helping with playing pain

[Andy Del]

Thoughts please?

One of my students has taken up the lead chair in our Wind orchestra and big band. He has a working range up to high C/D, and is one of those dream students, a sponge who takes in what is said. He even 'gets it' and I've seen him tear up watching brass sections playing in orchestras. Just an all-round great kid. Added to that, he is a champion athlete - representing the state and our equivalent of a straight A student. To say he leads a very full and busy life is an understatement. I do get a bit concerned that he is punching above his weight playing-wise, as there are times he simply cannot get to the horn outside of lessons and rehearsals.

Tonight he described a concern he has about his playing.

When he is playing sustained high notes, he gets shooting pain in the back of his head, immediately he stops blowing. It can last up to 20 seconds, during which he simply can't play, and in big band, fells he can't even stand up straight.

Alarmed? I am. Talking about it, he described one piece - a passage ending on a high B (Bb trumpet) as fine, but after 4 bars rest, he has a sustained 4th space E. He described the pain on ending that note as excruciating.

While I am happy to work on his production, I also told him to tell this to his parents (obstetrician and GP) tonight. In the meantime, take it easy, do his warmups and productions exercises, work on playing freely (he admits to forcing a 'bit' recently) and not push himself too much.

Thoughts, gentle reader?

cheers

Andy
_________________
so many horns, so few good notes

[Billy B]

Stop all playing immediately until he is checked out.
_________________
Bill Bergren
Obstacles are what appear when you take your eye off of the goal.
www.synergyjazz.org

[John Mohan]

I used to get this as well when I was a kid. It was caused by improper straining for high notes (an overdone Val Salva effect). With proper practice and development it went away. Basically, I think just as I was, your student is writing high note checks his body can't cash. The only cure is a long term diet of proper practice of a proper daily development routine that builds strength and helps him to overcome the bad habit of brute force type straining he's developed.

In the mean time, with the stipulation that this is not professional medical advice:

I found that back when I had this problem, as I finished playing something high and loud, if I would immediately tilt my head way up for several seconds, compressing the back of my neck, it would prevent the pain from coming on.

I'm fairly certain that the pain is caused by the rapid release of blood out of the head that gets trapped there during the playing of sustained high notes when the inter thoracic pressure caused by the exertion of playing the high notes is higher than blood pressure, which causes the veins that return blood from the head down to the heart to get compressed. This builds up blood pressure in the head, and then when the student stops playing, all that blood pressure is released at once, too quickly. This causes pain (the body signalling that something is very wrong), and can also cause the infamous passing out from high notes. Ask Stan Mark about that one (it used to be on YouTube).

I found that by tilting my head back right after playing the high notes, the veins were compressed enough to slow this rapid release of blood pressure from the head to acceptable rates and as a result, the pain (and potential passing out) were avoided.

Ironically, the pain the student feels is not when the danger to the student exists. It's during that build up of pressure while playing the note that the risk of stroke is elevated.

I'd suggest he backs off on those high notes. Inter thoracic pressure increases with both range of note and volume of note. If he has to play the high note, perhaps he can mitigate the pressure a bit by playing a little softer.

Have him try the "tilt the head way up" trick right after playing these high, loud notes - it worked for me.

Again, this is not professional medical advise.

Best wishes,

John Mohan

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