Embouchure Dystonia: Overcoming the Involuntary Spasms and Contractions When You Can't Play

 

How I Currently Manage My Embouchure Dystonia Symptoms

Ice Pack Roller and Rose Quartz Roller

For those who have embouchure or cervical dystonia and find ice/heat packing helpful; I wanted to mention that I recently bought my first ice-pack roller!!

I find it much better than the standard ice pack! It helps when I have been playing a lot, as I notice when I really get back into heavy playing, my muscles both overly-tense/contract and sometimes swell around the massetter in particular; especially on days where the FD is flared up more than normal. It helps to use the roller around my jaw joint since that tends to bulk up the quickest over time. I noticed an immediate difference and it feels great.

Also the rose quartz roller (which I never thought of using before) is great for massaging sore muscles, and it has both a large and small roller attached. I still do fascia release/myofascial stretches in combination, because I think both internal and external approaches work best for me. 💕 

Ohh! I also take collagen peptide supplement pills and my joint (especially wrists and ankle) has improved drastically. But it takes about 6 weeks of taking it 2-3x a day to see a physical difference - even in appearance/skin since it's originally used for that.

Usually around this time of year with weather changes bones/joints start to hurt. It’s nice to not rely on Tylenol or Aleve rarely if ever. A bit eye-opening I have to say when you’re use to being in pain! 😊

#musicianshealth #musiciansdystonia #embouchuredystonia #musicianinjuries #hornplayers #brassplaying 🎵

Horn Snippet: Merry Christmas Horn Solo (Brass Quintet)

#musiciansdystonia #livingwithembouchuredystonia #musicianinjuryawareness

A huge thanks to Hayley for recording this (Merry Christmas)!!! Had to crop everyone out, so apologize for the weird angle or closeups. It’s a great representation of my current level of playing abilities despite being plagued with Focal Embouchure Dystonia. 

Anywhoo! It’s taken years to get back to a place of sounding somewhat decent enough to feel comfortable playing within a group again.... or even to play performances again. That’s been the greatest blessing, as I know it could be a lot worse. I first started experiencing onset symptoms of Musicians Dystonia 13 years ago.

Still there are really bad days, but the good days out number relapse symptoms days, and things seem to get better every year. I am really happy and humbled that my body/embouchure has allowed me to retrain ....and to be able to hear my sound come out the bell and ring in a hall again. 

It’s nothing short of miraculous to beat the odds to even a slight degree when it comes to this disability. I thank God so much for hearing my prayers. There has been a lot of blood, sweat and tears over the years....literally. There still is a hole in my heart for missing out on my dream. But I try to not focus on that and look at the positive.

I’m so thankful to play in this brass quintet with my twin sister (trumpet), my brother-in-law (trumpet/picc), and Dan and Bruce (low brass power). You guys are the best! I wouldn't feel comfortable playing among anyone else....and so happy to be playing along with your recognizable voices/instruments. Means so much!!! 🥰💕📯💕📯💕📯💕📯💕📯

- Katie A. Berglof

Horn Snippet: Bizet (Brass Quintet)

(2 of 2) Will need to expand to full-screen to see facial movements. During brass quintet rehearsal we ran through some Bizet, and I wanted to capture it on camera! 

This is a particularly difficult part for me because anytime there are simple repetitive articulation patterns, short rests that require quick sensory feedback, embouchure dystonia is wicked awful. 

I started off struggling with getting separation between the notes and then eventually it kicked in, but you can see how much the muscles in my face are moving and working just to catch up and play in the middle register over and over again. 

I had a lot of fun though and so happy I get to play with my twin sister and her husband (on trumpet) and our friends. I have surgery at 5:30am in the morning (thus my lack of effort in fixing my hair), so this was my last rehearsal tonight for the next 2 months.

Horn Snippet: West Side Story (Brass Quintet)

 (1 of 2) Will need to expand to full-screen to see facial movements. Trying to get through some of the solos in West Side Story before Brass Quintet rehearsal starts. One of my many challenges with Embouchure Dystonia is that it makes descending more difficult than ascending...a task-specificity trait. Still happy my high range is slowly coming back!!! Woot! Last rehearsal before surgery, so didn’t bother to fix my hair. Scheduled for 5:30am! Will be waking up in a few hours...

Merry Christmas, More Horn Snippets (Brass Quintet), and Family Fun

 

Focal Embouchure Dystonia: Devices, Equipment, and a Few Daily Musts for me in 2020!

I've been meaning to write this blog post for a while! I'm writing this in a hurry, so will come back and edit when can...

• Since 2011, I have been playing on my gold plated Farkas DC, which I've stated before and mentioned how it provides a decent amount of back-pressure which is kind of like a crutch that helps hold me up. Yet, it has such a beautiful tone. It cuts into my endurance though, but it allows me to manage my dystonia symptoms more easily, so I'm willing to take that compromise. It's not a free-blowing mouthpiece that cuts through an orchestra like the typical mouthpieces I use to play on pre-dystonia. Before, I played solely on Moosewood Mouthpieces (i.e. B12, B16, and RBS16 Vienna Cup, and Megamoose; with a Lawson rim). 
  
  My current mouthpiece:
  
  
  
  An example of the Megamoose for comparison (I don't own one anymore, but very happy I returned to my original mp): 
  
  
  
  
• The Tens Unit I use(d) is the model 7000, 2nd edition:
  https://tensunits.com/products/tens-unit-7000-tu7000-original-tens-professional-unit-fda-approved 
  
  To find out more about what tens units are used for you can read this article here: https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/ 
  
  I used a TENS Unit in the past to help with my jaw pain and upper back tension, including fascial soreness which came about in 2013 and I resolved in 2015/16. It also helped relieve tension after intense dystonic relapses.
  
  Later on after myofascial release therapy helped get rid of my jaw pain and tissue build-up. I started using castor oil which was more effective than ice packing, heat packing, massage, and TENS unit combined! You can read more about my myofascial release therapy and stretches in a video on the left hand sidebar on my blog under "highlights". 
  
  I still do myofascial release once a week by myself if playing a lot. I no longer require TENS Unit, but definitely relied on it direly back then. 

• Castor Oil Pulling: This is a must for me after every rehearsal, concert, or practice session. I gently swish 2-3 tablespoons of castor oil in my mouth for 30 minutes, spit it in the garbage, rinse mouth with water, brush teeth, (then myofascial release afterwards - once a week only). If didn't play very long, I don't have to do this at all, but if an hour long intense playing session or I feel any tension in my face whatsoever, I will do a pull.
  
  Most people think of castor oil as a hair product or laxative, but it's actually one of those age-old remedies and a powerful anti-inflammatory that is effective when having TMJ problems, muscle pain, soreness, tooth pain, or any type of joint or muscle swelling anywhere in general. It has several benefits.
  
  I originally started using it to help keep my teeth clean, since oil-pulling is suppose to be better than mouthwash these days (I accidentally purchased it, instead of coconut oil, which is what most use for mouth cleanser), but found it was helping the tension in my face. I looked more information on it and read stories about how people found it helped them with severe jaw pain, mouth problems, salivary gland problems, and muscle problems. I use it all the time. Cannot live without it and so glad I came across it by accident.
  
  You can google more information on castor oil benefits.  Here is a photo of what I use. It has to be cold pressed and hexane-free. This is where I get it on amazon: https://www.amazon.com/GreenIVe-Castor-Pressed-Hexane-Exclusively/dp/B07QYC559Q/ref=sr_1_23?dchild=1&keywords=castor+oil&qid=1593744595&sr=8-23

• Power Lung: http://www.powerlung.com/region/us/models-accessories/powerlung-models/trainer/ 
  
  I use this for breathing exercises. However, I do have to mention that the first year I had it, I had troubles using it because my embouchure dystonia was so bad that it kicked in when I tried to put my lips over the mouthpiece. So I actually found that it was easier to put my lips "against" the mouthpiece and blowing air through it that way.  So that's how I managed using it for the first year. No regrets, because eventually I was able to use it the way intended.
  
  What I love about this device is it has resistance settings for BOTH the inhale and exhale. You can just naturally blow air against various resistance settings and what you are comfortable with. If I don't have it on hand, I just use my mouthpiece and cover the end of the shank with my pinky by various degrees, but the smallness of my mouthpiece usually triggered my dystonia back then too. Now I can use my power lung and my mouthpiece with no symptoms. This device resistance settings also helped me with regaining control of my corner breathing, which was very difficult in the beginning.

• P.E.T.E. Embouchure Trainer: I make sure to use this separately away from practice time and rehearsals just because it definitely can be easily overused and the muscles need time to reset after using it. So don't play right away after using it. I usually wait a few hours before playing, and I only use the device for about 5 minutes of work and sparingly.
  
  What I like about it, is again, you're practicing resistance training; using your muscles to grab/grasp the disc and hold on. Even better is that instead of dealing with resistance such as back-pressure from a mouthpiece or instrument, we’re dealing with resistance from the opposite side of the lips (inside the lips) with an object. With dystonia we don't get a lot of ways to practice keeping our strength up because we can't play. So this is one of the various ways I do that; including free-buzzing and mouthpiece buzzing. But these forms of strength training definitely are NOT a replacement for working on ones actual playing, so use it sparingly and only when you feel it really is helping. I like to use it to change things up...as with dystonia, change in sensation and ways of doing things is sometimes a very good thing. I also use it to help with stretches too. And in the beginning stages of recovery I use mouthpiece buzzing and free buzzing in a completely different way than intended and definitely not as a strengthening tool...been meaning to write a post over this too.

• Guitar Foot Rest: I know this sounds weird. But for a while I found this helpful. For a long time I had to play with the bell on my leg, but my horn would always be at a weird angle. By using an adjustable guitar foot rest under my right foot, it helped me get the correct position for the angle of my lead pipe. I could not play with my bell off my leg for years. My dystonia symptoms were way too overpowering in the beginning and playing off the leg was too unstable. I don't require the foot rest anymore, but I do still practice with it at home sometimes because I really like it.

• DAILY MUST: STRETCHES. As usual. Always, always, always!!! Upper back, shoulder, neck, jaw, tongue, face - both inside and out!
  
  I also want to mention something here I haven't posted in previous blog posts or videos, but will soon. Focal dystonia tends to affect our bodies either from upper body vs lower body, or left side vs right side. For me, the left side of my face has less sensory and control than the right side. The right side of my embouchure tends to do a lot of compensating.
  
  It is not easy to find which muscle groups in the face lack more or less control; but one way you can find it, is by practicing very slow natural movements (away from the horn).
  
  For example: Try to raise/arch your right eyebrow very slowly while looking in a mirror. Observe if it feels like it does it independently. Now try to do the same with the left eyebrow and see if it can move on its own as well. What I found is there where certain muscles that I had in my face (depending on the movement) that lacked less control or independent movement. I simply found this by practicing various facial expressions and movements. Try it and see if it is the same from side to side or any areas where things flare up more.
  
  You can do the same with the neck. What is your range of motion? Try sitting with good posture with your back against a wall. Tilt your right ear to your shoulder while looking in a mirror. Observe how far your neck bends and if with ease towards your shoulder. Now try the left side. Is it the same or different? Is there a huge noticeable area of restriction?
  
  Testing basic movement and by practicing stretches GIVES US a layout or map of our areas of lack of function, our restrictions, and our range of motion. This is another area that journaling comes in handy. 
  
  JOURNAL! Journal! Journal! Be scientific! - like Jonathan Vieker says. Observe and record all habits even if it's basic stuff like the food you eat; especially in the beginning stages of recovery or during onset of a possible injury or dystonia. 

• Lumbar Back support: Whenever you can, start implementing back support and relief now! Back pain is mankind’s #1 Achilles heel, and it’s very common to have it with all dystonia types. I use this back support device which comes with a pamphlet of stretching exercises, and two types of back/tissue massage balls (which can also come in handy for myofascial release around the chest and neck area). I also (not posted here) have a back strap device/splint that helps keep my back straight when sitting at a desk and fits under my shirt.

• Neck Traction Device: This helps with my neck tension from my dystonia. It's done SO MUCH for me. I have to use it, including my stretches. For those with mild to light cervical dystonia, you might find this handy. What it does is lifts the upper spine and skull so that the muscles, nerves, and spine in the neck have a chance to stretch out and reset. Gravity over time compresses your spine, especially in the neck area, and for those with neck problems, finding ways to relieve compression is vital.
  
  If I had space and could afford a Back Inversion Table I would get one! You can find one here if interested. This would be great for those with cervical dystonia: https://www.amazon.com/Innova-ITX9700-Inversion-Memory-Lumbar/dp/B00F950N3K/ref=sr_1_24?dchild=1&keywords=back+inversion+table&qid=1593833741&sr=8-24

• DAILY MUST: YOGA. A mat is inexpensive and very portable to take to work or anywhere! That's all I'm going to say here. Some form of movement exercise that helps the upper body; avoid tension-forming exercises like weight lifting, go for more graceful movement such as tai chi, Alexander Technique sessions also help in addition. Also will mention here, additionally, stepping away from a screen or cubicle and going hiking and getting out in nature helps my overall well-being too so much!
  
  
  
  
  
• DAILY MUST: MEDITATION OR MANTRAS. Something to center your focus and mind before you start diving into rehabilitation work. This goes double for those who are just starting their journey. There are several wonderful guided meditation videos on YouTube. Other forms of focus are "Tapping Meditation" or visualizations of relieving tension from areas of the body. It can simply be whatever you find calms and centers yourself; anything ranging from aromatherapy, to sipping tea and listening to music before you start, and just getting yourself into the right mental place of "mindful observation” so that you are tuning into your body with a calm nervous system and not reacting emotionally or critically to the dystonia and instead going with the flow.
  
  Not to get off topic, but it’s important to make time in the day or week to take care of yourself inwardly. The best advice given to me ever was: "Go to work for yourself before you go to work for anyone else!" Put your needs first daily and get into the routine.
  
  So first thing in the morning, do what YOU need; whether that's prayers, meditation, exercises, relaxing, cooking, or quiet time. Don't pick up the phone and don't check your to-do list. I make it a rule of thumb to not check my phone until I step foot in my office at work. I also turn off all push, SMS, and e-mail notifications for Facebook and social apps. They can wait! And I can always manually check it. Don’t need notifications.
  
  I also make it a rule to not reply to any emails after a certain time of the day. And a rule to turn my phone completely off when in the company of others if possible (unless an emergency or awaiting a very important call). If you have things you need to do in a timely manner that day, then set timers and reminders in a calendar or watch or prepare for it the day prior; but do whatever it takes to avoid going into "Sigh! What do I have to do today?" mentality or stressing about all that needs to be done as soon as you wake up.
  
  Learn to put aside that time in the morning to live for yourself. Time management is key and make yourself solitude/alone time a priority. It is your birthright to participate in happiness and take care of yourself first and foremost. 

 

• DAILY MUST: DRINK WATER. Believe it or not, a full 2 bottles before and after ever practice session. It really helps, and LOTS of it! Calming your nervous system helps you tune into your body, but also keeping your body in a state of wellbeing and running on its primary form of energy and cleanser is necessary too. Just like an athlete, or a person doing a intense workout session, or someone doing heavy work, or even going into surgery...we are ALWAYS required and asked to drink lots of water before hand or given liquids as a pre-requisite.
  
  Another quick daily must which I've written about before is upping my dental/oral health; which my water flosser, castor oil, electric toothbrush, and dental kit really help with. I especially love using the tongue scrapper as disgusting as it seems. Where has it been my whole life?!?!
  
  
  

Topiramate: is an anticonvulsant medication and it works by decreasing abnormal excitement in the brain. Usually this is used for seizures.



Oddly enough, I am taking this currently and just started it last week for weight loss. I was SHOCKED to find it carried over and improved my focal embouchure dystonia drastically!!! I'm actually very excited and hoping I can talk to my doctor about keeping me on it long-term if it helps me with my dystonia. I take a very small dosage of it. The only downside of it, is it makes me feel a little tingle all over...so when I practice, the sensation kind of freaks me out, as usually that warrants not a good sign. But she said it's normal. I use to take Tremor Miracle for a year and that helped me also, but too expensive. It is a dietary supplement for essential tremors that you can buy on Amazon.

• Halo Neuro Sport 2: https://www.haloneuro.com/products/halo-sport-2 

This is actually a device I purchased back in January, but wasn’t able to use it until now because my phone was a piece of junk until I upgraded to my first iPhone ever. Woohoo! About time Katie.

This nifty device is actually a Transcranial Electric Current Stimulator! Usually you see neurologist use these in research studies in the form of a electrode cap placed onto someone’s head after covered in substance. Except, this was designed into a portable headset in order to improve motor skill learning of athletes and it is placed directly over the center of the scalp. The electrodes come in the form of a foam band that soaks in water and magnetically attaches to the inner lining of the headphones. The headset connects via bluetooth to an app on your phone which then takes you through stages of priming and electric currents.

It’s quite expensive, but I found it actually helps me a lot too!!! I am way more in control of my playing the day after using it, than days not using it. However, of course being a electric current stimulator, I have yet to build up my endurance in order to use it on a consistent basis since it is quite intense - it really works you out in a way I can’t describe, and it wasn’t designed for brass players in mind, but more for string players as it says. I am hopeful, even though will admit the priming is a bit uncomfortable. Currently I’m slowly and carefully testing it out. But so far, so good!

Okay that is all I have for now! I'm sure I'm forgetting something, but will come back and add more if I remember! I hope this helps and that some of this is insightful, if not interesting! If anyone has any questions, feel free to comment, e-mail, or reach out! - Katie Berglof

Myofascial Release and Focal Embouchure Dystonia

Answering a question asked during a live-stream about how to do the myofascial release stretches/tissue work:

Part 1

Part 2

Part 3

At Orchestra Rehearsal 2020

The rest of the horn section! We just finished a sectional. During rehearsals my nephew Nathan, who I'm teaching horn, sits back stage directly behind us in the large concert hall. We took a goofy photo together during break. 📯

Symphony Orchestra 2020: Dvorak New World

Not my first time playing this symphony, but is my first time playing 4th horn on Dvorak Symphony No.9. It's even more fun playing those awesome low parts and my embouchure dystonia is manageable in this register. But the greatest blessing is playing it with family. Was planning on taking a photo of us all together on stage, but forgot! 📯🎶😊

Focal Embouchure Dystonia: Christmas Carols!

Merry Christmas!!! Here are some Christmas carols! ⛄❄⛄❄⛄❄⛄ Recorded this 30 minutes before work, in a straight mute, and no warm-up! Proud of how I sound despite no time to release tension thru prep-work. I know it's not easy to love the sound when you have embouchure dystonia, but gotta love it more than anything no matter what comes out or doesn't! Only way to enjoy playing is taking pride in what you can do...no matter how miniscule! Not focusing on what you can't do. 💕 Lots of love to the dystonian music community, and of course to my friends and family! 📯🎶🎉 #embouchuredystonia #musiciansdystonia #loveyoursound #beproud #playout

(Video) Timeline: My Embouchure Dystonia Rehabilitation Over The Years

Time Stamps of Tests
0:04 - December 2011 - A year before this first clip, I couldn't get a sound out
2:15 - January 2012 - Tonguing Mid-to-High Register, Slowing Things Down
6:39 - August 2013 - Transitioning between Low and Middle Range Gap
10:43 - August 2014 - Downward Movement and Large Interval Control
12:18 - March 2016
13:11 - August 2017 - Fluidity in Slurs, Paced Arpeggios, Held Notes
17:09 - April 2018 - Crossing Multiple Registers, Descended Landings.
19:44 - August 2018 - Melodic Passages and Descending Landings
21:52 - January 2019 - Crossing Multiple Registers, Descending Landings, Ascending Landings, Dynamic Control, and Tongue Control
23:28 - May 2019 - Upper Register; Ascending Landings and Grasp, Stability in Dynamic/Sound
24:42 - September 2019 - Holding Out Notes; Testing Length of Grasp

By FAR one of the most embarrassing videos of my face....lots of closeups, while having dystonia over the span of several years, while aging, while rolling out of bed, while gaining and losing weight, while going into my mid-30's, and crazy life stuff in general.

Wanted to post this for those who have Embouchure Dystonia. Keep up your efforts...I know it may seem like a long journey, but you can do it! <3 I'm new to editing videos even though I post videos on my blog all the time ....so have patience, will get better over time with practice.

This is the first timeline video I've done of my playing....approx 30 minutes. Please understand, even though I'm comfortable with showing my playing because I feel it's important and for a good cause, it doesn't mean I'm not vulnerable.

There's a reason musicians don't show this disorder upfront and why it's rarely documented thoroughly as such. Auff! 📯💔 Feel free to share though! I hope to spread Musician Dystonia Awareness.

Video Recording: The Subtleties of Focal Embouchure Dystonia

Video 1: The subtleties of FTSED. I'm testing/practicing holding out notes (straight muted) 

Video 2: The subtleties of FTSED. I'm testing/practicing holding out notes (straight muted)

The Role of Mentality or Focus in Rehabilitation

This is what I practice the most in rehabilitation. You must be mindful of your body and the signals that are being sent. Use your senses and simply observe.

Being present and observing what your embouchure is trying to tell you helps navigate throughout the complex symptoms so you can find and reduce areas of tension in order to start working on reprogramming your motor skills and regain sensory feedback.

Being aware of your body in a mindful way is not a negative thing! Your mind can't be focused on negative thinking (i.e. the way things "should" feel, the way things "should" sound, the way things "should" look), and equally it also can't be focused on musicality or just playing "through" things.

When your symptoms are severe, especially during the height of embouchure dystonia, you're not at a stage to even start doing that. If you do, you risk getting a secondary injury on top of your disorder. You can't force things, so it makes sense why a musician with a disorder or injury can't be focused on normal playing methods or tactics (i.e. focusing on phrasing, tone color, breathing, mechanics, technique, singing through or playing through things).

You must be aware and in the moment. Be fully present of what is happening and not panicking. Observing (I like to use the word "exploring") where you actually have functional brain signals being sent and helping those areas bleed over into the unstable areas of your dystonia (sounds easy but believe me it's not!)...this is where you find leverage and begin regaining your playing abilities and a sense of dignity.

This is what I mean when I talk about changing your mindset so that you can start focusing on what is really important - the neurological/physical symptoms in your playing.

If you are lost in the realm of emotions, musical-esque notions, expression, or advice of others who don't have the disorder, it's going to be impossible to see any major progress (unless you are 98% recovered already and can focus on that type of stuff).

If you struggle with focus, one way to engage mindful observation is to just breath and empty your head by listening to the white noise in the room, listen to the clock ticking on the wall, feel the sensation of your feet touch the carpet. Then try to visualize blowing on hot cocoa and start playing (or mouthpiece buzzing or freebuzzing). Remember you are simply observing and exploring what your dysfunctional embouchure is telling you....really get to know its tendencies and reflexes, even if sometimes you can't get a seal or sound out at all. Keep noting your observations. This will help you later with adjustments and modifications as you go along.

If you can learn to love the act of doing this and accept your sound and state of disability in a hopeful-survivor and explorative type of way, that's going to take you far in recovery.

Berglof: Latest Embouchure Dystonia Video, May 22nd 2019

(If the video doesn't work here, you can also view it on my facebook page: https://www.facebook.com/watch/?v=346595675996102 ). Originally posted this on my facebook page on May 22nd, 2019!

This is a really good example of what I mean when I tell people that during the onset of my symptoms my Embouchure started to move weirdly, as if I were chewing food or a huge ball of gum while playing. You can definitely see it in the chin muscles as they flex and how the corner muscles collapse involuntarily at times.

My first symptoms where not spasms....that's why I really try to explain to others that it's not just "the shakes". My first symptoms where a tiny air leak, then loss of control of larger movements/intervals, then progressed to loss of ability to decrescendo (embouchure started collapsing only on descending passages and on decrescendo), then after working on low brass playing for a few months and taking time off...then loss of control of smaller movements and spasms started setting in.

Anywhoo! Practiced a little bit today, but you can tell I'm a little frustrated. Overall things are feeling more stable, but now hard to move in certain ways...not due to loss of sensory/touch as much though.

The best analogy I can give is that Embouchure Dystonia usually feels like you are walking on eggshells or a bunch of wires that could zap you with a spasm at any moment, as if you are trying to walk on thin ice....but now I don't feel that way at this stage. Now I'm to a point where it's the opposite; like I'm trying to walk in deep mud and my shoes keep getting stuck.

The smaller muscles movements are more stable, but the larger ones are really being stubborn and not flexing in a natural way....they are slow to catching on. Instead of overshooting due to hyper muscle movement, it's sticky due to overly exaggerated movements/formations....if that makes sense? At least it feels that way. Still a lot of exertion or effort, but in a different way.

Thanks for watching and understanding! Sorry again for poor audio quality (also playing with a straight mute). 😊💕

New Videos: 2 Concerto Snippets and 1 Excerpt

*All recorded/played with a straight mute.

Mozart Snippet

Franz Strauss Op. 8 Snippet

Till Eulenspiegel Snippet

Just recorded this after rolling out of bed. Whenever I haven't done my hair, makeup, or in my PJ's, I just zoom in 4.0 X on my embouchure. hahaha! ;-) Literally look like I woke up in a hay bail behind the camera. Even though my embouchure still looks like a crazy frowny mess, it's actually the most stable I've played on in years.

You'll probably notice when I play on my farkas deep cup I tend to shift to primarily upper lip, and lately the setting has been moving more to the right side, and although it's comfortable, I frown a lot more/embouchure collapses more. Whereas with my Dennis Wick Heavy Weight Mouthpiece in previous videos (the latest mouthpiece I play on sometimes) is primarily center lip with more lower lip involved and less frowning. I will use my Dennis Wick on days where my muscles just can't handle very much, as it requires less effort. However, I will always love my Farkas Deep Cup because of it's tone, and most of all when my symptoms aren't that bad and my muscles can handle it, it's so much fun to play on and I feel more stable.

I can grasp notes, tongue most, start and end majority of phrases. Most of all no spasms, just mainly lack of endurance or embouchure collapsing because of it...but luckily not collapsing because of the dystonia...there is a difference, but I can't explain it because it's something you feel with your sensory.  Also that dang lower lip on the left side has a mind of it's own as much as I try to flex it when needed.

Anywhoo, my phone wouldn't let me record more due to space, so I labeled these as snippets.

I'm not quite to the stage of being able to add in more musicality or to focus on that because I don't have that level of control quite fully yet. Definitely can't "polish" things up....there is no such thing as polishing things up when you have dystonia, unless you are nearly at a 99% recovery.

For now I'm just happy to be able to get through quite a bit despite the air leaks and collapsing embouchure.

Looking at Overactive Muscle Groups in Embouchure

Before I go on break, I just wanted to share a bit of my playing. Mainly to show an example of which muscles are currently overactive (receiving overactive signals), which ones are lacking feedback/loss of sensory - mainly paralysis in the lower lip (left side) and the entire left side of face, and air leaks.

Sorry it's quite dark and difficult to see at times. It's very easy to see which muscles closest to the surface of the face are overactive while playing; especially the zygomaticus minor, zygomaticus major (runs from the upper lip into the apples of the cheeks); levator anguli oris (runs from the corners up along the sides of the nose), and depressor anguli oris (in the chin).

I'm also currently playing while tonguing, which is very difficult to do, but so proud I can do that now!!!! For the longest time I could only do air attacks/air puffs, and later alternate them. Finally able to add in tonguing more consistently without everything going haywire.

I'm playing with my mute in, on my phone, so not the best sound quality, but it captures how many air leaks there are if you listen closely.

You'll hear me use a couple of nose breaths in my pivot areas when I slur near the end. This is to help remind my muscles to not overshoot or become overactive as transitioning briefly. Sometimes I can tell if a normal breath will cause instability, and therefore take a nose breath instead. The same goes with tonguing; I can tell if it will cause instability and therefore will use a air attack instead or alternate.

My primary obstacles right now are air leaks in the low-to-pedal register, lack of sensation and control in the lower lip on the left side (limp/paralysis), and in the high register there are air leaks in the upper lip right side.

This is also the first time in years I've been able to play more aggressively or louder because I can grasp notes better when landing (landing on middle C and B is still the hardest), which I try to show in the octave jumps; demonstrating how I can dig into the notes more and not fall off.

I play a scale passage in the middle range and then play it in the low range to show the difference in the various movements going on in my face. You can see the most amount of overactivity happens when I go into my lower register and pedal register. Also in descending scale runs which are more difficult than ascending. Near the end I slow things down gradually to show you how the speed affects the symptoms too.

The entire right side of my face is stable. It compensates a lot for the lack of control and sensory on the left. It looks like it's the right side that is moving a lot and out of control, but it is actually the left side that is affected the most by dystonia.

Though it looks like a lot of facial movement overall (if it's your first time seeing dystonia symptoms).....this is actually very mild or light; usually there would be more sporadic movement going on, lateral pulls, tremors, spasms, abrupt stops in sound, and more noticeable unevenness between both sides of the face.

It also might look like it hurts, but embouchure dystonia is not painful despite how crazy things look at times. I feel it is significantly easier to play now, but the air leaks are currently the most frustrating thing occurring.

However, this is a good sign and I feel like it is a result of my sensation/feedback returning; I feel my muscles regaining more grasp overall; I can feel where I need to loosen up or grasp more. I don't know if that makes sense?

Better that it's air leaks than full-blown spasms, tremors, and involuntary aperture closing (abrupt stopping of the sound).

I've stated before that the symptoms have gone away in reverse order of onset. Air leaks and the lower lip escaping were near the beginning of onset before things got substantially worse near the height of the neurological disorder.

If you are struggling to believe you can play again, please know I had the most severe symptoms in the beginning and couldn't even get a sound out of my horn and it carried over to my ability to drink, smile, and at times - talk. Although it's been 9 years since I was diagnosed, there was a span of 4 years where I didn't play much or work solely on rehabilitating due to graduate school and teaching obligations. So about 4-5 years of solid rehabilitation, focus, and documenting to get to this point.

Hope this shows a little bit of how Embouchure Dystonia impacts my playing currently. This is actually not the best I've played or can play, but still wanted to record for this month. Will post some videos of actual pieces (2 concertos) when I return. Excited about that! :-)

Thank you for being supportive and understanding! Please remember I am going out on a limb and showing a vulnerable process/state. I wouldn't say it takes bravery, but more like patience made of iron when dealing with any inconsiderate comments that come with the choice of showing embouchure dystonia publicly sometimes.

Finally, I just want to say if you have Embouchure Dystonia, please remember you understand your body, signals/feedback, sensations, and what does or doesn't work better than anyone else ever will.

Return to Orchestral Playing

Hi everyone! In case you didn't know, I took a huge leap and started playing in a local orchestra again this past November. It's a community orchestra, so nothing too crazy or strenuous on my face. I'm hoping it will allow me to take my time re-introducing myself to playing more on a consistent basis.

It definitely has been helping a lot! Granted I never could have handled this years ago, and I would never recommend playing in a group during the onset or height of dystonia. However, I find it majorly beneficial at this stage of recovery.

There was a time when I realized I had to get back into the swing of things, instead of just taking small gigs or subbing. However, it can seem like a journey in itself trying to find the right environment that supports you and willing to take an injured musician in. Most of the time I have to mention it afterwards and hope for the best, and if not, then it's not where I want or need to be in the first place.

The last big orchestra gig I did was in 2017 for the Longmont Symphony, which is an advanced and professional sounding orchestra. Therefore it was nerve-wracking at first, but oh boy, did I have sooooo much fun just being surrounded by players of that caliber and feeling alive again. I played 4th horn on Pines of Rome, Daphnis and Chloe, Strauss 4 Last Songs, and Elgar Variations.

However, my very first time playing in a group since 2010/diagnosis was while subbing for a horn player in a unique jazz-orchestra ensemble called All Angles Orchestra, created by a former classmate of mine (Michael Conrad) who happened to be the doctoral teaching assistant of jazz at UNC (Colorado) at the time. He's now a professor and won several awards for his compositions. I didn't expect him to reach out to me because it had been so long (we attended undergrad together in Iowa) and also because of my setback, but I was so happy he did. It really pushed me to take that first leap of faith.

It can be a bit scary every time you take a gig, or even just playing alongside others at first. It can also be physically taxing committing to a group on a weekly basis if you're not sure you are ready or playing more makes your symptoms worse. It really depends.

However, I think if you are optimistic and know your limitations very well of what you can handle or not, everything can be manageable. The relapse days can be brutal sometimes, but they don't happen as often anymore, and very rarely are they so severe that I become concerned.

I still get to play some decent repertoire; we had our christmas concert in December, and now started opera season and some other great pieces. I'm playing 2nd (but currently covering 4th this month) on the Firebird Suite, which is always fun to revisit on a different part, and playing a couple light pieces like La Gazza Ladra. I've always been a lead/principal player most of my life, and ever since the height of my dystonia back in 2010, I have been on 4th horn whenever I play in a group. That's not to say it's a bad thing, but it has taught me a lot and helped me also separate that ego from needing to be the best. All-in-all it has been an ongoing lesson.

I look forward to orchestra rehearsals every weekend! I LOVE it, very much. I forget how therapeutic it is and how much I need to be a part of a music group. Before I was either playing via demonstrating for students or having to play with them due to teaching. It's not the same as making music in an actual ensemble. Therefore, I never felt fulfilled to a certain degree.

I actually ran into a former CU-Boulder classmate who is a trumpet player, and also a bassoon player who use to volunteer to help out at concerts at the school I use to teach at for El Sistema. The conductor of this orchestra has a great sense of humor and I can tell it's a healthy environment.

I just recently watched a video where Dr. Farias discusses how one of the key components during the recovery process from any type of dystonia is re-introducing yourself to a former social environment or activity you use to do. It will greatly improve your wellbeing and facilitates the progress more than you would imagine.

I know that a lot of musician's with embouchure dystonia are not able to take this step for many reasons, or it can be just the mere fact that dystonia makes things so unpredictable and unstable at times.

Overall I am really proud of where I'm at and just taking my time trying to regain the last portion of my abilities. I feel as though I have about 70% of my abilities back, and on relapse days 60%. I know that's a weird figure...but I don't know how else to explain it.

I know a lot of people think, believe, or will tell you that embouchure dystonia is an absolute end to your dreams and career. The truth is that if you believe that B.S., it will do you nothing but harm and may even stop you from recovering at all.

Believing in a 100% recovery is half the battle. I seriously will not give up, even if I die trying. Even if I'm 90 years old and lost all my teeth...I'm not the quitting type, and the more the odds are stacked against me, the more fuel to my fire and determination to prove those out there wrong.

Anyways, I just wanted to share this moment in my life. It may seem like a small step, but small steps add up over time. I hope that it provides hope to others who may be afraid that they won't ever play among other musicians again, or even enjoy it.

That's all for now, have a wonderful day, and never give up on your recovery efforts! :-)

Quick Video Post: Testing my Symptoms Across Registers

The other day I wanted to see how my large interval jumps were doing. So I started to play a little bit of the Till Eulenspiegel excerpt. Here I used a practice mute, which I often couldn't manage easily in the past from about 2010-2013.

This snippet of playing was used as a means to briefly test my symptoms, feel things out, and observe what signals my brain/body was sending me before I dived into really focusing on them.

It is not to show musicality, rhythmic accuracy, pitch accuracy, polished playing, or my skill level whatsoever. You can see my lower lip has paralysis going on in the left side and more viewable as I descend. It makes things quite taxing.

Though, I can't explain how happy I am to manage jumping across registers and play downward arpeggios spanning two registers, hit some high notes and low notes within a short consecutive time-frame. It takes a long time to regain those abilities even at a minimal/very basic level.

With embouchure dystonia, grabbing onto notes, maneuver them as they fly by, holding them out, or even landing on them is one of the biggest challenges due to the lack of sensation/sensory.

I've been able to regain the grasp on notes over time thanks to years of rehabilitation work. My main setback right now is air-leaks and landing on lower notes descending due to the lower lip protruding outwards on the left or because it is having troubles moving in general. You wouldn't believe me if I told you it actually use to be a lot worse. It's like trying to run a three-legged race and the other person isn't moving, so you're just dragging them along. haha! :-)

I'm also using a combination of air and tongue attacks. Tonguing is a whole different area on it's own, so won't go into detail there. It's task-specific, so the ability to do it depends on the register I'm playing in, if it is descending or ascending, the tempo, and if it is smaller or larger interval movement.

I will say however, I've noticed over the years that the receding of symptoms or regaining of control has happened in the reverse order of the onset and progression of symptoms. So my current state is a good place to be in.

<3 Until next time...thanks for stopping by! :-)