The word dystonia is used to describe a disturbance in muscle tone (tension) that results in a lack of muscular coordination. The muscles seem to have gotten a will of their own and don’t act the way you would like them to.

Embouchure dystonia is a form of task-specific focal dystonia. This means that symptoms occur in a relatively small (focused) area, such as the embouchure, and that the muscles only ‘misbehave’ during certain specific activities, such as playing a musical instrument. Common features are cramps and trembling in the embouchure, air leaking through the corners of the mouth, but coordination of the tongue and/or jaw muscles is often impaired as well.

Possible triggers

There are many things that may trigger the development of embouchure dystonia. Some of them are listed here:

• A direct embouchure change.
• An upcoming audition.
• Playing too much, not taking enough time to recover.
• Trying to play things that are beyond your current abilities.
• Forcing your way through a bad day.
• Having a bad day when you need to perform well.
• An accident damaging your lips and/or teeth.
• Critical remarks on your playing or how your embouchure looks.
• Being laughed at when making a mistake.
• Trying to imitate someone else’s (outer) way of playing.
• Inefficient embouchure mechanics.

Embouchure dystonia is not a disease, however, it is a symptom, the outer manifestation of a deeper, inner conflict, which involves not only muscles and nerves, but your entire being. That’s why it has such a profound impact on those who suffer from it. And that’s also why it’s necessary to look beyond a merely physical approach for recovery.

Inner conflict

Are you trying to hit the note, or are you trying not to miss it? Are you attempting to play well, or are you more concerned with not playing badly? Is there anticipation of joy, or fear of failure?

If you are suffering from embouchure dystonia, you will probably recognize these polarities within yourself. You are trying to achieve something, yet at the same time, you are trying to prevent something. It’s as if you have one foot on the gas and the other on the brake: you are sending out conflicting messages to your body.

To make matters worse, the brain does not recognize the word “not” in a command. If you want to test for yourself how powerful this is, try not to think of monkeys for a minute. The harder you try not to think of them, the more you will!

The word “not” is simply cancelled out. Instead of trying not to miss a note, the brain will try to miss it. Rather than trying not to fail, it will try to fail. Combined with hard work and a tendency toward perfectionism and strong self-criticism, you are setting yourself up for disaster. When this downward spiral hits rock bottom, you will have built up such a momentum that the whole system crashes. You are done trying. Now, you will make sure that you miss, that you fail. And that’s exactly what happens. You can no longer control your embouchure muscles, and similar to the thought experiment, the more you will try not to experience the symptoms, the worse they will tend to get.

Thoughts on recovery

Maybe the first step on your way to recovery, is to understand and accept that embouchure dystonia is self-created. In essence, it is a form of self-sabotage. This may be hard to swallow, but it has a bright side to it as well, as this means it is also possible for you to undo.

Mistakes and failure are an inevitable and even necessary part of every developmental process. There is a good reason for the old saying, “you learn by making mistakes.” Please allow yourself to make mistakes, to sound bad, even to experience your symptoms. Don’t resist. You have to accept where you are right now in order to move forward.

As the word playing implies, playing music should be fun. Of course, you may have to work hard for it, but it should also be a joyful experience rather than the dreaded torture associated with embouchure dystonia, so part of the recovery process has to be an effort to regain some sense of joy and fulfilment in playing your instrument, despite current conditions. With a tendency toward strong self-criticism, this may prove to be a big hurdle, so remember: don’t judge yourself too harshly. Maybe you can’t help it, out of habit, but it is not helping you. Try to be mild toward yourself.

Musicians tend to identify themselves very strongly with their art and craft. Music is not something that they do, it is who they are. Along with losing their playing ability, to a large extent they lose their sense of identity and self-worth. But there is much to be gained from discovering the person behind the musician, as what you are is so much more than what you do, and in that sense, I can testify from my own experience that embouchure dystonia, despite the struggle of dealing with it, may actually prove to be a blessing in disguise.

Tools for recovery

Next to being a trumpet teacher specialized in The Balanced Embouchure, I also run a practice where I help people achieve better balance in body and mind, primarily through the brain. Combining the knowledge and tools from both backgrounds, I have a unique and broad skill set to help and guide you in the process of recovery from embouchure dystonia.

As embouchure dystonia involves much more than just the embouchure, recovery is needed on different levels as well. Next to developing a deeper understanding of the condition and its cause, I recommend to address the following points:

• Developing more efficient embouchure mechanics. 
• Recognizing and resolving conflicting thoughts and emotions. 
• Stopping the fight-or-flight response in the brain, restoring hemispheric balance. 
• Improving posture and biomechanical balance.

Breathing

Perhaps the most powerful thing you can do to improve your physical, mental, and spiritual health and well-being, is to change your breathing. You can do without food for about a month. Without water, it will only be a couple of days. But if you can’t breathe, you’ll be gone in minutes!

Even though a change in diet can already be powerful, it pales in comparison to a change in breathing, which certainly shouldn’t be overlooked when trying to recover from embouchure dystonia, as brain functioning, muscle coordination, your state of mind and sense of self-awareness are all intimately linked to breathing.

Most people unknowingly breathe too much, easily two or three times more than the medical norm, with far reaching consequences. As brass players, we even have a higher than normal risk to breathe too much. If you want to know more about breathing and how to retrain your subconscious breathing patterns, I highly recommend the work of Konstantin Buteyko.

If you have any questions or if you need help to recover from embouchure dystonia, please feel free to contact me.

I also recommend reading Anna Détári's very informative and well-written website, musicians-focal-dystonia.com, and visiting https://musicianswellness.com, Jan Kagarice's website. As far as I know, Jan has the most experience with successfully retraining musicians who suffered from dystonia symptoms.