MALADIES & REMEDIES
FOCAL DYSTONIA
The Cleveland Clinic tells us, "Focal dystonia is a neurological disorder. It causes involuntary muscle contractions in one body part. You may have muscle twitches in your neck, face, jaw, feet or hands. Focal dystonia that affects hands and wrists is common in musicians, athletes and writers. In golfers and baseball players, people often call focal dystonia 'the Yips.' . . . Although dystonia is one of the most common types of movement disorders, focal dystonia is relatively rare. It affects about 3 in every 10,000 people in the United States. . . . Focal dystonia is idiopathic, which means experts can’t point to one factor that causes it." There can be a psychological component as well, but which is the chicken and which the egg is a question. Genetics can be a factor.
Musician's Dystonia can be soul-crushing. It can especially tough when it is not taken seriously or doubted. I had phone conversation years ago with a person in tears because their teacher told them they were faking it. Sometimes what appears to be dystonia is not, but faking it seems vanishingly unlikely. My personal experience with dystonia is discussed in Decline & Fall.
The Dystonia Medical Research Foundation tells us, "Experts estimate about 1% of professional musicians are affected by dystonia, but there are likely large numbers of musicians living with symptoms who remain unidentified. Almost all individuals with musician’s dystonia are classically trained, and most are male. Up to 25% have a family history of dystonia." National Institutes of Medicine's MedlinePlus.com says ". . . at least 10 percent of affected individuals have a family history of focal dystonia." Interestingly, the Cleveland Clinic indicates, "Women and people assigned female at birth develop focal dystonia about three times as often as men and people assigned male at birth do."
Larry Zalkind frankly discusses his dystonia, his recovery, and a genetic component, in great depth, on Anthony Plog's podcast here. Larry says, “There are 28 dystonia genes. . . . I don’t have any dystonia genes . . . [but] the surgeon who did my surgery said, ‘Oh you have a gene; we just haven’t discovered it yet.’”
Much remains to be learned.
Self-diagnosis is a very bad idea, over-diagnosis may be a thing, and psyching one's self into a problem is possible. A neurologist – preferably with expertise in embouchure dystonia – should make any diagnosis. Travel may be involved. Dr. Steven Frucht helped me; he is a world-class expert in embouchure dystonia.
However, diagnosis is NOT treatment. There are many therapies for dystonia; some work for some; others for others; some not at all. I know how I got out from under dystonia; I'm not sure I could teach it. It presents differently in different individuals. I am pretty sure Alexander Technique and Body Mapping can help prevent it.
Embouchure Dystonia: Mind Over Grey Matter, a presentation by Dr. Peter Iltis, Professor of Kinesiology at Gordon College, is just excellent.
MedlinePlus has more information here.
Musician's Wellness has helped some.
David Vining's Dystonia Narrative is revealing.
Larry Zalkind candidly discusses his dystonia journey with Tony Plog.
There are other embouchure maladies. Overuse is a thing – don't keep it on your face for hours on end – rest frequently. Embouchures.com has information about various embouchure problems.
IMPORTANT: Dystonia is rare. Amateur or self-diagnosis is a serious mistake and can lead down a rabbit-hole with a can of worms at the bottom.
Musician's Dystonia can be soul-crushing. It can especially tough when it is not taken seriously or doubted. I had phone conversation years ago with a person in tears because their teacher told them they were faking it. Sometimes what appears to be dystonia is not, but faking it seems vanishingly unlikely. My personal experience with dystonia is discussed in Decline & Fall.
The Dystonia Medical Research Foundation tells us, "Experts estimate about 1% of professional musicians are affected by dystonia, but there are likely large numbers of musicians living with symptoms who remain unidentified. Almost all individuals with musician’s dystonia are classically trained, and most are male. Up to 25% have a family history of dystonia." National Institutes of Medicine's MedlinePlus.com says ". . . at least 10 percent of affected individuals have a family history of focal dystonia." Interestingly, the Cleveland Clinic indicates, "Women and people assigned female at birth develop focal dystonia about three times as often as men and people assigned male at birth do."
Larry Zalkind frankly discusses his dystonia, his recovery, and a genetic component, in great depth, on Anthony Plog's podcast here. Larry says, “There are 28 dystonia genes. . . . I don’t have any dystonia genes . . . [but] the surgeon who did my surgery said, ‘Oh you have a gene; we just haven’t discovered it yet.’”
Much remains to be learned.
Self-diagnosis is a very bad idea, over-diagnosis may be a thing, and psyching one's self into a problem is possible. A neurologist – preferably with expertise in embouchure dystonia – should make any diagnosis. Travel may be involved. Dr. Steven Frucht helped me; he is a world-class expert in embouchure dystonia.
However, diagnosis is NOT treatment. There are many therapies for dystonia; some work for some; others for others; some not at all. I know how I got out from under dystonia; I'm not sure I could teach it. It presents differently in different individuals. I am pretty sure Alexander Technique and Body Mapping can help prevent it.
Embouchure Dystonia: Mind Over Grey Matter, a presentation by Dr. Peter Iltis, Professor of Kinesiology at Gordon College, is just excellent.
MedlinePlus has more information here.
Musician's Wellness has helped some.
David Vining's Dystonia Narrative is revealing.
Larry Zalkind candidly discusses his dystonia journey with Tony Plog.
There are other embouchure maladies. Overuse is a thing – don't keep it on your face for hours on end – rest frequently. Embouchures.com has information about various embouchure problems.
IMPORTANT: Dystonia is rare. Amateur or self-diagnosis is a serious mistake and can lead down a rabbit-hole with a can of worms at the bottom.
TMJ
I suffered from TMJ, or more precisely, temporomandibular joint dysfunction (TMJD), for several years. I now believe this was the result of stress from my Focal Dystonia. I eventually got relief from TMJ with the use of a NTI-tss® device from Dr. James Boyd in combination with the Trigeminal Pharyngioplasty procedure, performed by Dr. Paul Guerrero, D.C. at Muscle Works in Glendora, CA. I recommend both. I should note the procedure is quite uncomfortable and required several visits. These exercises may help.
TRIGGER FINGER
Sounds kinda romantic – like an old cowboy movie – it's not! My 2nd valve finger would lock. Trigger Finger is not uncommon with musicians. Some have had multiple surgeries. I was able to get relief from physical therapist, Lyn Paul Taylor. The treatment involved ultrasound, ibuprofen gel, and very vigorous manipulation of the surrounding tissues – uncomfortable! The ibuprofen gel combined with ultrasound, both before and after manipulation, prevents inflammation and recurrence. It resolved in 4 visits. A bass-playing colleague I referred to Lyn, got similar results. I was referred to Lyn by a former USC football player. Lyn's clientele consists of athletes, musicians – and horses. (When my doctor heard about the horses, he said, "That eliminates the placebo effect.") Catching it early is important. Deep tissue massage may help. If surgery can be avoided . . .
CHAPPED CHOPS
I stopped using lip goop decades ago; I found it to be "addictive." A dermatologist suggested the following remedy for chapped lips (which resonates with the article below): before bed, apply a hot (but safely comfortable), wet, washcloth for several minutes, and seal with petroleum jelly. This opens the pores, hydrates, and seals the water in. It works for me on the rare occasions it's needed. YMMV. I don't know how long this article will stay up (or if there's a paywall), but it's excellent.
NERVES
My teacher, Roy Main, told me, "Anything you're not used to doing can make you nervous." Roy was a very experienced, but primarily commercial, trombonist. He played on recording sessions, live TV shows . . . even playing I'm Getting Sentimental Over You in football stadiums – nothing fazed him. Until he began to explore brass chamber music; this was well into his career. His first brass quintet job was at a church in downtown LA; the audience was a priest and a couple winos; and his hands were shaking! (When we later formed the Composers Brass Quintet, he was well over it; we played hundreds of concerts together.)
Arnold Jacobs said, "The more you play in public, the easier it is." Another wise man once said, "Every Sunday there's some minister of music in some church somewhere wishing there was a soloist available." Tommy Pederson told me he once asked Timofei Dokschitzer, who was on a world tour representing the Soviet Union in the 1960s, how he stayed so calm and relaxed while performing. Dokschitzer replied, "They trained me very carefully. When I was 7, I played for my family; when I was 10, I played for my school; when I was 15, I was playing in soccer stadiums. I never noticed the transitions."
The use of beta blockers for performance anxiety is both controversial and widespread. I used propranolol (under medical supervision) for about a year to mitigate anxiety at work due to focal dystonia. It helped me enormously. I found this interview to be pretty informative. NOTE: Taking any prescription medication without consulting a doctor can be dangerous!
Also, while they may be placebos, bananas might be helpful . . . or not.
Also, see Auditions
Arnold Jacobs said, "The more you play in public, the easier it is." Another wise man once said, "Every Sunday there's some minister of music in some church somewhere wishing there was a soloist available." Tommy Pederson told me he once asked Timofei Dokschitzer, who was on a world tour representing the Soviet Union in the 1960s, how he stayed so calm and relaxed while performing. Dokschitzer replied, "They trained me very carefully. When I was 7, I played for my family; when I was 10, I played for my school; when I was 15, I was playing in soccer stadiums. I never noticed the transitions."
The use of beta blockers for performance anxiety is both controversial and widespread. I used propranolol (under medical supervision) for about a year to mitigate anxiety at work due to focal dystonia. It helped me enormously. I found this interview to be pretty informative. NOTE: Taking any prescription medication without consulting a doctor can be dangerous!
Also, while they may be placebos, bananas might be helpful . . . or not.
Also, see Auditions