What can studying musicians tell us about motor control of the hand?

Most standard accounts of human anatomy and physiology are designed to meet the requirements of medical education and therefore consider their subject matter from the standpoint of typical rather than outstanding levels of performance. To understand how high levels of skill are developed and maintained, it is necessary to study elite groups such as professional athletes or musicians. This can lead to the rediscovery of arcane knowledge that has fallen into neglect through a lack of appreciation of its significance. For example, although variability in the muscles and tendons of the hand was well known in the nineteenth and early twentieth centuries, it is through recent studies of musicians that its practical significance has become better appreciated. From even a cursory acquaintance with the training methods of sportsmen and women, dancers and musicians, it is clear that sophisticated motor skills are developed only at the cost of a great deal of time and effort. Over a lifetime of performance, musicians arguably spend more time in skill acquisition than almost any other group and offer a number of unique advantages for the study of motor control. Such intensive training not only modifies cortical maps but may even affect the gross morphology of the central nervous system. There is also evidence that in certain individuals this process can become maladaptive. Recent studies of musicians suggest that intensive training can lead to the appearance of ambiguities in the cortical somatosensory representation of the hand that may be associated with the development of focal dystonia; a condition to which musicians are particularly prone. The realization that changes in cortical maps may underlie dystonia has led to the development of new approaches to its treatment, which may ultimately benefit musicians and non-musicians alike.