Orchestra Life
:: Health
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Embouchure Overuse Syndrome in Brass Players |
Over the last 25 years, performing arts medicine has become a recognized specialty. 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, which begins as only a minor performance injury, but quickly evolves into something far more problematic.
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Static Loading, Back and Disc Problems: |
Muscles like to be in neutral position or at the midpoint of their normal range of movement. Loading, or putting stress on joints in uneven or asymmetrical ways due to awkward, fixed or stiff body positions will result in static loading on the body. Static postures are enemies to be avoided.
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Body Mapping: What Every Musician Needs to Know About the Body |
As a performer with injury, I was advised to take an Alexander Technique class, which was a revelation to me. The foundation for my Alexander Technique study was something my teachers, Barbara Conable and William Conable, called Body Mapping. Learning how to move more efficiently based on a corrected and refined body map allowed me both to play for long periods pain free and to achieve more musically-consistent results.
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When To Watch Change |
Sometimes it is necessary to challenge ourselves to reach a new level with our playing. Change can be wonderful. But for musicians, change is a time to be especially aware. Injury risk can increase with newness, if your body is challenged with unaccustomed stresses as you reach for greater heights.
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Onstage Tricks to Stay Well |
Muscle-tendon injuries can be avoided. Tension and muscle strain must be kept at bay. The following are several "Onstage Tricks" (c) that can be done even while performing. These strategies can give you "mini-breaks" to keep tension at bay.
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Hear No Evil |
Let's talk about something scary; something musicians are even more reticent to talk about than overuse injury. Hearing loss is on the rise and is a danger to all of us.
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Protect Your Ears |
Everyday, life is becoming toxically noisy and hearing loss is occurring earlier in life. In fact, 26 million Americans have hearing loss and, unlike other overuse syndromes, most hearing loss problems are cumulative and, unlike other overuse injuries, hearing loss is permanent.
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WARM UP! |
Warmed muscles are more efficient, strong, and resilient. Muscles that are overused, fatigued, and under-conditioned are more tense and require more work for a demanding task. It is important to start by gently and smoothly using your muscles for a few minutes to increase blood flow without stressing them. Cold muscles are inelastic!
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Common Health Problems for String Players |
The following information details the most common health problems that string players encounter. Be sure to consult a doctor. Self-diagnosis can be very dangerous, and doctors have seen numerous examples of each of these ailments.
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Five Essential Practice Rules |
One would think that when we practice at home on our own, injury risk is lower because we are in total control of what we do, what we play, and how we play it! Unfortunately though, we tend to get so involved that we lose track of time. We push ourselves into endless repetition, we try to cram, and we force ourselves to stay put and get through everything we have to prepare. We are ready to self-destruct to reach our goals. This is a recipe for disaster!
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When To Use Ice and When To Use Heat |
When you feel you have overplayed, when you have some pain, or for those hot, tired muscles after a heavy performance even when injury is absent, drop everything and ice the area.
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Are You "Double-Jointed?" |
If you are, take care! Musculoskeletal injuries are frequent in musicians with joint laxity (also referred to as double-jointedness, or hypermobility).
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Too Much, Too Soon? |
Overuse is a loose term applied to several conditions in which body tissues have been stressed beyond their biological limits.
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Mouthpiece Pressure - Fact or Myth |
All brass players have grown up being told that mouthpiece pressure is a bad thing. There are even new approaches to teaching brass instruments that use a "low pressure" method. But is mouthpiece pressure really as much of a problem as some suggest? Here are a few observations to consider.
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Playing For Patients |
Musicians frequently donate their time and talent to the community by playing in hospitals and other healthcare settings. This experience can be extremely rewarding, especially if we know what to expect and feel adequately prepared. Below are some tips I've picked up over the years - I hope some of them may be useful for you.
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String Players and Health |
Playing a stringed instrument is a physically and mentally taxing endeavor. When we first learn to play our instrument, years are devoted to mastering proper alignment, hand position, and posture. The older we get, the more we realize that these are life-long projects, not challenges that are easily confronted and resolved. Because of the sheer hours required to learn a specific piece of music and polish technical passagework, we are extremely susceptible to Repetitive Stress Injuries (RSIs) and general aches and pains. The best way to maintain a well-rounded and fulfilling career is to avoid injury if at all possible. Therefore, prevention is key.
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The Extraordinary Carmine Caruso |
I'm often asked about various "embouchure methods," such as the Caruso method or the Arnold Jacobs method. My response is, "Whatever works for you is the best method." It doesn't matter what anyone else thinks about a chop therapy - how does it work for you?
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"Things Are Seldom What They Seem" |
Little Buttercup's wisdom, quoted above from Gilbert & Sullivan's HMS Pinafore, can be liberally and usefully applied to many occasions. Here it serves as a segue to discuss how musicians can find quality medical care, and no, this is not an oxymoron.