Hiatal hernia prevention

Dbfinn · Regular Member Joined: 30 Jan 2016 Posts: 58 Location: UK

I have had some reflux problems during the last months. After two days with no symptoms at all it happened yesterday again while playing so I think playing trumpet make it worse or even it could have caused an hiatal hernia.

Actually, I found that this problems are more common among wind instruments players: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2009.04208.x/full

I have stopped playing to see if it improves and I will visit the doctor tomorrow. I am considering seriously giving up trumpet playing

When I read the Encyclopaedia I remember that it was recommended to keep the abdomen flat and activated when playing to prevent hernias. I would appreciate if someone could give me more details about hiatal hernia prevention when playing trumpet.

maynard-46 · Posted: Mon Sep 18, 2017 7:04 am Post subject: Hiatal hernia prevention

I've had a hiatal hernia since 1981!!! I was told it was caused by stress and aggravated by eating the wrong things. At the time I was teaching music in a public school system...teaching private lessons 3 days a week from 3:30 till 9:00...and playing about 200 gigs per year!!!! I did that for 4 years and my body just broke down resulting in the HH PLUS the beginnings of an ulcer.

During this time period I was a very strong lead player and all of my gigs were balls-to-the-walls type playing. Heck...I used to keep 2 bottles of Mylanta in my case and would always put one under my stand on the bandstand!!! I never felt that the HH had anything to do with playing though...or at least it wasn't caused by my playing. I've have 2 scopes done and each time they say..."yep...you've got a hiatal hernia!!!" You can have an operation to reconstruct the valve that let's the acid come back up but sometimes it does more harm than good and, overtime, the acid will eventually eat it away again.

I've managed to keep it under control via antacid medicine and watching what I eat...especially the spicy stuff. Yes...I still occasionally have flare ups and I always will BUT they're at a minimum these days and I know what to do when I get them.

Good luck to you!!

Butch
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kehaulani · Posted: Mon Sep 18, 2017 7:24 am Post subject: Re: Hiatal hernia prevention

Dbfinn · Regular Member Joined: 30 Jan 2016 Posts: 58 Location: UK

The more I read the more scared I am:

"I don't know a tuba player that doesn't have a hiatal hernia. (Including myself.) Coincidence? I bet not.

Most brass players I know have them as well, I suspect it's the price we pay as wind instrumentalists."

Here: http://test.woodwind.org/clarinet/BBoard/read.html?f=1&i=163807&t=163807

Time to change intrument

Irving · Heavyweight Member Joined: 11 Feb 2003 Posts: 1886

For those with reflux, have you ever tried apple cider vinegar? It's counterintuitive, but it can alleviate the discomfort. You mix a couple of tablespoons with a glass of water, and some honey if you can't stand the taste. If you heat the water, then the honey will melt. It's best to use a "live " vinegar, like Braggs, or anything from the health food store. Don't knock it until you've tried it. Don't boil the vinegar as that might kill the bacterias.

Dbfinn · Regular Member Joined: 30 Jan 2016 Posts: 58 Location: UK

Dbfinn · Regular Member Joined: 30 Jan 2016 Posts: 58 Location: UK

I have found a section of the Encyclopaedia where Reinhardt refers to hernias, but he does not specify if he means abdominal or hiatal hernia ( I think he means abdominal). Unfortunately the pdf copy I bought in qpress is not searchable, and I do not have the time now to read everything again to check if there is some more information elsewhere.

My conclusion is that a way to play to reduce the risk of hiatal hernia would be to release the air and not using the abdominal muscles. But I think this only possible for piano playing at low or mid range.

John Mohan · Posted: Tue Sep 19, 2017 8:14 am Post subject: Re: Hiatal hernia prevention

Jerry Freedman · Posted: Wed Sep 20, 2017 2:33 am Post subject:

I have had one for years. Apparently I got it from violent asthma related coughing ( used to fall on the floor and sometimes puke). I have been taking prescription omeperazole ( prilosec ) for many years since my final diagnosis for asthma. The HH was caused by coughing and because of reflux issues aggravated the coughing. Prilosec works wonders for me. No more problems

GeorgeB · Posted: Wed Sep 20, 2017 2:49 am Post subject:

Dbfinn · Regular Member Joined: 30 Jan 2016 Posts: 58 Location: UK

Thank you all for sharing your experiences.

I would use antiacid as a last resort solution. We have acid in stomach for a reason and very rarely GERD is caused by too much acid production. Acid is a barrier for infections and helps with digestion and absorption of nutrients.

I have started a relatively low carb diet that is working very well so far.

Here is another alternative to try: breathing exercises that strengthen the diaphragm and LES (the valve separating stomach and esophagus).

http://www.nature.com/ajg/journal/v107/n3/extref/ajg2011420x3.doc

This is the clinical study: https://www.karger.com/Article/Pdf/357181

conclusion: "We believe that these experiments prove that different types of breathing directly alter the reflux protective pressure zone of the LES and explain how suitable exercises can cause a long-lasting training effect that prevents reflux. The next step will be to optimize this program for introduction into clinical practice."

Good luck all!

razeontherock · Posted: Fri Sep 22, 2017 6:28 am Post subject:

Seems to me that this all points to the importance of sensible daily practice! We build up the necessary strength while young, take it for granted for a while, but then as we age we're forced to come to grips with how complicated our bodies are, and all this stuff we can't possibly control, consciously.

I'm reminded that the Encyclopedia says to alternate heavy and light playing days. In light of this thread, there seems to be tremendous wisdom in that simple point!

In various injuries I have been able to strengthen my body past any possibility of re-injury, but I have no idea if that can pertain to the valves and stuff under discussion here. Best of luck to the OP's recovery, and please do keep us posted on good info that proves beneficial!

I refuse to believe that the body simply cannot endure the rigors of playing, even demanding high parts. There may be increasing knowledge about how to more effectively train for it though!