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A-1151 Physiotherapy for Functional Dystonia of the Musician
Aude Hauser-Mottier, Geneva, Switzerland
Thursday, June 14, 2018 · 2:50 p.m. · 29m 34s
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00:00:03
yeah
00:00:06
no i'm going to go on with my experience of f. c. feature to it
00:00:11
redecorating many get nurses but specially functional eastern yeah
00:00:18
of the musician what like all the
00:00:19
musicians symbolic that's because the artist with with the distal no is really good
00:00:28
so what is the function of this this town you know i always explain my patients
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everything about the distant over the com and it is involuntary
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repetitive contractions close by don't or shouldn't euro jekyll mechanism
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so it's completed complicated for the patient and specially
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because the patient have no pain at all
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so for that they they each figure that it's not very
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says something very importantly just to trouble muscle trouble
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but um uh they have no pain in one way it's a good thing but
00:01:06
it's a very bad staying because they work on work more without pain
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and it happens only in the musical function if you try to make it uh
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a canister do some movement on another
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a place that that can no you will not have a the
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stone yeah most of the time i just so one patient
00:01:28
who had very very bad eastern yeah and had problems to heat but that she had problems
00:01:33
to talk to and it was very uh uh uh a very obvious very special
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it's a new screwy balance on it so does organisation between the hygienist muscle anti
00:01:47
antagonist muscles that's may concomitant contractions and
00:01:52
you can imagine that concomitant contractions
00:01:55
yep that's it gives no possibility for dynamic movement
00:02:03
oh sorry
00:02:08
problems
00:02:10
maybe a touch something no
00:02:15
i thank you i can tell you as that of quinn said the functional distilling
00:02:23
yeah is definitely also on the candies and which tries to emotional origin
00:02:29
and i will take you a story of one of my patients with a a
00:02:34
very known janice stuff and uh he came for education not my praxis
00:02:39
and uh we made exercises and i tell you about the exercises but i ask him to
00:02:45
play the piano because i want to to to see fred uh improve the or not
00:02:51
and but as i have neighbours in the my taxes and it was quite late in the evening
00:02:57
i point the piano with a silent on the silent way
00:03:02
i was very interesting because he played the piano with the silent way
00:03:06
and he has no the stone yeah you could play completely absolutely
00:03:11
normally and we were so both of us souls stratified on
00:03:17
and uh so it it means really that the sound ah the sun alrighty
00:03:23
the emotion of the music makes a big part of the distant you know because when it was only
00:03:29
doing the movement of this music you had no not at all no distant yeah at all
00:03:39
so psychological trauma or physical trauma naturally
00:03:43
uh of of very intense trends are very often with this
00:03:47
patient linked to competition that is awful in our times
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awful because uh you know when i did my study it was a long
00:03:57
time ago no actually we had to have a very good technique
00:04:01
but a competition was that's the first element about music and
00:04:09
very pleasure of the music was very important video videos
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city has become and and believe all factors
00:04:18
and uh you you told about how many nodes of the second can can display it's
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absolutely terrible you imagine how much the brain must work and the
00:04:31
muscle together on to to have a dispute use it to
00:04:35
and that's the the stress absolutely terrible and
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they have performance obligation really obligations
00:04:45
and this mechanism i'm very unconscious in the musician oh that's the problem you
00:04:50
have to talk talk with them to make them understand what is happening
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and uh this is the reason why is a of time was a pianist
00:05:00
and uh i became a feature therapist but also
00:05:03
a psychotherapist to be able to top
00:05:07
of all these problems with the musician and that they can recognise there is
00:05:12
i would say from our very intense trends that's that the beginning when they began
00:05:17
a distant yeah and try to to to make them understand and accept
00:05:25
what is intense stress for this musician as i
00:05:28
set off but what does make intense stress
00:05:32
physical this earth this stabilisation physical bad posture
00:05:39
psychological disabilities and as i said unconscious most of the time
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with a physical this tabulation you have a change of the appropriate
00:05:50
section you know of the the body and the re presentation
00:05:55
does organisation of the some metal sensor real information
00:05:59
oh and actually does organisation of the coming back it means cortical representation
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and these organisation of the motor control so it's
00:06:11
a whole way to to to radiate kate
00:06:15
physics psychic and to to make all these uh mechanism go on
00:06:23
a and b. medication i would say almost from dabble around stuff from the beginning
00:06:29
as if the the the pianist or the musician had never
00:06:33
played on the instrument would be gained from the beginning
00:06:39
cycle factor that's a psychological factors or principles also
00:06:42
function of a function disown yeah like
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you know the characters of the musician most of them have unsightly
00:06:50
on the arm more sensible i would say that they're normal people as
00:06:55
you said no more but sometimes they have a depression that
00:07:00
not close by the music but something else well and can be the the beginning of the of a distant yeah
00:07:07
depreciation of themself because every sensible you have
00:07:12
they if they have some time to critique yeah it's uh
00:07:15
uh can be a catastrophe on to the our uh
00:07:20
you have to to treat them real even with the discussions so and they
00:07:25
have no confidence in them so it changes the boss to physically
00:07:30
and or on the contrary i saw a couple of of of
00:07:35
musician i've had things such a a road bing bing bing angle
00:07:41
or that they thought they work the the best stuff
00:07:46
but they didn't have the competitors not look at the technique to be
00:07:49
the best and that can be a very very big problem too
00:07:54
so back a bit per topping factors as we so
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we can be also a change of technique
00:08:02
are sometimes they try to do something as another technique to have a bit
00:08:06
of zone already and uh sometimes a good idea but sometimes it's not
00:08:11
ah change of instrument with a violent now on with the chill
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it's a it can be a big problem because the the the the feeling of the artist is not the same anymore
00:08:22
change of teacher no yeah i'll show you the to the
00:08:26
change of teacher with the uh one of my patients
00:08:30
who had the them beautiful the most beautiful the study i've ever seen and i showed you the video
00:08:36
uh and uh hard practically us because they have a concert
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so because they want to be heated best uh
00:08:43
a hyperactive psychological and physically with too much effort too much
00:08:48
stress and too much strength uh this is so
00:08:55
what that this is the best so
00:08:58
the stern yeah i so
00:09:02
oh on the left hand that's very rare generally and can use it
00:09:09
or so this ago came two years ago my
00:09:14
praxis saying in tones i have my
00:09:18
examination and i have my uh it no commitment concert for the master or
00:09:25
my master into most do you think i will be able to play
00:09:31
i say i'm sure you will able to play but not in two months but in two years is that okay
00:09:39
that i didn't say this souls also quickly but uh i don't know
00:09:44
it what takes so much time to recover sometimes we can help
00:09:50
we it's not me and the doctors with but dogs but i don't think that
00:09:55
the result is so good because every three or four months they have
00:09:59
to to to go back to book talks and uh if
00:10:02
they accepted the relocation very long predication there is that
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i would say at at the longtime uh a better result so this together all
00:10:14
came to the conservatory geneva that's very good conservator but uh had
00:10:21
a a professor and she didn't she didn't like yes
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they didn't like each other ah was stress tension and uh
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the the the teachers said always your left hand is weak your left and is bad
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and she well the left hand so much so much and if the type teachers say is the left hand
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is weak what do you do you work with much
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friction fiction because the friction muscles of five times
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stowe local mostly of approval well more strong than
00:10:56
the expenses and that was the problem
00:11:00
so we did many big discussion exercises and
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last week two years later she had a master with congratulations
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and she was the first master of the whole class but she worked about
00:11:16
five to six hours a day one whole year without playing
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oh just working thinking not just playing in front of the television now
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where did my exercise it it's no use because you have to make all those
00:11:33
format all sound so real and reaction and new image in the brain
00:11:42
and what she did when she began to have these so anyhow
00:11:48
she did like almost all the musician now there's no pay
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and should believe that was the question of the technical problems
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she worked more on more and more i did was to get s. role of
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amplified the problem because you know of that um we presentation integrate and
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the mechanism of automatic movement you had at the beginning it after you know
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how a steady normally like scales like a a a calm or
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the the this exam or the ah up a job on page of thank you at work
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completed a seven days there by the new backed allergic mechanism that was engraved and
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this is from where we have to work with the with this this is patience
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functional but this on your participation
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base ganglia limb mixes them this is the centre
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of the emotions so the motion make plays
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a big part it is a it is really it is a pathology and education
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some metal whistles i just did it uh i said it already some buttons
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and sorry and cortex mortal come to a coat extra increases stress emotion
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ordered sensation through deficiency of the posture too much
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flexion and internal rotation and ordered movement
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and i love it to who is that big medical scientific as we turn the book
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and he says there is new movement without
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emotion very interesting to read this book
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i don't know if it's true the project that a translated in english
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i don't know but it's a wonderful a very interesting book
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eight active uh intensification by m. r. i. fusion of the representation of the finger
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and i will talk about this a fusion of the fingers later goes into an stress clenched and there
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tighten fingers because of working with the dynamic extrinsic muscle
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and lack of support of the intrinsic muscles
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and you see here you know to know this tiny hand with the the real
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just with the fingers and the distant week with fusion of the fingers
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and here it's the same thing but it's a a shame are
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very interesting different possibility the possible localisation of the functional
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the stone you know by the that the musician
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hence for and fifth finger most most of the
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time for janice guitarist on the right hand
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left hand for the cellist naturally because it's always the the the
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the the side of the the hand that makes the most
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features city and uh uh as levels responsibility i would say
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all and you have lips off with when instrumentalist and shoulder
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you have shaking shoulders all sometimes with the the the children
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and the lance is very hard to read you kate because the it's it's d. or make your own
00:15:12
of the lips up that's is on the
00:15:15
on the year uh instrument but doesn't
00:15:20
criminals who anymore and you hear it goes out and it's impossible to play
00:15:28
but the problem is mostly not d. o. b.
00:15:31
q. low of the lips but the other
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muscle that to make the whole thing as support position of the lip so
00:15:42
the big scene at a and is uh to to recover the
00:15:46
the balance between big senate though and i'll be cool but it's not easy
00:15:51
oh i do it in front of the mirror i i do it with the the exercises and
00:15:57
it's it's a big big work but it works if the patients have really the patients
00:16:04
ankles i've seen also that question is an
00:16:07
drummers with movements that's on controlled movements
00:16:16
this i've said already now we come to the most the muscular system and
00:16:22
that i think is the basic of the raid occasion when the
00:16:25
the patient has on the student you know all the the the brain
00:16:29
problem the muscular system will be less instead belies the different articulation
00:16:35
and they are divided into rules you know it's a long extrinsic says
00:16:40
that that of flexion and extension muscles uh uh shouldered intrinsic system
00:16:48
and the problem is very often with the intrinsic muscle
00:16:53
you have the long one here i said the flex are are more stronger and the extension less
00:17:00
so it's already a a problem but you have to do it you have to do it
00:17:05
with it because it's it's life or and uh here you have the showed intrinsic
00:17:11
and the uh it's a inside of the hand in the palm of role or
00:17:17
that as sure the coherence of all this movement lack
00:17:20
support of the liberty liberty of the movement
00:17:27
the song to marion and or we could uh important right on our part of the
00:17:31
intrinsic muscle but this to muscles and all
00:17:37
the colour and then i and our
00:17:41
the pasta arc control possible the the it side to the other
00:17:46
ones are not controlled like or a couples can you know
00:17:53
they cannot be controlled by by the brain yeah just uh of the support muscles now
00:18:00
uh the intrinsic muscles have a small slice or try and lou all parameter form
00:18:07
and that can be a problem here you see intrinsic muscles
00:18:13
and if you look at it you see it's like oh oh a boat further there is a little
00:18:20
line uh in the centre and the fibres of
00:18:23
the muscles are like triangle without the stress
00:18:30
this intrinsic muscles make like a feather can do it's close
00:18:37
so i i work very much with this intrinsic muscles with
00:18:42
the the with the the patient because if it's
00:18:47
closes the signals space between now on
00:18:53
the the the the the bones
00:18:56
they had an all the fingers get close closer and closer and
00:19:02
with a little bit of flexion because of the longer can
00:19:06
no so i'll be working on the opening of the hand
00:19:12
uh working on making space between the base of the fingers is
00:19:18
very important i try some sometimes to work with uh
00:19:23
a couch group of little things uh between the the um the
00:19:29
thing is the base of the fingers but not too much
00:19:33
because with the sensibility of the skin on the the artist make
00:19:40
trying to to hold it the thing that's inside and i
00:19:44
said you have to all button and making a like
00:19:48
it was something that uh i come out the other it's that's something
00:19:52
that is not comfortable and you try not to touch it
00:19:58
or so it's quite different still a bit difficult i don't want the same thing with a little ball
00:20:04
inside the hand to make the had opened and like
00:20:09
the whole soul that people recruit to uh
00:20:14
what if we could read the the the the strikes but the opening strands
00:20:21
he is c.
00:20:24
extracts it the the the uh hand with extrinsic force of the muscle
00:20:30
not only but almost only and you will see the
00:20:33
video of the digital big can is so
00:20:38
who played like that you played beautifully but always told him be careful with your hands
00:20:43
because you are too much with the intrinsic muscle with affliction of the rest
00:20:49
here you have recuperation of his hand what i call seven hand
00:20:54
because it seems to be calm to be round to be
00:20:57
and it's the support of the intrinsic muscle that make all the
00:21:02
difference and here you have the end of a concert
00:21:07
oh you plated and you've with see the beginning of the destiny of the fourth and fifth
00:21:12
i was there and said what are you doing ah very afraid for you
00:21:17
want he said well i have a little problem in this passage but
00:21:20
the orchestra covers you know one people boldly don't to understand exactly what happens i
00:21:26
said no stop you you have you have a beginning of a distant yeah
00:21:36
or or or one fifty
00:21:38
mm and uh we so that is so immediately and said be careful we have to work this
00:21:47
and evaluation of cover to depending also individual
00:21:52
but here on the violin you see a flat and the predominance
00:21:57
of extrinsic it was somebody what no problem but it waste
00:22:03
do have that they just don't yeah and here you have the beautiful
00:22:06
hand that is round predominance of it intrinsically that hold the movement
00:22:12
of flexion and extension now you will see the the v. day
00:22:17
all of the of the the the the big canister
00:22:22
who played with this tiny out and after one moans working
00:22:27
only exist sizes only exercise five hours a day
00:22:33
it's better or are or or it's not perfect
00:22:39
but it's much better and after that you
00:22:42
worked five months without playing music five months about five to six hours a day
00:22:48
and now he's absolutely okay but you can imagine what the ford it it's
00:22:54
now i got to the musician postures the pasta i mean
00:22:59
the the global poster interaction of support point and
00:23:04
movement liberty control functional design yeah it's always bad support
00:23:10
but for the whole body and give stiff movement
00:23:15
that's a good and no and the a factor of stress on the poster
00:23:20
you know we have a a ref like cell in the mine
00:23:24
reflects if you had if you are in a very difficult
00:23:28
position on or acts it out and things like that
00:23:31
you make a fraction very very tight friction to be able to fly all to fact
00:23:38
i think that exactly exactly this same reflects with the musician
00:23:43
but at a lower level but with stress virtuosity competition
00:23:49
take close they they should they make their shoulders closing on top
00:23:54
and flexion but it under what ration out to stroll and they
00:23:59
have no liberty or no free no it's not free
00:24:05
this budget they kind of look a bit okay i sell is two points i ready kate with all
00:24:14
the distant now is that global construe it means extension
00:24:20
recover the very strong extension all the spy
00:24:25
and then the tool belts that hold the spine me is
00:24:29
the tron versus at domino's so bad week for
00:24:33
like in the that you see on the left one is a good posture and on the the right
00:24:41
right uh uh dissension mark you have a very bad
00:24:46
posture with somebody or if it is position
00:24:51
if you see people that this position when they play the music ah they will
00:24:56
have no also caught on the on the shoulder to shoulder and all that
00:25:03
our and had our in dollar ordination and that that's the the biggest problem
00:25:09
so i do well i do recuperated all this global posture huh
00:25:19
and the second belt is this capital o. this capita us the
00:25:25
topic window said on is a very important because this
00:25:29
capital uh especially the latch sir artist is the muscle of
00:25:33
that external rotation of the shoulder on of the r.
00:25:38
and is if you see the dances the dances classical dances they
00:25:43
make much older part it's not only for the duty
00:25:48
it's for the gravity centre they work all gravity centre between
00:25:54
stock and skip a lot and it's the same thing to have
00:25:59
with the a musician they must work from the sceptre low
00:26:05
honking yeah
00:26:07
sixty percent of the weight of the show to the bottom and instrument
00:26:14
and forty percent only on the shoulder and you are and when
00:26:20
they are on this position they have almost a hundred percent
00:26:24
of the weight on the shoulder and no support point so
00:26:28
this is how i work with or my my patient
00:26:34
some but i have a son but posture and here is is apparently is is this
00:26:39
just to show the mechanism it's not a musician and it's not a a lack
00:26:46
of uh was a lobster writers but he it empowers
00:26:50
us to show what happens when the laps or
00:26:52
what is is very bad you see the the the us kept real uh in this position
00:26:58
and there is no support for the movement for in the musicians
00:27:04
good position and psychotherapy take following up i do not a a
00:27:09
very big treatment but i try to reduce the unsightly
00:27:14
avoid the obsession all working or movement
00:27:19
accept the reality that is the perfection is impossible
00:27:24
possible that's very hard to tell them i and we gain pleasure draw a an linked with
00:27:34
the audience pleasure is the first distressing of the brain
00:27:39
and they have to have much internal pleasure intrinsic pleasure
00:27:44
to be able to transmitter to the you know to the audience if they don't have
00:27:50
the link you they have the strength to say look at me i'm the best
00:27:55
i that's not a good emotion you have in the brain only one good emotion it's a joint all the other ones i'll
00:28:02
that emotions to a survival oh reflects so regained pleasure and emotion
00:28:11
good emotion and i make them play when they they are
00:28:15
already kate yeah the good predication pleasure pleasure pleasure
00:28:20
oh and it's going for the meat of says if was to work all the time with uh
00:28:26
you know with the rock and realise that was able to take all the precautions
00:28:30
remains conscious i make the the the the work conscience with the music
00:28:35
oh they learn the music the saying the music they count
00:28:40
and that they have the sense of the rhythm so that all the conscious thing are uh
00:28:47
integrated and they can he for the emotion
00:28:52
this is conclusion relocation pasta role and cycle
00:28:56
psychological integration seven it a pleasure
00:28:59
pleasure pleasure pleasure or or what i say or was that the word pleasure
00:29:04
and it's michelangelo said it is important to know how to work in a lot of on grace
00:29:10
without resisting not putting up a fight this is how
00:29:14
one becomes strong and this is the book i
00:29:18
wrote about seven cases of eastern europe and it's
00:29:23
available soon in english and in shiny so
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