focal-dystonia 13 Nov 2026

Nora Krohn on Focal Dystonia: Why Old Repertoire Can Be Dangerous during Recovery

The old repertoire contains the ingrained Route A movement patterns that the brain created before the onset of focal dystonia. Nora Krohn explains why old songs can activate dysfunctional mechanisms and how learning a whole new repertoire allows you to build healthy Route B movement strategies based on the logic of normal everyday movement. The new repertoire provides a "clean canvas" on which the musician can create new neural pathways free of old mistakes and learn to play in a completely different, healthy way.

Nora Krohn plays the viola in front of a music stand, in the middle of focused work, with the text caption of an article about the dangers of old repertoire during recovery from focal dystonia. Created by Chat GPT

Old and new repertoire

During recovery from focal dystonia, a fundamental difference arises between two neural pathways: Route A (old, dystonic patterns) and Route B (new, healthy movement strategies). Every track we've ever played is full of Route A because we didn't have any other technical system at the time we studied it. Therefore, going back to something familiar almost always activates old bugs.

Once the basics of Route B are stable on the instrument, the next step is to apply them to a whole new repertoire. The new track does not carry over any old associations and therefore allows the brain to build a new movement map cleanly, safely and gradually. Nora emphasizes that the first work with the new repertoire should be as matter-of-fact as possible: without musical emotions, without phrasing, purely mechanically. It is a study of movement, not an interpretation.

Why the new repertoire works

Breaks automatic returns to Route A.
It does not contain any musical or emotional memory associated with faulty formulas.
It forces the brain to solve the situation in a different way than before.
Enables safe and controllable introduction of new movement strategies.

For players with dystonia in the left hand, it is possible to play the new repertoire without a bow so that the sound is not distracting. If the dystonia is in the right hand, one can start on empty strings or even with the silent contact of the bow on another object.

Return to the old repertoire

When Route B is stable, old songs can be revisited — but with a whole new perspective. It's surprising how old movement associations can pop up even with songs we've never played and only listened to when our brains were on Route A.

Only when the brain can accommodate the old repertoire in new coordinates can it be truly safe.