Musician’s Dystonia and Movement Variability

Extreme repetition of a movement pattern, or doing the same movement in the same manner for a long time, might actually cause motor neurons to “burn out”.

“Musician’s dystonia (MD) is a neurological motor disorder characterized by involuntary contractions of those muscles involved in the play of a musical instrument. It is task-specific and initially only impairs the voluntary control of highly practiced musical motor skills.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691509/

Variability of movement is good.  And perhaps essential when dealing with chronic pain.  This is a brilliant Cor-Kinetic article detailing this concept.  The article is rather damning of the FMS (Functional Movement Screen).  Ingraham of PainScience has spoken about the problems with FMS: PainScience FMS article

Some of my favourite excerpts from the Cor-Kinetic article:

“Decreased ability to move differently and have other movement options has been associated with the transition from an acute injury to chronicity”.

“Simply altering foot positions in a squat or a lunge will adjust femoral orientation in the acetabulum and provide a different stimulus to both the tissues of the hip and the CNS for a different response – hopefully less pain.”

“In a pain situation the aim may simply be to move with less pain rather than targeting a specific muscle to make it stronger. I would hope we are now moving away from a single muscle weakness as a cause of pain or biomechanical ‘dysfunction’.  The more you move in the same way with pain the more you are likely to trigger the same response. The painful movement could look like ‘really good’ movement and ‘really bad’ movement could be pain free. We need to get MORE comfortable with being able to adapt exercises and movements to the person rather than shoehorning them into an ‘ideal’ version of an exercise.”

“Essentially some peoples CNS’s get very good at being in pain! So pain is very easy to trigger and because it is easy to trigger people become both aware and wary of this. We see this with hyper vigilance and fear avoidance. Being able to find pain free movements with these people becomes of huge value far outweighing if it is the ‘right’ exercise performed in the ‘right’ way. If we can also make movement relevant to the person then the psychological value is going to be significant. Fear avoidance is in part is maintained by avoiding perceived pain situations and therefore not getting pain, the relevance of movement and the dosage of how we interact is paramount. Not addressing relevant movement may sustain the problem.”

“Movement also promotes basic fluid dynamics that can take away the nasty stuff and bring in good stuff so not moving is generally not the answer. Movement is also analgesic *HERE* An increase in corticomotor output promoting descending inhibition and an increase in endogenous opioid production have both been discussed as potential mechanisms. The more inhibitory chemicals we have floating around the spinal cord the less sensitive it is likely to be, this includes chemicals such as GABA and endogenous opioids. This top down inhibition can influence what’s happening physiologically within the tissues and even simply having positive associations with movement may have an inhibitory effect on pain.”

 

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