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 Warning labels?
Author: Dan Shusta 
Date:   2015-08-20 00:40

Greetings everyone,

As some of you already know, I stopped playing the clarinet a long time ago due to my development of "embouchure dystonia" for which, as far as I know, has no cure.

Now, I have another problem. On Sept. 8, I'm scheduled for a left hip replacement. My surgeon and his x-ray tech were absolutely astonished that the cushioning material between the top of my left leg and its associated socket simply "didn't exist".

As I sat in my surgeon's office, I showed him how I use my left leg to play my double keyboard organ and then all of a sudden it dawned on me. My 54 years of playing the organ probably destroyed my left hip.

To verify my suspicion, I Googled "organist" "hip problems" and was quite surprised as to how many professional organists have had left hip replacements. I read about one jazz organist who was playing with his "third" hip replacement.

This got me to start thinking about all of the maladies or medical problems that "can be or are" associated with various musical instruments including, of course, the clarinet.

Right now, I'm frustrated. I'm angry. I'm in a total state of disbelief that my playing of what I was convinced was a "completely safe" musical instrument has totally destroyed, IMO, a part of my body and that unfortunate result is now leading me to a surgery date.

So, this leads me to an expanded version of the title of my post and that is:

Should musical instruments have "warning labels" as to what "could possibly happen" to the player due to sustained playing over a number of years?

It's too late for me now, however, I wish I would have been at least warned of the remote possibility of future medical problems associated with the instrument I was playing.

I apologize for the rant. I'm still hobbling around in a daze.



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 Re: Warning labels?
Author: fskelley 
Date:   2015-08-20 01:00

Hi, Dan.

That's really sad. I send you all the good wishes I can muster for successful surgery and quick recovery, and a prayer or 2- hope that's OK with you.

I'm sorry you already had to quit clarinet. I think you should be able to continue organ at some point, perhaps with altered technique, balance, or methods.

And music is a thing of the mind, which unfortunately has to be translated into motions of parts of our bodies (until there's some kind of direct mind-computer input- which carries all kind of other scary implications). And our bodies are failed machines, which we hope will last a suitable interval of years, never enough. We have to choose what to spend all our resources on, and I can't imagine much of higher value to purchase- than music. That's my 2 cents worth.

Stan in Orlando

EWI 4000S with modifications

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 Re: Warning labels?
Author: kdk 
Date:   2015-08-20 01:31

I don't want to minimize in any way the pain you're dealing with or the seriousness of the hip replacement surgery you're evidently considering. But, with no intention of being snarky, everyday living is to some extent destructive of our bodies and, therefore, hazardous to our health.

I don't know your medical issues or history except as you have described them here. Your hip degeneration may have been caused by your organ playing or only aggravated by it. There may be a statistically significant increase in the chance of destroying hip cartilage among organists, but I just had both hips replaced and there wasn't much cartilage left in either one, with no organ and very little piano playing (with it's pedals) in my history. Lots of folks play organ without suffering such damage and lots of us whose hips (and other joints) become completely dysfunctional have never touched an organ's keys or pedals. So, with complete respect for what you're dealing with, I don't know what a "warning label" on an organ would say.

I don't know enough about embouchure dystonia to know what else could cause or aggravate it, but I personally know no one among my clarinet (or other wind playing) friends, colleagues and acquaintances who have developed it. That isn't to say the clarinet wasn't involved in your case, but embouchure dystonia isn't necessarily a predictable probability for clarinetists or even wind players.

There are a few ailments that do seem, from my anecdotal experience, to be connected with playing certain musical instruments. I know lots of string players and a few pianists who develop carpal tunnel problems and problems involving the nerves that exit the cervical spine. There have been a number of well-publicized cases of very heavily scheduled concert pianists who developed focal dystonia of one hand or the other (often, for some reason, the right hand). These are, apparently, almost always repetitive use injuries and could in many cases be prevented by following warnings about incorporating adequate rest into practice routines and sometimes adjusting playing mechanics to avoid the injury-causing stresses. So, if anything, we should all as teachers and students be more actively seeking advice from physiologists, sports medicine specialists and others who could contribute, if consulted, to making the techniques we use safer and less prone to cause injury.

Best of luck with your hip surgery in September. You're joining a fairly non-exclusive club, but, fortunately, damaged and degenerated hips are easily repaired and hopefully once it's done you'll be thrilled with the difference.

Karl

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 Re: Warning labels?
Author: Dan Shusta 
Date:   2015-08-20 04:41

Thanks, Stan, for your kind words. After Googling the connection between "organists" and "hip problems", I began to think that I was simply sitting at the instrument incorrectly. Sure enough, I wasn't sitting at it the way I should have. However, the procedures that I was taught back in 1960 by a professional accordionist from Austria were probably the reason why. So, why was he my teacher? When my mother purchased the organ, 6 months of free lessons came with the deal. When the six months were over, that was the end of my lessons. And besides, back then the Internet didn't exist and correct, accurate knowledge about anything was difficult to obtain. I felt no need to change because I appeared to be playing successfully with no negative side affects. Yesterday, I did some more searching on the Internet and found a few sites where it appears that, today, sitting at the organ is pretty much an "exacting science" that needs to be mastered. Obviously, that was never taught to me.

Karl, I always enjoy reading your responses and through them I gained a sense of your personality. I don't recall reading any of your responses where the poster or the question/idea presented was ever minimized. I have always felt edified afterward.

Your response, this time, was particularly rewarding because you hit so many nails right on the head that to even comment on all of the valuable information you presented might possibly dilute the articulate way you expressed yourself. I truly hope that many musicians of all instruments read your response and take heed so that they can continue to play successfully without adverse effects.

I don't think I revealed on this BB how I would up with embouchure dystonia. Perhaps I did and I just don't remember. I did have a teacher. Unfortunately, IMHO, I had a very poor one. To make a long story short, I was taught the "smile" method. An extreme smile method which I practiced for hours without breaks. I had trouble with leakage on the right side of my mouthpiece and I found it nearly impossible to broadly smile and yet close off the leakage. I believe I'm correct in saying that this method is old, outdated and just flat wrong. I can still remember seeing pictures in method books around 1960 showing this method. Oh, how I long to play again! However, it appears that the Pavlov effect kicks in and even holding just the mouthpiece in my mouth for a few minutes always produces disastrous facial expressions the next day due to severely self-contracted muscles which require medication and time for my face to look normal again.

So, whatever the instrument, get the absolute best teacher you can possible find and I strongly recommend heeding Karl's advice above.



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 Re: Warning labels?
Author: WhitePlainsDave 
Date:   2015-08-20 05:40

...living life may put its duration into jeopardy....

...not living life may make any of us consider putting its duration into jeopardy ourselves.....

Somewhere between the two lies a balance specific to each of us I suspect.

The dystonia shows no Bell's Palsy component correct? If it does, other therapies could be called into play. Your facial muscles issues weren't characterized by rapid onset, were they-which might suggest "Bell's"?

Good luck with the hip replacement. A couch potato sometimes needs one. At least, if your organ playing was a factor, you have something wonderful to show for such "scars of age."

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 Re: Warning labels?
Author: Silversorcerer 
Date:   2015-08-20 05:45

[Content deleted]

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 Re: Warning labels?
Author: kdk 
Date:   2015-08-20 05:56

> Maybe I will eventually take
> up singing? That way I can just scream in pain at the proper
> pitch....
>

Be careful about technique here, too - you could end up with nodules on your vocal chords. ;)

Karl

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 Re: Warning labels?
Author: GeorgeL 2017
Date:   2015-08-20 19:43

"which I practiced for hours without breaks."

I have always been at odds with most of the people who post on this forum because since first starting sax lessons in the 4th grade (my last music lesson was in the 12th grade, 55 years ago), and continuing to this day, I have always hated practicing by myself, but enjoyed playing in groups.

It is refreshing to realize that while my lack of practice undoubtedly affected my ability to play well, it may have helped me retain my health.



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 Re: Warning labels?
Author: Dan Shusta 
Date:   2015-08-20 22:51

Yes, George, that was the straw that "broke my camel's back".

As painful as it is for me to come out of my "little closet", perhaps doing so may help others.

I have suffered horribly from OCD my entire life. Only, neither I nor my parents were able to recognize it for what it was.

Interesting, when I read about "embouchure dystonia", there's usually a reference to players who have a tendency to be obsessive in their playing. Also, the word "perfectionist" will pop in now and then.

Did I master the organ very quickly? Yep. When a young person is practicing 3 to 5 hours per day, it's easy to master anything in such a short period of time.

If you ever take notice of who wins the International Violin Competition, invariably the person who puts in the most hours of practice always wins. Time after time after time, they are the one's who win.

Even in my thirties, I would practice the clarinet until my cheeks hurt. And then...I would continue playing. Why? Because I simply couldn't stop playing. Yeah, I had a serious disorder but I was still totally unaware of it or what it was called.

I've kept my "strange conduct" neatly tucked away in my "little closet" for over half a century. Although I believe there were some positive sides to having OCD, I believe on reflecting back on my life that the negative aspects certainly outweighed the positive ones.

Need I tell you that I'm a perfectionist and always have been? I'll probably reread this response at least 3 times before posting to be sure that the grammar is correct, that there are no misspellings, that the syntax is the best I can produce, etc., etc., etc.

Although Karl said "but embouchure dystonia isn't necessarily a predictable probability for clarinetists or even wind players". May I beg to differ. IMHO, the longer your playing periods without rest, the higher the probability of developing this particular disorder. However, again IMO, Karl also brings out an extraordinarily important point when he wrote: "incorporating adequate rest into practice routines". There simply is no way for me to say it any better.

So, enjoy your playing, but, take a break now and then. If you find it hard to do that, if you feel "compelled" to continue playing, you "may" have a serious problem which needs medical attention.

If my response here helps even one person, it will be worth the embarrassment of revealing some very personal information about myself.



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 Re: Warning labels?
Author: fskelley 
Date:   2015-08-20 23:17

Super cool, Dan. I hope anyone who needs to read this, does.

Stan in Orlando

EWI 4000S with modifications

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 Re: Warning labels?
Author: sfalexi 
Date:   2015-08-21 02:05

I see the dark humor in "warning labels", but to keep it serious, I understand where you're coming from. I guess the best we can really hope for is knowledgeable music teachers, or private instructors, and hoping they can spot the risks before people develop those bad habits.

I recently got VERY into weightlifting, and this is something seen VERY often in that world. Everyone knows that a basic SQUAT, BENCH PRESS, or DEADLIFT are good compound movements. Excellent for general health and muscle growth. And people sometimes go into the gym, throw weights on a bar, and just go for it. But there IS form to consider, and risk of injury, either acute or chronic, depending on that form.

Same applies with ANYTHING where the body is holding some sort of form. Heck, play clarinet looking down enough, and walk around looking down at the ground in front of your feet, and by the time you're 60, you CAN'T raise your head cause of neck pain and you never having good posture.

I think a post like your post up top is great and a step in the direction. Let it be known that playing clarinet or organ wrong, for many many years, every day, and develop a chronic condition.

Maybe this is something that people with more pull than me can start talking about at least at a collegiate level. All those performance and ed majors can get instructed on form as part of their instrumental (hehe pun intended!) classes, and what to watch out for to preven future problems. And then when THEY become teachers or private instructors, they can teach the young folks that much better and we can prevent a lot of these problems from even starting when you start the instrument.


I feel like the Alexander Technique/Method classes touch on this sort of stuff, and maybe can be even tailored to unique instruments.

Alexi

US Army Japan Band

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 Re: Warning labels?
Author: Dan Shusta 
Date:   2015-08-21 03:12

This article is V-E-R-Y long, however, I found it to be quite informative, and IMHO, I found the "warning label" in the last paragraph.

http://www.cassgb.org/features/post/musicians-dystonia-a-silent-plague/



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 Re: Warning labels?
Author: Lelia Loban 2017
Date:   2015-08-22 20:22

One thing a person can do to avoid stress injuries is to alternate which side of the body performs the necessary tasks. That's probably one reason why musicians end up with these problems. Playing "backwards" won't work on the organ. It won't work on the clarinet, either -- I know there are a few specially-made leftie clarinets out there, but with the usual arrangement of keys on a clarinet, we can't just decide to practice with the left hand on the top stack and the right hand on the bottom.

When I first started breaking glass for a living, I found out that a high percentage of stained glass builders and repair techs have to quit long before they want to retire, because of carpal tunnel syndrome and other repetitive stress injuries. I avoided those problems by learning to do each task with either hand. On odd-numbered days, I worked left-handed. On even-numbered days, I worked right-handed. Too bad we don't have that option with musical instruments -- but one thing we cantry to do is become doublers, alternating practice days between instruments that put the stresses in different parts of the body.

Lelia
http://www.scoreexchange.com/profiles/Lelia_Loban
To hear the audio, click on the "Scorch Plug-In" box above the score.

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 Re: Warning labels?
Author: Dan Shusta 
Date:   2015-08-22 23:13

Good point, Lelia. IMO, you "saw" the "warning label" when you paid attention to your fellow employees' medical symptoms as their reason for retiring early. Good for you.

There's another thread going on right now about a young fellow having a collapsing embouchure after 20 minutes of playing. Yes, he had a slight smile to his embouchure formation and other responders rightly told him to form an "O" around the mouthpiece. However, something else began to bother me. Why was this young man "pushing" himself to play continuously for such a long period of time? I'm curious...are there musical pieces out there where a clarinetist has to play continuously for longer than 20 minutes? When his embouchure collapses, IMHO, that's his face telling him to "STOP! It's time for a rest period!"

As difficult as that may be for some, I believe our embouchures need a "rest period" now and then.

Just my opinion.



Post Edited (2015-08-26 04:31)

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