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The Greatly Misunderstood Subject of Embouchure Overuse and Embouchure Dysfunction Common in Brass Instrumentalists |
Editor's Abstract (Click to Hide)
Lucinda Lewis, Principal Horn with the New Jersey Symphony and author of Broken Embouchures, explores the symptoms and treatment of embouchure overuse syndrome. She explains how the basic mechanical structure of the embouchure works while playing, and how it can become damaged and disabled by an episode of overuse.
Cindy lists the hallmark physical symptoms of embouchure overuse, and denotes the most common playing problems that result from overuse. One of the most important issues to consider is sensory feedback, which is critical to brass playing. Finally, she offers a list of clues that can indicate that you are developing embouchure overuse syndrome. The only treatment is mechanical rehabilitation, which can be frustrating but, if done correctly, can restore the embouchure to proper functioning.
- Ann DrinanOver the last 25 years, performing arts medicine has become a recognized specialty. A number of clinics around the world treat the aches, pains, and injuries of performers. Unfortunately, while much is now known about the performance injuries of string players and pianists, brass players suffer a unique kind of performance injury that is not well understood by the music medicine community. As a result, brass players have to suffer lengthy, painful, and debilitating lip injuries with no hope of effective medical treatment.
The kind of embouchure injury/disability that most commonly affects brass players is embouchure overuse syndrome. Embouchure overuse syndrome begins as only a minor performance injury, but it quickly evolves into something far more problematic. Within days, it will musically cripple a brass player without his even knowing what has happened.
Embouchure overuse does cause initial injury to a player’s lips and face; but a disabling, residual cycle of injury persists for months and even years that is perpetuated by the erosion of the physical ability of the embouchure to function correctly in playing. A more detailed description of how embouchure overuse syndrome evolves and ultimately disables a brass player artistically appears later in this article.
Anecdotal Statistics
In the years that I have been writing about embouchure overuse and brass injuries, I have received thousands of emails, letters, and phone calls from desperate players seeking help. From the information that they shared with me about their respective injuries, interesting statistical patterns began to emerge.
In the first twelve years of my research, 3658 bona fide embouchure overuse injuries/playing disabilities were reported. Approximately 2/3 were from professional players. All had been suffering with ongoing playing-related lip pain and/or lip swelling, and developed serious playing problems, including loss of endurance, trouble playing in the high range, a lack of clarity in tone and in articulation, and a general sense of overall playing disability. 97% reported that the onset of their lip pain and playing problems had been preceded by a period of intense, physically demanding playing. 48% indicated their injury and playing problems had persisted for two years or more. 89% had consulted at least one physician and/or dentist. None had found any lasting medical solutions. Their physical discomfort, and playing problems continued even after medical treatment had concluded.
Interestingly enough, 75% had taken a therapeutic holiday from playing of at least 2 weeks. However, time off the instrument of any duration did not permanently resolve either physical or playing problems, all of which usually reappeared within two to three weeks of returning to the instrument.
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I think Cindy Lewis's ideas are good, but don't get too far ahead of yourself. You don't mention if you've taken any lessons from a horn player-- the horn is really drastically different from the low brass instruments you are accustomed to playing. I think the first step is to find a horn teacher in the area, perhaps someone who works primarily with beginners and explain your situation to them. In my experience, those are the teachers who know what to look for in an embouchure, and how to start a player off "right." They might be able to give you the minor tips you need for a healthy, functioning embouchure. You also don't mention if you are switching between the instruments on a weekly basis, which might create some sort of "chop confusion." While the large concepts are greatly the same (buzz and blow!) the mouthpieces are not. I am a horn player, and haven't ever played low brass instruments, but I think that you will have to think of a narrower stream of air than on the tuba and trombone. Just based on what you've written, I'm going to guess that you may be over-engaging your cheek muscles in an attempt to vibrate a larger portion of your embouchure to force "too much air" through the horn. I don't think you are broken by any means, but do proceed with caution. Good luck!
L.
I have played Trombone, Euphonium and Tuba for many years, and I'm 38 years old.
I just recently started playing French Horn to help out our local community band. I've discovered that there is a set of muscles in my cheeks that are being worked for the first time that were not used as much playing low brass. I've been playing Horn for about 3 months now, at least once a week. Within the last week, those muscles have become permanently sore, and hurt when I smile. I've heard of permanent injuries to the cheek muscles that put trumpet players out of business, so I thought I should be asking questions. I'm still able to play, but I don't know if I should lay off for a while, or what therapy is recommended.
If you have any advice, I'd be happy to hear it. If you know of someone I should talk with, please let me know.
Thanks so much,
Brian Bergman,
Astoria, Oregon