The Effect of Focal Task-Specific Embouchure Dystonia upon Brass Musicians: A Literature Review and Case Study

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Seth David Fletcher (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Dennis AsKew

Abstract: To promote awareness and understanding among brass musicians of focal task-specific embouchure dystonia (FTSED)--a misunderstood and debilitating occupational disorder--a comprehensive review of literature from prominent medical, scientific, and musical sources was undertaken to determine the definition, causes, and treatment of the condition. A case study was also included with the intention of providing a source for reference and exploring possible pedagogical influences on FTSED. FTSED can be defined as a neurologically-based movement disorder characterized by abnormal random or sustained involuntary muscle contractions, initiated during playing, that cause embouchure dysfunction. A muscle spasm that occurs in a trumpet player's lips when attempting to start a note, a horn player's inability to sustain a tone without a rapidly shaking embouchure, or a tubist's jaw inexplicably clamping shut when attempting to play octave leaps are all examples of FTSED. Chapter One contains a brief introduction and definition of FTSED, a discussion of embouchure terminology and function, and an overview of key neurological concepts. Chapter Two includes further investigation of the definition of FTSED, with consideration of the causes, symptoms, diagnosis, and treatment of the disorder. Chapter Three presents summations of empirical studies of FTSED and similar dystonias, while Chapter Four presents summations of case studies of musicians with focal dystonia. The final chapter includes a summary of key points, suggestions for future research, and guidelines for recovery. A case study of FTSED is contained in the appendix, including specific details of the initial appearance and progression of symptoms, pre-diagnosis symptom management strategies, a week-long intensive re-training program, and subsequent methods and routines leading to a return to public performance. The exact causes of FTSED are unknown and current treatment options provide only minimal benefits. Often career-ending, FTSED has no known cure and medical research and insight with regard to the disorder are limited. Additionally, trends in brass pedagogy may contribute to the development of embouchure dystonia. Despite the minimal reports of successful long-term outcomes in clinical studies, recent findings indicate that FTSED may, in fact, be treatable and preventable, yet research must be undertaken to test such assertions. Improving the prognosis for FTSED and facilitating rehabilitation necessitates increased awareness among performers and teachers, a re-thinking of brass pedagogy, and the development and testing of effective treatment programs.

Additional Information

Language: English
Date: 2008
Focal dystonia, embouchure, brass pedagogy, euphonium, musician's health
Brass instrument players.
Brass instruments--Embouchure.

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