Pain and Injuries

1. Hand, arm, or jaw pain
2. Common oboe family injuries
3. Additional injuries

1. Hand, arm, or jaw pain

The weight and work of playing the oboe is reduced (and the chance of injury lessened), if it is spread throughout the body, with the arms supported by the ribs and shoulders, which in turn are supported by the spine and pelvis, ultimately supported by the feet on the floor.

Fatigue, numbness and/or pain in the thumbs, hands, arms, shoulders, or jaw, can be caused by holding the instrument awkwardly, having too much body tension, general improper body use, or overuse. The nerves may be constricted, and/or muscles or tendons inflamed.

If pain occurs during practice, practice for shorter sessions that are distributed at least a couple of times throughout the day. If it occurs during rehearsals, stretch out and move arms, wrists, the jaw, and shoulders when possible. During rests, don’t hold the oboe in the right hand if that is what is in pain. When preparing technical passages, practice as much as possible without tension to support a tension-free performance.

Becoming aware of body tension is the first step toward resolving pain. Try moving each part of the body, even just a little bit, while playing. Are there any places that will not move easily? And are these “fixed” places positioned awkwardly? For example, is there a huge angle at the wrist, is the head pushed forward, or the knees locked? Try moving any fixed places while not playing, and then again while playing. Is it possible to let go of the tension and allow for movement and balance? Is there another way to play that is easier and more fluid?

To avoid and alleviate pain, it may be appropriate to use stretching, and icing or warming, to reduce inflammation and/or relax muscles. There are also several devices designed to provide relief from the weight of the instrument that may help resolve pain, including specially designed thumb rests and shoulder harnesses. Neck straps are not generally recommended because they can cause muscle tension and the neck to come too far forward, though some players use them quite successfully. Many of these items may be purchased at Forrests Music.

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2. Common oboe family injuries

If physical issues cannot be resolved with stretching, re-positioning, or taking more breaks, it is important to seek help because seemingly small problems may develop into serious disorders that are difficult or impossible to treat. It may take some time to find an appropriate doctor as many are not trained in the very specific issues that musicians have.

There are also body-use specialists used to working with musicians on both prevention and recovery from injury. These specialists include those trained in the Alexander Technique and it’s outgrowth Body Mapping, and the Feldenkrais Method.

Following are five performance injuries from most to least common. Probably every musician has experienced some symptoms of overuse or repetitive stress injury at some point, which can often be mitigated by rest and more distributed practice. Carpal tunnel, TMJ, Focal Dystonia, and Hyperacusis, depending on the severity, may need much more time and effort to overcome.

  • Overuse

The pain from using muscles too long and with too much stress. Click here for more information from the Center for Arts and Wellness at George Mason University.

  • Repetitive stress injury

The pain from using muscles in a similar way for too long. Click here for more information from the Cleveland Clinic.

  • Carpal tunnel syndrome

The numbness and pain that happens when the tendons in the wrist become inflamed and restrict movement through the carpal tunnel. Click here to read more.

  • TMJ (Temporomandibular joint pain)

When the jaw becomes painful and hard to move. Click here for more information from the Mayo Clinic.

  • Focal dystonia

When a small part of the body, often a finger, or part of the lip, no longer moves in the way the brain is directing it to. Click here for more information.

Here is a narrative from David Vining about his recovery from dystonia.

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3. Additional injuries

  • Hyperacusis

Hyperacusis is an extreme sensitivity to sound. Click here to learn more.

Other injuries include tendonitis, numbness from nerve pinching, other types of hearing problems, headaches, or dizziness.

  • Embouchure pain and strength

While building muscle strength, some embouchure fatigue and even pain is to be expected. Generally, if there is pain or tiredness on the sides of the embouchure, it will go away after rest or overnight. Pain on the top lip, likely caused by the teeth being used too much to keep the reed under control, may take longer to go away. Better to use embouchure strength for dynamic variation rather than tonal focus and significant pitch control. However, oboists seem to have different natural amounts of embouchure endurance not necessarily related to general health, amount of practice or reed style, and therefore must adjust reed strength accordingly. Building embouchure strength usually involves simply playing and practicing, while increasing the time slowly as strength develops. Many oboists use long tones and slow scales to help build endurance and steady tone. Playing duets and trios with colleagues also works well.

The process of building embouchure strength is similar to how an athlete builds muscle. Consistent training, but not always the same stress of work out, seems to be successful for many players. Rest is an important part to allow the muscle to recover. When preparing for a recital, approximately once a week (or even every day, or twice a day as seems appropriate), in the weeks before hand, play through the complete program to both get a sense of the endurance required, and to help build up the strength for it.

  • Stress velopharyngeal incompetence or air leakage through the nose while playing.

Having air leaking through the nose while playing is something that happens to woodwind and brass players, particularly those who play instruments with higher intraoral pressures, such as the oboe, bassoon, clarinet, and trumpet. While blowing through the instrument, there can be a palatal air leak, causing a snorting sound when the soft palate does not remain properly closed. This also causes a reduction in tone and/or note length because of the loss of air pressure and volume. This problem can occur to otherwise perfectly healthy individuals, though it can also happen randomly to people with colds, or to those overly tired and stressed.

Though there has been success with surgery, the initial recommendations for treating this problem include rest followed by slowly building back to high air pressure playing situations. Changing a reed/instrument set up to one that involves less air pressure can also be successful. Working on reducing overall body tension also appears to be helpful. There are some observations that suggest that these air leaks are more common in younger players, and likely will not continue to be an issue as they reach adulthood.

  • Other health issues (and disinfecting reeds)

Cold sores, canker sores, AIDS/Hepatitis B or C, flu or colds

Any of these illnesses, except canker sores, can be passed by the saliva when sharing a reed (making this practice inadvisable), but they don’t necessarily put any other limits on playing. Cold and canker sores may hurt to play with, but don’t likely cause any other long-term issues. Some oboists aren’t comfortable sharing reeds anyway, and some disinfect reeds with small amounts of Sterisol germicide, bleach, hydrogen peroxide (one part in nine parts water is a frequent recommendation followed by rinsing before playing), oral rinses from the dentist, or even vodka. Some oboists swear by ultra sonic jewelry cleaning devices.

Dental braces

While not really a health issue, dental braces can be an inhibiting factor in embouchure formation, and may cause pain and/or bleeding.

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Front Notes of Hope smallMany musicians grapple with the heartbreak of pain and injury, yet stories of recovery remain woefully scarce. This book is intended to help rectify that shortcoming. All the authors in Notes of Hope have dealt with debilitating injuries that made making music painful, difficult, or impossible. Their stories are offered as a testament to what is possible through resourcefulness, creativity, and perseverance. These stories are real-life snapshots of musicians who have come to terms with their difficulties. Those who are in trouble and those who wish to avoid trouble will find refuge in Notes of Hope.

Purchase Notes of Hope.