I’d Like You to Meet My TMJ

I’ve debated writing this post for a long time. Not because it’s particularly controversial, but because I didn’t always know where to start. Musicians don’t like talking about injuries—so often we keep them under wraps, not wanting to get bumped down a part or looked down on by our peers and mentors, that the only time we really hear about big physical roadblocks are in whispers months after the fact. And that takes its own toll, leaving those struggling feeling like they’re in it by themselves. I’d really prefer people not feel like that, so I’m sharing a little about what I’ve spent the last couple years navigating.

Three Octobers ago, my jaw locked up. I was in the middle of a normal evening, and all of a sudden I couldn’t get it more than about a third of the way open. For twenty minutes. After some frantic Googling, a bunch of massaging, and some fervent prayer to the brass gods, it finally relaxed, but I didn’t know what to do from there. One drop-in visit to the health center later, I came back with Temporomandibular Joint Disorder (TMJD, but literally everyone shortens it to TMJ). If you want to get really colloquial, it’s lockjaw, but without the tetanus associations. While the locking up and the fatigue was new, since then I’ve realized that tension in my jaw has likely followed me since childhood, which makes it so much more fun to get rid of. [Insert eye-roll here.]

For awhile, I didn’t do much of anything about my jaw—the advice I was getting was all sort of in the “it’ll just go away eventually” category. Sure, I tried not to strain it further, and I always took a break from talking/playing/basically everything when it was telling me it had done too much work for the day, but when your medical advice is from a student health center on campus and you don’t have a GP, you’ve only got a sliver of knowledge from a single visit to work with. It wasn’t until I arrived at CalArts (and, really, got most of the way to my mid-res recital) that I started getting information that was actually going to help me in the long run.

Before we go on, it’s probably time to elaborate on the big problems with TMJ when you’re me. The obvious one is that I’m a brass player; I literally rely on my jaw health for my living. The one that’s not so clear, though, is that my knees and my back are a little screwed up. (I blame the knees almost entirely on high school marching band—I don’t have as simple an answer for the back.) It’s not uncommon for me to spend awhile rolling around before bed, trying to find a position that doesn’t inflame my jaw or the rest of my body. I’m still not great at it, especially because I fell asleep almost exclusively on my stomach as a kid and I haven’t convinced myself to sleep on my back yet. Over the course of the last year, I’ve also realized that I had (thankfully now in the past tense) a decades-long habit of clenching my jaw all the time. My hypothesis for this is that because my molars don’t close properly unless I have an overbite, and my two-and-a-half-year stint with braces got rid of said overbite, I started wanting to double-check that everything still fit together right (though I’m sure it started long before I got braces). Nobody noticed it while I slept, because I was doing it while I was awake, too. Since I’m almost four hundred miles from my dentist, it’s not easy for me to get in for an appointment, and I’ve gone far too long without one (for all the folks clamoring “get a new dentist”: I will after I graduate, but my teeth have other ongoing adventures besides my TMJ, so I’m trying to wait until I’m settled somewhere).

Ultimately, my main goals for controlling my TMJ involve getting as much tension as possible out of my brass playing—which has already necessitated that I buy a new horn to replace one that I absolutely couldn’t play tension-free—and finding a way to sleep comfortably without sacrificing my jaw, my knees, or my back. Those are absolutely still works in progress, and some days it doesn’t seem like I’m winning the battle. It’s difficult to work on healthy high range and flexibility when I can’t leave the staff without tension in my neck and shoulders. It’s hard to convince myself I should be performing when I eliminate one point of tension only to find three more. But even though I’ve had people come up to me and tell me I’m going to have to quit playing eventually, I’m not focusing on that right now. I’ve got solid mentorship and people to give me hugs on rough days. I’m still working on my lip multiphonics and I’m still finding fun things to do with my horn. As long as that’s true, I’m okay.

Looking forward, I hope the musical community starts being more open about injury prevention and rehabilitation. If I’d kicked some of these habits during private lessons in high school, I might not be dealing with all of this now. For the record, it is possible to kick TMJ—but you do it by building a brick wall of healthy habits (though that’s if you’re lucky—sometimes other medical options are necessary, too). But because this can be a big problem for musicians, and because women of childbearing age experience severe TMJ pain exponentially more often than their male counterparts (just Google it), I’m making it part of my outward-facing musical life. If I can talk about my assault, I can talk about my jaw. At least, I hope so. ♦

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