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 Medical Limits for Clarinetists
Author: SamBoutris 
Date:   2011-07-13 05:06

Hi!

Does anyone know anything about laying clarinet with ay of these conditions?

Cleft Palate

Velopharyngeal Inadequacy

Or a Sub-mucous palate?

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 Re: Medical Limits for Clarinetists
Author: kdk 2017
Date:   2011-07-13 12:19

Lots of players, it seems, play with velopharyngeal inadequacy. It's come up on the BB and, I think, Klarinet more than once. Since there are several possible causes, the difficulties it presents vary, but for most of us who deal with it to one extent or another it's manageable.

Karl

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 Re: Medical Limits for Clarinetists
Author: ThatPerfectReed 
Date:   2011-07-13 14:33

It would be nice if someone on the board was, in addition to being a clarinet pedagogue, a dentist, oral/plastic/maxilofacial surgery, and/or ENT specialist.

Baring that, and especially if you have a specific case of 1 or more of these conditions possibly interfering with clarinet playing, might I suggest you shooting an email over to Tom Ridenour. A quick internet search will lead you to him.

Though not a physician, Tom's understanding the biometrics needed for clarinet playing might only be trumped by his humility, gratiousness and generosity.

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 Re: Medical Limits for Clarinetists
Author: kimber 
Date:   2011-07-13 15:07

As long as the soft palate is both long enough and strong enough to close the velopharyngeal port to moderate resistance, they would not impair clarinet playing. Oboe playing, with more oral pressure, may be more difficult with just-getting-by palatal closure. A person with those, or other oral abnormalities, who has difficulty with extra nasal resonance during speech, or drinking liquids and having them come up into the nose will have trouble playing any air instrument.

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 Re: Medical Limits for Clarinetists
Author: Buster 
Date:   2011-07-13 18:59

Sam,

I can only speak from experience with one student who fought Velopharyngeal Inadequacy. The problem was not severe, and was alleviated by using a slightly lighter reed.

They were using a bit too resistant of a set-up looking for that "magical dark creamy chocolate" sound- the resultant back pressure was causing the soft palate to lose its' "seal". In using a bit lighter/ more vibrant reed the problem went away; and they actually sounded much better with more vibrancy and flexibility in the sound.

As for one that suffers this chronically I cannot speak; as suggested we'd be best served having some input from an Ear/Nose/Throat doctor.
-JH



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 Re: Medical Limits for Clarinetists
Author: DavidBlumberg 
Date:   2011-07-13 23:40

There is an ENT on the Board. I'll try to find him - he is a Register Tube Customer of mine.

Harvard Medical

http://www.SkypeClarinetLessons.com


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 Re: Medical Limits for Clarinetists
Author: DavidBlumberg 
Date:   2011-07-13 23:46

http://test.woodwind.org/clarinet/BBoard/read.html?f=1&i=234629&t=234457

SDR is the poster :). Nice guy, tell him I said hi.

http://www.SkypeClarinetLessons.com


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 Re: Medical Limits for Clarinetists
Author: BartHx 
Date:   2011-07-14 16:38

I had a Zenker's Diverticulum just past the branching of the esophagus and trachea. It was not bothering my clarinet playing, but was causing other problems, so I had surgery to remove it. It has been over a year, but I am finally back to reasonably normal (or as "normal" as I get). Although healing was entirely satisfactory, I had a problem with air leaking and being forced down my esophagus as I played. It was necessary for me to periodically stop and burp out the surplus air. It is very nice to finally be at a point where that is rarely a problem now.

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 Re: Medical Limits for Clarinetists
Author: sdr 
Date:   2011-07-14 16:58

Blummie has outed me again. I am an ENT doc -- though my practice for many years has been limited to disorders of hearing and balance.

Cleft palate and sub-mucous cleft palate are anatomic conditions that can be associated with velopharyngeal insufficiency -- incomplete closure of the soft palate against the back wall of the throat (pharynx), resulting in nasal air escape. Velopharyngeal insufficiency (VPI) is not an "all or none" phenomenon. Someone may be perfectly able to speak clearly, e.g. articulating "k" and hard "g" without air escaping through the nose, but have some degree of nasal air escape against the pressure of playing a wind instrument, especially with a more resistant set-up or with extended playing time. There are some people who can overcome this with practice and training (by a speech pathologist) and others who cannot. Physical exam by an ENT doc, and possibly by a speech pathologist, should determine if there is an insurmountable anatomic barrier to VP function. There may also by players who develop "functional" VPI -- the have completely normal VP anatomy and neuromuscular function but develop a pathologic habit of misusing the palatal muscles so they suffer nasal air escape -- sort of the palatal equivalent of lisping. I believe there was some discussion on this BB recently of a teenager who had been playing well but as he advanced he developed more nasal escape. That would be a typical story of functional VPI that might respond well to therapy with a speech pathologist.

-sdr
-------------
Steven D. Rauch, MD
Professor, Otology & Laryngology
Harvard Medical School
Massachusetts Eye & Ear Infirmary

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 Re: Medical Limits for Clarinetists
Author: SamBoutris 
Date:   2011-07-16 07:03

Hi, very interesting read-

do you know what kind of effects any of the things you said above have on articulation?

thanks so much

sam

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 Re: Medical Limits for Clarinetists
Author: DavidBlumberg 
Date:   2011-07-16 13:20

Articulation is all about air - so yes, would have an effect.
That just means that you would have to control it more.

http://www.SkypeClarinetLessons.com


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 Re: Medical Limits for Clarinetists
Author: kdk 2017
Date:   2011-07-16 13:47

Just curious - is there a particular reason why you've asked about these specific problems? Are you dealing with a specific situation in which someone you know has one or more of these conditions and wants to play clarinet or has begun to play and is running into barriers? There are so many other physical challenges you might have included that I'm interested to know if there was a reason why you focused on these three.

Karl

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 Re: Medical Limits for Clarinetists
Author: Madame 
Date:   2011-07-29 17:47

I had an issue with air escaping from my nose when I was maybe a junior in highschool - to the point where I actually wore a swimmer's nose plug to get through playing stupid pomp & circumstance for grad ceremonies that year. Years later I made it through college concert band requirements and a couple of semesters of lessons with the professor who taught clarinet - his explanation when I asked him about it was, "that happens sometimes". I just wanted to write & thank you for bringing it up, because I had no idea there could be underlying problems that would cause such things. I still feel a lot of pressure there when I play, to this very day. Funny thing....he said because I was a singer that I probably have a lot of wind and should use a harder reed....which is exactly the opposite of what I just read above. He probably didn't realize.

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