There Must Be a Logical Explanation

[Chuck Jackson]

Greetings To the TNFJ,

As some of you may remember, I stopped playing because my Focal Dystonia was becoming too hard to mask. I haven't seriously played a tuba for 6 years. In the past couple of weeks I have had some extra time to mess around with a Conn 5J and one of the new Kings, both owned by the High School where I teach. I have to share a really interesting scenario with you:

When I play a metal mouthpiece, ANY metal mouthpiece, the effects of my FD are severe. I can't hold a pitch between an F right below the staff to a D in the staff. Slurring is hilariously bad.

When I play a Kelly mouthpiece, ANY Kelly Mouthpiece, the FD is so slight (some slurring issues between the aforementioned notes, and those are mimimal). I actually sound ok. I am not at all interested in playing on any level anymore as my time is taken up with teaching, conducting, and arranging, BUT I am really flumoxed as to why this may be happening.

This is not BS, those of you who know me know the mental hell I went through with this that I would never play around. Why do I sound like the tuba player I was 10 years ago on a Kelly ANYTHING and not on a metal MP?

Any thoughts would be most welcome.

Chuck "mystified" Jackson

[Brian C]

Maybe because your sensorimotor cortex map for tuba-playing depended on using a metal mouthpiece? IOW, maybe it changes the feedback to your teeth/jaw/lips enough to trick your brain? You could test this by procuring a hard, rubber mouthpiece or some other material that does not carry vibrations well.

[Doug Elliott]

Many tuba players are almost dependent on nebulous mouthpiece placement to facilitate shifts... and there's the problem.

One of the main causes of embouchure troubles typically called "focal dystonia" is a slipping placement.

Lexan has much more "grip" than any metal. No more slipping - no more embouchure problem.

[j1007hc]

When you say metal mouthpiece, does this include stainless steel/titanium? Not trying to be dumb.

[ShoelessWes]

Many tuba players are almost dependent on nebulous mouthpiece placement to facilitate shifts... and there's the problem.

One of the main causes of embouchure troubles typically called "focal dystonia" is a slipping placement.

Lexan has much more "grip" than any metal. No more slipping - no more embouchure problem.

Using this logic, does playing wet vs. dry also have similar effects?

[Doug Elliott]

You want enough lubrication so the lips can move as they need to play the range, but not so much that the mouthpiece placement becomes inconsistent. Playing wet on a sticky rim is actually a good combination, because the sticky rim material promotes consistent placement without sliding around, while the wet embouchure lets the lips move and adjust against each other as necessary.

A slippery rim like gold or stainless may feel good but it can be detrimental for some players who need more security in mouthpiece placement.

[imperialbari]

Wood

[Alex C]

Focal dystonia is an issue with brain mapping and is not in the muscles per se. Curiously, changing the input (as in changing the size or material of the mouthpiece) may access associated areas of the brain and allow some degree of performance and not access the affected areas. Therapists have tried this with pianists who develop FD with some success.

Medicine evolves quickly, but the last time I looked, focal dystonia still had not been recognized as occurring in the nuero pathways associated with brass playing. I don't have a recent DSM-IV so my copy is out of date.

With pianists, the research suggests that focal dystonia is caused by excessive repetition of a muscle pattern as in playing a difficult passage until it is mastered. That is something all of us do, actually. Scary.

There may be some predisposition to FD but, once again, not enough research has been done. Re-mapping is possible but recovery of all skills is unlikely.

FD has become a catch phrase for brass players when "things quit working.' Basically, if the pianist can recover it is unlikely that FD was the correct diagnosis. I suspect that the same statement would apply to a brass player, when and if FD is accepted as a diagnosis.

A friend of mine postulates that many cases of "brass-player-FD" are actually related more to valsalva. He is much smarter than I am and would never post the statement without research to back it up. I think he is probably correct in his postulation.

Warning: I am a layman reading medical material which frequently exceeds my ability to completely understand. In my explanation of what little I do understand, I may not express it completely accurately. Leeway should be given.

[Doug Elliott]

Focal dystonia is an issue with brain mapping and is not in the muscles per se. Curiously, changing the input (as in changing the size or material of the mouthpiece) may access associated areas of the brain and allow some degree of performance and not access the affected areas. Therapists have tried this with pianists who develop FD with some success.

Medicine evolves quickly, but the last time I looked, focal dystonia still had not been recognized as occurring in the nuero pathways associated with brass playing. I don't have a recent DSM-IV so my copy is out of date.

With pianists, the research suggests that focal dystonia is caused by excessive repetition of a muscle pattern as in playing a difficult passage until it is mastered. That is something all of us do, actually. Scary.

There may be some predisposition to FD but, once again, not enough research has been done. Re-mapping is possible but recovery of all skills is unlikely.

FD has become a catch phrase for brass players when "things quit working.' Basically, if the pianist can recover it is unlikely that FD was the correct diagnosis. I suspect that the same statement would apply to a brass player, when and if FD is accepted as a diagnosis.

A friend of mine postulates that many cases of "brass-player-FD" are actually related more to valsalva. He is much smarter than I am and would never post the statement without research to back it up. I think he is probably correct in his postulation.

Warning: I am a layman reading medical material which frequently exceeds my ability to completely understand. In my explanation of what little I do understand, I may not express it completely accurately. Leeway should be given.

You are contradicting yourself, in accepting "focal dystonia" as a valid diagniosis, and at the same time admitting that the promblem known as "focal dystonia" may not be a correct diagnosis.

As you said, focal dystonia still had not been recognized as occurring in the nuero pathways associated with brass playing.

It is diagnosed by symptoms alone.

I am not a doctor, however I know infinitely more about embouchures and how they work than any doctor does. I have seen many people who were officially and unofficially diagnosed that way. I should point out that for many years I have been in the habit of watching people play and noticing what they're doing mechanically as it relates to what I know. Having watched many of them BEFORE it happened, it did not surprise me at all that they ran into trouble - due to their embouchure mechanics.

My point is that many brass players, especially in the tuba community, are completely ignorant of the way the embouchure works and needs to work for long-term playing heath. It's a lot harder to fix ingrained habits AFTER they fall apart, but it can be done in many cases. I don't see any point in having a mis-diagnosed medical excuse for something that could have been prevented. Real dystonia originates in the brain, not from the muscles TO the brain. The embouchure (or piano) kind originates in bad habits and becomes a psychological issue. To me, a diagnosis of "focal dystonia," just like many other words used in medical diagnosis, means "I don't know what's wrong but here's a name for it."

[Alex C]

[
You are contradicting yourself, in accepting "focal dystonia" as a valid diagniosis, and at the same time admitting that the promblem known as "focal dystonia" may not be a correct diagnosis.

As you said, focal dystonia still had not been recognized as occurring in the nuero pathways associated with brass playing.

It is diagnosed by symptoms alone.

Apparently you don't grant me the leeway I asked for.

When I wrote that focal dysfonia has not been accepted as a medical diagnosis, I was referring to the medical manuals that doctors use when they look at a mixed set of symptoms. Focal dystonia does not (or, at least, did not) conform to brass players' symptoms; that was the statement of the medical community the last time I did reading on the matter. Any further use of the term 'focal dystonia' by me was expediancy for the sake of communication and not as a diagnosis. There is no contradiction in that.

I do not doubt your experience with embouchures and this BBS is a good place to postulate all you know. The difference is that I was trying to relay researced information to the original poster. I hoped that pointing him in a direction would help get him started in research, if he was interested. I'm sure he's smart enough to get a better grip on it than I could. I probably should have done that in a PM to avoid this type of misunderstanding.

I don't see a point in bantering back and forth in confrontational posts; while I used to do that myself, I found it unproductive, a waste of everyone's time and bad for the environment. And, as you can see by my signature, I am keen on the environment.

[Doug Elliott]

Not trying to be confrontational, just pointing out that the contradiction exists, not just in your post but in a general sense.

The word "dystonia" used to mean an actual brain disorder; now it's being used to describe everything from writer's cramp to easily fixable very typical embouchure problems.

[brianf]

What we have here are two different methods of playing. I know both Alex and Doug and respect both. When it comes to this subject, it is almost like mixing oil and water, hardly ever do they agree.

First off, here is a video about stablizing the embouchure - http://www.windsongpress.com/stabilize_embouchure.wmv" target="_blank

Yep, you heard it, Mr Jacobs says do not stableize it contrary to many teaching methods. His teaching of Song and Wind is based on sound, or the sense of hearing as the primary sense being used. What happens if you do not use the sense of hearing as your primary sense while playing? It drops down to the sense of touch or feel. Where is the primary place that the horn makes conrtact with the body? Of course the embouchure! Here we have different schools of playing - one primarily sensing sound and the other primarily sensing the feel of the embouchure.

Where does this fit in with focal distonia? Those who play by song are not really concerned about the embouchure. Those who play by feel are looking for a physical problem or solution. This is like someone trying every mouthpiece in the world that will get their low D flat in tune - it does not exist, in the computer world they are looking for a hardware solution to a software problem. Many players came to Mr Jacobs with these problems and the ones he helped did it not through physiology but through psychology - it is a software problem!

[Doug Elliott]

...
Where does this fit in with focal distonia? Those who play by song are not really concerned about the embouchure.
...

So where does this fit in with focal dystonia? Many, maybe most, maybe all of the players affected by it are of the "Song and Wind" approach.

Maybe they should be more concerned about their embouchures. I have had good success retraining players with these problems, as long as they're willing to seriously consider a different perspective.

And referring to the original post, I would say that stabilization IS the solution.

[brianf]

Hi Doug

Told you that there are two sides to this, like mixing oil and water.

At the Army tuba show how about we go out for a beer and talk about anything else (except the Bears who just blew another game)!

[Lee Stofer]

Chuck,
Very interesting post, and from my experience with Kelly mouthpieces, I'm really not surprised with your experience.

I am no expert on this, but I have found, from practicing and particularly gigging from time to time on a Kelly tuba mouthpiece and a Kelly trombone mouthpiece, that it seems that the extreme light weight of the mouthpiece and structure thereof make it easier to excite a vibration, although it will not have the metallic "ring" in its sound. I think that this characteristic, added to the facts of the embouchure grip and the feel that is neither hot nor cold on the chops, makes for a mouthpiece that is just easier to play. Jim Kelly has advertised for several years now that the lexan polycarbonate mouthpieces reduce chop fatigue, and I know that it is so. And, I found that if you play exclusively non-metal mouthpieces for several months, you will literally have a metallic taste in your mouth after playing a metal mouthpiece again - at least, I did.

I know you are busy with a lot of other things, but I hope you get the opportunity and desire to do some playing again - I think you're too good a player not to play, my friend!

[UDELBR]

Like Bloke, I was wondering if the Kellyburg doesn't tie into the Jacobs "strangeness is good" pedagogy: removing old pattern 'triggers' in order to evoke new & better patterns. I wonder how this would hold up after several months of using the plastic 'piece...

[Alex C]

Like Bloke, I was wondering if the Kellyburg doesn't tie into the Jacobs "strangeness is good" pedagogy: removing old pattern 'triggers' in order to evoke new & better patterns. I wonder how this would hold up after several months of using the plastic 'piece...

Avoiding old patterns and introducing new ones is at the heart of treatment for FD in hands. It would seem logical that similar treatment for the same symptoms would render similar results.

[Frank Ortega]

Hey Guys,

I wanted to relay a correlation that I've recently made in relationship to some embochure issues I've had. I started developing a tremor in my upper range about a year and a half ago. I've been through a number of different therapies and now wear a mouth guard at night to prevent TMJ. The most effective part of therapy was taking 6 weeks off over the summer. Pretty standard for any sports injury. Next, when I came back, I did find a clear Kellyburg to be most helpful in recovery. I've seen several specialists and teachers who have dealt with FD, and they all said that it was not FD, but embouchure overuse syndrome, or a basic sports injury.

Now for the interesting correlation. One day recently I came in to school and tried to play. The whole problem came back like it hadn't in months. Suddenly and without warning. I was actually shaking mid range! Than I realized that the night before was the first time in months that I took an Ambien. I've always had trouble sleeping, and I've been taking sleep aids very sparingly for the last 5-6 years. Never more than once a week to every two weeks. When I researched the effects of Ambien I found out that it is not just a tranquilizer, but an Anti-Convulsant! It's also a neural inhibitor, and in the same family of drugs used to treat epilepsy. Now, try to buzz your lips while using an anti-convulsant! When reading some blogs on the matter, I discovered that some people experience symptoms of MS when they've been on Ambien for a prelonged period, and that it takes at least four moths to get out of your system. None of this is in the indications that come with drug, by the way. A few days after this experience, my playing went back to normal. As a matter of fact, because of these experiences, in some ways, my playing is better than ever.

But, I tell you this, I will NEVER take another sleep aid again.

Hope that this will be helpful to someone, somewhere.

Thanks for listening.
Frank Ortega

[NDSPTuba]

This will tell you all you need to know about focal dystonia as it applies to brass players. By an actual brass playing doctor.

http://www.youtube.com/watch?v=2pKHuH5L ... plpp_video" target="_blank

[Doug Elliott]

That's all very interesting but nothing that has been done in the field of embouchure dystonia research addresses the subject of the varying embouchure mechanics that exist in the three different major brass embouchures.

I can clearly see that his problem is related to his using incorrect mechanics for his own embouchure type, even in the video where he has supposedly fixed the issue but admits it would come back under the pressure of performance. He has simply gotten better at doing it wrong. The only "treatment" that is a long term solution (in my opinion) is to learn to use the correct form for his embouchure type... and that is never addressed because he doesn't know anything about what to look for.

There is NOTHING unusual about this problem. A lot of brass players do exactly the same thing to varying degrees. The reasons it affects some more than others are related to how much and how often the incorrect form happens. For some it's every minute they're playing, for others it may only be in certain ranges or at certain levels of fatigue.

My point is that correct form for an individual's face is extremely important for long term success. Not what works right now, but what is actually correct form for the particular embouchure. It's not really that much different from lifting weights in a gym. There are many ways to do a particular exercise, and the person doing it may not know the difference between them... but some incorrect ways can and will result in injury if they are done long enough or often enough.

I am well aware that most people reading this don't really care about what I have to say, and many probably think it's total BS because it is contrary to what Arnold Jacobs taught. But it's not "oil and water" two totally different ways of playing. They're both really the same way of playing... as long as the mechanics are correct, either by chance or by design.