only to have it curl under again in 3 years (first knuckle is bent at a 45 and that is as straight as it goes) Certain tunes tire the muscles in that hand quickly to the point I don't bother to play them anymore. The tunes I played before this started trip me up now and sometimes I hear the errors in a repeat and have trouble why I can master it once but not the second time. I am headed back to the surgeon to see what's next. but I am taking this information with me. Who knows...

John McCain
04-19-2014, 06:56 AM
but the ring finger on the left hand wouldn't move when desired and actually started to curl under to the point I couldn't play. Dr. appointments, therapy and eventually surgery allowed to straighten it back out, but only to have it curl under again in 3 years (first knuckle is bent at a 45 and that is as straight as it goes)...

This sounds like Dupuytrens contracture. I'm not a doctor, but this runs in both my father and mother's family.

My dad has it back after surgery, too. He doesn't mind since he's a drummer. Says it helps his grip on sticks.

04-19-2014, 07:43 AM
Re: Where was this thread 3 years ago.
Originally Posted by 57Piper1 http://forums.bobdunsire.com/forums/images/BDFClassic/buttons/viewpost.gif (http://forums.bobdunsire.com/forums/showthread.php?p=1257813#post1257813)
but the ring finger on the left hand wouldn't move when desired and actually started to curl under to the point I couldn't play. Dr. appointments, therapy and eventually surgery allowed to straighten it back out, but only to have it curl under again in 3 years (first knuckle is bent at a 45 and that is as straight as it goes)...

This sounds like Dupuytrens contracture. I'm not a doctor, but this runs in both my father and mother's family.

My dad has it back after surgery, too. He doesn't mind since he's a drummer. Says it helps his grip on sticks.

Not Dupuytrens, that was ruled out.. Therapy would straighten it but it would curl right up again. Surgery was kind of exploratory at best I might say as my surgeon, who is highly recommended and top her field, was baffled as to what was going on. She was able to make it straight and move normally but even after all the rehab therapy it curled again.. I can grip but not straighten. Kinda frustrating.

04-21-2014, 01:27 AM
Lately I've been having a lot of trouble with D grace notes. I can play grips and such fairly easily but I can't do a tachum to save my life.

My hands do seem to be curled and it feels like an effort to keep them straight.

Is this worth seeing a doctor about, or am I reading too much into it?

04-21-2014, 12:40 PM
Am I right that it isnt so much a physical thing like arthritis, but a nerve interlace issue where say 2 fingers might get the message one was supposed to. So either multiple fingers move, or neither. As I understood it, it is the nerves overlapping the signal paths to be efficient, to the detriment of the musician.

Jay Close
04-22-2014, 07:15 AM
That is basically my understanding, too. The problem isn't "mechanical", but has to do with the way signals are coming from the brain. I do not think that their is yet a definitive understanding of the cause of the problem. One explanation I've heard is that the normally discrete areas of the brain that control specific parts of the body begin to have "blurry edges" so the signals are confused and intermixed.

Patrick McLaurin
04-22-2014, 10:01 AM
That's my experience, mixed nerve signals. Every time my brain tells my E finger to play a grace note, my pinkie (top hand) gets a signal to contract violently, thus prohibiting the E grace note finger from moving.

I can play the note E just fine. E grace note all by itself, not going to happen. I've spent the last several years retraining my fingers. The last year or so I've finally been able to play a taorlauth, I basically reprogrammed my fingers for that specific motion. Dre in piobaireachd were a challenge, until I started thinking about the initial E grace note as the note E instead of a grace note E, then no problems. As such, my crunluaths are currenlty a grip with a dre at the end. GDE has taken longer and is coming around. D doublings are going to take another year or two. Shakes (or peles) are a crap shoot. Primarily, I've stopped playing them, though I did try substituting a D grace note for the B and C ones, but my D grace note isn't up to snuff enough to pull it off reliably.

I find the more relaxed I get the less of a problem it is, but there's a point of diminishing returns as it starts sounding mushy overall.

Jay Close
04-22-2014, 10:25 AM

There are some good tips there, some of which I came to myself --- parallel invention or parallel accommodation.

I, too, find E gracenotes awkward, in all of their permutations, and I, too, find that relaxation helps, but it's not a cure.

One thing I've done to help keep my bottom hand in a more relaxed and neutral posture is to apply a spacer block to back of the chanter where the thumb lies. I found that with a open grip my hand was more relaxed and it helped with birls, darodo etc.

Patrick McLaurin
04-22-2014, 11:36 AM
Very interesting about the spacer block. I am definitely going to have a go at that. What do you use?

I guess the irritating thing about Focal Dystonia is that it starts some random day and doesn't go away. There's no moment in time that you can blame, no tangible physical reason why it happens, it just does.

That I don't like playing strathspeys (doubling tachums) and piobaireachd (crunluaths and the like) can be traced directly to the difficulty with E grace notes. One piece of advice is to change your repertoire which is great advice, but can be difficult if your dystonia affects something ubiquitous.

Unfortunately, I'm not sure cutting off that pinkie would help! :woot:

Jay Close
04-22-2014, 01:49 PM
This may sound crazy, but one of the things I did which helped keep the E finger relaxed was to tape the E finger to the little finger of the top hand. That way, those two had to work in concert. I've had some of my students do it too when they'd gotten the habit of pulling the little finger into their palm. Needless to say, it takes some getting used to.

The tendency for the entire upper hand to become a claw rather than move has also been frustrating. The one thing that has helped has been to modify my finger placement on the chanter. I play with the second joints rather than the first, more like the bottom hand. For some reason this tends to minimize the claw effect, but I can't do the tape trick anymore.

Patrick McLaurin
04-22-2014, 02:12 PM
I have tried both of these. Taping does take some getting use to, not the worst of many ideas I've tried over the last couple years. Also moving the fingers over seemed to help, but, hard to remember to do it, haha, as I just came across the discovery only recently.

I actually overcame this once before by simply forcing my pinkie to stay sticking straight up, but that makes everything very tense and hasn't worked at all on this second go around of the E finger problem.

04-24-2014, 10:52 AM
This would be a great topic for your blog, Patrick. Knowing you have to deal with these issues, don't ever apologize for your playing heard on the clips on your blog again. Getting this information out there is a great service to other pipers with similar trials.

Patrick McLaurin
04-28-2014, 11:56 AM
I've never been sure how to broach the issue for the blog. FWIW, the audio on the blog is very often the best of the best. Gotta avoid those E grace notes! Some days are worse than others.

I go back and read some things I post and I think, wow, that explanation wasn't very clear at all, haha. Almost streams of consciousness (aka useless) at times.

04-29-2014, 10:40 AM
This explains it and gets into some thoughts for help. It sounds difficult.
Part 1 - 3:




and this guy backs it up


05-05-2014, 03:30 AM
Very interesting about the spacer block. I am definitely going to have a go at that. What do you use?

I used to use a small box taped to the chanter but it was never quite right so bought one of those (?Piper's Pal) thingumys that you can use for covering the bottom holes when you are tuning, and cut an appropriate piece out of it. The advantage is that it is round (a square box being awkward to position right) and shaped to attach to a chanter. You can stick it on with glue if you want or tape, blu-tack or anything else.

Jay Close
05-05-2014, 06:25 PM
What I use is literally a block of wood, poplar or pine. It's about 3/4 inch thick, adds about 5/8 inch to the dimension of the chanter and about 1 and 1/2 inches long. I use hot melt glue to attach it. I think it helps, but is just one aid in a constant search for little improvements.

Jay Close
11-28-2014, 03:41 PM
The following Youtube link takes you to a recent paper presented at a symposium on musicians' dystonia. It makes a number of points, but most importantly argues that there is a non-drug therapy that has been clinically proven successful.


A Google search will bring up 2007 preliminary paper that outlines in some detail the nature of the therapy. It is long term and requires significant discipline, but it holds out hope.

Good luck, one and all!

11-29-2014, 10:45 PM
Mine began last spring.

I proposed to do 400 crunluaths a day for Lent: by the third week they were getting dodgy on E and F. By the 5th week I simply couldn't do a crunluath on E or F. My fingers locked after the first G grace note.

In a private lesson shortly thereafter with Dr. Angus MacDonald in Portree he caught it immediately and told me what it was. I had never heard the term "focal dystonia" before that day.

I just attempted a few standards tonight ("Massacre of Glencoe" and "Cabar Feidh Gu Brath") for the first time in many months of staying away from such movements and it was no go.

For the the moment, I'm left to those few piobaireachd are crunluathless, such as "Old Woman's Lullaby", so it seems.

Lent means detachment, I suppose.... I sure got it!

Jay Close
11-30-2014, 09:15 AM

I'm very sorry to hear this. It's a condition I wouldn't wish on any piper, and the more committed you are to the instrument, the more psychologically painful it is.

Mine hit in force in the Winter of 2004 starting with awkwardness in the little and ring fingers of both hands. Like you, I can no longer do crunluaths and toarluaths are cumbersome. I play in a band and have a couple of students who understand my limitations, so my life is not GHB-free.

Relaxation is a big key. Experiment with the ergonomics of the instrument and try to remain positive. I would dearly love to hear of a workshop associated with any of the established piping summer schools that would focuse on issues of dystonia.

Good luck!

11-30-2014, 10:21 AM
Thanks, Jay.

A workshop on this sounds like a great idea!

Of course, not every method to overcome this works wiuth everyone, but a collection of examples from different pipers could prove very beneficial and even ignite some imagination for newer methods.

Jay Close
12-02-2014, 04:11 PM
Check out the following link --


And try a Google search on the term "sensory motor retuning".

Josh Whitson
12-05-2014, 07:11 AM
I've known several pipers with focal dystonia - it unfortunately seems to be relatively common among pipers and musicians in general (or perhaps we just have a higher rate of diagnosis due to how much we use our fingers).

One had some skin colored plastic tubes created that when placed over a finger were open on the end that would cover the chanter holes. He used a few of these on his bottom hand to keep the fingers from curling. Another I know uses a furniture tab (those things you stick on the bottom of chair legs to keep them from scratching the floor) on the back of the chanter where the thumb goes to increase the width of the chanter and create a more ergonomically fit.

I've heard it helps to work with a doctor that is also a musician so they really understand the problem.

12-05-2014, 04:33 PM
After reading this, I feel that it somewhat explains my situation. Mostly affected in my hands are the F and C fingers and some but less in B and E. but in trying to accomodate those fingers, the rest gets all messed up. When I go to do a movement that I suspect will be affected, I feel the tension build in my hands to try to keep the right fingers moving and not the wrong fingers. Relaxing the fingers helps but is really difficult to do. I find it takes about 20 minutes of playing before I can even get the holes covered properly then my hands will losen up some but not entirely. but after another while, my hands get very tired from fighting the wrong fingers from moving. Birls are hit and miss, but mostly miss. Not because of the pinkie so much but because of the B and C fingers. My B and C and E and F fingers feel like they have been through work outs when not playing because of the stress to control them while playing. Finger exercises seem to help for a while then out of nowhere i Cannot play. I think this started back about seven years ago, I made a goal to get to Grade two in solo competition. I worked hard to this goal. IT was a two year plan. First year, I saw great improvement. I really enjoyed it. By the middle of the second year my hands were struggling. I ended up 2nd in standings in WUSPBA Grade three, but by the start of the next season I could not bear listen to myself.

I still play band competition (Grade four) and have moments where all is well and others where it is awfull.

I have had my time in this hobby but I don't want to stop. I have to find this optimal line between tooo little practice and too much, and accept that even though I was never a star, it is becoming just a challenge to keep playing.

Patrick McLaurin
12-05-2014, 11:06 PM
While our affliction manifests differently, the feelings are all the same!

01-01-2015, 10:10 AM
A workshop is a great idea. My suggestion would be that Chris Hamilton might be a great guy to lead it. Drs Norris and Patrick Potter would be outstanding presenters as well and Hamish Moore from the piper's perspective. Judging from the amount of interest in this thread and the aging population, a very successful workshop could be held somewhere where this could include participants from Canada as well as the US. The EUSPBA comes to mind. Video taping could make it available to the rest of the world. Why not? Who could sponsor or launch such a workshop?

Patrick McLaurin
02-22-2015, 06:02 PM
If anyone is interested (I don't think I'm delusional in offering this video for your viewing), I uploaded a video of me playing my A440 pipe setup. In the first jig I play, Rory Gallagher, you'll notice the last bar of each part requires a GDE followed by a birl. While the video was made for other purposes, it was finally video evidence of the focal dystonia I suffer from. Please observe the hesitation on the E grace note ( of the {g}{d}{e} ) in the last bar of each part: | {g}B{d}A{e}A {GAG}A2 :|

Oddly enough, the hornpipe shakes on D in the second part were coming off with no hitch, which is a first in many years. This is indicative of luck and my retraining of my fingers one movement/embellishment at a time. One of the hardest things to conquer has simply been the lone E grace note. They're easier at the end of a GDE movement as I can retrain the group of muscle movements as 1 muscle command, but as obviously seen in the video, it isn't always a sure thing.


Jay Close
02-23-2015, 07:37 AM
I believe you, Patrick!

Unless one has experienced this odd affliction it is hard to describe. Those E gracenotes in almost any manifestation or context are hard for me too, but F doublings have actually improved and other technique has remained the same.

In the grand scheme, you still play well, much more competently than I. On the other hand, a long time piper here in the Carolinas, a man I've known casually for very many years has focal dystonia in spades with his fingers dramatically clawing as he plays. My heart goes out to him because I know what a big part of his life has been piping and pipe bands.

This is all very frustrating, but from what I've read, the condition doesn't seem to be relentlessly progressive. You tend to get it at a certain level and it stays at that level.

My only advise is what I keep telling myself: keep playing and keep trying to improve; find some aspect of the piping experience that still excites and makes it fun.


02-24-2015, 06:33 AM
Your left hand tenses quite visibly about a quarter second before the E grace note. You're making the grace note by rotating your hand more than lifting the finger.

D shakes are quite nice and musical. It's amazing that that's a retrained movement. There's none of the tension that's present with the regular E grace note. Even if they're not 100%, it's proof that it can be done.

Nice work on that and don't settle. If you can fix a D shake you should be confident you'll be able to fix the E grace and someday return to normal playing condition.

It's like the saying goes, whether you believe you can do a thing or not, you are right.

Patrick McLaurin
02-24-2015, 07:36 AM
It's amazing that that's a retrained movement. There's none of the tension that's present with the regular E grace note.

This would seem to be perfectly in line with the mechanism of FD. The problem starts when your brain starts sending signals to fingers it's not supposed to, or perhaps it's further down and some nerve "wires" are getting crossed. My theory here assumes it's the brain boogering everything up.

For whatever reason some time ago, my left pinkie started getting the signal to contract along with my left ring finger getting the signal to lift off the chanter, hence the tension you see. Of course, as time progresses, some of that tension is probably attributable to knowing what's coming and getting ready to force the movement.

I've had some success retraining my pinkie's position by trying to hover it over my ring finger, hence why it looks a lot like a rotation.

Movements with other notes in front of the E grace note are becoming a new pattern in my brain as I relearn them. Taorluaths were the first movement for me to work on. It all started with playing a grip followed by the note E closing to low A. It boiled down to how I thought about the movement. The trick is then to speed up the E to grace note length.

I do the same for dre/edre (which ever comes from below E). The first note is a full note E closed down to low A for the rest of the movement. Just have to make the E short.

D doublings have been coming along only in the last few months and is probably consistent with why the shakes came off well. I was totally surprised during the recording. To see it manifest so completely in the GDE but not at all in the shake is simply indicative of how weird FD is. :crazy:

GDE having been coming along for a while. Any jigs posted to the blog for a while now, you might have noticed have kind of fat GDE grace notes. This works because I'm actively telling the G and D grace notes to be bigger and so the E grace note usually comes off, also bigger, because it's a new pattern sent from the brain, and therefore doesn't initiate the pinkie contraction.

But the lone E grace note with no preceding pattern to re-encode, hasn't changed a bit in the years I've been working on this. It does help to move my pinkie over the ring finger as then it can't contract down below the chanter when I try to initiate the movement. That seems to be the only thing to pursue at the moment as a fix, because nothing else has worked.