TromboneChat

Hey everyone,

I’ve been experiencing sharp, shooting pain in my upper left lip, around where the edge of the mouthpiece meets the lip.

This has happened here and there over the past two years, usually when I play too much. It has always been fairly manageable — I take a day off, and then I’m totally fine.

However, after a few days of a lot more strenuous playing than usual, I experienced the pain again, stronger than ever. After my obligations were done, I took off two days. I came back, expecting the pain to be resolved, but it is still there.

Has anyone had any experience with this, or have any words of wisdom? I saw a general physician, and he thinks I may have simply bruised my lip. I’m not sure if this is the case. Regardless, I am taking a week off from playing, and I’ll see where my pain is at. I’ve heard all of the horror stories of dystonia, muscle damage, embouchure overuse syndrome, etc. Are these things I should be worrying about, or is it possible that I simply played too much, and just need a break?

I’d love to hear your thoughts.

Thank you,
Madelyn

madelynstoklosa wrote: ↑Wed Nov 29, 2023 1:53 pm I saw a general physician, and he thinks I may have simply bruised my lip.

And you told him this has been a problem for two years?

I got whacked in the mouth by a tree limb last summer and it hurt to play my horn for a week. But two years sounds like something other than a bruise, especially if you haven't been whacked in the mouth.

Right, it sounds very much like you're using wrong mechanics for your embouchure type, otherwise called "switching types.". It's VERY common in varying degrees, and can cause exactly what you describe.
It has nothing to do with "overuse" and just comes back after rest because you haven't ever fixed the actual problem.

And yes, I give Skype lessons to correct mechanical problems like that. One lesson is usually all it takes.

Colin Williams (assistant principal in NY Phil) had an injury that started with a sharp pain in the lip. He goes into detail on it, diagnosis, and recovery in podcast interviews for The Trombone Retreat as well as for the Brass Junkies. It could be worth giving a listen to see if it sounds similar. He talks through the recovery and who helped as well if it is a similar thing (hopefully not!).

I hope everything is ok!

I've had a sharp pain happen in my upper lip on a few occasions when I'm really pushing past a point of fatigue in rehearsals that have gone too long, but it's rare, maybe once a year. It's like a pain that goes up along the philtral ridge during very loud playing. It happens when my chops spread too far, both vertically and horizontally and I'm trying to keep a loud high note going. This happens 100%, for me at least, from over-fatigue. I just stop playing for that piece. There is no point in hurting yourself.

If I'm in shape and conscious of keeping the chops together and supple, it doesn't happen.

Maybe you've let a bad habit creep into your playing? It might just be that you need a week off.

There is another possibility for a sharp pain, and that's if you have either a tooth or gum structure that is causing a pressure point under the rim. Usually that's more of a constant situation, not just happening on a long gig. I have had excellent success modifying rims with a dip in the surface to relieve the pressure at that point.

Thank you for all of the input! I just thought I'd come on here and give an update.

After the onset of the pain, with the recommendation of my professors and doctor, I took about 10 days off the horn. My doctor recommended taking 600mg ibuprofen every 6-8 hours for about 3 days to reduce any possible inflammation.

After 10 days, I slowly eased back into playing. There was some discomfort, but no pain. (I believe the discomfort was attributed to not playing for 10 days.) For a few days, I only did long tones, slow scales, and Bordognis down the octave until I felt completely comfortable. I slowly kept adding more time to my practice sessions, and now I am happy to say that I am completely pain free, and my face honestly feels better than ever.

Perhaps I simply just pushed myself too far after the point of fatigue. I will definitely continue to keep an eye on this situation, and I will be extra careful not to push myself too hard in the future. (Taking some time off was also a great mental refresh!) I hope this can help anyone with a similar issue!

MS