Lip Hernia?

GenoValet · Heavyweight Member Joined: 30 Aug 2006 Posts: 1244

From http://abel.hive.no/trumpet/embouchure/Broken_Embouchures.html :
“A stretched lip muscle is a more advanced form of a hot spot and is also accompanied by chronic playing discomfort [which the player suffers as soon as he begins playing], as well as lacking endurance, and difficulty playing in the high range. A player can sometimes feel a divot in or thinning of the lip tissue where the muscle is stretched.”
Looking for some serious advice here. This happened to my chops on a big band gig last night. Let me preface this by saying I’m a middle-aged, advanced, player; I play with a fairly pressureless embouchure - even after several sets I barely have any mouthpiece halo & it dissapates quickly. It was toward the end of the 2nd set; I had done a few solos but hadn’t ventured above high C. It was actually during a mundane passage in the next-to-last tune of the set when I felt something “give out” on the upper right lip. The best I can describe it, it was as if something “shifted” (rather than tore) and the mouthpiece edge slipped inward quickly, but just a fraction (not even “banging” into a tooth). It became very tender immediately. I went to the restroom mirror; no bleeding, but I had a literally arc-shaped “divot” - about 1/8" long - in my upper lip right where the edge of the mpc would lie. I immediately iced it & by the end of the break it was still tender by the “divot” was gone. I shifted to low book & finished the gig playing with the mpc shifted off it to the left. More ice & when I got home, just to aid recovery, I poured a shot of bourbon over it... This morning there is no bruising, but it’s still a little swollen & tender & a faint “divot” is visible in the magnifying shaving mirror. I plan to lay off completely for at least 2 weeks since the next gig is fortunately not until April 5th. I know some of you out there are medical types, or maybe just have actually had this happen to you: Is that a long enough layoff? Is it something I need to be wary of in the future, sort of like a “hernia?” Permanent? Or just should I lay off longer to prevent it from happening again? Thanks.

trickg · Posted: Mon Mar 05, 2007 6:22 am Post subject:

Geno - dude, on one hand I totally respect that you finished the gig, but on the other hand I wonder if you didn't exacerbate an already bad situation by continuing to play.

After having a similar situation once, my advice to you would be to work with hot and cold compresses and to start up a regimen of some sort of anti-inflamatory. I was talking to my doctor once about the fact that I sort of self-medicate with ibuprofin due to issues related to an early onset of arthritis. (runs in the family) I told her that at times, I would take doses of three or four 200 mg ibuprofin tablets several times a day. This is also due in part to actually having been prescribed to take 4 800 mg ibuprofin tablets four times a day for a total of 3200 mg. She told me that at my size, that 3200 mg is the highest recommended dose, that it can cause some stomach issues if you stay on it too long.
Anyway, my point is that you could take some higher level doses of ibuprofin for the next couple of weeks to deal with the inflamation and to simply stay off of the horn until the tenderness goes away. I think that if you do that on top of the hot and cold compresses, there is a good chance that it will heal up fine. Then again, I'm no doctor, so if you can go get it checked out, that's probably the best option.

getting back to my related incident, back when I was playing in the Latin band there were some times where I had to play the lead book and one night after a hard gig, I noticed on the drive home that my upper lip had started to swell. I figured that I was just going to get a little bit of swelling - something that had happened to me a bit in the past after me and Flex Armstrong played a grueling gig together.

When I woke up the next morning, my upper lip was swollen from the base of my nose all the way down to at least 3 times normal size - I looked like Homer Simpson! It took a couple of days for the swelling to subside and it left me with a very tender and sore upper lip, but more to the point, never having experienced anything like that in the past, I was scared to play. Then, even a week or so later when I did pick the horn back up, I didn't play very hard because things just weren't feeling quite right.

Ultimately, whatever I did (I think that I blew something out - possible tore or herniated a muscle in my lip) it healed pretty quickly and I have never had that sort of thing happen since.

Good luck with it - I feel for you!
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Patrick Gleason
- Jupiter 1600i, ACB 3C, Warburton 4SVW/Titmus RT2
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"95% of the average 'weekend warrior's' problems will be solved by an additional 30 minutes of insightful practice." - PLP

GenoValet · Heavyweight Member Joined: 30 Aug 2006 Posts: 1244

oxleyk · Heavyweight Member Joined: 12 Apr 2006 Posts: 4180

I have a vein that runs parallel with my top lip on the inside and there's a slight bulge right in the middle where I play. It seems to be close to the inside surface of my lip. I don't know if the change was caused by trumpet playing but I've had it for 20+ years. I've discussed it with my dentist and he doesn't seem to be concerned about it, but then he isn't a trumpet player.

Since my comeback last year I've been working on reducing mouthpiece pressure as much as possible so hopefully I won't have any serious problems with it.

Kent

trpt.hick · Posted: Mon Mar 05, 2007 7:28 am Post subject:

I urge you to see a doctor. You can also email a friend of the trumpet community, Dr. Richard H. Cox, who is a retired MD, PhD, and has 3 Honorary Doctorates. He also happens to play the trumpet and lectures at ITG and other trumpet conferences. I really trust this man and seek his advice often. He was also gracious enough to be the editor of one of the chapters in my TRUMPET PEDAGOGY book.

Dr. Cox provides his email address on the brochures he passes out during him many clinics, so I don't think he will mind it if you contact him. Maybe you could provide him with a link to this thread, too. Anyway, here is his email address:

r-bcox@ix.netcom.com

Dave Hickman

GenoValet · Heavyweight Member Joined: 30 Aug 2006 Posts: 1244

Tnx Mr. Hickman, I've forwarded your recommendation & a copy of my orig post to Dr. Cox with some added details. I'm sure he'll know how long I should leave the horns on the shelf

. . .

Luke6335J · Posted: Mon Mar 05, 2007 5:29 pm Post subject:

Maybe this is the kind of example of the way a trumpet player can "blow his lip" happened to me in year 9, one day of hard playing and i never got it back. Something happened and i felt something similar to described here. I think it must happen a fair bit to high school trumpet players, because a local trombone player was telling me how he used to be able to squeel on trumpet in highschool. One day he felt something weird and couldn't do it again.
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GenoValet · Heavyweight Member Joined: 30 Aug 2006 Posts: 1244

trickg · Posted: Thu Mar 08, 2007 2:06 pm Post subject:

I've started working out again too and in the last two weeks, I've finally gotten back to the point where I can work out HARD. Most of the "arthritis" issues I was having seem to have disappeared, as has the general mailaise that I always seemed to be under. Part of that might also be due to my purposeful effort to detox - not only am I working out, but the facilty I'm using has a sauna so I have been hitting that several times a week too, just to help sweat the junk out of my system. This is also on top of a shift in diet. I've lost weight, gained energy slimmed up a bit and my joints don't hurt anymore.

Anyway back to the subject, your injury may have been a one time fluke. Mine was. (so far) I have played harder both before and since I had my lip injury and it has never recurred. This isn't to say that it won't happen again but I do try to keep that sort of thing in mind and even though I still play pretty hard, it isn't anything like it was a decade ago.
_________________
Patrick Gleason
- Jupiter 1600i, ACB 3C, Warburton 4SVW/Titmus RT2
- Brasspire Unicorn C
- ACB Doubler

"95% of the average 'weekend warrior's' problems will be solved by an additional 30 minutes of insightful practice." - PLP

bg · Posted: Thu Mar 08, 2007 2:42 pm Post subject:

"See a doctor" is the best advice you have been offered.

I stretched my lip in 2001. I quit playing for a year. I saw Dr.
Simon McGrail, in Toronto. He is the doctor reccomended by Lucy
Lewis in the website you initially quoted. Dr. McGrail is an E.N.T. and
a plastic surgeon. If you tore your lip, he can perform the surgery to repair it. If you have a stretch, he will prescribe physical therapy exercises to restrenghten the muscle. He plays the French Horn.

I have made a complete recovery. If you have a muscle injury,
rest will NOT help, nor can you "play your way out of it".

Brad Goode

GenoValet · Heavyweight Member Joined: 30 Aug 2006 Posts: 1244