Posted by: eaubeauhorn | March 16, 2008

What IS embouchure dystonia?

When someone develops embouchure dystonia, it appears, both to the person who developed it, and to observers, to be a muscle problem. But it is not; the name I have personally assigned it is “an intent-path corruption syndrome.” That is, when one forms the mental intent to do a physical task, the signals that the brain sends to the muscles that are to perform that function, are corrupt. There is speculation among the medical community that sensory information gets sent down motor neural pathways. Personally I don’t care about what actually happens except in terms of understanding what I can do to correct it.

Since the “intent path” from the brain to the muscles has become corrupt, any attempt to fix the problem by practicing more, makes it worse, because the same intent path is being used. To fix the problem, two things need to be done: stop using the corrupt intent path, and develop a new path. It is similar in a way to what stroke victims have to deal with: they try to move their leg or arm and nothing happens. If they regain function, it is a slow and frustrating process because different portions of the brain have to take over what the functions that were destroyed, were doing. But of course since dystonia is task-specific, depending on intent, the muscles in question function fine except when the person is trying to play their instrument. This is part of why this condition is so intensely frustrating to the person who develops it, and why it appears to be a practice problem. It also explains why dystonia “spreads” from a note or two, to the entire range of the instrument if the person intensifies practice in an attempt to overcome the dystonia. At first only a small portion of the “intent path” is corrupt, like one strand in a bundle of nerves; but as the person intensifies practice (which means they intensify their focus, or intent, on playing the horn) more and more strands in the bundle that sends messages, become corrupt until the entire bundle is corrupt and the entire range ceases to be playable. That is why it is supremely necessary to stop playing immediately once one realizes that one has developed embouchure dystonia.

So, then what? You stop playing; now what are you supposed to do? Well….I stopped for a full six months. I was not a pro, and I had six months before I had to play again, because in this part of the country everyone leaves in the summer and the amateur groups don’t have the personnel to continue. Every few weeks I’d take the horn out and do a “systems check.” Slowly, ever so slowly, I saw hints of progress. In retrospect (I did not understand it to the extent I do now) this was because the “intent path” was less “grooved” (you’ve heard of “grooving” your golf swing, right?) Stopping playing allows the intent path to lessen the depth of its “groove.”

But I also play other brass instruments: both euphonium and tuba. I had had some problems on tuba too, so I stopped playing it also. But euphonium….even in the same problematic range as the horn’s (a few notes surrounding the A below concert middle C) …. worked. So I wondered why I could play an A on the euphonium when I couldn’t play an A on the horn, without having my lips flutter in the cup. I realized, specifically, that I focused, mentally, differently on my upper lip, on euphonium, as opposed to how I focused mentally on my upper lip, when I played horn. (Read that sentence again; all those commas are there for a reason.) Like, put all your attention on your right big toe. Be really aware of it, how it feels. Is it warm? Cold? pressed up against the side of your shoe? Is the top of your shoe pressing down on your toe? Can you feel your big toe touching the toe next to it? This is what I mean by mental focus; we all do it when we play our instruments, but everyone does it differently.

I had attended an International Horn Society presentation by Janine Gaboury-Sly on focal dystonia, some years prior to developing it myself. She was a young professional horn player, and she had overcome dystonia. I still remembered from her presentation, that she had stated that she had had to change how she focused on her upper lip. It turned out to be exactly the same for me, at least as a starting point; it may well be different for you, and you will have to do your own detective work to analyze how you focus on your embouchure when you play, because if you have embouchure dystonia, it is this focus that you will have to learn to do differently. It is NOT impossible!

The next post will detail the next steps I took in my journey with embouchure dystonia.



  1. Very interesting. I am surprised the aberrant pathway faded over time. This has not been my experience…just more evidence as to the very unpredictable nature of this enigmatic dysfunction!

  2. Hi Dave,
    I may have changed my opinion since then, about the groove’s sort of fading. I think what “actually” happened was that my approach changed slightly during the time I was not playing….this ended up being a pattern; if I did not play for several months, then I could play for a day. But if I trumpeted “I’m Cured!” and tried to play the next day, whammo-dystonia again. So I don’t think it was a groove fading but a slightly changed approach, and as soon as I started to try to get back into playing, I’d slide down the slippery slope into that malfunctioning groove. And as you know….it is changing the approach that brings about the fix. I still remember clearly your explanation about the 10,000 repetitions being required to change the monkey from right-handed to left-handed.
    Just this morning I dragged out the horn and managed to do a warm-up on it, but my embouchure is different from what it was then; we’ll see what happens the next time I try to play it. And I still have to BLOW in order to have have the entire thing take off down the tracks without me.
    Someone else (one of those who says dystonia is “only” a technique problem) brought up the issue of timing, that it is poor timing that is the complete cause of what is diagnosed as dystonia. He, of course, is wrong, but that doesn’t mean I can’t use what he said, and pay more attention to exactly when I tongue a note; if my chops are not “ready” then garbage is going to come out. And paying attention to the timing is a re-focusing of intent, plus a change in technique which may be why he (claims to) get results with people he works with.

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