Saturday, March 16, 2013

Embouchure Dystonia: Blogging

Hey everyone!  I'll keep updating the blog as I go along with things here and there when I can. I'm very excited about contemplating over everything I've learned, it will be a good reflection on how far I've come. This will benefit me a lot and hopefully allow me to explain the many factors involved with dystonia and coping with it more clearly to others. Now to get back to work...see you soon!

- Katie Berglof

Monday, March 11, 2013

Musician's Dystonia: A Guide To Understanding And Coping With The Disorder. Edited by Juame Rosset I Llobet, and Silvia Fabregas I Molas.

Thought I'd throw in a little motivational quote here while I could! Keep your chin up! (even if it wobbles!) 

I found another great PDF file over Musician's Dystonia.

Check out the table of contents on page 3 and 4. It covers quite a bit, and surprisingly goes over diagnosis process and what to bring to your neurologist/what you can expect, etc. Which I find really important information to pass on to others! I think this is a great manual for anyone to read!!!! Also check out page 119, I find the table showing the percentage of effective treatments outlined in a study. It's really interesting! It took a bit to read through it, and I'm still not done reading it. I basically looked up the areas I was interested in by the table of contents, but hope I get to read more of it when I have time! What a great find!!!! Hope this helps others! Here is the link:'s_Dystonia-complete.pdf

A practical manual to understand and take care of the disorder that
affect the ability to play music.

Jaume Rosset i Llobet and Sílvia Fàbregas i Molas
Institut de Fisiologia i Medicina de l’Art-Terrasa. Barcelona, Spain.

Josep Fargas Fernández.
Professor of Labour and Social Security Law, Universitat Pompeu Fabra. Barcelona, Spain.

Álvaro Pascual-Leone.
Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School. Boston, Massachusetts, USA. Hospital de Rehabilitació Institut Guttmann. Barcelona, Spain.

Josep Valls i Solé.
Neurology Department, Hospital Clínic, Universitat de Barcelona. Barcelona,

I'll also post it on my sidebar too! :)

Embouchure Stretches / Lip Stretches And Massaging Lip Tissue

I guess I could have recorded this on camera as it would have been easier. But I'm so use to doing this when I wake up and still lying down, so took photos instead. Just a warning, there are some not-so-pleasant close shots of my embouchure ahead. Let me tell you, these are super flattering pictures of me! (sarcasm). It's just photos of the stretches I do, but not the most pleasant to look at, and quite comical to me. What can I say? Sometimes working with embouchure dystonia takes weird distorted movements in the face in order to get all the spasms out.

Why stretch? Just like with larger muscles, stretching increases flexibility, it is elongating a muscle - squeezing the muscle and then completely relaxing it. It is the relaxing which is the most important (sometimes our muscles don't want to, for example like in our calf...instead of relaxing it might turn into a muscle cramp instead). It helps prevent overuse injury, and allows you to get blood circulation going. However, too much stretching can be dangerous if you start to feel pain or numbness or no blood circulation; you don't want to overdo if it hurts, take it easy. It's like trying to do the splits....that type of flexibility doesn't come easily and takes time to build...not always going to happen the first day! Stretching in a sense is also a workout in itself, so this why it is important to not overdo it. I think it is the most important thing for me to do though before playing horn. Low-warmups are not always enough to get all the tension out of my face.

The most important part of stretching is what the muscles do between point A and point B. The first exercise I do works on this concept. Let's say you want to flex the muscles in your arm (as if you were showing off); your arm is at rest, and then when you flex it it jumps right into don't have to think about it, or the motion of the muscle movement getting there from point A (at rest) to point B (flexed).

With Embouchure Dystonia it IS very important to be aware of the motion between the movements; from point A and B; it is usually the between motions where you will see spasms and quivers occur, so this is the area you wan to be aware and take notice what happens. So here we have the first exercise I do to test to see how my symptoms are for the day. Usually I do this when I wake up. Some dystonic people find that your symptoms are not as strong right when you wake up, and this is usually because sleeping helps as it increases dophamine levels. For some dystonic people it doesn't effect them...for me not so much...but I like to stretch in the morning anyways just to get circulation going.

The most important thing about stretching is (1) The motion between point A and B, and (2) Holding the stretch once you arrive to point B. Just like when you stretch you're legs, you hold the stretch in position for a couple of seconds or a minute and then release. 

STRETCH NO. 0 AIR OR WATER STRETCHES (whoops, forgot to add this one labeled it 0).
I do this one on camera all the time. I either roll air or water around the inside of my mouth, making sure to get under my upper lip, chin area, cheeks, etc. This helps stretch from the inside-out, and it can also help with other injuries, for example if you have a muscle tear. This is actually one Dr. McGrail's exercises for musician's with lip muscle tears! 

So this first exercise below I call the "GOLDFISH LIP STRETCH." I start at point A which is at rest (meaning relaxed and still/no executing movement yet), and then slowly (I mean unbelievably slow) starting to move my muscles into formation...moving towards my destination of point B (the goldfish lips):

I start to slowly form an opening...
I slowly start to stretch my lower and upper lip outwards, and it is usually this first motion which has the most spasms or shakes since it requires me to keep my muscles relaxed yet while flexing them.
As I keep slowly stretching my lips into formation, I want to make sure I don't jump directly into the final formation. Usually with dystonia your muscles can handle point A and point B, but it's the getting there/between state which is difficult to maintain and execute. So I try to not flex too fast in an outward motion with my lips!
And the final formation...the comical goldfish lips! After they are formed, I hold them like this for a couple seconds and then release/relax my face back into a resting position/stillness. I do this many times until I can go from point A to B with less spasms. I'm at a point where the spasms go away fast and melt away as I stretch. May look crazy, but what's weird is I can feel my muscles wanting to stretch in a certain's much like when you wake up and stretch your arms above your head...or how you see a cat just FEEL like you have to do it! Another interesting observation is I can feel the sore-spots; the areas or muscle groups in my embouchure that have been working the most in my embouchure at the time (ex. my chin muscles are doing a lot of work lately more so than my corners, so they feel sore as I stretch).
Pretty much explains itself. However, I feel like when I frown my corners go so extreme that they feel like they are along the sides of my chin and I can definitely feel the stretch! Good stretch! ahhh...:)
This one makes me laugh! When I do this one it's important that there are two areas of "scrunching"; I want to feel as if the upper most region of my upper lip (near my nose) is scrunching up into my nose.  and secondly I want my nose to scrunch as if the apples of my cheeks are being pulled inwards towards the sides of my nose. This not only stretches my upper lip muscles (in a non-linear way), but it stretches the muscles that run from my nose down to the corners of my lips and also the muscles that buccinator muscles in an upward stretch/vertical. 

This is just a mini-embouchure crunch. I form an embouchure, with my lips closed, and focusing on my corners, I want to stretch them as far out as they can go in a horizontal direction <----->. Then I bring the corners back in. I do this flexing my corners back and forth/in and outward. Similarly...

Similarly...I do the pucker stretch which is also part of an embouchure crunch. I form an embouchure , with my lips closed, then while focusing on my corners being firm, I move my corners inwards, resulting in a pucker. Then I move them back out...I move them out and in/back and forth, then go back to relaxing.

I didn't get a photo of this one, since this one takes quite a bit of movement. It's basically a combination between the Goldfish lips stretch and the smile stretch (but with mouth open)...moving in a circular pattern. I always do this one on camera too. I'm just moving the muscles in my face all over the place in order to stretch the whole group of muscles in my face all at once. 

I know I may seem crazy posting all these weird looking photos, but honestly! I'd do anything to regain my playing abilities on horn, even if it means I have to make weird faces in order to stretch and reduce the spasms/symptoms before I play. These stretches really help me a lot, especially right now since I'm working a lot in my mid-to-upper range that builds up a lot of tension.

Also a little bit about massaging. Massaging the inside of my upper/lower lips moving horizontally outwards rather than in a vertical motion, and also massaging the inside of my jaw line helps with sore muscles. I don't massage both the outside and inside with my thumb and index in a circular pattern like most people suggest, I just use my index to caress the tissue on the inside.

What I find most beneficial to me is using the thumb to push against the inside of the cheeck (starting at the center of the cheek, and stretching the tissue outwards and holding it for a cuple seconds. As soon as this releases, I move on down to the bottom of my jaw line (still near the center of my lower jaw, and eventually make my way to the back of my jaw.

Most of the tension I find in the back of the jaw, and believe me it is painful to release!!! So that is why I start near the center of my cheek and work my way back to the bottom of the jaw. Alright! Enough awkward rambling about my lips. :-/ I'm out! Will be back again soon!!!

Wednesday, March 6, 2013

Cloud 9

Best practice ever!!!! I was actually very scared these last 2 weeks or so, as I was going through an intense relapse (the longest relapse I've experienced so far) and had to be careful; the relapse was different/weird this time around because my upper lip would have a random singular spasm while I was at rest (meaning not while I was playing, but while I was just watching TV or driving...which never happens), and the singular spasm was really forceful...almost painful. I felt like my embouchure was really freezing up like a muscle cramp and it was stuck like this. I couldn't relax it even with ice pack/heat packing or with stretching, etc. Then it swelled up randomly in week 2 even though I hadn't practiced (could have been something I ate). I thought "What the heck? Maybe I overdid it." I feel it's because I've been working my way into my treble clef/upper range and it takes a lot out of me...sometimes hard to tell how much is too much. So I rested for a couple weeks just letting my muscles settle, and could tell whether or not it was safe to play just by trying to form an embouchure. Even last week my boyfriend asked me, "Why are your lips quivering when I try to kiss you?" ...that was embarrassing to explain!!!! uhhhg.

But a couple days ago I felt like my face settled, was at rest and relaxed, so I went ahead today and practiced. I did a lot of stretches, and immediately saw the spasms melt away in the mirror as I stretched and re-checked them. My embouchure gave into relaxing and I started to play.

I did my overtone series exercise and I couldn't believe the improvement! It was unbelievable!!!! Remarkable!!!!!! I felt more definition of the space between the partials, and it wasn't frustrating/difficult to control the movement/fluidity as I went down into the lower partials on the F horn side. It felt natural and wonderful!!! I've never felt that natural ease of control ever before when working on overtones...usually something that's extremely difficult for me to control, and takes a lot of endurance. Hoping this improvement will stick and I can capture it on camera. It's just like another dystonic musician said, "You can't have a relapse unless there is significant improvement!"

I'm on cloud 9!!!! :D :D :D :D :D :D

A happy picture!

Friday, March 1, 2013

I love teaching!

I can't emphasize how much I love teaching! I work with some really talented kids, and have the greatest supervisor. I am extremely grateful for each and every day I wake up and get to teach. I have never been so happy in my life as when I am when I'm teaching. It is my purpose in life, and a calling I never knew I had.

I also love spending time with my nieces and nephews...a picture of my youngest niece, and my youngest nephew (baby B!)....