Trumpet Related Injuries

YouTube user “Rufftips” (John) has posted a video about injuries that trumpet players are at risk for. Take a look.

It’s almost 10 minutes long, so if you don’t feel like watching it all the way through just now, I will summarize what he discusses and offer some additional thoughts of my own.

The first condition that John discusses is focal dystonia. Like some other folks online, he passes along some misinformation here. He calls focal dystonia a “muscle condition,” where it is more accurate to call it a neurological condition. The National Center of Neurological Disorders and Stroke discusses dystonia here.

The cause of dystonia is not known. Researchers believe that dystonia results from an abnormality in or damage to the basal ganglia or other brain regions that control movement. There may be abnormalities in the brain’s ability to process a group of chemicals called neurotransmitters that help cells in the brain communicate with each other.  There also may be abnormalities in the way the brain processes information and generates commands to move.  In most cases, no abnormalities are visible using magnetic resonance imaging or other diagnostic imaging.

I’ve written several times briefly about “embouchure dystonia” before here, but I tend to avoid going into too much detail about it because I understand that even experts poorly understand what’s going on. In fact, my personal opinion studying brass embouchures leads me to believe that much of what gets defined as embouchure dystonia may really be related to the player doing some embouchure type switching. Since most brass players (let alone medical professionals) don’t have an idea of what embouchure types are and how they can vary from player to player, the underlying cause of a player’s difficulties get diagnosed as an extremely rare neurological disorder that, as you can see from the NCNDS’s quote above, is challenging to diagnose.

My advice here is if you feel you might have a neurological condition affecting your brass playing you should get a referral to a specialist and never take medical advice from a brass teacher. A brass teacher who is diagnosing and claiming to treat “embouchure dystonia” is not qualified to do either, no matter how many players he or she has helped with lessons.

John next discusses is Bell’s palsy. He does the right thing here and recommends viewers to visit a doctor. I wish he had mentioned that early on in his video.

Over the course of video recording brass player’s embouchures for some of my research I’ve documented two trumpet players who had prior to my recording their chops suffered from Bell’s palsy. While both felt things were not quite 100% for them at the time of the video recording, they both have made complete recoveries. I believe that one of them commented that his doctor told him that the early this condition is diagnosed and treated the faster the recovery period and the more likely the player will make a complete recovery. At one point this disorder might be career ending for a brass player, but these days the medical profession knows enough about Bell’s palsy that treating it has much better outcomes and most people make complete recoveries with proper treatment.

After discussing Bell’s palsy John covers nerve damage. He mainly talks about nerve damage that might occur from getting dental work. John comments that diligent and careful practice can eliminate playing symptoms from nerve damage, but how much of that is simply related to recovery time and how much due to a specific sort of practice isn’t clear to me. Again, if you suspect nerve damage I suggest you discuss your symptoms with a medical professional.

Laryngocele is the next condition John talks about and he even demonstrates what it looks like. I had not heard this term used before, but it’s essentially a neck puff, at least as defined by John. I found a paper published in the Internet Journal of Otorhinolaryngology that defines it slightly differently.

Laryngocele is a rare, benign dilatation of the laryngeal saccule which may be asymptomatic or they may present with cough, hoarseness, stridor, sore throat and swelling of the neck. The incidence of laryngocele is 1 per 2.5 million people per year.

I’ve written about a neck puff before. If you want to read what Donald Reinhardt wrote about this and his recommendations for reducing or eliminated a neck puff please check it out here.

Next up is a brief discussion of the teeth and John’s personal experience with this issue. He recommends getting a mold made of your teeth so that in the event that you need some reconstructive work done on your teeth you can have the dental technicians reconstruct it as close as possible.

Just to add my two cents here, I generally don’t recommend dental work to try to fix a malfunctioning embouchure. I feel that it’s better (and cheaper) in the long term to learn to work with your anatomical features. It is definitely possible to play correctly with all sorts of tooth formations, so there is little need for a player to have his or her teeth worked on in order to find a nonexistent (in my opinion) ideal tooth structure.

John finishes his video discussing lip injuries, again using his own experiences here as a case study. After injuring his upper lip accidentally with a pair of pliers. Eventually he ended up having a plastic surgeon remove the scar tissue from his lip and carefully rebuilt his playing.

If I recall correctly one of my teachers, Doug Elliott, when through something similar when he hit himself in the lip with a hammer. Or maybe this was one of his other students. At any rate, Doug is a fantastic mouthpiece maker and he scooped out a rim to fit the scar tissue and he (or his student) was able to play normally. Eventually the scar tissue healed and he was able to go back to a normal mouthpiece rim.

John recommends what I feel is good advice about rebuilding your chops slowly and carefully. I would also emphasize playing softly throughout your rebuilding, something I don’t recall John mentioning in his video.

In short, I think this video is worth checking out, particularly for folks interested in medical issues related to or affecting brass playing. I wouldn’t suggest folks looking for help with embouchure problems watch it with the intention of self-diagnosing (ironically, I don’t want the same for a lot of my blog posts). I prefer to refer musicians to medical professionals for medical issues. Self-diagnosing from stuff you read on the internet is a bad idea, especially when that medical information is coming from someone like me, a non-medical professional.

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