Overcoming Performance Injuries

by Marilyn Kloss, Cornucopia, November 2001

Janine Gaboury-Sly gave the impression of having it all together. She could play anything, and she could play all day. I heard her play in a tribute to her teacher, Verne Reynolds, at the 1997 IHS workshop in Kansas City and was impressed with her confident performance of technically demanding repertoire.

I heard Janine play a new work at this year's symposium in Kalamazoo and was again impressed with her solid playing, so it was a surprise to learn what had happened in the meantime. Janine had temporarily lost her ability to play the horn in what was believed to be focal dystonia and had to start over, rebuilding an embouchure after many months off of the horn.

Fortunately, Janine stopped playing before she had done irreparable harm, partly because of the example of a trombonist colleague, Curtis Olson, who, experiencing similar symptoms, increased his practicing in an attempt to "play through" the difficulties and ended up losing his ability to play entirely. Janine would like to bring attention to the dangers of serious injury so that players will not ignore symptoms and will get help.

Focal dystonia is something of a mystery. It is difficult to diagnose, partly because there is no pain and nothing to show up on any test. Its symptoms are similar to writer's cramp; in fact, writer's cramp can be a form of dystonia. It is task-specific, meaning that you can do other things with the same muscles, but lose the ability to perform the one specific repetitive activity. There is a loss of endurance, which affects lip seal, for example. There is a rapid loss of facility, and it is suspected that the brain's motor program goes away. It happens more to men that to women, and more to people in mid-career than to the young.

There is no cure for focal dystonia. No one is even sure exactly what occurs. There may be some damage to nerves. Sometimes drugs used to treat Parkinson's are effective. In the case of brass playing, it is very difficult to isolate which muscles are causing the problems. Therefore using injections of botulin toxins is not an option for treatment. It would be too easy to treat the wrong muscles, and to cause other damage. As with many other disorders, the earlier it is caught, the more options available to treat it.

Many performance injuries can be overcome. It is im- portant to pay attention to your body and not to ignore pain. Remember that what we do is a highly taxing athletic activity; taking proper care of oneself physically may be the most important preventative step that one can take over the course of a long career of playing. Janine suspects that many young players push themselves hard while neglecting their physical maintenance, and that the results don't show up until they are older.

Dr. Richard Lederman at the Cleveland Clinic has helped many musicians with these difficulties and has published an article on embouchure problems in Medical Problems of Performing Artists, Volume 16 No. 2.

Janine is talking about her experience because she feels that performance injury generally -- not just dystonia -- ought to be discussed more frequently and openly within our community. If the presentation on performance injury she conducted at the Kalamazoo symposium demonstrated anything, it was that hornists are widely interested and concerned with the subject, and that our meetings should deal with it more than they have in the past.

Janine is on the faculty of Michigan State University in Ann Arbor and will give a presentation and perform at the 2002 Northeast Horn Workshop.

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