The lifelong ability to adapt to environmental needs is based on the capacity of the central nervous system for plastic alterations. In a series of neurophysiological experiments, we studied the impact of music and musical training in musicians on the specific functional organization in auditory and somatosensory representational cortex. In one such study, subjects listened to music from which one specific spectral frequency was removed. This led to rapid and reversible adaptation of neuronal responses in auditory cortex. Further experimental evidence demonstrated that long years of practice and training by professional musicians to enable them to reach their capacity is associated with enlarged cortical representations in the somatosensory and auditory domains. This tuning of neuronal representations was specifically observed for musical tones and was absent when pure sinusoidal tones were used as stimuli. In the somatosensory cortex, plastic changes proved to be specific for the fingers frequently used and stimulated. These changes were not detected in the fingers of the hand that were not involved in playing the particular instrument. Neuroplastic alterations also may be driven into a domain where they may become maladaptive. The clinical syndrome of focal hand dystonia that may occur in musicians who engage in forceful practice may be one such consequence. We will discuss the possibilities of reversing maladaptive responses leading to the successful treatment of focal hand dystonia, which relies on basic research about cortical reorganization. This example elucidates how neuroscientific progress can guide the development of practice guidelines and therapeutic measures for the benefit of professional musicians.