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Think:Health - Dystonia

17 July 2017

The following is an excerpt from a Think:Health episode that aired on Sunday 16 July 2017.

Listen online 107.3 2ser (audio length 5:30) 

Host: Jake Morcom

Guest: Alana McCambridge, Lecturer, UTS Physiotherapy

START OF TRANSCRIPT

Gordon Sullivan:        

I'm a guitar player. I'm familiar with Les Pauls, 335s, Fender Strats, the works... Mesa Boogie amplifiers… your dad will know about this, you probably don't!

Jake:   

This is Gordon.

Gordon Sullivan:        

Okay Jake, my name is Gordon Sullivan, I am a musician.

Jake:   

Gordon's career as a musician dates more than 30 years back.

(To Gordon)

What sort of music?

Gordon Sullivan:        

I was playing Funk and Soul and bit of Jazz, elements of Rock as well, so it was a bit of a cross section of the whole thing.

Jake:   

He's originally from London, but back in '84 came to Australia to give the Ozzie music scene a go.

Gordon Sullivan:

But when I came to Australia it was mainly a Rock 'n Roll type of situation. I'll drop a couple of names here - I immediately met a player going to pick up some mail or something… I just bumped into him. He said, "Man I've got a gig for you, why don't you come and play?" So we started off with a band called Dick Jay's Overboard. We’d do all the gigs, up and down Australia and so on, up the coast. Then a bunch of guys called Gangajang saw me playing in a venue called the Bombay Rock. Bass player came and said, "You wanna come and do some stuff with us?" So I said, "Yeah, fair enough." I went in and did some recordings with them. Of course then they started to have the hits and we went on tour.

Jake:     

But while Gordon was picking up some momentum on the Ozzie music scene, he ran into a problem. A problem that made playing the guitar increasingly difficult. Do you remember the first time that kind of happened to you?

Gordon Sullivan:              

Yeah.

Jake:     

And what happened?

Gordon Sullivan:              

I was playing and I found that this finger was wanting to just pull the strings down. It was the pinky that had the problem and of course that would want to lock up and in fact would bring the fourth finger down with it.

Jake:     

It's just kind of folds back into your palm.

Gordon Sullivan:              

Yeah, it wants to do that, it just wants to grip. And it would throw the guitar out of tune, because it would just hang on to the string and just pull it down.

Jake:     

Did you think much of it at the time?

Gordon Sullivan:              

No. Not much, I thought it's something that'll probably disappear.

Jake:     

So you didn't ... What did you think it was? Or did you just…?

Gordon Sullivan:              

I had no idea and even the medical people that I went and saw had no idea.

Jake:     

Gordon had and still has something called musicians dystonia, also known as musicians cramp. It's a neurological movement disorder where messages from the brain to, in Gordon's case, his left hand don't work properly. Instead of getting his 4th finger and pinky to help pluck the strings on his guitar they freeze and they contract downwards. After playing the guitar for more than 35 years professionally it was only 10 years ago that Gordon even learned the word dystonia.
(To Gordon)

How does that affect your playing?

Gordon Sullivan:              

I learned to play with just the three fingers. With the thumb, first and the second.

Jake:     

Did it piss you off?

Gordon Sullivan:              

Oh it freaked me out. I had to change careers. I had to just stop playing music, because I wasn't having fun playing and as any musician would know, if you're not having fun playing music, go and do a day gig mate, because that's the only option you have. Otherwise, the music becomes a chore and that's not the point of playing music.

Jake:     

Gordon's musician cramps is just one type of dystonia. A typical dystonia is that of the neck. Also, called cervical dystonia, which is similar to what Gordon experiences in his hand. The continual contracting of the muscles will cause them to freeze, lock into place and result in abnormal fixed postures. It can be hugely debilitating and is also incurable, but according to Alana McCambridge, from the Graduate School of Health at the University of Technology Sydney, there are some ways to manage it, but they're not all ideal.

Alana:  

The only treatment available for them is Botox. You just-

Jake:     

Wow-

Alana:

…the contracted muscles they just numb and that works well for some people and they'll just have regular four monthly Botox cycles.

Jake:     

Even into a musician's finger?

Alana:  

Mm-hm (affirmative).

Jake:     

Really?

Alana:  

And then obviously the muscles get weaker and weaker over time and you're not really addressing the underlying issue that the brain's controlling the muscles wrong, you're just addressing that the muscles are contracting.

Jake:     

I imagine Botox, too, restricts movement on the superficial sense.

Alana:  

It just numbs the muscle, so it blocks the transmitters from getting to the muscle, so the muscle can't contract anymore and so if you are having a problem where your muscle is overly contracted and then you block the transmission from the nerve to the muscle and then the muscle is just going to go lax. Not everyone is happy with that kind of treatment and especially for the people that I see with cervical dystonia, one of the adverse systems of having Botox in the muscles around your neck is that when those muscles loosen, you start to feel like you're choking, which isn't great, so a lot of them don't like that side effect and it's why they're quite interested in a different method.

Jake:     

And that different method is where Alana's work comes in. What does it feel like?

Alana:  

You get a little bit of a tingle and a warm feeling, but after 30 seconds or so the feeling, you just get used to it.

Jake:     

Alana's research is looking at transcranial magnetic stimulation for those with dystonia and essentially what this is, it's sending a weak current through the brain to test for muscle abnormalities. It's a noninvasive electrical technology, however in the past, it has been used in other ways.

Photo: Anna Zhu

Alana:  

People would put electric fish on people's heads and then they noticed that-

Jake:     

Fish?

Alana:  

And then they noticed that, yeah, scientists recorded that people's depression improved like melancholy is what they called it back then.

Jake:     

Fish?

Alana:  

Yeah, electric fish.

Jake:     

What's ... Oh like an electric eel or something.

Alana:  

Yeah, yeah-

Jake:     

Really?

Alana:  

And they would put it on people and as a treatment, so then scientists continued to explore electrical therapy.

Jake:     

What will happen is rubber electrodes wrapped in a sponge and placed in saline will be placed around the head. An anode on the back of the head and a cathode on the cheek. What this will do is send little signals trough the brain to the targeted part of the body, like the neck or hand and try to get them up and running. This type of treatment is still in experimental stages and is yet to be perfected, but Alana thinks that TMS alongside other physio therapies, which help dystonia sufferers to cut down on repetitive movements is key, because it's these repetitive movements, which seem to be one of the main causes of dystonia.

Alana:  

What we try to do is you try and break that movement pattern and have them practice a different movement pattern so that they're not constantly reinforcing their bad pattern.

Jake:     

For someone like Gordon, whose livelihood is dependent on his hands and repetitive movements, plucking the guitar strings, dancing around the frets, stroking back and forth with the guitar pick, to get him to completely change the way he moves and the way he plays seems pretty much impossible, but what he can do is look at signs early and become aware of when his hands might be tensing up.
(To Gordon)

To try and mix up is hard though, and I guess if you've been playing guitar in such a way for however many years, to try and change that practice and get your brain to think differently is hard.

Gordon Sullivan:              

Yes, it is, it is extremely difficult. You have to have a lot of self-discipline and probably as most musicians would know they're not the most disciplined people. In general musicians like to be freer to play and improvise and so on and if you had this rigid way of thinking, your improvisation is not going to be great.

Jake:     

It changes the vibe of the performance.

Gordon Sullivan:              

Yeah absolutely.

Jake:     

Do you feel like that sometimes?

Gordon Sullivan:              

Yes, yeah, if you discipline yourself too much, the thought process tends to go into the disciplined area, kind of blocking the free flow of information. That's where the thrill comes from.

Jake:     

But funnily enough for Gordon, when he's on the stage, there’s no freezing.

Gordon Sullivan:              

When I went on stage and start to play, the adrenalin actually got these two fingers working.

Jake:     

Right, okay-

Gordon Sullivan:              

Not all the time, but a lot of times if I'm doing something and the adrenalin was there, the fingers would work normally. But if I actually sat down and picked up a guitar, it would immediately start to lock up.

Jake:     

And even noticing small things like that gives Gordon the upper hand on his dystonia.