More Alternative Medicine/Therapies (Part 2): Body Movement Awareness Methods (Somatics), Modifications, and Musical Exercises for Focal Embouchure Dystonia

PART 2: Body Movement Awareness Methods (Somatics).

In my last post I spoke a little about being mindfully aware during physical rehabilitation. This is a huge part of recovery for me; making adjustments and modifications to help improve or redirect my tension into a less tense state of contraction based on both mindful awareness, and understanding of anatomy/functional muscle movement.

There are quite a few body methods out there that you may have heard of. Why these methods are important is because most of them focus on reprogramming a more efficient body map. Your body map is the brains general perception and understanding of ones body/movement/function based on the sensory input it's been receiving. This carries over to how we use our bodies with our instruments.

Body Movement Methods are technically referred to as somatics. Somatics refers to practices in the field of movement studies which emphasize internal physical perception. The term is used in movement therapy to signify an approach based on the soma or "the body as perceived from within."

I'm listing them here as a resource because knowing a little about them or even taking the time to take a course in one of these methods may be helpful to you, as they can help with the rehabilitation process...it doesn't mean that one method or any of the methods are the answer to overcoming dystonia, but can be used in aiding the physical rehabilitation process to an extent.  

I've noticed universities recently incorporating classes on some of these methods which is awesome to see!

Types of Body Movement Methods or Somatics

• Alexander Technique - Most musicians know of this method, and it is not uncommon these days to see it being taught as a course or summer course within music programs at universities or institutes. Alexander practitioners are certified and teach the course between 10-40 sessions. Alexander's approach focuses on mindful action. The instructor uses guided modelling with light hand contact for detecting and guiding the student past chronic pain and effort. It should be noted that A.T. is also used to help with stage-freight and anxiety too. Suggestions for improvements are student-specific/individual-specific, and the instructors analyze the student's responses, as well as using mirrors, video feedback, or classmate observations. The practitioner is well-trained in guiding free-movement.

• Feldenkrais - Feldenkrais was highly influenced by Judo. He taught that increasing a person's kinesthetic and proprioceptive self-awareness of functional movement could lead to increased function, reduced pain, and greater ease and pleasure of movement. The Feldenkrais Method is therefore a movement pedagogy, similar to the Alexander Technique in being educational and not a form of manipulative therapy. The method is experiential, providing tools for self-observation through movement enquiry. The practitioner directs attention to habitual movement patterns using gentle, slow, repeated movements. Slow repetition is believed to be necessary to impart a new habit and allow it to being to feel normal. These movements may be passive (performed by the practitioner on the recipient's body) or active (performed by the recipient). Feldenkrais is used to improve movement patterns rather than to treat specific injuries or illnesses. This holistic focus means that the primary intention is not to treat injuries. However, it can be used as a type of integrative medicine because correcting habitual movement patterns can help heal injury, pain, and physical dysfunction.

• Mitzvah Technique - is focused on dealing iwth body mechanics in a state of motion. It is a development of the Alexander Technique, the Feldenkrais Method and health-oriented work on musculoskeletal problems and stress diseases. Each of these techniques are based on correcting common postural faults by addressing  the neuromuscular system through postural re-education. Yet the Mitzvah Technique encompasses both a unique philosophy and a set of procedures. This includes the discipline, exercises, the work that Mitzvah Technique practitioners do with their hands. The Mechanism consists of a sequence of natural body movements that magnify the ripping motion in the body. There are four components to the Mechanism; (1) The interplay of physical forces acting between the pelvis and spine, (2) the rippling spinal motion, (3) the dynamic relationship involving the pelvis, spine and head in a synchronized motion, and (4) the freedom of the head to balance on its spinal support. All of these together promote the operation of the Mitzvah Mechanism. It is designed to improve posture and release tension and stress through exercises and therapeutic table work. It claims to realign, re-balance, and exercise the entire body during sitting, standing and waling. It's aim is to replace long-term work by practitioners, to have people learn how to use the technique itself. Musicians, actors, and singers have been extensive users.
  
  *These next two listed are not so much a body movement method (except Rolfing is kind of), but more of a alternative physical therapy that integrates somatic education into it's foundation.

• *Oral Myofascial Release (MFR) - This is what I currently have experience with. Myofascial release deals with built up/rigid connective tissue or fascia in the jaw-joint and muscles surrounding the face. My acupuncturist was a specialist in John F. Barnes technique of MFR, which is a much gentler approach to releasing the tissue tension than the traditional way. Typically they will wear a glove and push their fingers against pressure points inside of your mouth (in the cheek or back of jaw) and they hold it for 2-6 minutes until the tissue releases; this is highly painful but extremely relieving afterwards.When I think of the jaw-joint, I compare it to the wrist-joint. A lot of woodwind players or typist get carpel tunnel, which is connective tissue built up in the wrist. The same thing can happen to our jaw-joint...it too can build connective tissue and cause our jaw to be unaligned, in pain, cause TMJ, or build more tension.

• *Rolfing - It is very similar to myofascial release to an extent. It is a holistic system of soft tissue manipulation and movement education that organizes the whole body in gravity. It is essentially identical to structural integration. The difference between myofascial release is the cumulative process over ten session. Although myofascial release techniques derived form the work of Ida Rolf, it does not have the same strategic planning as rolfing. The various parts of the human body relate synergistically to each other, therefore rolfing integrates the whole body or various parts of the body, rather than focusing on one central area.

• Andover Educators - This is actually not a method, but a service. I wanted to list this here as a resource. Bodymap.org is the home of Andover Educators, a non-profit organization of music educators committed to saving, securing, and enhancing musical careers by providing accurate information about the body in movement. 

Some Alternative Medicine/Therapies (Part 1: Non-traditional Medicine or Treatment) for Facial Pain, Trauma, and Dystonia

PART 1: NON-TRADITIONAL MEDICINE OR TREATMENTS

Happy post-day-of-Halloween! Here are a couple of things that may possibly support the recovery process for various facial ailments such as TMJ, Nerve Damage, Muscle Tears, Bell's Palsy, and Focal Embouchure Dystonia.

Again! These do not cure, nor is there any guarantee that this will help you. There is research on some of the methods applied to specific issues, for example - Bell's Palsy and Acupuncture, which can be found online.

However, embouchure dystonia doesn't leave you with many options, and when there is no known cure, one cannot help but do what is natural and test/observe various treatments through trial and error in the hopes of finding a small glimmer of hope.

It is important to realize that there are few musicians with dystonia that go out on a limb and share their personal process and do trial and error publicly. It is important to share the process, even if it cannot be applied to all. It is my hopes to bring more awareness of this disorder and provide a rare look at what this disorder can be like by sharing my own experiences. Although my experience is subjective, I am someone who thinks objectively, therefore I posted the statement above.

•  Acupuncture, provides blood flow/circulation to specific areas and activates the nerves. I received acupuncture for once a week, for a year. It wasn't until about my 15th session I started to feel and notice drastic improvement in reduced tension overall in my face. It cost about $65.00 a session, and my acupuncturist had a passion for helping people with facial trauma.
  
  She had previously helped many people overcome Bell's Palsy, Nerve Damage from car accidents or injuries, etc. She also was certified in John F. Barnes Myofascial Therapy, so that was also included in my sessions.
  
  Just a note of caution though: I did find that the acupuncture made my nerves in my face very overly sensitive and it took about 2 years to fully wear off. At times it limited me from playing because my muscles were so loose (like jelly) and my muscles/nerves could only handle so much playing. I had to be very careful when working on my playing. I also would not suggest playing at all if you are receiving re-ocurring acupuncture treatments because the acupuncture is actually quite exhausting on the face because it is bringing in so much blood flow to a centralized area. Most acupuncturists will tell you to drink lots of water and to rest a lot after receiving treatment.
  
  I also would say that if you are going to try acupuncture, to consider doing as a last resort. Although I felt it helped me in the long-run, it was scary how overly sensitive my muscles and nerves became. The best example I can give is if you received a muscle relaxer. It feels great and there's not tension whatsoever left, but you're also left with no endurance, strength, and the muscles and nerves are much more sensitive to playing and get twice as sore. So please be careful. Maybe don't do a years worth of acupuncture and only do it 2 times a month or not every month.

• *Oral Myofascial Release (MFR), which released built up/rigid connective tissue or fascia in the jaw-joint and muscles surrounding the face. My acupuncturist was a specialist in John F. Barnes technique of MFR, which is a much gentler approach to releasing the tissue tension than the traditional way. Typically they will wear a glove and push their fingers against pressure points inside of your mouth (in the cheek or back of jaw) and they hold it for 2-6 minutes until the tissue releases; this is highly painful but extremely relieving afterwards.When I think of the jaw-joint, I compare it to the wrist-joint. A lot of woodwind players or typist get carpel tunnel, which is connective tissue built up in the wrist. The same thing can happen to our jaw-joint...it too can build connective tissue and cause our jaw to be unaligned, in pain, cause TMJ, or build more tension.
  
• *Rolfing - I haven't received rolfing, but wanted to list it here. It is very similar to myofascial release to an extent. It is a holistic system of soft tissue manipulation and movement education that organizes the whole body in gravity. It is essentially identical to structural integration. The difference between myofascial release is the cumulative process over ten session. Althogh myofascial release techniques derived form the work of Ida Rolf, it does not have the same strategic planning as rolfing. The various parts of the human body relate synergistically to each other, therefore rolfing integrates the whole body or various parts of the body, rather than focusing on one central area.
  
  *I've listed Myofascial Release and Rolfing also on my blog post over Body Movement Methods too. Since it crosses over into that area as well.

• TENS unit, which sends electric pulses that interfere with the signal of pain being sent to the brain, it stimulates the nerves and endorphins, and helps control pain. This allows the muscles to relax instead of being in a state of contraction all the time (which dystonia causes our muscles to be in a state of chronic contraction...therefore the TENS helps me a lot). I use to receive a light does of TENS unit or electromagnetic therapy in acupuncture, but it wasn't until I started seeing a neuromuscular dentist that I used a heavier dose of TENS unit therapy which helped me tremendously. Now I  even have my own TENS unit at home after borrowing a friends for a while...decided I needed to invest in one for long-term relief.
  
  I feel like the TENS unit is more effective than acupuncture in relieving tension. Acupuncture was too over the top. Whereas TENS unit I can control the strength of output, and it doesn't overly-relax my face to the point of weakness. It helps relieve the right amount of tension. It takes time to get use to knowing how to use it and works best.

• Po Sum On Oil, which can help with many ailments, including neuralgia. It provides deep muscle pain relief, headache relief, etc. It consists of Peppermint Oil 45%, Dragon's blood 1%, Cinnamon oil 1.5%, Camellia oil 100%, and Methanol 15%. It only cost about 6 bucks or more for a little bottle which will last forever. 

• Ice packing/Heat packing. Alternating the two is highly important! Sometimes I will drink hot tea instead of heat packing, and then apply ice pack between drinks. I'll hold the tea in my mouth so that it warms up all my muscles.

• Facial Muscle Stretches. i.e. Making certain facial expressions or movements to help relieve tension. I have various names for them too like duck lips/goldfish lips, the scrunchy face, the clown-frown, the angry brow, marshmellow cheeks, the horror screamer, the side-grin, etc. 

• TMJ Jaw Stretches. i.e. Specific jaw stretches that help the mandibular joint. (I'll try to find a link to post on here of some stretches I use)....also buying a mouthguard may help relieve jaw pressure, even if you don't have TMJ.
  
• Tongue Stretches

• Neck and upper back stretches, which help relieve tension and keep the muscles flexible in the neck and upper back. (I posted a link somewhere in one of my posts on the stretches I use, I'll try to find it and repost it here)....this is important because the neck and shoulder muscles DO pull on the jaw muscles. They are all connected and work together. Think big picture! :-)

• Taking off as much external pressure on your upper body as you can. Ex. Not wearing backpacks, heavy instrument cases, non-supportive or constricting bras that may dig too far into the shoulder, baby slings, avoiding lifting heavy things that require the shoulders or upper back. If you have pain at all on a certain side of your face, avoid sleeping on that side. If you have clenching problems with your jaw, avoid putting any pressure on the bottom of the chin/jaw when sleeping and practice holding the tip of your tongue in between your upper and lower teeth...this takes the pressure off the jaw immediately. Even if keeping your hair down and not pulled back it into a bun helps lessen muscle constriction on the face/head, then do it. 

• Taking daily vitamins - keep your body provided with enough nutrients. I take women's one-a-day, and also GinkoSmart, and sometimes Fish Oil. There's also men's-one-a-day. It just depends on what your body needs or what you think will help boost your nutrients. It can even be in the form of a shake.
  I also write a blog on natural supplements.

I'm hoping to come back and add more to this post, because there's quit a bit more detailed information I'd like to share about each area. But for now, if you google any of the things I listed, you should find a wealth of information.