focal-dystonia 13 Nov 2026

Nora Krohn on Focal Dystonia: The Importance of Instrument Setup

This article discusses the key role of correct instrument tuning when playing the violin or viola in the context of recovery from focal dystonia. Nora Krohn explains how an inappropriate combination of chin rest and shoulder rest can lead to tension, compensations in the body and restriction of natural movement, and presents the principles of a neutral and individually adapted instrument hold that promotes healthy technique and fluidity of play.

Illustration of a violist holding the viola naturally and relaxed, with emphasis on the correct setting of the instrument and a neutral position of the head, neck and shoulders. Created by Chat GPT

Why tool setup is so important

Nora explains that the setting must allow the body to function in accordance with its natural structure. The head, shoulders and arms must remain in their natural range of motion without twisting, excessive lifting or pushing. In other words, the tool must adapt to the body - not the body to the tool.

This applies especially to the combination of chin rest and shoulder rest. Every player has different proportions – neck length, chin shape, shoulder width – so there is no one-size-fits-all choice. She points out that forcing all students to use the same type of brace is as pointless as forcing everyone to wear the same shoe size.

Basic principles of neutral possession

When placing the instrument on the shoulder, the head should rest comfortably and freely, without significant tilting, pushing forward or turning. The arm should not be raised to "hold" the tool. If there is a large gap between the jaw and chin, height can be added - either at the top (higher chin rest) or at the bottom (higher shoulder rest).

At the same time, Nora cautions that too high a setting can block head and shoulder movement, preventing free movement of the left arm and bow. The goal is balance, not a rigid position.

Three-point tool holding mechanism

Three areas work together to hold the tool correctly:

1. An instrument resting on the shoulder 2. Head gently resting on the chin 3. The left arm that supports the instrument in motion

When one of these parts is not working properly (for example, the instrument is too low or high), the body starts to compensate: the player starts to pinch the neck with the thumb, push with the shoulder or stretch the arm. These compensations lead to pain, tension, loss of control and, in some cases, the development or maintenance of dystonia.

The angle of the tool is not decisive

Nora points out that the tool does not have to be horizontal to the floor. In everyday life, we don't think about whether we are holding objects "straight" - we orient them so that it allows us to move freely. The same goes for the violin and viola: what matters is that the player is not twisted or strained, not how the instrument looks optically.

Recommendations for the selection of equipment

For players with longer necks, Nora recommends considering a raised chin rest. As an example, she cites the "Krešl" (Kredel) model, which is fully adjustable in all directions, which enables adaptation to individual proportions and gradually changing technique.

She emphasizes that even though equipment changes can sometimes be met with misunderstanding, they can fundamentally improve comfort, sound and motion control in the long term.