Embouchure Dystonia



  • My endurance comfort level seems to be about 75 minutes. The band I have been playing in for the last six months has a 90 minute practice session once a week. So for me there was always a struggle to get through the 90 minutes but I had seemed to be making gradual improvements. In early June we embarked on what is known as a summer tour, where we played a gig every Tuesday night for 6 weeks, ending sometime in late July, after which the band closed down for the summer break. During the six weeks the concerts were mostly 45 minutes ( at nursing homes ) and the occasional one hour gigs. During this time there were no 90 minute practice sessions, so when we had two back to back concerts to play August 27 and tonight, the 28th, we had our first 90 minute practice session last Wednesday to go over the material for the back to back concerts. For me, it was the first time I had to play 90 minutes in more that two months and it was a helluva struggle and by the end of the session my lips felt like chopped liver.
    The next morning during practice ( I play approximately 45 minutes horn on the face technical stuff every morning and the same time playing tunes every afternoon ) nothing sounded good and the mp on the chops didn't feel right. The next 4 days I struggled to get back my tone, and on the 5th day ( Monday this week ) after playing two songs horribly, there was suddenly nothing but dead air coming out the end of the horn. Tuesday and this morning I tried to blow a few notes and nothing but a horrid sound.

    I have heard about embouchure dystonia becoming a problem after overuse and my symptoms seem to fit that category. There is a website, I believe it is by the gent who wrote The Balanced Embouchure. it is heavy reading for someone who is not a doctor, so I sent a link to the site to a doctor who is a member in our band. I am looking for answers as to what I have to do to make a full recovery.

    If anyone here is familiar with this problem, I would appreciate your input.

    Since this is apparently a neurological disorder, I am doing my best to approach the situation with a positive outlook. I will play the trumpet again.

    George



  • In addition to a possible medical checkup (which I don't think you need) it is time for a teacher who really understands embouchures. It sounds like your approach is wrong from the start. Playing more should make you tired but not damage you.



  • I, personally, wouldn't over-theorise/think it. It sounds to me like your chops are swollen. I'd give them a rest.

    That's not to say that there may not be something fundamentally wrong that's the underlying cause. See a chop doctor.



  • @Kehaulani
    Yeah I am trying not to overthink it. There are no chop doctors nor are there any teachers in my neck of the woods, but there is a doctor member of the band who I will be seeing.



  • Before going down a rabbit hole, I'd just give the chops a rest and see if that cures it. As I get older, my endurance certainly hasn't improved...I just think it comes with the territory for amateur players who push the envelope.



  • Hi George,
    Here are some things to look for to help determine that it is in fact ED.
    Patients may be categorized by their predominant phenotype: task-specific tremor; lip-pulling; lip-lock; jaw; tongue; and task-specific Meige [2]. Playing difficulty is often limited to one register (pitch range) or to one specific technique, for example articulations (separated notes) or legato (connected notes). About 10 % of ED patients have coincident writer’s cramp, suggesting a possible genetic predisposition to developing focal dystonia. Patients with ED involving the jaw or tongue frequently experience spread of dystonia to other oral tasks such as speaking or eating, and these dystonic features may persist even if they discontinue playing. ED may stem from a central disorder of cortical and subcortical sensorimotor networks that control the lower face, jaw, tongue and pharynx.
    Something to ponder. Have you started a new technique in how you play the trumpet? If so, go slow.
    Also, notice that you were able to find the event that seemed to be correlated to your condition. The first time after two months that you played a 90 minute practice set.
    Some things to look for; If you were wasted after the 90 minute set and the next day you sounded like crap, that's significant and probably an external situation in that you've possibly used bad technique to struggle through the 90 minute rehearsal. Remember, ED may stem from a central disorder of cortical and subcortical sensorimotor networks that control the lower face, jaw, tongue and pharynx.
    My advice. Stop playing for a couple of days and then start back slowly (SOFTLY!) and give your lip a chance to recover. My guess is that you've hammered the shit out of your lip and when the next day came and you sounded like crap, it scared the hell out of you and you tried harder on lips that have been put through the wringer. Pay attention to your tongue and keep it loose. By doing so, it can help decrease some of the abdominal tension and overblowing we often experience as trumpet players. Will you be able to play again? It depends. It seems like a man made (not neurological) problem. It will depend on how you handle the recovery. Also, ask yourself how you got in this boat in the first place. Good luck and work on healing.



  • @Bob-Pixley said in Embouchure Dystonia:

    Before going down a rabbit hole, I'd just give the chops a rest and see if that cures it. As I get older, my endurance certainly hasn't improved...I just think it comes with the territory for amateur players who push the envelope.

    Yeah, I am 83 and I am constantly pushing the envelope. I agree though, that rest is necessary before taking any kind of action. It just scares me that my symptoms are similar to overuse embouchure dystonia.



  • @Dr-Mark
    All good advice, Dr-Mark. It has already been two days since the dead air incident and I still can't make a decent sound, so yeah, I am going to do nothing for a few days and give everything a rest, like you suggest, start back slowly and SOFTLY. I have over played before but I was never wasted like I was this time. Anyway, I am a positive thinker and I will play again.



  • @GeorgeB said in Embouchure Dystonia:

    @Kehaulani
    Yeah I am trying not to overthink it. There are no chop doctors nor are there any teachers in my neck of the woods, but there is a doctor member of the band who I will be seeing.

    Check out John Mohan (Claude Gordon teacher). You can contact him through his account on Trumpet Herald under the Claude Gordon forum. He teaches by Skype.

    (BTW, his wife is German, as is mine, so . . . extra points, 😁 )



  • Hi George,
    There's pushing the envelope as it pertains to learning new stuff and there's pushing the envelope as it pertains to physical requirements of trumpet playing.
    My advice is to possibly not push the envelope when it come to the physicality of playing. When you notice it(tension and force) happening (and we've all experienced it!) back off and play easier. Only use what is needed to get the job done. Tension and force are not your friends and never will be. Will you play again? In my opinion, it will depend on how you handle the consequences of your behavior. This is your new dragon to conquer.
    Dr-GO has more background in neurology that I, so you might want to get his input on your situation.



  • I have been talking to a physician who is a member of our band. She doesn't feel it is Dystonia. She asked me to blow a G, and after several attempts I managed it. She could tell my lips were definitely swollen and feels it is an injury that will take a lot of rest time. She also suggested I put ice on the lips 2 to 3 times a day for 5 minutes. I did that last night and was actually able to play a weak A to F on the staff. I tried it again about 20 minutes later but the lips were swollen again. So that is it. I am putting the horn down for 2 weeks and then try a few notes. Age is against me, so if the swelling is still there I will continue to rest until the chops return to normal, then start to carefully rebuild my embouchure. In the meantime, I will attend our weekly practice. The new term starts next Wednesday and there will be new material. I can't play but I can read and pretend to play. That way I will keep up with anything new that is happening.

    I don't give up easily...☺



  • I have been reading your thread as it develops, GeorgeB. This is a useful discussion, perhaps particularly so for those of us who are seniors. I applaud your intention to stay involved in your band while you cannot play your horn. Best wishes for a fast and complete recovery.



  • @GeorgeB said in Embouchure Dystonia:

    She could tell my lips were definitely swollen and feels it is an injury that will take a lot of rest time. She also suggested I put ice on the lips 2 to 3 times a day for 5 minutes.


    Hi George,
    In addition to ice, there's nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, or naproxen. These are over the counter and require no prescription.
    As with any drug, take with care.
    I know its hard to stay away from the trumpet so if you must play, easy peasy is the way to go. Soft and without tension or force. It appears that you've arm-stronged the mouthpiece into your face and as a result, you've got swollen lips.
    All we need is enough pressure to create a seal. You're not the first or last person to have an unusually long session and used excessive mouthpiece pressure to make it through the show. Just take it easy and be aware of excessive mouthpiece pressure.
    My guess? I think you'll conquer this and you'll be playing better than before. Why? Because you know not to do what you did and that's moving towards better. For the most part, we all start out blowing too hard and using too much force and tension. Our job is to learn how to use the least amount of stress and strain t get the job done. Its kinda like meditation with an attitude.



  • @Dr-Mark said in Embouchure Dystonia😆 My guess? I think you'll conquer this and you'll be playing better than before. Why? Because you know not to do what you did and that's moving towards better. For the most part, we all start out blowing too hard and using too much force and tension. Our job is to learn how to use the least amount of stress and strain t get the job done. Its kinda like meditation with an attitude.
    I trust that GeorgeB will find these suggestions as helpful as I do, Dr Mark. As I return to trumpet again, overdoing, using too much pressure, and relaxation continue to challenge me. Your last sentence is kind of catchy!



  • @GeorgeB said in Embouchure Dystonia:

    I have heard about embouchure dystonia becoming a problem after overuse and my symptoms seem to fit that category. There is a website, I believe it is by the gent who wrote The Balanced Embouchure. it is heavy reading for someone who is not a doctor, so I sent a link to the site to a doctor who is a member in our band. I am looking for answers as to what I have to do to make a full recovery.

    (I'm a physician. I am making some general comments about dystonias and your post.)

    Sorry to hear about your problem. Based on what your saying, it is very likely not an embouchure dystonia.

    FWIW, a dystonia is an irreversible neurologic condition. It is believed to be the result of a disease state, although the exact cause is often unknown. It often begins abruptly and without warning. And it never goes away. (It can be compensated for, by doing things differently, but it never goes away.)

    Do you have a reason to believe you have a neurologic disease? If so, you should talk to a doctor. And without commenting on any specific embouchure-rehab website, I would be highly skeptical of any non-physician trying to diagnose or treat a so-called dystonia.

    But based on what you shared, you're playing the trumpet beyond your normal abilities, and you are suffering negative consequences. You most likely have a soft tissue injury. Based on this, you need rest, you need to avoid the type of playing that caused this problem, and you need to work on exercises to refocus your embouchure.

    Mike



  • @GeorgeB said in Embouchure Dystonia:

    The next morning during practice ( I play approximately 45 minutes horn on the face technical stuff every morning and the same time playing tunes every afternoon ) nothing sounded good and the mp on the chops didn't feel right. The next 4 days I struggled to get back my tone, and on the 5th day ( Monday this week ) after playing two songs horribly, there was suddenly nothing but dead air coming out the end of the horn.

    What we do the day after a tough gig is important. What you did the next morning may have created or significantly worsened the injury.

    I had a tough gig last week. I was sitting in with another band, and by the end of the gig, my chops were spent. The next day, I played softly for 10 minutes, and then put the horn away. The following day, I practiced for 45 minutes (instead of my normal 60-90 minutes), and was careful not to push anything. The next day, I felt great, and resumed my normal playing.

    Mike



  • @tmd
    Thanks for your wonderful response to my posts. The things you suggest fall right in line with what the doctor in our band told me. She is also a brass player so I had faith in what she told me.
    And common sense told me I made a mistake in playing the way I did the morning after that tough practice session when my tone went to hell in a basket. I continued to make a mistake right up to the point a few days later when I kept playing thinking I could work through the problem and ended up blowing dead air. NEVER AGAIN. Once I am playing again, I intend to take off the day following practice or tough gigs.
    Again, thank you, sir.



  • @Dr-Mark

    I can't thank you enough, Dr-Mark, for taking time to offer so much valued advice. The band member physician's help and advice was also wonderful, especially because, like you, she is also a brass player.

    I have learned a valuable lesson from this unfortunate event.



  • @Comeback

    My sincere thanks, Comeback. I am with a great band. I am the oldest. They know it and give me a lot of leeway, including permission to skip some pieces in order to narrow my playing time when my chops are getting overtired.



  • @GeorgeB said in Embouchure Dystonia:

    I have learned a valuable lesson from this unfortunate event.


    You've probably learned more from this incident than you would've learned from two years of college trumpet.


Log in to reply