New instrument introduces right temporomandibular joint (TMJ) pain?

August 26, 2013 at 05:24 PM · "Because the violin and viola are held underneath the left side of the mandible, players of these instruments can be predisposed to jaw disorders. Violin and viola players often report signs and symptoms identical to those of temporomandibular joint (TMJ) pain dysfunction syndrome. They report an increased frequency of pain and noise in the TMJ area as compared with a control population. Mandibular movement is more limited in these musicians, and there is increased rightward deviation of the mandible on opening. Symptomatic violinists and violists can alter their technique to reduce the force on the mandible by the instrument and thereby minimize pain and dysfunction."

I'm a violinist, but only recently began playing viola, and my right TMJ has been in severe pain for the last couple of weeks. Anyone have success stories on reducing this mandibular force? I'm not sure what I'm doing differently on the viola, but apparently it's enough to make a painful difference!

Replies (5)

Rocky Milankov

August 26, 2013 at 08:44 PM · This is why every violinist should play viola; some problems with violin that can be neglected, with viola become magnified and have to be addressed.

Get a copy of "Playing the viola" conversations with William Primrose by David Dalton and read what Primrose said about holding the viola.

Viola is heavier than violin and it should be at least partially, if not completely held (supported) by left arm. In any case, there should be absolutely no clenching with your jaw!

His photo with instructions how to find the best placement of viola on your collar bone is also very useful [stand up, take viola in your right hand and hold it on C bout with your fingers on the back of instrument and your thumb on the front. Place your left hand on the top of your right shoulder. Place viola on your collar bone - your right arm is now on the top of the left and lower arms are touching (arms should be symmetrically placed at this point in time). Release your left arm from the shoulder and hold viola in the 1st position. ]

Repeat this basic placement procedure often to make sure that your have not slipped back into uncomfortable position.

Viola is also thicker than the violin, so if you are using the SR, make sure it is at the lowest position under treble side and on the mid-to-low position under the bass side; viola should be tilted about 45 degrees, or at the angle that allows you to clear the A string. Chin rest should also be lower than on the violin and preferably flat.

It is also possible that the instrument is too big for you; try smaller instruments with thinner neck and shorter string length if this one keeps feeling uncomfortable.

I hope that above will be of help.

marjory lange

August 26, 2013 at 11:22 PM · One doesn't play viola exactly as one does violin. The Size/weight of instrument, and A GOOD AND PROPER SET UP suitable for the viola/ist are essential.

If you are gripping too hard with your jaw rather than supporting well with left hand, that could be part of the issue. Your left shoulder may not be well-aligned for the task--but...That said, it's a tough one to self-diagnose; an observant and intelligent colleague/teacher is usually necessary.

Good success.

Christian Lesniak

August 27, 2013 at 02:32 AM · I think that there is a way to use the weight of your head without clenching your jaw. Making your set-up more comfortable should help, and you should look at whether you are having to crane your neck to get that comfortable feeling that the violin isn't about to slip out. I have been helped quite a bit by Alexander Technique and would recommend it. Mind you, this is not something I've figured out completely, but it is something that has greatly improved for me. Also, beware of how you carry tension in your daily life.

Mike Laird

August 27, 2013 at 02:23 PM · The TMJ pain is caused by clamping. You are pressing down with more force to hold a heavier instrument. The force compresses the joint cartilage, and in simple terms, you have a severe bruise of cartilage. The normal jaw movement over this "bruise" aggravates it.

You need to quickly change your stance and stop clamping. Joint and tendon injuries take a long time to heal. They have no blood supply to speed up healing like muscles.

Rob Schnautz

September 3, 2013 at 12:58 PM · Thanks for the responses! I'll see what I can do to improve my posture!

I wonder if hanging upside-down would increase the blood supply? :) Just kidding.

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