Me and my pharyngocele
I’ve got an injury. I am an injured musician.
Injury prevalence among musicians can be a difficult thing to measure, depending on how you define injury. Modulated by age, sex, instrument, musical style, physiology, career demands, all the non-performance related risk humans take outside of music-making, and the shame and guilt that injury can inspire, it’s hard to know how many musicians are injured in ways that affect music performance. “Injury” can also imply damage not easily observed in the body. Many, if not most, musicians likely experience some psychological or emotional trauma at some point in music study and work.
But, without a doubt, many musicians are broken in some way. Here’s my way:
That’s nasty.
This is a bilateral mixed/external pharyngocele. The tissue in my pharynx has herniated. It bulges out between muscles that should be able to hold it in. The scant research on pharyngoceles (and their close cousin, laryngoceles) suggests that they primarily bother trumpet players, oboe players, and glass blowers…three professions characterized in part by blowing lots of air through a small hole.
Like most strain and overuse injuries, mine is the outcome of pairing a physiological predisposition with experiences that make it worse. In my case, the natural weakness in the muscles around my pharynx was made worse by a few thousand hours of inefficient trumpet playing.
There are surgical options to help this injury, although, as my very smart anesthetist wife will tell you, surgery isn’t ever a “fix” the way lots of people think. I’ve known two fantastic trumpet players, Mike Bosch and Brian McWhorter, who have each had surgery to address a pharyngocele, and both eventually quit playing altogether. The procedure, which basically involves folding the bulging tissue over itself to strengthen the weak spot or spots comes with risks. Poking around the neck with sharp things can easily lead to bad things. Even if successful, this procedure is simply a temporary solution unless accompanied by a change in the behavior that led to the injury in the first place.
I’m lucky though. For now, the effects I feel from this injury go away if I don’t play too high or too loud for too long. Although my pharyngeal bubble is quite large, when inflated, it mostly leaves the important stuff (like the vegus nerve) alone. Occasionally though, through pain and difficulty swallowing, my body lets me know I’ve pushed it too far. A few days off helps. But I know that my pharyngocele is not going away. It’s not going to heal and will likely loom larger in my playing life as time passes.
Surprisingly, this eventuality is freeing to me. Knowing that there’s an end date to my trumpet playing makes me appreciate the opportunities I have now. I only have a fixed (if unknown) number of performances left in my professional career, and it seems boneheaded to not enjoy them.
But then again, we all have a fixed (if unknown) number of performances left in our lives. May we all be less boneheaded and enjoy the ones we have ahead of us.
