(Ouch!) Four Practical Tips for Painful, Swollen Lips

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iStock 000011768755XSmall 150x119 (Ouch!) Four Practical Tips for Painful, Swollen Lips

Back when I was in graduate school, swollen lips were more-or-less a regular thing for me to deal with.

This was due to a number of factors, but in hindsight I would attribute it mostly to my own reckless attitude. My playing schedule was very heavy and I was burning the candle at both ends.

Temporary lip swelling is not a major issue; it is a natural part of the muscle-building process. Over the long term however, it can lead to more serious problems.

Muscle Inflammation 101

I am not a physician, but what follows is my basic understanding of why lip muscles can feel swollen and achy after hard playing sessions.
Soreness in a stressed muscle is initially due to an accumulation of lactic acid. This acid is a byproduct of muscle metabolism; it can irritate and cause soreness. Typically, it dissipates within 12 hours or so.

Another natural part of muscle building is microscopic tearing of the myofibrils (labeled as #4 in the illustration below). This process, known as anabolism, is what builds up a muscle fiber and makes its stronger.

In a very broad and metaphorical sense, we tear down our embouchure muscles in order to build them up.

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Soreness that occurs days after a heavy workout is known in athletics as Delayed Onset Muscle Soreness (DOMS). DOMS can make your chops feel swollen and puffy because your body is sending all sorts hormones, fluids and cells to the area in order to make repairs.

This is a normal response to what might be a change in routine or an increase in muscle activity.

1.) Ask questions.

This all being said, it can be helpful to think seriously about what might be the root cause of a swollen lip – especially if it is impairing your performance level over a period of days or weeks.

A few questions to ponder might include:

  • What did I do yesterday?
  • What have I been doing over the past few days?
  • Am I playing too much (or not enough)?
  • Have I been making significant changes to my daily playing schedule?
  • Am I focusing on one aspect of my horn playing too much; for example, too much fortissimo playing?
  • Have I spoken to my teacher about this?

2.) Get the mouthpiece off the face.

Probably the best tip for sore chops is to immediately stop playing and rest. If time allows, not playing the horn at all – for a half day, whole day or even a few days – can sometimes be the best medicine.

If taking time off is not possible, taking mini-rest periods – even while rehearsing – might help.

Tempering the louder dynamic levels is also a great tip; try reducing everything to a mezzo-something (or mezzo-nothing!) dynamic for a few days.

If you are playing music that is in unison with other players, try laying out altogether. If work or school politics is an issue, keep the horn up to your face and pretend that you are playing. In the context of a loud unison passage, few people will even notice.

Also, (whenever possible) try physically removing the mouthpiece from the lips in order to relieve the pressure – during several measures rest, or even on whole, half or quarter rests. Every little bit can help.

3.) Think about recovery.

From the world of sports and athletics, the acronym P.R.I.C.E. is often recommended as a recovery method for aching or swollen muscles. It stands for:

  • Protection
  • Rest
  • Ice
  • Compression
  • Elevation

Four elements of this method – those that apply more specifically to the embouchure – have been highlighted: protection, rest, ice and compression.

In using ice to reduce swelling, care must be taken to not ice the lips for a period longer than 10 minutes. Research indicates that keeping any muscle iced for too long of a period can backfire. While it can indeed reduce pain and inflammation, it may also reduce blood flow and hamper healing if left on the lips for too long. Frostbite can also be a concern.

Typically the compression element of the P.R.I.C.E. acronym refers to wrapping the injured area with an elastic bandage. With embouchure swelling this is really not practical, but one can certainly massage the lips, and perhaps even kill two birds with one stone by using an ice massage.

The easiest way to perform ice massage on an injury is to freeze water in a small paper cup. Rip the cup to expose the ice. With the injured body part elevated above the heart (if possible) to reduce swelling, massage the injured area. Keep moving the ice in a circular motion for 10 minutes; never hold it in one place. As the ice melts, tear down the sides of the cup to expose the rest of the ice.

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The most effective and safest use of ice has been found with a repeated application for 10 minutes at a time. Allow the injured body part to warm for at least an hour before repeating the ice massage. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin. It also allows the superficial skin temperature to return to normal while deeper muscle temperature remains low.

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Most importantly, avoid playing for at least one hour after using the ice treatment. A freshly-iced embouchure is susceptible to further injury.

Non-steroidal, anti-inflammatory medications – such as ibuprofen, naproxen and aspirin – may also help. For myself, I temper ibuprofen doses to a higher level, taking three tablets every six hours – as opposed to two tablets every four hours. I have also found that antihistamines can help, especially if I am having an allergy attack and my entire face feels swollen.

4.) Re-think your methods.

The big trick in avoiding swollen chops and lip injury is, of course, to not overdo it in the first place. As the old saying goes, an ounce of prevention is worth a pound of cure.

To close out this topic, here are a few ideas that might help you to make a change for the better.

a.) Consider implementing a warm-down.

When you are playing a lot it is tempting to not warm up much but it is also especially tempting to not warm-down at all. You are tired at the end of that 2 1/2 hour service and want to get the horn in that case again!

But you will set your chops up better for the next service if you cool-down a bit.

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b.) Balance your warm-up and practice routine with your performance schedule.

Do you want a better high range? Try spending more time on your low notes. Do you want better fortissimos? Try balancing your loud playing with more pianissimo playing.

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c.) Examine your warm-up routine and your attitude towards it.

Many players like to practise exactly the same things every day. That way, they claim, they can “measure” what shape they are in for the day as well as their progress. I feel somewhat restricted by this idea. On “heavier” days, when the lips are strange from too much or too little playing, or from the weather, the food, the drinking, the mood, the lack of sleep or whatever, I find it better to play something easy and pleasant to boost the self-confidence first.

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 d.) Take more breaks.

Muscle conditioning is a gradual process and when muscles tingle or burn that is normal. This is normally a sign of lactic acid building up in the muscle tissue and it is a natural part of the re-building process.

It can also be a sign to take a break – for a few minutes, or even for a few hours. In more extreme cases these sensations may even be micro-tears in the embouchure muscles.

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e.) Consider other equipment.

A final student came to me complaining of endurance and range issues. The mouthpiece this student uses is a popular model but with a very thin, “cookie cutter” rim and at #8 bore it might be just a bit too big. Some of you reading out there are thinking “what, #8 too big???” but having been there, done that and bought the T-shirt in terms of big mouthpieces I would dare to say you may be working too hard, and while a thin rim is good for accuracy, too thin can cut and reduce endurance significantly.

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 f.) Examine the timing and length of each practice session.

Whether it be for a full-time player in a major orchestra or a part-time player with a day job, a busy lifestyle forces one to adapt the practice regimen accordingly.

Necessity, goes the old saying, is the mother of invention.

This is not to say that the old rules suddenly become invalid, but rather to suggest that pedagogy is something that exists on a continuum. Experienced teachers and players, well-versed in a variety of approaches, know this and are prepared with an arsenal of learning tools to draw from.

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Sore chops?

  1. Ask questions.
  2. Get the mouthpiece off the face.
  3. Think about recovery.
  4. Re-think your methods.