 The Clarinet BBoard
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Author: martin
Date: 2004-11-26 11:19
Does anyone know if clarinet playing can cause or exacerbate symptoms of a hiatus hernia?
Martin Shapiro
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Author: Alseg
Date: 2004-11-26 12:38
The act of inhaling lowers intrathoracic pressure.
If the gastroesophageal sphincter has a low pressure, as it does in reflux,(ie hangs open) reflux is favored.
On exhaling against a resistance (your instrument) if you are using abdominal contraction to assist you, then reflux is again favored.
If you are using diaphragmatic contraction to blow out, then reflux is less likely, since the pressure is generated solely in the chest.
The trick is to use the diaphragm in exhaling and not the abdominal musculature.
Other contributing factors include posture and weight.
Esophageal manometric studies and ph monitoring are the gold standards for measuring this.
Hope this helps.
One thing to note....Not all hiatal hernias cause reflux. And you dont need a hiatus hernia in order to reflux...the key is the zone of pressure at the gastroesphageal junction. Rarer types of hiatal hernia can cause other difficulties (Paraesphageal and gastric volulus, but I doubt that this thread needs to address them)
AS (non disclaimer-author is a surgeon who does antireflux operations)
Former creator of CUSTOM CLARINET TUNING BARRELS by DR. ALLAN SEGAL
-Where the Sound Matters Most(tm)-
Post Edited (2004-11-26 12:41)
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Author: Brenda Siewert
Date: 2004-11-26 14:15
Glad to have you around, Alseg! As I was reading I was hoping you were a real doctor and not just someone who slept in a Holiday Inn last night. Smiles!
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Author: Copemom
Date: 2023-04-21 19:18
Hello Alseg,
I hope you get this message. I was thrilled to stumble across your post! Knowing you can’t diagnose anything, I’m hoping you can point me in a direction of what type of Dr I should start with. My son has been playing for 5 years. He just got accepted to Interlochin and School of the Arts to study clarinet performance.
For 3 weeks he has felt a steady nausea feeling (no throwing up) along with a gagging feeling. It’s so bad he can’t play his instrument, even privately at home or during his private lessons!
He is quickly seeing his entire future ruined and being taken away from him. We are looking at his wisdom teeth being removed, just began omeoprzol (sp), and have an apt with an ent, and possibly we are considering muscle freezing (?) of the esophagus? If you could just give some insight to say… if it were my kid I would start with…. I would greatly appreciate it.
Thank you-
A frantic mother 🥺
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Author: Paul Aviles
Date: 2023-04-21 19:40
I’m not sure if Dr. Segal regularly checks in anymore. He no longer produces barrels, but he is a heart surgeon. Look him up on the interweb, I’m sure he’d be happy to offer some advice.
………….Paul Aviles
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Author: Mark Charette
Date: 2023-04-21 20:36
Copemom wrote:
> Hello Alseg,
> I hope you get this message.
Alan posted that almost 20 years ago - though his advice may still be relevant.
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Author: SunnyDaze
Date: 2023-04-21 21:47
Hi Copemom,
If he's just started, then symptoms like that could be anxiety. Anxiety can trigger reflux and hyperventilation which would both produce the symptoms that you describe, but in totally different ways.
In either case, the worry about not being able to fix it will be massively counter-productive unfortunately. What he really needs is to find a way to dial back the pressure somehow.
I'm not a medic, but I'm super-anxious myself, and went through quite a high powered education and career, so I look at your post and think "yeah, I totally know that feeling..."
Good luck - and loads of sympathy from me.
Jen
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