About Guidance

A reminder that I do not diagnose embouchure problems. I am not qualified and cannot tell you what you have and will refuse to do so. There are several reputable neurologists such as Dr. Eckart Altenmüller, Dr. Steven J. Frucht, Dr. Stephan U. Schuele, Dr. Mark Hallett, Dr. Richad J. Lederman, Dr. Joel S. Perlmutter, and others. 

If you think you might have dystonia, but it's too early to tell: Please understand that embouchure dystonia is hard to diagnose during onset/early stages due to it mimicking overuse injury and other setbacks.

It is important to know the differences between motor fatigue, overuse injury, dynamic stereotype, and focal dystonia; as well as other disorders such as muscle tears, etc.

Although you might be experiencing what you consider subtle symptoms, usually the signs need to be more prevalent/progressed and visible. 

For resources, articles, information, etc. please check out my blog (left side bar), as there is a ton listed: https://focalembouchuredystonia.blogspot.com/

For more information on signs and symptoms: http://www.dystonia.ie/forms-of-dystonia/focal-forms/musicians-dystonia/embouchure/

The best video description is going to be Dr. Frucht's evaluation documentation of task-specificity in embouchure dystonia. You may have to use desktop to view videos on this page: 
https://clinicalmovementdisorders.biomedcentral.com/articles/10.1186/s40734-016-0035-x

One of the most important case studies and review of embouchure dystonia research is by Seth Fletcher: http://libres.uncg.edu/ir/uncg/f/umi-uncg-1548.pdf?fbclid=IwAR1YlwSc7YtAZOqm0gtHzFO6xWrVC1Q1nlm9-jVRF0FBK66ELbRRqGQWIOY

Please do not self-diagnose. Although it's been difficult in the past to find neurologists who understand this disorder, please refer to the ones listed above. They are very experienced with musicians, and it is important to have this connection and also to rule out other types of dystonias, disorders, or nerve impairments.

 

There is not much we can do as far as prevention, except taking time away from playing in order to assess our own embouchure; being hyper aware of our body, documenting any changes within coming months in a journal, knowing signs/symptoms of common setbacks, and taking care of our health as best can, and foremost seeking out professional medical help if things do not improve. Please do not underestimate the importance of taking time off from playing to assess your situation more in-depth! 

If you think there is a high chance you have musician's dystonia: Please take time off if possible and seek out a reputable neurologist or physician who can refer you to a neurologist as listed above, and then seek out guidance rehabilitating from a musician who has dystonia (on your instrument is best) with experience overcoming or progressing significantly from it and who has helped others and hopefully doesn't charge massive amounts of money. A cohesive approach is best; so if you have any pre-existing conditions or injuries prior to dystonia, you will need to address those first or alongside rehabilitation (ex. anxiety disorder, physical injury such as muscle tear).

There are several other things you can try in order to reduce symptoms if you think you have embouchure dystonia (again, these do not work for everyone, but worth the try); such as sensory tricks, increasing dopamine levels, tremor supplements, testing to see if a mouth guard helps or splint/something between the teeth. Also I would highly suggest implementing stretches immediately in the upper back, neck, jaw, tongue, and face every day, reminding your face/embouchure of different sensations besides the mouthpiece. This should already be a part of any routine, but often not taught to students traditionally. It helps take away tension from fighting the symptoms. When practicing/playing, avoid repetitive tasks like scales or isolated exercises or technique. Focus on motor disassociation - practicing opposite movements. None of this is guaranteed to help or reverse things, but worth the try.


For those who have been diagnosed with embouchure dystonia: I can only share what strategies have helped me and you can take or leave whatever works. I do not charge anything ever.

However, if you also just need someone to simply talk to or relate with, and not necessarily looking for advice, feel free to reach out as well....just let me know. I always enjoy connecting with other musician's who are coping with this disorder.

 

There are too many non-dystonic musicians out there that are trying to help musicians with dystonia by fixing what they "perceive" as mechanical issues, faulty technique, or breathing technique....which most experienced teachers/musicians can provide. Yet this can be risky by possibly further developing a secondary injury such as a muscle tear or actual overuse. 

Focal dystonia is not about fixing bad technique, faulty mechanics, or any of the above....it is about rebuilding neuropathways and sensory. Although some fundamentals are involved, to be honest, only trained neurologists and musicians with dystonia (who help others rehabilitate) would understand how to properly apply them and are better at helping navigate this complex disorder. 

Some non-dystonic musicians that try to help may have good intentions. However, there are more than a handful that use their reputation or status as a professional musician to coax people into receiving help from them because they want to prove something or publish their own made-up theory about what they think musician's dystonia is or isn't (there are even greedy artists who try to join the dystonia forums and groups just to collect information for their so-called books so they can write about how much they know). Believe me, I have come across plenty! And I have met dystonic musicians who have wasted years with people like this.

If a non-dystonic musician says they want to help you, but is unwilling to prove to you that they have dystonia, tries to throw you off or refuses to answer you immediately when asked if they have dystonia, then run....as far away as you can. Please! Even though some might act as if they genuinely care about helping you, please do not underestimate the importance of seeking out help from someone who has/had embouchure dystonia and experience helping others recover.

List of Questions

Before meeting or talking, please prepare a list of questions. I only have 2 requirements: You must be willing to show me your playing so I can at least understand your current playing abilities better, and there is a 4 page questionnaire that needs to be filled out. 

 

The questionnaire document will take time to complete. Just click on the highlighted link to access it. Although lengthy, it helps me understand your playing history, signs and symptoms in greater detail. The questionnaire also includes what should be played in order for me to see your symptoms clearer.


If can, please read a little bit of my Embouchure Dystonia Blog or watch the videos, as I have put years of work into sharing information and resources on it. Don't have to agree with everything I write, but this will help you understand my journey and process of rehabilitation better.

Schedule a Time

Please fill out the form on my contact page or feel free to call/text if prefer. I don't charge any fees and never will....I am against it.
 

If scheduling a meeting for the first time, please take into account that it usually takes 1-2 hours or more to discuss everything. 

If you would like to continually stay in contact afterwards, that is okay too, but not necessary.

I only provide guidance via video chat or meeting in person because of the advantage of being able to see your symptoms up close. I cannot help anyone based on only written descriptions of symptoms in an e-mail.

 

I am only here to help to shed light on what I have learned through my own experience and what has helped me. So please do not assume I have all the answers or can cure you. I only aim to give you supportive knowledge, resources, and guidance that you can take or leave as you please.

If you just need someone to simply talk to or relate with, and not necessarily looking for advice/guidance, feel free to reach out as well....just let me know. I always enjoy connecting with other musician's who are coping with this disorder.

 

Thank you to all who reach out. My door is always open and I hope to provide some hope!

© 2011 by Katie A. Bergløf