What Focal Hand Dystonia Taught Me About Piano Technique

When My Hands Began to Change

When I developed focal hand dystonia at the age of twenty-four, I blamed myself.

At the time, I had become deeply absorbed in exploring new ways of understanding piano technique. I wondered whether years of questioning traditional ideas and experimenting with movement had somehow ruined my hands.

The sensations felt strangely familiar.

I had experienced tendinitis before, and by then I had already discovered something that had transformed my playing: audiation. Learning to hear the music vividly before touching the keyboard had helped me recover from physical pain and had changed the way I practised. Instead of trying to solve everything mechanically, I had begun learning from the invisible world of imagined sound.

So why was this happening again?

Except this time, it wasn't the same.

The sensations were more elusive. Almost electrical. Less painful than frightening.

I couldn't understand them.

Learning Without Touching the Piano

I took a sabbatical during my final year at the conservatory and stopped playing completely.

Gradually, the symptoms subsided.

Preparing my final recital almost entirely in my imagination did not seem impossible anymore. Audiation had already become a natural part of my musical life.

A week before the examination I met my professor, Pavel Nersessian, for a single rehearsal so we could agree on tempi.

Then I stopped playing again.

On the day of the exam, I warmed up for only ten minutes before walking onto the stage.

For forty-five minutes I performed Bach, Beethoven, a Rachmaninoff piece and his concerto.

There were no symptoms.

Not a single memory slip.

That performance remains one of my greatest personal triumphs.

But life continued.

Away from the stage, the problem remained.

When the Piano Wasn't the Problem

Curiously, my worst symptoms did not always appear at the piano. They often appeared while typing on a computer keyboard or using a mouse. Yet whenever I sat at the piano and managed to play entirely from my inner hearing, the frightening sensations would often become much quieter.

The Mystery of Sight-Reading

One thing puzzled me more than anything else.

Sight-reading.

Whenever I had to process unfamiliar music quickly, my thumbs would stiffen, while my fourth and fifth fingers seemed to curl inward against my will.

Years later, I began wondering whether this was connected to something I kept observing: whenever my mind became confused, overwhelmed, or internally conflicted, the neurological symptoms became much stronger. Sight-reading naturally placed me in exactly that state.

"Go Home"

When I was thirty, two neurologists independently confirmed the diagnosis of focal hand dystonia.

Their advice was simple.

Stop playing. Go home. Recover.

It sounded reasonable.

Except I had no home to return to.

Instead, I eventually stopped playing for almost five years.

Five Years of Silence

During those years my life changed completely.

I left a physically abusive relationship. I travelled. I spent long periods singing and praying in churches instead of practising the piano.

Music remained with me, but in a different form.

Only years later did I feel ready to touch the keyboard again.

I deliberately avoided classical repertoire. Instead, I played simple gospel music, allowing myself to build new musical associations rather than immediately returning to the habits my hands remembered so well.

Three Discoveries

Looking back, I think three discoveries changed everything.

The first had very little to do with the piano itself. Over the following decade I noticed a deeply personal pattern. Whenever I experienced rejection, abandonment, or emotional conflict, familiar sensations sometimes returned. It gradually became clear to me that my nervous system responded not only to movement, but also to emotional states. I cannot say whether this is true for everyone with focal hand dystonia, but it became impossible for me to ignore in my own life.

The second discovery happened at the keyboard. I realised that my hands had to become softer than I had ever imagined possible. Instead of trying to make my fingers produce music, I allowed them simply to follow it. My palms seemed to glide across the keyboard. My fingers no longer felt like independent workers with their own agenda. They simply completed a musical thought that already existed.

I made myself one promise.

Not a single note without audiation.

Every movement had to be a consequence of hearing the sound inwardly. The amount of muscular effort became only what was necessary for the key to descend. Nothing more. Nothing less.

The last was a simple observation that helped me during those years. The symptoms of focal hand dystonia often left my hands feeling strangely weak, even when they were not. The weakness was difficult to describe. It wasn't ordinary fatigue, but an elusive sensation that made it feel as though my hands no longer belonged to me. As I gradually rebuilt my general physical strength and developed more muscle, I noticed that my hands felt steadier and more capable. I cannot say whether the muscles themselves changed the neurological condition, but having stronger hands gave me greater confidence and made the sensation of weakness much less overwhelming.

Returning to Chopin

Eventually, I returned to classical music.

To test myself, I chose some of Chopin's most demanding études, learning most of them from scratch over a remarkably short period.

For me, this was never about proving anything to others. I simply wanted to know whether the understanding I had spent years developing could withstand the greatest technical challenges I knew.

It did.

That became my second personal triumph.

More importantly, it marked the beginning of something I had almost stopped believing was possible.

It marked the beginning of my return—not only to the piano, but also to myself.

What Dystonia Taught Me

Looking back, I no longer think focal hand dystonia was the most important part of this story.

What stayed with me was the question it forced me to ask.

If my fingers could no longer be trusted, where did piano playing actually begin?

For years I had believed that technique lived somewhere in the hands.

Dystonia slowly dismantled that belief.

It taught me that movement cannot be separated from thought, and that the hands become remarkably quiet when they are no longer asked to invent the music themselves.

Their task is much simpler.

To give physical form to something that already exists.

Perhaps that is what piano technique had been trying to teach me all along.