by Erin Finkelstein, GCFP
I was diagnosed with Temporomandibular joint (TMJ) disorder while studying the clarinet during my sophomore year at the University of the Pacific, Conservatory of Music. I felt radiating pain whenever I played my instrument and feared that my future as a musician would be compromised. Wind instrumentalists, violinists, violists, and singers produce sound or hold their instrument by using their jaw and face. TMJ disorder is a common injury for musicians and can be debilitating for professionals.
I traced the seed of my physical problem to my earliest years as a clarinetist. It is a typical developmental milestone for middle school aged clarinet players to have to “fix” their embouchure (the shape one’s mouth is in to hold the instrument), as they grow physically. We are told to make a flat chin to allow the reed (which one blows into to make a sound) to rest on half of the pink part of the lip and not the skin below. As a rather driven young person, I achieved this quickly by forcing the TMJ and jaw forward, rather than using the facial muscles to open the jaw and hold the instrument. What my teacher and I did not realize was that I had translated her words into pushing my jaw forward and locking the hinge of the TMJ out of its neutral position while I played, creating an unnatural underbite for long periods of time.
Once in college, I began playing my instrument over four hours a day. My development hit a wall when the pain in my jaw increased to the point where it hurt to chew. I was forced to take some time off to find a solution. I started by visiting my dentist. He fitted me with a mouth guard. It prevented me from grinding my teeth at night. Unfortunately, that didn’t translate into playing the clarinet pain-free. I kept searching for a solution.
I found an article in the International Clarinet magazine describing TMJ issues amongst clarinetists. It included an anatomical drawing of the face and jaw. Until that moment, I’d been unaware of the bones, TM joint, and muscles in my face. I entered a sensorial discovery, using a mirror at first, to inform my senses about what was actually moving when I played. I spent my time off from traditional clarinet practice exploring the small movements in my face. What ensued was a process I can only describe as my first Awareness Through Movement lesson. I used my hands to feel where the TMJ opened and explore which movements triggered the pain. I instinctively tried to make the movements small and slow, simply to avoid feeling the discomfort. I repeated the minuscule movements until I could open and close my mouth without pain.
The next level of translation was more challenging. As soon as I brought the clarinet to my face, my lips and face would move habitually into the embouchure it had held for the previous six years. I was stunned by the dissonance between my intention and what I saw happening in the mirror. In order to learn how to bring my clarinet to my face without pain, I had to move even slower–with my eyes open and then closed, lying down on the floor, on my side–and sense while also picturing the new skeleton and jaw function I wanted to encourage. I knew about “slow practice” from my music studies, but this brought “slow” to a whole new level. I did not try to make a sound on my clarinet until I could control the movement of my face and create a proper embouchure with good jaw alignment and no pain. I would then take the clarinet away, and start the whole process again, so I could ensure that I could reproduce it. As a musician, I understood the concept of repetition to learn new pieces of music and now applied it to move in order to heal my injury and inflammation. While this was four years before I attended my first Awareness Through Movement class, I had essentially experienced Feldenkrais’ concept of coordinating my thinking, feeling, sensing and moving, to heal my TMJ disorder.
This type of more organic learning, born out of desperation to return to my college studies, spurred my imagination about what was actually occurring when we learn to play an instrument at a high level. Attending my first semester of an Awareness Through Movement class four years later at Arizona State University led to me becoming a Feldenkrais Practitioner. Through my Feldenkrais practice and work as a professional musician, I developed a concept I call the “Magic Zone,” which I teach to every musician who seeks my assistance with playing issues.
I describe the “Magic Zone” to new students as accessing the part of the brain that can attend to new sensations. I describe what it feels like to brush your teeth with the opposite hand, causing one to move slower with less refinement, sensing your arm and hand moving, the brush making contact with the teeth, the bristles moving across them, and feeling the size of the teeth, gums and tongue – all things you no longer pay attention to with your habitual hand. Musicians, by necessity, have hands in specific places to hold the instrument correctly. They are also habituated to sound as the primary sensation, and often want to work with their musical instrument during a Functional Integration lesson. This “Magic Zone” helps them access spontaneity while still dealing with the compulsion that exists from performing in the necessary orientation to the same instrument over time.
The primary act of bringing one’s instrument to their face is akin to suckling. It’s one of the first things musicians learn to do and rather difficult to do slowly. When working with musicians who have TMJ disorder or other overuse issues, I compose a spontaneous Awareness Through Movement lesson, based on what I observe as their fast or habitual movements. I have the musician bring the instrument up and down many times slowly, shifting their attention through different sensations that I guide them through: weight shifting, hips/sit bones, head in relation to the sit bones, feeling the “involuntary” habitual movements in the face (particularly as the instrument gets closer to the mouth), the jaw, the breath, the small movements in the neck and upper spine, all without making a sound on the instrument. I teach them how to bring this awareness into their practice session for a few moments before they start practicing, in order to wake up this part of the brain.
During our second or third lesson, I see if the musician can attend to themselves, or what I call their “sensorial instrument,” while playing a passage of music. It should be noted that this is best attempted with a piece of music that is known very well or memorized. I ask the musician to play. Afterwards, I ask them what percentage of the time was their attention on the different sensations of weight, breath, movement, and what percentage on the musical outcome. At first, many people can only track their sensorial experience 10% or less of the time, or, they are so engrossed with the new sensations that they no longer listen to their sound. Sometimes through sensing themselves, they learn they didn’t have a clear musical intention to start with. At this point, I learn much about the musician’s self-image and invite a conversation about letting go of immediate expectations. I encourage them to make “mistakes” in the short-term, in order to rewire the brain to create a satisfying long-term solution for music-making. For many musicians, this is the most important part of the lesson and the beginning of a long relationship with our work.
Erin Finkelstein is a professional clarinetist, educator, and Feldenkrais practitioner with a private practice in Phoenix, Arizona. Erin works with musicians from all over the country to help assist in physical comfort and musical vitality.
Visit ErinFinkelstein.com to find out about workshops and classes.