Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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Embouchure Problems in Brass Instrumentalists

Richard J. Lederman
From: Medical Problems of Performing Artists: Volume 16 Number 2: Page 53 (June 2001)

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Abstract: In a series of 81 brass instrumentalists personally evaluated over the past 16 years, 43 had problems with embouchure. The 31 men and 12 women ranged in age from 16 to 74 years, averaging 35. Twenty-seven were professional performers at the onset of the embouchure problem and 12 others were students, all but one in college or graduate-level music programs. There were 17 who played the French horn, 15 trombone, ten trumpet, and one tuba. Symptom duration varied from as little as one day to as long as 14 years. A diagnosis of dystonia involving the muscles of embouchure was made in 18 cases. Symptoms in this group primarily consisted of impairment in lip control, problems of articulation or tone quality, and loss of seal. Eleven patients were diagnosed as having overuse phenomena and an additional six had evidence of soft-tissue injury. These patients reported predominance of pain, swelling, or discoloration. Four patients had a sensory or motor disturbance of a lip segment, implying focal nerve injury. Treatment generally consisted of a period of rest followed by lip rehabilitation, including buzzing and gradual return to playing. Change in technique was often required to prevent recurrence. In patients with dystonia, technical retraining appeared to be the preferred treatment method but remained unsatisfactory in most cases.

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