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 HANDS ON! 

 ACHIEVING A HEALTHIER RELATIONSHIP WITH YOUR FLUTE  

The HANDS ON!website is published by JOHN LUNN FLUTES 

Editor, John Lunn

ISSUE # 4

In this issue, you can choose any of these articles:

A Possible Cure for Focal Dystonia by Mark Dannenbring

A Note on Antidepressants by John Braverman Levine, M.D.

Book Review: THE ANATOMY BOOK FOR MUSICIANS

A guide to understanding Performance Related Muscle Pain by Susan L. Weiss

What is most important in making a flute play well? by John Lunn

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A POSSIBLE CURE FOR  FOCAL DYSTONIA

I am writing about only one case of "writers cramp." I realize that every case may be quite different; however, it is my

hope that what I describe might provide benefit to o ther sufferers of this little known illness or to the medical personnel

who are searching for cures.

I began having problems with my right hand while s tudying for a doctorate at the University of Iowa. I was under a

great deal of pressure to complete my D.M.A. in two years while also experiencing fatherhood for the first time. One

night I had a dream of being on a rack. When I awoke, I found my body taut. I experienced numbness in my arms,

especially my right, for three weeks. After the numbness wore off, I suffered pain in the right arm, usually while sleeping,

for a number of months. I saw hand specialists , orthopedics, and neurologists , but everything appeared fairly normal intheir eyes. The pain also finally faded, but I was left with a right middle finger that contracted every time I picked up the

flute. I did eventually learn to accept this condition, changing my F#s to the middle finger so I did not need to pick it up

for an e/f# movement, and continued to play with few additional problems.

Three years ago I slipped on a ball and into a cement wall. I was taken to an emergency room in the middle of the night,

and the doctors s titching my head had a good laugh over the incident. The accident appeared to produce only a surface

wound with no permanent damage. A few weeks after that accident I noticed that I was losing control of my left middle

finger. Every time I picked up the flute the middle finger would stick straight up. Now I was in real trouble playing the

flute. I also began to experience what I thought were ear aches while sleeping. I continued to play flute for about half a

year, but the finger condition worsened until my hand completely knotted each time I attempted to play.

One of my students suggested that I see a chi-kung doctor who had cured her of a shoulder injury. Up until that time, I

had continued to see phys ical therapists , western doctors, and acupuncturists about my right hand problem. No one

had any answers. I knew my career was over if someone could not help me soon.

In my first meeting with the chi-kung doctor, Mr. Hwan-Chang Wang, he felt around my neck area for what he calls

"soft bone." He was quite sure I had developed this material, and asked me to get an x-ray of my shoulders and neck 

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area to confirm this. The therapy cons isted of a combination of pressure and chi  applied to various points which he felt

were obstructing my flow of chi  through the body. It is by far the most painful procedure to which I have ever been

subjected.

The New Encyclopedia Britannica says that chi  in chinese philosophy is "the ethereal substance of which everything is

composed." My chi-kung teacher, Yang-Ming Lu, thinks of chi  in terms of bio-energy. "Although nobody knows what

the element of chi  is, the practitioner can feel the bio-energy when it moves through the body on a revolving path."

I would not have continued pas t the first session had I not felt an immediate change in my body. At the worst point of 

my illness, I felt that my hand was no longer a part of my body. I could not play a note on the flute or write. After onesession I felt that my hand regained some sens e of belonging to the rest of me.

The s ess ions sometimes lasted 40 minutes and at other times 20 minutes or less. Initially I saw the doctor three times

each week. As my condition improved the sessions were diminished from two to eventually one per week. After two

years the therapy ended. The doctor told me it would still be a period of time before I regained all of my s trength, but he

felt chi was pass ing smoothly through the body and would not be a problem in the future.

I no longer suffer from aches near the ears. (The aches were actually caused by the jaws.) I also am back to normal

fingerings on the flute and can play most any work with a brace I had made for the left middle finger. In addition, I am

 back to playing the baroque flute. I had not been able to execute forked fingers since 1990. Everyday I continue to

experience improvement, so I know it is only a matter of time before I will be free of any crutches.

Mr. Wang is a very soft spoken individual. He reluctantly consented to an interview with my wife and myself about half 

way through my therapy. He only speaks Taiwanese fluently, so my wife acted as an interpreter. The following is a

summary of the most important aspects of his diagnosis and therapy.

Mr. Wang feels my illness arose from the constant turning of the head to the left to play the flute, and insufficient rest

 between playing ses sions. The constant blockage of chi  at the pressure points in the neck from the position of the head

obstructed chi from pass ing smoothly to various areas of the body. That is why I felt numbness and eventually pain

and weakness in my hands . Without chi pass ing smoothly through the pressure points eventually my circulation got

slower and s lower arising in the formation of the "s oft bone" tissue. To solve the problem the doctor needed to open up

the blocked passages. Though I can feel chi  when I practice chi-kung and could also feel the therapy freeing my chi to

flow freely, chi  remains a challenge for me to explain.

I have either sensed chi as electricity pulsating through my body or as a feeling of heat. Chi  is definitely attached to the

same chi which means breath, but it also has to do with circulation of the blood. Mr. Wang says that there must be a

 balance between chi  and blood circulation in order for one to carry on phys ical activity properly. He says that weakness

in a part of the body is caused by a lack of blood flow to balance the chi , and that pain is a result of a lack of sufficient

chi to balance the blood circulation.

The most important advice he gave me to keep from a recurrence of "writers cramp" was to take sufficient rest between

 periods of playing and always warm down after playing ses sions. If I practice for 45 minutes , then I should rest an hour 

and a half before playing again. After every session I perform stretching exercises for 5 minutes or more. We often think 

about warming up, but rarely do we think about concluding our sess ions with exercise.

I still am uncertain as to whether my head injury had any bearing on my condition. Doctors I have consulted doubt there

is any relationship. I do cons ider myself extremely fortunate to be able to play again, and hope that my rehabilitation

may provide hope for others suffering from similar conditions. I am not trained in medicine. I can do no more than to

describe my s ituation to others and hope there are readers out there who may be able to use this information for future

investigations. I have been told that Mr. Wang has gained the respect of many people in the medical profession in

Taiwan. He certainly has gained my respect and admiration.

~Mark Dannenbring is ass ociate professor of flute and head of the wind division at Tunghai University in Taiwan. He is

also a lecturer on western music at The Ins titute of Arts at Cheng Kung University and artistic director of Vivezza, a

 professional chamber orches tra. Besides a DMA in flute performance from The University of Iowa he has also s tudied

music theory and dance at Ohio State University, Alexander Technique, Feldenkrais, Dalcroze, Orff, and chi-Kung. Address:Box 5-807. Tunghai University. Taichung, Taiwan 407. Phone: (04) 3590640

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A NOTE ON ANTIDEPRESSANTS  BOOK REVIEW

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 by John Braverman Levine, M.D.

The year 1997 marks the 10th

anniversary of the introduction of 

Prozac. Domestic sales of this drug in

1996 were $1.73 billion. Why should this

matter to flute players? Prozac belongs to a new class of 

antidepressants called SSRI's (serotonin-

specific re-uptake inhibitors). Other members of this class include

zoloft(sertraline) and Paxil(praroxetine). SSRI's have less intense and more easily

tolerated side effects than tricyclic

antidepressants, an older class of drugs,

 but they have side effects of their own. Thus individuals taking thes e new

antidepressants can experience dry

mouth, difficulty focusing one's eyes,

nausea, and gastrointestinal distress.

These effects may be tolerable in a

rower, but for small muscle Olympians

such as musicians, they can cause

serious interference with playing. Less well recognized is that abrupt

cessation of antidepressants can lead to

a withdrawal syndrome characterized by

return of depressive symptoms,

irritability, instability of mood, muscle

stiffness, dizziness, headache, and

insomnia. 

What can we learn from the above? 

1) If you are taking any psychotropic(mood changing) medications, don't

adjust your dose without first consulting

with the prescribing physician. 2)As side effects and direct effects can

chang over time, if you experience any of 

the changes listed above while taking an

antidepressant, call the fact to the

attention of your physician. Questions

about interference with ease of musical

 performance are still not yet part of the

routine "review of symptoms" in medical

 practice. ~ 

John Levine is a ps ychiatrist in private

 practice in Cambridge, Massachuset ts .

and a Clinical Instructor in Psychiatriy at

Harvard Medical School.

The Anatomy Book For Musicians: A Guide to Understanding

Performance Related Muscle Pain by Susan L. Weiss with

illustrations by Jill Chittenden.

This illustrated reference book helps the musician and teacher 

familiarize themselves with the muscles used in performance. Each

muscle has an illustration of its location and attachment to the

surrounding bones. There is also a detailed description of the type of 

action that uses that muscle and the various musical instruments that do

as well. Symptoms of overuse and causes are discussed for each

muscle followed by self-help tips with suggestions on how to help

minimize overuse and when it might be advisable to seek help from a

specialist.

The author discusses the use of ice application to muscles and its

 positive and negative affects. She also lists organizations to help locate

Alexander and Feldenkrais specialist, message therapists and certified

 personal trainers.

In reading this book I found it well planned and easy to understand.

Each page is dedicated to a muscle with a detailed illustration on the

facing page making it easy to lay open and refer to. Please note that

the author states up front that this is not intended to be a substitute for 

a physician's diagnosis but hopes that it will facilitate communication

with physicians.

~ 

Susan Weiss is a graduate of the chicago School of MessageTherapy. She is certified in neuromuscular herapy and is nationally

certified in theraputic message and bodywork. She is also certified by

the American Council on Exercise as a personal trainer. Her practice

consists mainly of musicians. She is an amateur flutist, member of the

 NFA and NFA Performance Health Care Committee. I the U.S.A.

this book is $18.00 + $4.00 for shipping (+ $1.40 tax for Illinois

residents only.) Any inquiries should be directed to her at:

MUSCLES DYNAMICS P.O. Box 431, Glenview, IL, 60025

 phone:(888)729-3770. email:SusanLWeiss@compuserve.com

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What is most important in making a flute play well? 

 by John Lunn

Whenever someone learns that I make flutes for a living, they invariably ask that question. The most recent

occasion was while meeting some new friends. Before I could answer someone said, "That's easy - the

flutist!". That is what I would have said.

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In an age of gadgets and techno-improvements, we tend to forget that technology doesn't make the world

go around, people do. Unfortunately, flutists are just as susceptible as anyone else in believing that there are

external answers to internal questions. In the last 22 years I've seen many flute players searching for some

magical trick in the flutes and headjoints they buy hoping to find a special quality in them that no one else

has.

But, aside from the basic quality of the instrument and a handful of options and innovations, the flute's real

 promise comes from you. Your self-confidence, determination and ability are the key elements in making a

flute exceptional. They gives you the strength to step onto the stage and share a piece of yourself. Certainly,

there are variations between manufacturers that give different flutes different qualities. But without the

individuality of each flutist to bring them out the flute is just a tool.

When self-confidence is challenged due to a physical injury or hand problem, many flutists lose their way.

For all the years of practice, study and performance sudden loss of ability will leave you totally unprepared.

The trick is to return to the basics: confidence, determination and ability. Getting to whatever degree of skill

you are at right now took incredible patience and determination. Use it again.

Take the time to research and find out what you need to do to recover. Whether it is having your flute

modified to fit your hands, getting medical advice or treatment, retraining and developing better habits,

don't back down once you realize that a problem exists. It doesn't matter if the cause of the problem was

 bad hand position, overpracticing, a car accident, arthritis or tendinitis the only solution you will find is

within yourself. Your body is your instrument; your lungs, embouchure, fingers and mind. The flute is only

an extension of that. You are the most critical and important part of the flute.

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 HANDS ON! is a public service provided by John Lunn Flutes 

The opinions expressed are not necessarily those of the editors.If you have questions, comments, articles, ideas or letters to the editor, we'd love to hear them.

If you are in pain or experiencing phyical difficulties while playing, email us.

ADVISORY BOARD 

Jeanne Baxtresser, Mary Louise Poor, Richard N. Norris M.D. 

Janet Weiss, John Braverman Levine M.D. 

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