Focal Dystonia in Pipers – A Response to Rumours of Successful Management

Interest in Musician’s Focal Dystonia (MFD) has recently resurfaced in the light of articles in Piping Press and rumours of the condition’s successful management. The term ‘Piper’s Palsy’ which is sometimes used to describe MFD is a misnomer. Palsy implies paralysis and paralysis is not a feature of MFD

MFD, as experienced by pipers, is characterised by the development of inability to perform specific transitions from one note to another. In other words, against a background of previous normality, the relevant finger (or fingers) refuses to carry out straightforward demands.

  by Norman Matheson MBE

More severe forms may include involuntary movements and cramps. MFD has features in common with conditions such as writer’s cramp and ‘yips’ in golfers. This common and intractable condition evidently affects 1% of all musicians. It is known to have put paid to the careers of leading soloists, forced to retire from renowned orchestras.

The most prominent musician to have been afflicted was Robert Schumann, whose brilliant early career as a concert pianist was prematurely terminated. Fortunately, he was able to divert his talents to composition.

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Risk factors
Characteristically MFD is prevalent in highly motivated, self-critical individuals with a predisposition to intense perfectionism. Exposure to stress, as in intensive practice and subsequent performance on the concert stage, or on the competition platform, is a contributory factor. It varies with mood: the more one thinks about it the worse it becomes.

These factors suggest that piobaireachd players may be particularly at risk and it is characteristic that the crunluath, the most challenging notational sequence, is a common source of dystonia. Many may recognise a number of renowned exponents of the twentieth century who struggled to execute fluent crunluath movements, a defect judges were apparently often prepared to overlook.

Personal experiences
Years ago, in addition to my own experience, I received confidential accounts of experience from three contemporary pipers. It is fascinating that, of the four players, two had an identical problem, namely, hesitation in lifting the fourth finger (E finger) of the left hand.

One of these writes: ‘I had been playing in competitions and missing the odd crunluath. I decided to go home and practise the movement for hours, day after day. Anytime thereafter that I played a piobaireachd, I was focussing on the crunluath movement to make sure I never missed any. All of a sudden I found myself struggling to do the movement and, the harder I tried, the worse it got.’

That is a typical observation from a musician with excellent technical ability. It is now recognised that obsessional practice simply makes the problem more entrenched. Although the crunluath may be a frequent source, pipers experience difficulties with various other notes.

Causative factors
The temptation to think of MFD as a neurosis or some kind of phobia should be resisted. However, once it becomes entrenched, it becomes a phobia, magnified in the mind to a highly distressing and destructive degree. However, the true reason for such incongruous difficulties has to be considered in terms of neuro-physiological function.

It is difficult to do justice to neuro-scientific studies reported in the argot of neuro-science, abstruse enough for the medically qualified let alone a lay audience. In short, highly developed musical skills are matched by anatomical changes in the brain. Practice can induce changes in the cortical map, which may become ‘hard-wired’ over time.

These properties of cortical plasticity are relevant to the development of MFD, which is probably due to dysfunctional or maladaptive changes in the brain. To simplify, it seems likely that MFD is attributable to practice-induced disintegrating changes in the cortical map, disrupting fine motor control. More detailed scientific information may be read in ‘A Scientific Overview of Musician’s Focal Dystonia’ (https//

  • To be continued under the heading ‘Management of MFD’. Norman Matheson, having spent his boyhood in upper Speyside, in 1964 became a Consultant Surgeon at Aberdeen Royal Infirmary. During a busy surgical career, he was also active in laboratory research both in Aberdeen and in Sweden. A champion amateur piper and much sought after judge, he was instrumental in the recording and dissemination of the teachings of RB Nicol (his tutor) and RU Brown, Balmoral, this via the medium of the series of CDs entitled ‘Masters of Piobaireachd’ on Greentrax Recordings.

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