 The Clarinet BBoard
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Author: Shostakovich
Date: 2017-01-07 04:13
I had a long rehearsal a couple of days ago, and haven't been able to open my mouth fully since then. The left part of my face feels normal, but the right side feels tight, such that it's painful to open my mouth wide (such as when eating). I'm hoping it'll subside soon, but was wondering whether any has observed similar problems.
Note that I haven't actually had the problem diagnosed yet.
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Author: smokindok
Date: 2017-01-08 19:48
You may want to google search for treatment of "trismus". Of course, seeking proper care from an dental professional experienced in management of this sort of problem is recommended.
John
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Author: Brad Behn
Date: 2017-01-08 19:49
If you are feeling pain, your body is talking to you. You should be very cautious. Seek professional guidance. You should attempt to relieve the pain before damage occurs.
Regarding TMJ, this is a common issue for clarinetists.
Suggestions:
1. Do you clench your jaw - do you harbor jaw tension? If so, try to avoid those tendencies. Place your tongue on the roof of your mouth and remain in an open posture (teeth apart, your lips can remain closed as you prefer).
2. Remove unnecessary tension by reducing reed strength.
3. Learn to play (voice your sound) in such a way as to reduce embouchure pressure "bite". Note: changes with jaw pressure can require reed/mouthpiece changes in order to achieve your tonal concept.
4. Seek the advice of a professional who has expertise in TMJ. Dentists can offer help, but you should look for a specialist. The expert will examine you, and probably fit you with a mouth "appliance" which worn at night while sleeping causes your jaw to remain open and forward to allow the joint to repair itself over time.
5. Work with a physical therapist to develop exercises, heat and cold treatments to help mitigate pain, and strengthen your body. Prior to playing, warm up your joint with a heat pack, and stretch your jaw (these stretches will come from your PT - don't just wing it as there is a learning curve. Warning: you could over stretch and make things worse if you don't know what you are doing). "Ice" the joint following a session to reduce inflammation. Warning: proper ice packs and technique is important. Icing shouldn't be too long, and actual ice isn't advised - use a gel cold-pack which is frozen, and place a cloth between the cold-pack and your jaw for an interval of about 15 minutes.
Bottom line: This is a very important issue, and it must be treated with care and seriousness of intent. Pain over time can cause damage. Damage can kill your music career!
Good luck,
Brad
Brad Behn
http://www.clarinetmouthpiece.com
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Author: smokindok
Date: 2017-01-09 00:12
Brad mentions some good points, but it is most important to have a proper diagnosis and treatment plan. The treatment of temporomandibular disorders can very depending on the etiology. If indeed, as you description suggests, it is trismus from the trauma of a long rehearsal, the sooner you start proper management the less likely it is to progress to a chronic condition.
John
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Author: kdk ★2017
Date: 2017-01-09 05:03
Interesting topic. My TMJ pain wasn't *caused* by playing the clarinet, but it was interfering. I developed pain in my jaw a couple of years ago that seemed not to be going away, and not for the first time. I had had a couple of extended bouts in earlier years. I consulted my dentist, who sent me to an endodontist. The diagnosis, after no dental abnormalities could be found, was TMJ pain, although it seemed very much a default diagnosis because no other explanation could be found.
Soon after, I mentioned all of this to my chiropractor. Apparently, treating TMJ pain is a standard chiropractic technique. Within two visits the pain was gone and hasn't come back since.
Karl
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Author: donald
Date: 2017-01-11 09:55
I experienced TMJ before studying with Dr Dave Etheridge at OU (where I was to meet Brad, who makes excellent comments above). The most significant thing that improved MY situation was a change in "concept" of my embouchure. Here I am talking about the concept of how the embouchure is functioning, rather than references/advice to change certain aspects (ie "push down with upper lip" "smile" and such advice).
This may or may not help you, but I suspect it MAY as I also suspect (as do others above) that you are playing with unnecessary tension in your embouchure.
Many players think of the embouchure like this- we put the instrument in our mouth, and then hold it with our mouth, the physical effort of our mouth is part of the exertion that is creating the sound.
I found it incredibly liberating and helpful to instead think of it this way- we create a shape with our mouth, and then place the instrument (mouthpiece) into this shape. The primary function of the embouchure is to SHAPE the AIR, not manhandle the reed. Think of a flute player, or a trumpet player- the shape they make with their embouchure is vital as it is directing/controlling the AIR, not holding the mouthpiece (though of course the trumpet players lips have an extra important function!)
IMAGINE you are playing, make your embouchure, and blow air- wwwwffffffff. How much muscular effort/tension is REALLY required to do this? Just enough to stop your lips from making that "horse noise" (surely you know what I mean) and hold your lips/cheeks against your teeth. Your mouth muscles need to be FIRM, but not strenuously active.
NOW your clarinet can be held steady by upward pressure of your right thumb pushing the mouthpiece gently against your top teeth (assuming you play with a single lip embouchure).
The REED is held against the lower lip only by the pressure created by the downward angle of the instrument (and if you have the optimum amount of reed in your mouth, the contact is very close to the point where the reed comes away from the facing).
Here is what I was taught to be the most important bit- the jaw is lowered away from the reed (it HAS to be, so you can make an "O" to fit the mouthpiece in your mouth, right?), so the MUSCLE FLOW (or direction of effort) is actually AWAY from the reed, not TOWARD the reed. Some teachers refer to this as a "flat chin".
Ok, so I've just written a lot about embouchure that may not seem relevant (it's the summer holidays and I've a big cup of coffee), but this idea of....
Embouchure- a shape/structure you have made to shape air.
Minimal tension of facial muscles- only enough to hold lips against the teeth, and lower the jaw so the mouth is opening, not "clamping".
.... these two things were the key, FOR ME, in eliminating TMJ.
Post Edited (2017-01-11 13:38)
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Author: donald
Date: 2017-01-11 10:11
Two other details- you say your pain was only on one side.... does this mean your embouchure is "lop sided"? I had this problem due to uneven teeth (a chipped tooth from school yard bullying at Fraser High!), however I eventually discovered a dentist could level the teeth out- greatly improving embouchure for me.... (AND, reeds lasted longer when being played more symetrically)
Also- pain in the jaw can come from moving the jaw to one side when playing (in my case related to the uneven teeth above), but also from pulling the jaw BACK (so that the lower teeth are further back from the front teeth than they would be in a natural relaxed position). This unnecessary jaw postion sometimes happens as a result of other (and good) advice- as an example, sometimes if a teacher asks the student to push down with the upper lip, the jaw movement happens as a consequence (or, as a reaction- many muscular actions in our lives and music making are like this).
Sorry to write a novel for you- anyhow, I suffered this problem quite badly and the things above were what solved it for me (Brad gives great advice above, but for me a CLARINET DOCTOR in USA did way way more than the medical doctor I found here in NZ)
dn
Post Edited (2017-01-12 01:04)
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Author: mtheis
Date: 2018-07-16 06:56
I hope you were able to find a solution to your problem. A little over 40 years ago I was a serious clarinetist who developed a TMJ problem. There were several factors that contributed to the problem. I was clenching my teeth at night, and my teeth and jaw structure is not ideal for playing the clarinet. I found a dentist who knew a lot about occlusion. He made a bite splint for me. I also found that if I used a mouthpiece better suited to my teeth and jaw, it helped. In my case that meant one with a narrower taper so that it didn't force my mouth open as far. Unfortunately I was not able to continue my graduate studies because I could not play enough hours in a day to do what I wanted to do. I became an elementary school teacher and sometimes played the guitar and sang songs with my students. Several former students have mentioned this as a highlight when we have conversed. Anyway, I sincerely hope something worked out for you. It does take many months to heal and to make the needed adjustments in your equipment, etc.
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Author: Bob Bernardo
Date: 2018-07-16 08:17
Ouch...
I can't offer any advice because you already got some really good advice.
If you have TMJ perhaps you've had it for awhile? Do you bite down when tense with your teeth or at night do you grind your teeth? A dentist should be able to tell if you are unaware at night.
I'd say to cut way down on your practicing until you see a dentist. When you do practice really try to play with a double lip embouchure and a patch on the beak of the mouthpiece, but don't put the patch too far forward. The patch should be around where your teeth are. Play some low tones like E, F, F# and G. starting at ppp < F > ppp to get the feel of this. You surely don't want the upper lip to hurt, nor the lower lip. A nice relaxed feel.
Clarinet playing should be fun, and you may just need some embouchure adjustments.
TMJ sucks. Try to get it under control with a night guard, possible medications for a short time like muscle relaxants.
Please keep us posted. This is a subject that could help out many.
Designer of - Vintage 1940 Cicero Mouthpieces and the La Vecchia mouthpieces
Yamaha Artist 2015
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Author: Shostakovich
Date: 2018-07-16 23:29
I've had exactly this issue. It happened to me once after an 8 hour rehearsal.
It took about a week before it resolved itself, but it did completely heal without me doing anything. It's never happened again since then.
Just don't panic, I'm pretty sure it'll go away.
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Author: Cappuccino
Date: 2018-07-18 12:52
I have TMJ, but not from the clarinet.
I talked with my dentist about this the other day and he said a hot compress on/off for 10 minute intervals is good enough.
Typically, it heals itself unless very severe.
Alexander May
https://www.youtube.com/watch?v=YFZta2RG4iM
https://www.youtube.com/watch?v=rh8O5DC4Tqs
"Looking at art, you're looking at the result of a philosophy." - John Emmett
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Author: DavidBlumberg
Date: 2018-07-21 16:21
For TMJ/TMD there are warm up stretches which are very, very important to keep functioning. I've never had it, but the former Principal Alto Sax of the Presidents Marine Band had it bad, and was told that playing would never be possible again.
She got it under control with stretching, time.
http://www.SkypeClarinetLessons.com
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