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Embouchure focal Dystonia



 
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chronic4him
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PostPosted: Mon Mar 26, 2012 6:29 pm    Post subject: Embouchure focal Dystonia Reply with quote

I'm looking for someone that might be able to give me some direction with a severe embouchure problem. I've been diagnosed with focal dystonia. The left side of my embouchure primarily in the cheek area shakes the majority of the time I play. I have been playing for over 30 years. This problem began several years ago after deciding to make some adjustments in hopes that it would improve my playing. I've never been a strong player so you could say my original embouchure was never that solid to begin with. However, I new my limitations and could play up to that. Now I can't play at all. I know I need to remap the brain and go back to fundamentals. I've tried different embouchure settings with the same result. If I concentrate just on pushing air through the mouthpiece I can often play middle register notes without shaking. As soon as I attempt to do lip slurs or play any melodic passage the left facial muscles shake. Any guidance is appreciated.
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tomba51
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PostPosted: Tue Mar 27, 2012 4:43 am    Post subject: Reply with quote

http://www.embouchures.com/

Lucinda Lewis specializes in this sort of thing. Contact her thru the web site and she will help you.
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TrpPro
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PostPosted: Tue Mar 27, 2012 8:15 am    Post subject: Reply with quote

Go back to your original set up: same horn, mouthpiece, mouthpiece placement, etc., and give the Caruso Six Notes exercise (follow the 4 rules as closely as you can) a run through.
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Pops
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PostPosted: Tue Mar 27, 2012 10:04 am    Post subject: Reply with quote

Sometimes FD is a sign of facial isometrics when they play.

They slightly tense a muscle that causes a smile. To stop smiling they slightly contract 2 muscles (Yep it takes 2) to prevent the smile. Sadly this is often slightly over done and the contract the other smiling muscle more. Then they ....

The muscles shake because of the isometric tension. That is the FD because without FD people do the isometrics and don't shake.

Since you have FD you have to learn to turn off some contractions so that there isn't a tug of war going on.

One player I worked with now has a full time military band gig. You can get much better. Start relaxing and learn to play from your at rest facial position.
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zinc cure
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PostPosted: Tue Mar 27, 2012 2:26 pm    Post subject: Zinc Cure for Focal Dystonia of the Lips Reply with quote

I am a flamenco guitarist with focal dystonia in my left playing hand. This condition is also referred to as "Writer's Cramp." My left hand cramps up when ever I begin to play. However, I just recently overcame this condition by increasing my intake of the mineral zinc. I learned about this from a trombone player on the "Musicians With Dystonia" bulletin board forum.
It seems that when you do not have enough zinc in your diet, you get an accumulation of copper....This can bring on focal dystonia in any body part that is used repetitively, such as a trumpeter's lips, a violinist's bow arm,
or a guitarist's hands...In the case of a trumpet player who uses a brass mouthpiece, this may contribute to a copper overload in the player's body because of the copper in the brass mouthpiece.
If you go to the forum: :Musicians With Dystonia," their is much more information there about other musicians who found ways to treat their dystonia.....I forgot to mention that the zinc has to be taken on an empty
stomach and before sleeping because there are certain foods that contain phytates that prevent zinc's absorption. You must also take vitamin B-6 in the morning because it helps to absorb the zinc.
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stanton
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PostPosted: Tue Mar 27, 2012 7:24 pm    Post subject: Reply with quote

And I thought I was the only one on this forum...

Sorry to hear about your bout with FD. I am 3 years 1 month into recovery. I am about 95% of the way back and feel I will ultimately be better stronger than ever.

I have some thoughts about playing with FD, but everyone is a bit different. If you would like to PM me perhaps I can be of some assistance.

What I do know is that I had to learn to form my embouchure differently, breathe differently and use my tongue a bit differently. For awhile you will not feel like yourself, but it won't be long before you are playing stronger than even before.

As far as the recommendation for Zinc goes, I hadn't heard that one. I will have to look into it further. Coincidentally I just posted on this forum about taking vitamin D. I take two 4000 iu capsules every day (8000 iu). It seems to help me significantly. Vitamin D doesn't have the same prerequisites as does the Zinc.

Someone recommended the Musician's FD forum. I haven't been there for awhile, but you will find ideas and possibly some help there.

Good luck,
Stanton
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Wilktone
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PostPosted: Wed Mar 28, 2012 9:04 am    Post subject: Reply with quote

I'm sorry to hear about your issues.

Standard disclaimer first, I am not a medical professional so you should take all of the following information with a grain of salt. The one thing I do feel I can with some certainty is that you shouldn't take any medical advice from an internet forum, music teacher, or anyone who hasn't seen you in person, no matter what background they have.

You state that you have been diagnosed as having focal dystonia. It should probably go without saying, but do not accept this diagnosis unless it has come from someone with the training and qualifications to do so. I have had the opportunity to work with several players with dystonic-like symptoms and document a few of their cases and one thing that amazes me is how many of people with embouchure dystonia get their diagnosis from a musician.

I've spoken to a couple of neurologists, a general practitioner, a speech therapist, and a physical therapist who specializes in therapy for musicians about embouchure dystonia. They all agree that dystonia is something that is rare and not well understood. If you haven't done so already, you should make an appointment with your doctor to rule out something more common (like a damaged muscle or Bell's palsy) and get a referral to a specialist who can diagnose dystonia and prescribe treatment. Consult with your doctor or neurologist before trying out any sort of treatment program, even something harmless sounding. You can potentially waste time and money on something that hasn't been proven effective and sometimes mundane sounding things like taking vitamin supplements can actually be harmful or conflict with other treatments under certain circumstances.

Quote:
This problem began several years ago after deciding to make some adjustments in hopes that it would improve my playing. I've never been a strong player so you could say my original embouchure was never that solid to begin with.


Again, you should not take advice of this nature from someone who has not watched you play. However, based on what you have written it may be possible that your problem is related to doing something wrong to start with, getting so used to playing this way, and then things finally broke down after the demanding nature of making whatever changes you were trying out. The corrections you made may not even be directly related to your problems, just a trigger. One analogy is that it's sort of like lifting heavy objects with your back. You can get away with this for a while, but eventually you'll injure yourself this way.

While I make no claims about my abilities to help players with neurological disorders, I can speak on certain embouchure characteristics that the players with dystonia-like symptoms I've studied share. For one thing, it's common for these players to do some sort of embouchure type switching at some point in their range. By embouchure type I'm not referring to a particular instructional method, but rather particular characteristics related to the players mouthpiece placement and how they push their lips and mouthpiece together along the teeth while changing registers. Using these two general characteristics all players can be classified into a particular embouchure type (see this brief resource I put together if you want to learn more about what I mean). Many players I've come across with dystonic-like symptoms switch between two of these embouchure types, which may result in their chops going unsteady on them. I think it just works better anyway to stick with one embouchure for your entire range.

Another common characteristic for players with this sort of chop problems is that they seem to end up doing the muscular work in the wrong place. For example, they often they hold their mouth corners very loose and they frequently bunch their chin. Because their embouchure formation isn't firm enough they don't seem to be able to tolerate enough mouthpiece pressure to help keep their embouchure stable. It's possible that one area of their embouchure formation is overcompensating for another area not being firm enough to start with. Concentrating on the spot that's quivering may not help because that area isn't the main source of the problem to start with.

Here's another resource I put together that includes some video of 5 players I documented that exhibit those embouchure characteristics. Hypothetically, if you can correct those mechanical issues (which are different for each player) it may be possible to eliminate the actual cause of the symptoms. This assumes that the problems are mechanical in nature, and not neurological. Of the 2 players in the video who had less-than-serious problems, one had a pretty easy time making corrections and I understand is playing just fine now. The other I've lost touch with, but he was more interested in playing piano anyway and may not have tried out my suggestions for very long. Of the three more serious cases, one had sought help from someone about a year prior to the video taping session, which doesn't seem to have helped much. He had pretty much given up playing by the time he volunteered to be documented for my research. The other two have been making progress, one I understand is largely symptom free now and the other has made some good improvements but is still working on corrections.

I'm afraid I'm not familiar with anyone out in California that I know enough about to recommend for embouchure problems, but I would again caution you to make sure you get medical advice from a specialist, not a musician. Personally, I would avoid getting help from any musician who gives you a medical diagnosis, no matter how much of a reputation they have for helping players with dystonia. Out of the handful of people I'm familiar with who do claim expertise in helping brass players with focal dystonia I've noticed they all have different theories about the cause and how to fix it. One thing they all seem to have in common is they don't have medical qualifications. Some may be helping, but I really can't say if it's because of or in spite of their treatment programs.

Good luck and speedy recovery!


Dave
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trumpetera
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PostPosted: Wed Mar 28, 2012 9:51 am    Post subject: Reply with quote

I STRONGLY advice you to get in touch with Jon Gorrie, a trumpeter from NZ living in Sweden. He suffered from focal dystonia, the doctors said there was no cure-they wanted to inject botox!

He now-a few years later-works as a extra player in my orchestra! He gives lessons worldwide via skype, and has also written a book, Performing in the Zone, about performance anxiety and how to cope with it and perform at your full potential.

He has helped quite a few wind player to come back since he did this journey himself.

PM me if you want his number, or google him.

Good luck, i feel for you!
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Vin DiBona
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PostPosted: Wed Mar 28, 2012 11:47 am    Post subject: Reply with quote

I read these dystonia threads with a feeling of great distress for those who have it.
Focal dystonia has claimed the careers of many great musicians. Leon Fleischer, the great pianist who after 40 years of being able to use only his left hand can finally now use his right hand on the piano. Gary Graffman, another great pianist lost use of his right hand as well and the great principal tuba of the New York Philharmonic was forced to retire with focal dystonia in his upper lip. I believe Alex Klein, the oboist who took over for great Ray Still in the Chicago Symphony also suffered from this terrible issue in his right hand and had to retire from his prestigious position as well.
From what I can gather, these uncontrollable muscle spasms/tightenings are extremely difficult to actually cure, but it is possible.
R. Tomasek
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stanton
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PostPosted: Thu Mar 29, 2012 1:22 pm    Post subject: Reply with quote

Vin DiBona wrote:
From what I can gather, these uncontrollable muscle spasms/tightenings are extremely difficult to actually cure, but it is possible.
R. Tomasek


You have witnesseed FD first hand Rich, so you know how debilitating it can be. As far a a "cure", though everyone is different, I'm not so sure if is actually cured, or just dealt with.

In my case it is a lot like learning to walk again after a spinal injury. There is a lot of neural pathways that need to reconnect. At the height of my affliction my lips buldged out the sides of the mouthpiece and my cheeks puffed out quite a bit. I used a (plug for Jo-Ral) a mirror on my leadpipe so that I could cerebrally will them back inside and keep an eye on my embouchure. Learning to breathe effectively was something required as I could no longer muscle thru stuff (which probably contributed to the damage).

Again, I don't know if FD ever goes away or we just work to minimize the symptoms and work around it. Though I am not completely satisfied with the recovery of my playing (yet) there seems to be continual progress. I hope the OP and others can stick it out and work toward improving.

Best regards,
Stanton
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md-jones
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PostPosted: Fri Mar 30, 2012 2:19 pm    Post subject: Reply with quote

I just watched Wilktone's videos and I finally found out that there are others that have the same problem as I do!
I have had this for several years, it comes and goes.
Keep up the great posts, there may be help for us yet!
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