Freelancing and Overuse

What was the nature of your injury and how did it come about?

It was overuse. I was playing a strenuous piece with an orchestra. It was a long week of rehearsals and I had been pounding hard to play the piece. By midweek, I felt a little burning feeling. On Sunday, I got up in the morning and could not really get centered, playing-wise. I touched my chops and they felt sore and I had not even played. I was worried. The performance of the piece sounded tentative but I got in a groove in the middle of the first page. Then, I had to unexpectedly play principal on the second half of the concert. I was terrified. I got out the high notes at the end. I walked out, went to the bar, and started to ice. 

Did you see any doctors or specialists? 

I saw Dr. Steven Frucht [a neurologist in New York], Laurie Frink, and Arnold Jacobs

Can you tell me about your work with Laurie Frink?

Certainly. Laurie asked a ton of questions regarding how this happened. Did I hear a pop? No. Was there a divot or any type of indentation? No. Any lumps or very uneven tissue? No. Was this sudden onset? No. Was I swollen? No, not really. Were my issues all over the horn? Yes. Was the burning in one specific place? No, in the lips and facial muscles. She asked if I felt there was a cushion left between my lips and mouthpiece. No, it felt like I was trying to play on my teeth. Did it feel like someone else’s lips were on my face? Yes. 

Do you remember what kind of exercises Laurie gave to you, or any advice she had? 

Her advice was not to play until the pain and burning are gone, and don’t tell anyone. To say you are just too busy right now to take the gig. She would check in with me every week but at that point I had nothing because I could not get the buzz happening. 

The exercises and advice once I had no burning were the same she gave for anyone coming back from a lay-off, which is middle register stuff, five minutes on, 10-30 minutes off, throughout the day. The object is not to get tired, and always to leave yourself feeling like your chops are in a great place. I went in every week for a good two months to make sure I was not developing any bad habits. So, nothing special other than normal rebuild after being off a while. They were very much her normal bends and Clarke studies and slow, soft mid-range easy patterns, nothing extreme in dynamics or range or duration. When I could make it from middle C to second line G and was saying, “Oh come on this sucks,” she was her positive, cheery self and reminded me that I had nada a few months back. She also always checked that it was not getting worse or sliding backwards in any way, and checked that the pain was not changing to stabbing or shooting but staying at very sore and burning, but starting to subside. 

She said to stay calm, and in the end, I would be fine. And to get into doing something else. 

I know she was extraordinary. I worked with her a few years before she died. She was succinct and had the instincts of a doctor. She always prescribed the right exercises and was such a calming presence.

I had known and worked with Laurie before I had the incident, so I trusted her. Although I had doubts, I had a support system and a belief that she was right and that this would get better. 

And her calm manner was good for me. In fact, I only ever had one interaction with her when she was not calm, and that was a different situation. 

What about Arnold Jacobs? Had you worked with him before? 

I had studied with Jake when I went to Northwestern. Laurie actually called him for me initially after she understood what happened and while I was beginning to FREAK OUT, because I had nada coming out of the horn, nothing. He agreed with her that this was overuse and to rest, and that I had not torn anything. Once I was back into playing a bit (not out working, but getting sounds out and kind of playing) I felt like the mouthpiece was sliding around like there was no real good spot for it to be. Laurie thought that I was subconsciously avoiding the problem spots. That was true because the burning was gone except when the rim hit the wrong spot and it burned like hell. I was in Chicago for something else and went to see him. We went over what happened and he reiterated that it was not a tear and tried to help me get a spot (embouchure set) that worked and was consistent. He spent a lot of time with me trying to get me to think about exactly how I picked the horn up, placed it from the bottom and let it rest on the top to get rid of the slide. That worked, but it took an automatic action I had done for a long time and turned it into a thought process. That kind of screwed with my air a bit. But he got that sorted through. 

Regarding the burning sensation — was that something that went away eventually? 

Yes, for the most part. It diminished in scope and intensity. I would say about once or twice a year I hit a spot on a note, and it would say, “hey remember me?” Otherwise it was fine. I can’t give you a time frame but it was long. 

Also, it felt like the muscles in my lips were stretched, flabby, and not taut – sort of like the rubber in the rubber band was sagging. That also took a long while to feel better. Another thing Laurie did was to have me play on a trombone mouthpiece to make sure my lips were flat and not sinking into the mouthpiece. 

Did you do any at-home therapeutic treatments?

I tried ice and heat in various combinations. Got rid of the swelling, but did not help anything else.

How long did you have to stop working?

I stopped playing for two weeks, played an opera run that did not go well, then did not work for another three months.

Did you change your approach or technique?

My mouthpiece placement is slightly different, and mymouthpiece rim is more rounded

I have found that regaining trust in the body is tricky. Did you experience this? How did you do it? 

For me it was a matter of time.

Did you come to feel like “yourself” again eventually?

I still don’t think I play as well as I did before the injury.

In what way?

I don’t have the endurance I once did. I also can’t bury a section with notes above the staff for a long duration. I used to get called to play Ned Rorem pieces that went up to high D and stayed there. I would think twice about that now. Also, Bach cantatas and masses that sit above the staff without an assistant – again, I would probably now say no. Before the injury, it would have been no problem and I might even have had a brass quintet rehearsal in the morning. So, I don’t cram my days full of work. I always ask for an assistant, and I am careful what I schedule in a week.

Any general advice to those going through an injury or recovery/rebuilding?

It will get better. Time off is your friend.