Dystonia (Focal and Musicians)

Dystonia is a complex neurological movement disorder, where involuntary muscle contractions occur. The accuracy and speed of tasks/movements is affected and can be life altering. Dystonia may affect one or many muscles of the body. Cramping, slow movement and altered postures are some common symptoms. Focal dystonias can often involve hand writing “Writers Cramp” and playing instruments “Musicians Dystonia”. Frequently there is an element of high stress associated with performing at an elite level or preparing for final assessments or working in a very detailed role.

Common symptoms:

  • Difficulty with task accuracy
  • Tremor in the hand or arm
  • Cramping
  • Twitching
  • Pain
  • Reduce dexterity, increased clumsiness
  • Reduced circulation and poor tolerance to cold/heat
  • Poor performance (eg for a musician)

Potential causes:

  • Hand and wrist fracture
  • Nerve injury
  • Past history of hand and wrist injuries
  • Injuries in the other parts of the arm e.g. elbow and shoulder
  • Injuries in the neck (cervical spine)
  • Stress
  • Anxiety


Subjective assessment: We will ask you about your hand and wrist injury, how and when it is limiting you, your daily activities and preferred sports, your general health and other potential factors that may contribute to your concerns. We will also ask you what activities you enjoy and what your goal is.

Objective assessment: We will look at your hand and palpate around the area. We will look at your hand and wrist movement and your grip strength. We will look at the rest of your body including your elbow, shoulder, neck and core to see if they are contributing to your condition. We may perform special tests to pinpoint where your limitations may be coming from.


  • Education regarding your symptoms and how to manage/reduce them
  • Neural mobilisation
  • Graded motor imagery
  • Muscle and/or other soft tissue release
  • Activity modification
  • Custom made thermoplastic or neoprene splint, casting if needed
  • Taping
  • Dry needling
  • Home exercise program including stretching, movement and strengthening exercises
  • Referral to a counselor or psychologist to make sure all base are covered


From the moment we meet you, we are planning an individualised and holistic approach to help you reach your goal and be your best!

Rehabilitate, Educate, Innovate.

Providing excellence in physiotherapy from assessment to diagnosis, treatment and rehabilitation