Nora Krohn explains how dystonia develops in musicians as a combination of inefficient movement patterns, psychosocial influences and possibly genetic factors. It shows why it is not necessary to know the exact mechanism of dystonia in order to recover, because the principle of neuroplasticity allows the brain to rewrite using physical logic. Using concrete examples, he describes how the Till Approach gradually replaces dysfunctional movement maps (Route A) with new, organic and healthy patterns (Route B), which are clearly different and naturally pleasant.

In this article, Nora Krohn explains why musician's focal dystonia is the result of a combination of inefficient movement patterns, psychosocial influences, and possibly genetic disposition. Together, these factors disrupt the structure and functioning of the brain, which subsequently manifests itself in movement patterns that become confused, uncoordinated, or completely dysfunctional.

1. Dystonia as a “perfect storm” of motor and psychosocial influences

According to Nora, dystonia appears when problematic movement habits, stress, emotional stress and other factors accumulate in the body and brain for a long time. These influences can gradually change the way the brain organizes and executes movement.

Although the exact mechanism of dystonia is not yet fully understood scientifically, we do know at least that a combination of physical and psychosocial factors can create conditions in which the brain is "rewritten" into a dysfunctional pattern.

However, according to Nora, the important message is: we don't need to know the exact cause to find a way out.

2. Neuroplasticity: the brain can be guided back to healthy functioning

Recovery is possible due to the principle of neuroplasticity – the ability of the brain to change its maps through repeated experience. When the brain gets the opportunity to experience healthy, logical movement, it begins to gradually weaken old patterns and replace them with new ones.

The same physical principles that can prevent dystonia can also redirect the brain back to healthy functioning, regardless of whether the player is going through stress, trauma, or has some genetic vulnerability.

Nora does not say that it is impossible for a player with flawless technique to develop dystonia, but she emphasizes that technique based on physical logic provides resistance even in demanding situations - for example, under stress or high performance pressure.

3. Recovery with the Till Approach: we change the brain through the body

The basic idea behind the Till Approach is simple: we change the brain through movement. For this process to work, it's important to understand how neuroplasticity works in practice – which is often the complete opposite of the normal exercise regimen musicians are used to.

That's why the start of recovery can be destabilizing. Old habits are disappearing and new ones are just being formed. It's helpful to know at the outset how the whole process works and what steps it will involve.

4. Identification of erroneous concepts and their replacement

The first step is to determine where the brain is using "foreign logic" - that is, misconceptions about the body, the tool and their relationship to each other. These ideas need to be gradually replaced with healthy concepts and corresponding movements.

It is essential that this correction must be directly linked to playing the instrument. Movement cannot be rehabilitated in isolation – a healthy pattern must be created in the context of playing, otherwise the brain will not receive an understandable clue.

5. Route A and Route B: two clearly distinct movement paths

Nora distinguishes between two paths:

• Route A: old, inefficient, sometimes painful movement pattern,
• Route B: a new, organic, physically logical movement.

Although both paths may lead to the same goal (such as placing a finger on a string or making a draw with a bow), their physical and conceptual experience is completely different. Route B is clear, uncluttered and natural. Route A is confused, broken and unreliable.

The fact that the difference between the two is so pronounced is a huge advantage in recovery – the brain very quickly understands which way works.

6. An experiential example: what organic movement is and what it isn't

Nora offers simple examples from life. When we walk, the movement is smooth, timely and the body is coordinated automatically. However, when we try to "break" our walking and, for example, first lift the leg, and then transfer the weight, the movement is ridiculous and cumbersome. No one would naturally walk like this.

Similarly, when we put our hand on our head, we intuitively know what is right - what is too much, what is not enough, what seems normal. The brain clearly tells us what is organic.

And it is this ability to recognize the correct movement that is the basis of the transition from Route A to Route B.

7. Why the brain always returns to Route B

in the end

Once the player experiences how a physically logical move really works, the brain begins to prefer it. Route B is pleasant, stable and natural. Route A leads - as Nora says - to an "accident or a defect".

This is why even deeply rooted dysfunctional patterns can gradually dissolve. The brain chooses a path that is safer, clearer and more meaningful.

Notes

This article was co-created by ChatGPT.
Nora Krohn channel link: https://www.youtube.com/@norakrohn