Month of May Links of Interest

I haven't written a blog in a long time! I've been so busy. My summer feels like it won't begin until July. I'll be back soon to update with more!

The first link is by Round Earth Publishing over head/neck/upper body pain.
The second is an article in Peabody's Magazine of Fall of 2009 over musician injuries.
I'm pretty sure I already have this link on here, but just encase: Embouchure Dystonia Ireland
A recent and wonderfully written and well informed post by Wilktone over FTSED diagnosis and treatment and criticism.
An Altenmuller article: From Embouchure Problems to Embouchure Dystonia? A survey of self-reported embouchure disorders in 585 professional orchestra brass players.
An article by Fruscht over Embouchure Dystonia.  
A flute player starting to document their journey through a blog too.

My Academic Year (Photos)

Well. It's been a busy school year! I'm almost done....5 weeks left. Whew! I just wanted to share some photos I've took throughout the year. It's been extremely challenging yet rewarding; 3 deaths in my life, lost my job, lost my car for a while, and way too much drama, on top of full-time work and full-time school, but on the positive side a scholarship, plenty of opportunities to teach, make friends, and let go of my past. This summer I'll be focusing a lot on work, getting in shape, and preparing for presentations over musician injuries. Cheers to my first year at CU, and looking forward to summer soon!

Learning/Practicing Timpani

Outside Macky Auditorium

Teaching a trombone sectional on Holst Suite



Macky Auditorium



Hiking in the Flatirons

More hiking....

My nametag from the school of education.

Macky Auditorium

Downtown Boulder

Pearl Street

Snowfall on CU campus

My bus pass and ID...I was so excited to receive these!

More snowfall on campus

More snowfall on campus...

Saying goodbye to some kids moving away from graduate family housing! My roommate and I always played basketball and football with them during the summer.

More campus photos...

We were learning how to do basic colorgaurd during Marching Band Techniques class.

Saying goodbye to the children moving away from graduate family housing. My roommate and I played basketball and football with them all summer. We miss them very much!!! :'(

The hour before my very first conducting experience. Dvorak Wind Serenade.

My first Music Educators Journal! I open it up and there's my high school band director Dr. Burrack.

Fireworks at Farrand Field

At an elementary school in Denver visiting my roommates mom's music class! I taught them about brass and introduced them to the horn and trombone.

Walking home....

More walks....

Conducting high school band on Halloween

More snowfall outside...

Teaching flute basics

Teaching solfege / hand signs.

Working on subdivision charts with a high school trombone section

More conducting....

More conducting photos

Katie Berglof: My Neuromuscular Dentistry Results

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Since writing my last blog post, I recently underwent Neuromuscular Dentistry tests within the last two months on my jaw, muscles, and nerves. With as much pain as I'm in, I'm not surprised they found that my joint was messed up. Apparently my right side jaw joint is severely compressed, it should be positioned down and forward from where it currently rests, my spine is not curved in the back of my neck like it should be, my masseter muscle is not activating, and my bite is too deep and misaligned.  The right side of my face is in more excruciating pain than my left, and I have to massage and pop the joint back in place with my hand whenever I'm practicing instruments; horn, clarinet, flute, sax, etc.

My doctor has prescribed that I do not resort to undergoing surgery, and instead have a professional neuromuscular orthotic (dental splint) to realign my jaw first and position it back to where it should be. They would track my improvement using CMS (Jaw Tracking), and use Sonography, Electromyography, TENS, diagnostic casts, and diagnostic photographs; all as part of my treatment, testing, and tracking of progress.

They are confident this will help me tremendously because they had me undergo a TENS test and wear a splint  during one of my four hour visits and retested the readings on my bite, jaw movement, and strength, and it showed drastic improvement in my clench and motion. My face even felt relieved for almost a week after that.  I also believe this is the source of my problems, as most of my pain is coming from my joint area. I also wanted to share this research study over FTSED (Embouchure Dystonia) and dental splints: Three cases of Focal Embouchure Dystonia: Classifications and Successful Therapy using a Dental Splint.

I'm planning on using insurance from work to help with reducing the price of undergoing this. I'm not sure when I'll be able to afford it, but hoping someway, somehow, things will work out.

Katie Berglof: Updates on my Jaw

 

This painting resonated with me more than I can put into words; as it visually captures what I consider the amount of pain my jaw is currently in or feels like. I previously wrote about how I was going to get the right side of my jaw checked out this coming summer because I felt like something was causing problems at the back corner of my jaw. Some minor pain started to set in that area a little over a year ago, and it wasn't so bad, except it set off my nerves and then the pain was not tolerable. My whole face started to feel like it was on fire. So instead of waiting until summer, I took all the money I had saved up and put it towards a doctor/dentist; someone who specializes in both oral care and facial pain.

 

I had just enough to pay off a couple of visits, but my first visit was a couple weeks ago to do routine tests. They did a full scan of my skull and an x-ray and nerve conduction. What's interesting is they found that the joint on my right side has a severe compression. They can't tell if it's because of a tooth nearby that's also causing problems or other factors, so they're doing more tests. All they've told me is that it's this compression which is causing all the pain and that one of the bones in my joint have deformed due to being rubbed up against so much. I asked if it was TMJ, and they have to find out what else may be contributing to it. I'm going in this coming Friday for more tests on my muscle weakness, motion, and nerves.

 

Part of me is worried....I keep thinking, "Why is my jaw so messed up! It's one thing after another. Always." It's extremely stressful having to play secondary instruments for classes (i.e. flute, sax, trumpet) and no one understands. I constantly have to remind them I'm in pain. Luckily I do have a couple people around that are going through similar things, and/or understand. 

 

Despite the frustration, I do feel better knowing I might actually find the true source of my dystonia and nerve damage. It would make sense that it comes from deep within my jaw, but as to why it's happening, or how, that's for me to find out hopefully soon. I am optimistic! It's so hard to find the source of everything that's going wrong with my face, but at least there are more signs leading to what's going on, and they're more obvious. Praying that everything works out.

 

I am hoping that a jaw replacement is not required, or surgery, but we'll see. I honestly will do whatever it takes to not be in pain and to regain control over my facial movements and sensations.

 

- Katie Berglof



TMJ Animation Images

I don't have much time to write, but want to say I came across this wonderful resource while looking up information on compressed joints. It's animation showing what normal jaw looks like in movement, a locked jaw, a popping/clicking jaw, and a dislocated jaw.

You can find the link here: Rich Hirschinger: Diplomate American Board of Oral Facial Pain (TMJ animated images)

Truman Blogspot Article: Mentalis Strain

Truman Orthodontics Link: Orthognathic Surgery, Skeletal Discrepancies, and Mentalis Strain
I found this very informative and amazing blog over orthodontics. This particular post is over Mentalis Strain (chin muscle formation problems). I feel like it gives an extraordinary example of mentalis strain. Take a look! A huge transformation is shown! #knowyourface:)

Updates: Welcome to 2015!!!

I though I'd write a more personal blog post for this....

Soooo...where to begin? It's been crazy! The last five months have been a whirlwind of great changes and challenges. I started my studies at CU, which are pretty intense. I haven't stepped foot in a classroom for YEARS, so I was in a for a big surprise. I've been teaching A LOT; high school, middle school, and elementary music levels, including all my other studies and work at the same time. I'm a part of NAfME, and selected to teach in the CU MSE program this Spring, and received a scholarship which has helped out tremendously.

I've made many friends, love the city, and love everything I've been learning. I've also been working on preparing a lecture for next academic year over musician injuries and disorders/ musician health. I've been very fortunate to have friends, colleagues, and some professors who are supportive and helping me organize this. I'm also hoping to present at some of the music education conferences.

Despite having not much time to write for my blog, things are good with my dystonia. The pain in the right side of my face has subdued, yet I will still have another x-ray and MRI scan of that area to check for arthritis, etc. any other problems that may be occurring just encase. That will happen over the summer.

I've been very fortunate to have many musicians who are struggling with dystonia or an injury contact me! Thank you for all the helpful resources sent, your stories, questions, and support. I'm glad we are in it together, and I know we all are fighting a hard battle to overcome this huge setback. It's inspiring to see so many people willing to open up about what they are going through, what they have learned, and reaching out to others. I swear, it's been a huge movement, and I'm just extremely thrilled and overcome with joy knowing the awareness of musician's dystonia is heightened more so now than ever. I've seen a huge flux in my blog views; reaching 30,000+ ...which is both exciting and embarrassing for me at the same time....I'm extremely honored and humbled. If you were all here, and if I could afford it, I'd buy all a beer! (or wine...or something great!) hehehe

This year should be a huge one for me, and I'm looking forward to it, no matter how exhausted I am....I can't even begin to explain how happy I am doing what I love!!! Cheers to a wonderful year and may miracles and blessings continue to flow our way! Have hope, and see in yourself what you see in others; we all have the potential to accomplish something great, one step at a time, even if it goes unnoticed!

Pathways in Focal Embouchure Dystonia by Dr. Denton Thomas

I've been busy as usual and didn't find time to update my blog for all of December! I found this handout online written by Dr. Thomas, so thought I'd share it and post it for December. Dr. Thomas hails from Melbourne currently, and previously from UT-Austin.

I'm so happy to see professionals writing about this neurological disorder, spreading the knowledge and backing it up with research study. Thank you for contributing your work and passion about this area of musician injuries/disorders Dr. Denton Thomas!

http://www.dentonlt.com/sites/default/files/webfm/fdresearch/ITF2010-LectureHandout.pdf

Berklee College of Music: A New Understanding of Overuse Injuries by Dr. William F. Brady, D.C.

I just had to share this amazing find! It is an article titled: A New Understanding of Overuse Injuries by Dr. William F. Brady, D.C. Please read the article linked, because it provides a new way of looking at overuse injuries or repetitive strain. I highly recommend it.

I find this highly fascinating because my acupuncturist and myofascial therapist told me a similar thing when I went in for treatment. She said that part of my problem was built up connective tissue in the back of my jaw. She felt around my face and the inside of my mouth (I know, weird) and said I had an overwhelming amount of it.

So I basically went under several months of myofascial release therapy where she released the connective tissue from the inside of my mouth by using pressure. The connective tissue started in the middle of my cheek and went back deep into my jaw and even as far back as the corner of my lower jaw. Equally important is we worked a lot on releasing tissue and tension around my whole upper body, and predominantly around my neck.

Many other forms of therapy such as rolfing and feldenkrais use similar methods of helping the body release tension. It was very very very painful releasing the tissue. But! It was definitely needed and it actually changed the way my face looked and felt (my right side of my lip and face looks more equal to my left now without the upper lip pulling back and upwards on that side, which gave me a weird appearance). I wish I had known about it before, even as a non-injured musician in the past! A professional European horn player told me that he also received this, even if he isn't injured because it's important to take care of the body. Warming-up is always not enough.

We have to treat our bodies like athletes, even if it's use of smaller muscles. A lot more goes into playing than we give credit because we are not aware, and tension can build up over the years....and not necessarily because we're doing anything wrong, but because it is natural. Some people can take a beating for years and years and not feel anything, whereas others are more prone to overuse because of their physical makeup, or even genetics in the case of onset of dystonia.

We just have to take extra measures that are not traditional to keep check on tension....which is hard to do since most often injuries sneak up on us and slowly degenerate our ability over time before we are even aware of it.

Also a lot more muscles come into play than we know. Most brass musicians consider their embouchure as only the use of the muscles around the lips, and never understand the actual anatomy or function of the muscles in the face (where the muscles connect to, what each on initiates) and that the neck and upper back muscles make a great impact on your playing too, since they tie into the facial muscles and nerves around the jaw.

Additional notes: Thank you to Scott King, DC for getting in touch with me! If any injured musicians are in the Denver/Colorado area and looking for soft tissue diagnosis and treatment, Scott is available and has trained with Dr. Brady who wrote the article I shared above. I offered to share his contact information below:

Scott King, DC
Novo Soft Tissue & Spine

720 S Colorado Blvd Ste 610S

Denver, Co 80246

(303) 990-0159

List of Performance Arts Clinics

I've been so busy with school that I haven't had a chance to write a blog post for the month of October AT ALL. So I'll try to post 2 blogs this month. Right now this current post is a draft. I want to make a list of performing arts clinics around the U.S.

As you can see, I just started this, so let me know if you want to add any and I'll upload the link, or post in the comments. On a different note, just want to say I have 4-5 weeks of fall classes left and then I get a break, which I'll be posting quite a bit within my time off. See you soon! I miss writing on my blog, so hope to get back to it soon!!!! - Katie Berglof

University of Michigan

Allina Health - Minneapolis MN

Performing Arts Rehabilitation Institute of Chicago

Bringham Performing Arts Clinic - Boston MA

Virginia Mason Clinic - Seattle WA

Cleveland Performing Arts Clinic

List of Performing Arts US clinics

New York Presbyterian Clinic

Musicians Clinic - Texas

Performing Arts Physical Therapy - Boston MA

UNT Performing Arts Medicine Clinic

Al Hirschfeld Health Clinic - New York

Jerald Harscher: The Poised Guitarist

I wanted to share Jerald Harscher's fantastic website on my blog. I had always been meaning to and now just got around to it! You can find his website at: The Poised Guitarist. He is a wonderful person to chat with and very kind, so please contact him if want to know more!

Jerald is a guitarist who has helped many (MANY) musician's with hand-related injuries and Focal Task-Specific Hand Dystonia. He can help you lessen tension in your playing and guide you throughout recovery. He knows a great deal about body mapping which I believe is essential to a musician overcoming any type of injury, and for prevention in general.

If you are looking for information, resources, help, and knowledge on anything hand-related within music, please contact him! He is a great resource. Check out his forthcoming book, videos and information. It is even helpful for brass players to read his writings over the hand/arm movement. Sometimes we use a heavy amount of tension in our grip on our instrument which can sometimes transfer and/or add extra pressure on our embouchure via the arm force.

Quantification of Instability of Tone Production in Embouchure Dystonia

Quantification of Instability of Tone Production in Embouchure Dystonia Link
I finally have a quick moment to update my blog. Right now I just wanted to share another article I came across! A really great read which discusses how hand dystonia can be objectively assessed, yet it is extremely difficult to do with embouchure dystonia. This research shows a possible way of measuring embouchure dystonia through the frequency of a note being played.

Roger Frisch Undergoes Deep Brain Stimulation

I just wanted to share this video! Roger Frisch, concertmaster of the Minnesota Orchestra underwent brain surgery to overcome his essential tremors. I'm so happy it helped him overcome them completely! Essential tremors and dystonic tremors both have no known source of cause. As well, they both involve misfiring signals from the brain.

However, essential tremors are much different than dystonia. Essential tremors are usually in just the hand, arm, and fingers (mostly all at once) and are a constant tremor (even when not playing their instrument). Whereas Focal task-specific dystonia, the tremors are set off by a specific motion or movement or task initiated (in other words they only happen when a person is playing their instrument), and the tremors are irregular or sporadic. Essential tremors usually develop in older age, and dystonia usually occurs in young adults 25 and up.

There are many people with general types of dystonia who undergo brain surgery, but not many musicians who do due to the difficulty stated below...it's not easy to find out how to correct the tremors or where the signal is coming from when the musician is not playing their instrument. In this case, he has essential tremors and was able to play his instrument during surgery. I can't imagine! I don't think I could ever be brave enough, nor afford it.

Quick Catchup

I haven't been able to write a blog post for the month of July! I've been so busy!!! With school coming up very fast, I've been working hard to save money for books and rent, and there's been so many events in Boulder this summer. As far as my playing is going, it's good as usual, just taking my time. I'm still having a bit of issues with the right side of my jaw in the far back corner. I've been able to go higher on my horn more consistently, and my lips don't quiver, but instead make air-leaks on some of my lower notes. I've been playing a lot of scales, arpeggios, and a little bit of etudes when I can, but it's only once a week. When school starts I'll be transferring my acupuncture record to CU and will receive it closer to home. The only issue so far is the back of my jaw like I said. There is a slight dull pain, but most of all it just feels stiff and I have to crack it by moving my jaw side-to-side, and then heatpack it for a while and I feel better. I hope I'm not developing TMJ. But it doesn't hurt in the joint, just the bottom far back corner of my jaw every now-and-then. Anywhoo! I'm excited about school and looking forward to being involved in music again!

May Video Blog

This video was done on a whim, but I think I covered a couple improvements in the short amount of time filmed. Next time I'll use a tripod. haha! Will try get on here when can. :)

April 5th Acupuncture Update!

I have some pretty awesome news! Now that the tissue around my back, shoulders, and neck have been loosened up (combined with daily stretching exercises, an item/technique given, and some pain relief stuff), the pathways that run up into my face are now open. I don't know the terminology.

Before they had to do acupuncture right on the face, and around my face, but no matter how many needles they put further away ...like in my arms, hands, feet, or even behind my ears or on my neck never made a difference before...because I had so much blockage from tissue and tension.

However, now they can finally do acupuncture needles in farther away areas like on my hands and feet, etc. and I can feel it in my face!!!! It's such a weird feeling, because I didn't think it was possible for those areas to affect my face, but I could feel the blood current pulsating all the way up into my face, and I could feel my muscles and nerves start to respond.

Last week they put needles in a bunch of places, but what hit me the most was a needle they placed in the side of my hand. They also use to put a needle between my thumb and index and that didn't work for a while, and then one day it was really intense, and I felt the sensation travel down into my wrist. However, this one that was in the side of my hand...nearest the pinky....I felt it in my upper face around my nose, and behind my ears.

What's even more surprising is I could feel some muscle contractions start to flare up in my lips and around my nose, and 3 minutes later all of a sudden they calmed down. In the past it took the whole session to finally see the contractions calm down...and they only calmed down a bit...I could still feel them, just less noticeable. However, this time, the completely calmed down.

For the first time in forever, I tried puckering my lips outward (like a duck face) very slowly and I had NO spasms! Then I tried rolling back my lower lip slowly ...up and back over my teeth, and it didn't spasm at all. The feeling of my face was so drastically different than before too. Different than any other sensation. It felt heavy....like my face was normal. I'm not use to things feeling THAT normal. I couldn't believe the ease of movement in my face without a spasm taking over, or without pain. I could still feel some throbbing around my forehead on the sides, near my ear....but the muscles in my face felt different. It felt heavy....like my movements were stable. STABLE!

I don't know how to describe the feeling of stable. I felt like I was placed in a normal body with a normal face, with normal movements. I also could feel the left corner of my face pull back even further without difficulty when I smiled. Usually when I try to make very slow movements; like doing a sly grin (pulling my left corner of my mouth slowly back and up) there is contractions beneath. Or even when I try to slowly crinkly my nose, my upper lip feels unstable. But for once nothing!!!

I was so shocked that I had to keep looking in the mirror and doing it over and over again, just to see if a spasm would happen. Anywhoo, even though the symptoms started to set in about 4 days later, I was still ecstatic about how long I went without symptoms. I know it can only keep getting better and better from here on.

My acupuncturist asked me how I feel about sessions once a week. I said it was absolutely necessary, and that I noticed the symptoms come back 4 days later...so I want to be consistently addressing it. She said she is proud I am so very aware of my symptoms because not everyone keeps a log of what they feel or when things reoccur or how they arise. Also she agreed every week is best. I told her about how the one time I couldn't get in for 2 weeks and I felt like I was back at ground zero.

My session this previous week was just as good. We did the same treatment, including some work on my back. I was feeling sore around the ridge on the back of my head, behind my ears, and in my right shoulder. I also felt the constant need to squeeze my upper back muscles and neck. The soreness I felt was no longer in a very small specific area as before....for the first time the dull soreness spanned across a greater length of my face; for example from the sides of my nose all the way down into the sides of my chin...whereas before I would usually feel soreness in one or the other, but never tied together. Again, 3-5 minutes into my session the contractions around my face/lips went away.

We'll see how things go this next week. But I'm very happy and surprised with the progress made. It may seem small, but to me it feels worlds different than before. I told my acupuncturist that on a scale of 1-10 (10 being the highest pain) the pain in most areas is now down a to a 4 or 3, and as far as my spasms/contractions they are also at a 3 or 2 in the larger areas I get them in. Anywhoo, it's so hard to describe what I'm going through, but I still feel the need to write about it. I can definitely feel the nerve going from behind my ear, into the side of my face and up near my cheekbones right now flaring up...but it's been flaring up on and off. However, as the days pass, the consistency of the flare has gone down. I don't feel as sore in so many areas all over now, just in certain areas, but broader ...if that makes sense.

I'm so very happy with it all! I still am on cloud 9 just remembering how my face felt normal for a couple of days. I know that tension in my upper body may be a lifelong battle, but I feel through this experience I am learning how to prepare and protect myself from overusing my muscles and nerves....and most importantly I'm learning how to LISTEN to my body and being highly aware of it's signs and changes given. I feel I understand the complexities of people's physic much more....well...maybe not understand....but respect and am mindblown by the human body and how it functions...and how each individual's form and function varies.

Stretches, Deep Tissue Massage, Myofascial Release, and Horn Playing

Two sessions ago I had some tissue relieved around my back. After that session I had all the soreness and tension move up into primarily my neck. I felt like the contractions around my neck were so strong they were choking me (I'm being overdramatic, but it really did hurt). I could feel a lightening like shock start from the back of my head, run down my neck, and into my shoulder blade and right shoulder. This happened everytime I tried to turn my head to the left. I didn't have tremors, but if I tried to pull my face to the left and hold it there, a spasm would creep up and jerk my head to the right. I knew this feeling in the past....

It felt very similar to my encounter with neck dystonia in the past. I kind of got freaked out. I asked my doctor about it and they said it was definitely a pinched nerve, trapped by the surrounding tissue. We were doing everything we could to release the tissue in the places I felt either pain, soreness, contractions, spasms, or tenderness. But just recently it had flaired up in my neck.

So this week I've had a lot of deep tissue massage to help loosen up the tissue in my back, shoulders, neck, and lower jaw, then combined with acupuncture, and myofascial release. My neck feels so much better now!!! I can still feel the nerve a bit irritated in the right side, but there's definitely been a softening of the tissue. My shoulders and neck have never felt this light, relaxed, and fluid....like butter. My right side is of course still a little tense in areas. 

This most recent acupuncture session was very good. She said there's been a significant break-through. We made great progress. She was working on loosening up the tissue right on that fleshy mound at the back of my neck. She did some type of stretch with my lower jaw and was also pushing on tissue back there, and there was a huge release. We also did a lot of needles around nerve points. My skin has been red for 2-3 days straight now. She said that was normal though and that this is great news because it means the blood circulation is consistent now, and that the pink around my face will go away in time, but for now it is a good sign we hadn't seen before. I also was very lucky to receive a device that will help me at home. 

I'm feeling really good right now. The pain in my face has gone down significantly, and I only feel slight throbbing up near the sides of my eyes along the zygomatic nerve. Otherwise most of my tension and pain is still in my neck and shoulders, but less intense than before...wayyyyy less tense. One a scale of 1-10, my pain before was close to a 9, and now it feels more like a 4 or 5. Again, I'm not playing my horn at all. I'm not allowed to until my body is 100% free of pain, soreness, muscle contractions, and spasms. 

I've also been doing stretches to help with my muscles around my upper back, neck, and shoulders. Here are a couple that help me out a lot (I tried to find them online as best as I could), and have done wonders for me within the last couple of weeks:  

Also this too ---> :) Link: Upper Back Stretches

All Signs Lead to the Source

My last acupuncture session was intense. The week before it, the soreness I felt in my face was most noticeable in my higher cheek bone, the lower jaw closest to that corner/round part of the jaw below the ear but on the corner of the bone (that didn't make an sense at all did it?). I also felt a lightening like shock run from the top of my cheekbone all the way down to the upper corner of my lips. This shock would go off even when I heard a loud noise, or if someone surprised me, I could feel the tingling shock run down my cheekbone. The sides of my chin hurt.

My acupuncturist did some needs around the areas I felt soreness, but also did a bunch on my back...and my god....did I feel the blood start to immediately take over my right back shoulder. I could feel this intense warm feeling that was almost heavy. I could feel my muscles loosing up and a sense of relief....a painful relief if that makes sense. I had never realized how much tension there was in my shoulder. I always knew my shoulders were pretty crappy because I've always had football/quarterback shoulders that are very broad and tense. I always thought it was genetic as I see the exact same shoulders in my biological family.

Anywhoo, after that session the soreness moved from the right side of my shoulder to the left, and I could feel soreness behind my ears and all the way down the back of my neck. I felt part of the back of my jaw on the right side loosen up since the muscles on the back of my right shoulder loosened up or did something. I felt a change. It was somewhat better, but not completely relaxed.....but definitely way better than before.

My acupuncturist/myofascial specialist said that it's normal for winding (what they call what I have in Chinese Medicine) to move around. But it was definitely good that I was finally feeling things in the left side of my face, neck, and shoulder.....whereas my primary symptoms have been on the right side heavily. Therefore the left side is actually the weaker side/non-responsive...and finally we saw a change. I can feel the left side's sensations become just as heavy as the right side....where before like I said it was less noticeable on that side. More than anything acupuncture has made me highly aware of my body even more so. The first couple sessions I didn't notice too much of a change, and the soreness remained in the same areas, but over time I noticed things starting to move around more drastically...like Christmas tree lights that dance to music...that's what I felt like the soreness in my face was doing; just moving all around the place.

This last session my acupuncturist was feeling around my upper body. She's amazing because she can feel and sense where my soreness is...I rarely have to tell her where I'm having problems because she can already tell by just looking at me, or by what she feels. It always blows my mind how much she knows about my facial problems.

Anyways, she was feeling my neck and she said, "Your neck feels like a concrete rock. That's not normal. I bet you this is where your nerve entrapment is really coming from...your neck/shoulder muscles. They are all linked. Plus, you said that in the past you had neck tension problems when younger and you couldn't turn your head to the left and they diagnosed you with another form of dystonia. I believe your neck or upper body tension will always be a chronic problem you need to address. It's probably crept up on you again over the years and affected your face. Also combining that tension with repetitive state of contraction; the way you hold your horn, the muscles being overworked, etc. However, it can be corrected by focusing on better posture, constant care in addressing the tension when it starts, and knowing now where is comes from...in your shoulders and backs, and making sure it doesn't spread any further into your face. When I first saw your spasms in your face, I knew that the source is not always what it seems.

You first felt weakness or a burning/lack of sensitivity in your upper lip, then a dull soreness in the center of your cheeks, then after acupuncture that soreness spread to many different areas of your face, and eventually led to the back of the jaw, then the upper cheekbone, then the lower jaw, then the corners of the mouth, and so forth, and eventually moved to the neck and shoulders, and now the back. Everytime that sore feeling moves, it is like a torch lighting up a pathway that leads to the source. But we can't just work on the source right away...you have to work your way backwards.

I'm guessing what happened is the tension in your back and neck entrapped a nerve, then this led to the muscles in the face having to overwork themselves, this built up tissue in the jaw, and this changed the way your face functions, and eventually led to injury, and pretty soon not only were your facial muscles overworked, but your nerves too, and you're left with a very weak embouchure. No wonder you are experiencing spasms when you play, and now pain. But we have to work our way backwards. We have to loosen up the tissue built up, we have to address where the soreness occurs first around the face. We can address the back and neck at the same time....but you never want to ignore the signs and just address where you think it's coming from. That's just like putting a band-aid on something and hoping it heals all the other areas you feel tension and pain. It's not enough to just relieve tension in one area. All signs lead to the source."

She did some type of ointment on my back and scrapped with something along my shoulders. I felt very relieved after that. More than anything I started to feel more things in my left side than before, which is good!!!! I'm so surprised to feel this. Also she was observing the spasms in my lips when I was showing her my stretches and embouchure formation, and she moved some tissue around my face very gently, and when I tried to do the stretches and embouchure formation again it was completely different...it was less noticeable. The spasms are less noticeable when I form an embouchure, however they are very noticeable when I do the opposite and try to pucker my lips outward  like a duck-face. But I did notice the tension in my corners has now moved more lower and I can feel them when I make a frowning face. Overall things look a lot better and my face looks different!!!!

I haven't played my horn AT ALL. I'm determined not to play my horn until I know my face and upper body is 100% free of tension, soreness, and contractions. This week I've been super aware of my posture and I realize one of my biggest problems is of course that which only a woman gets to experience due to their chest. However, I've been working out a lot to try to take less stress of weight on my body, and I already feel better. Ever since moving here, I've lost a total of 41 pounds! I still have 40-50 to go and I'll reach my target. More than anything I just want to take really good care of my body and help take some stress off. I feel so upset that the source of my dystonia symptoms and my nerve damage may be because of the stress put on my shoulders and neck over the years, and especially the lack of care of taking care of my body and even my face while playing at a high level. But of course when you're younger you think you're invincible, especially when things are going great and on cloud 9 with your performances, etc.

Anywhoo, I'm rambling! That's all the news I have for now. Next session is coming up on Monday, and we're going to do some myofascial release again, as well some more work on my back/shoulders/neck. Wish me luck!!!! I know I can overcome this!!!!

100th Post! Facial Myofascial Release, Acupuncture, Embouchure Dystonia, and Nerve Damage Work on my Face

I think it was 4 weeks ago I had gone on a 2 and a half week stretch without acupuncture. I began to feel the soreness in my face start to creep back in and I had no idea what was going on. Things seemed to be getting better until then.

I was becoming worried. Also even though I'm only allowed to practice 15 minutes a week, I noticed my face was pretty weak due to the intensity of the sessions, so I backed away a bit and have been avoiding my horn as much as possible. However, when I did play, it seemed a lot worse...and I just didn't want to push myself. I realize it's going to take a lot more time.

When I went to my acupuncture appointment I realized my original acupuncturist must have went on maternity leave since there was someone else standing in. We went over my symptoms and paperwork. Surprisingly she specialized in (barnes?) myofascial release and acupuncture. She had some facial damage after a car accident a long time ago, so she knows what it's like being in pain.

There is a huge difference between myofascial release and just a facial massage. I don't know a whole lot about it yet, but will post more links after do some reading. She told me that repetitive movement (such as what I do with my jaw and facial muscles when I play horn) causes the body to build up connective tissue to reinforce the protection of the muscles from being overworked. This tissue becomes too strong and can cause a lot of problems such as nerve entrapment, TMJ symptoms, spasms/involuntary contractions, pain, and can cut off or lessen blood-flow to certain areas of the limb/body part.

She could tell immediately that the right side of my face had a lot of tissue built up and was tense....not soft tissue like it should be. She could see the left side of my face was the side that was weak and not moving properly. The right side also was so tight that the skin was pulling my lower lip....which is what I always see most noticeably when I play horn. Also when I open and close my jaw, the right side has so much tightness that it closes first more than the left side, and the left side is able to go down further when I lower my jaw.

Her aim in the first session was to release some tissue in my face and then do acupuncture to increase the blood flow to the trigger points or areas needed. This required her to push against the tissue on the inside of my mouth. It was very painful!!!!! But! Afterwards the reward was an enormous amount of relief of tension form my face. She was surprised to see an immediate softening of the tissue in one area, and even I could feel how soft my right side had started to feel compared to how it felt before. Even when looking in the mirror, I could see that my physical features were more aligned.

Even more pleasing, was how much less tense my jaw was when I slept at night. I feel like my right side joint had been able to close properly or seemed to sit properly...if that makes any sense. I had always felt like my jaw had been becoming more and more misaligned and thought maybe it was a wisdom tooth coming in or something, but the dentists said I had none coming in.

She's also working on opening up my C1 ...which I think is the cranial nerve?
I am really surprised as to what acupuncture is teaching me. When I first came in, I never expected for things to get so intense, as I only had a slight bit of throbbing in my cheeks...but thought it was because I had been playing a lot in rehabilitation. I never thought much about it. But the sore muscles became more constant and eventually became chronic soreness.......but it always remained in just the center of my cheeks. But once I received acupuncture, it's like all my nerves flaired up, sending signals. I felt certain areas all over my face start to feel sore, and I realize that these types of signals area always signs pointing to the fact that there's something wrong or that there's something more going on besides just the embouchure dystonia symptoms, or just the soreness in my cheeks.

However, the more I received acupuncture, the more relief I've been getting. But the myofascial release I believe is exactly what is getting to the source of my dystonia and pain relief. Acupuncture has helped with the nerves and blood flow in my face, and it's definitely done a lot to help, but myofascial has made such a huge difference in the structure of my face and feeling of my face from the inside-out, that I can't help but notice how significant it is to my recovery....and I've only had two myofascial sessions so far.

Anywhoo! I feel like it was a blessing or miracle that I met her!!!! I'm so glad she knows what I'm going through since being through something similar but different, and her passion about helping those with facial trauma means a lot! I got that feeling like I had fallen into the hands of the right person at the right time. Divine timing!

The soreness in my face was most noticeable near my ear and back of my jaw when I first started acupuncture in November. However after one session of myofascial release, it has now moved to primarily the front of my face and behind my ears, and the back of my head. I also am not allowed to play my horn at all. Which I think is really good. I can do this! She said that if the muscles are always in contracting-mode, they will remain contracted. We must teach the face to have the natural reflex of relaxing again. The body has "contraction" built into it now, and it takes a lot of repetitive work to reverse this and teach the body to relax instead of contract. That is the aim. So playing my horn would just reinforce contractions in my face, so I need to wait until I'm 100% recovered before trying anything again. And even then, I will have to of course relearn how to play my horn avoiding as much tension as possible.

I think myofascial release would be great for even non-injured/disordered musicians. Like sports medicine, but for musicians; it's good to have a licensed professional release some of that tension from the body from time to time.

I am really grateful to God for bringing these people into my life. My acupuncturists have changed my life and I have so much hope and faith with the relief they've given me in this short amount of time. I will do whatever it takes and be patient with however long it takes to make sure my face is relieved 100% of tension! :)

Moving to Boulder!!!!!

It's official! We're moving from Denver to Boulder!!!!!!!! No more commuting so far! I might not be able to keep up my blog for a while, but again, I'll try to get on here when I can......that is all for now. (Waves!) :-)