Claude Gordon Brass Camp 1987 - Dr. Larry Miller, M.D. on The Diaphragm Fallacy

The photo above comes from Masashi Sugiyama, who is an excellent protege of Claude Gordon with a successful studio and brass camp in Japan.

It's a real privilege for me because not only did I learn a lot about the trumpet, but you'll find that good trumpet players at this level teach a lot about life.
And Claude and I had a good time learning about the physiology of trumpet playing and meeting people across the United States and talking with them about their various ideas about trumpet playing.
And the great respect with which Claude has been held has really amazed me.
I have seen some of the so-called university experts come to Claude humbly about problems that they're having and they want to know.
And you folks are really privileged to have the exposure that we have here for six whole days.
And I hope that you'll really understand what a tremendous opportunity it is.
The reason that I attached myself to Claude was that I wanted to learn to play correctly and make up for lost time as I mentioned last night.
And I went to several different teachers and I was convinced that what they were teaching was not going to get me where I wanted to go.
Some of them were very erudite and names that you would know and I just wasn't getting the kind of information that I wanted to get.
So I called Claude one weekend just before the camp was to begin.
I said, I read your books and I want to know if there's anything that I can learn from this.
I said, you know, I've played the trumpet since I was eight and I guess I was about 35 then.
And I said, you know, I've got a lot under my fingers but I don't play the way I would like to play.
Is there a place for a guy who wants to restart?
I said, sure.
Immediately it was obvious to me that the man's magnetism and ability to give you the feel for what the thing was all about made it worthwhile to come to camp.
I came to the first camp and I listened and I wondered if there wasn't just a little bit of snake oil salesman in this guy because it sounded too good.
And being a physician and being analytical and having been the type of person that wanted to know why things worked the way they did, I really scrutinized everything that went on at the camp.
I watched the professional players that were brought in.
I wanted to see where their armatures were, how they breathed and what they did.
And at that camp he convinced me that I needed to change my armature and this was the third change.
And armature changes are no fun when you don't have good instruction but the way it can be done.
I remember how terrifying my other two changes were and I wasn't anxious to do this but I did it at that camp and I couldn't go out of the staff at that camp and I was really frustrated.
When I got home I decided I wanted to know if I could prove some of the things he was saying.
He was talking about the diaphragm and saying the diaphragm really doesn't do anything, not diaphragmatic breathing.
It's breathing from your chest and getting air into your lungs and moving it out.
And a lot of the things he was saying were making sense to me because I remember as an intern and as a resident working with cardiac surgery at Long Island University that
the diaphragm wasn't a very impressive muscle.
In fact most of the diaphragm was transparent and looked like clear parchment.
And so I first went into the lab at our hospital and got ahold of the pathologist and said,
I want to review some fresh specimens with you and the next post-mortem that you do I'd like you to call me.
And so he did for the next eight or ten autopsies, what we call post-mortem exams, were done.
I went down with him and we reviewed those things and took portions of the diaphragm out and it reiterated my feeling and the pathologist agreed with me.
The pathologist happened to be a jazz pianist so we did a lot of things together musically and he was into this study with me.
And so we took pieces of that and then I began saying now if this is just a kind of a parchment membrane,
like how in the world can this be a muscle that we're told to push and a muscle that we're told to move and that we're told to strengthen
and that we're told to do thus and that with.
So I then went to the index medicus, which is a library resource which allows us to look up any topic in medicine that we want to look up.
And I looked up under neurology. I wanted to find out if there was any evidence that the diaphragm was controlled by a nerve
that we could voluntarily make work. In other words, was this a voluntary muscle or not?
I looked through Gray's anatomy and I looked through Gray's neurology and all the neuroanatomists called the neuroanatomists that I had worked with as a student
and none of them knew of any evidence that the phrenic nerve, which is the nerve to the diaphragm, had any voluntary control.
And so that made me wonder if they're telling us to move our diaphragm and push our diaphragm and strengthen our diaphragm,
how can we do it if we don't have a nerve that goes to it that is under voluntary control?
For instance, the bicep, you can say, all right, I'm going to move my arm and pick up a weight and you can do a number of repetitions
and strengthen the muscle and the muscle will hypertrophy or increase in size and strength.
And that's what they're trying to tell us to do with the diaphragm. They're trying to tell us to strengthen the diaphragm by exercising the diaphragm.
You can't do that if you can't voluntarily make it move.
So what we then designed was a study to try and show what really happened with the diaphragm.
I wanted to visualize that diaphragm as it worked in the human body.
I'd seen it at surgery lots of times and every time I'd have an opportunity, I'd dissect the way the organs and take a look at the diaphragm as it functions.
So I could reiterate my feelings and every time I looked at it,
I saw this clear parchment like dome with some periphery of a fine little muscle fiber that attached it to the wall of the body.
And so I really convinced that this didn't work.
So I then talked to several pulmonology friends of mine, people who study lung diseases and work with breathing diseases.
And I talked with radiologists, friends of mine, because radiologists every day while they do upper GI, X-rays and various things, see the diaphragm move.
And I wanted to know, do you believe that this is a voluntary organ? Is it something that you can control?
And every one of them, none of the physicians that I talked to thought that the diaphragm was under voluntary control.
So that reiterated these things.
I contacted a good friend of mine who was the head of the pulmonary department when I was going through school
and was later the head of the pulmonary department at Harvard General Hospital here in Los Angeles.
I designed a study that we could put together to satisfy the needs of both the brass playing and musical society and also the medical curiosity.
And that's the study I'd like to talk to you about today.
But before I get into that study precisely, I'd like to give you a little of the background of why I think that it's really important for you to understand your bodily function in relationship to brass playing.
Because as Claude pointed out in his lecture last night, the trumpet is really only a piece of pipe that's wound around.
It's no different than a pipe that you might find in any industrial situation, except that it's made to certain specifications.
And it won't make any sound without you applying your bodily functions, so to speak, to the horn.
And so it's really an athletic endeavor.
And it's not necessarily a natural undertaking.
We were not designed necessarily to play wind instruments.
But the body has tremendous powers of compensating and what we in medicine call homeostatic mechanisms.
You do one thing to the body that seems to throw it off center, and it'll compensate by doing another thing.
The blood, for instance, maintains its acid-base balance very carefully by a mechanism of homeostasis that keeps us alive.
If the blood acid-base balance moves one way or the other, it can very quickly kill us.
And the body does lots of things to keep that from happening.
Our blood pressure is maintained in a certain realm by the amount of cardiac output, the amount of blood that moves from the heart.
As we walk up the hill of the meeting today, our heart rate increases so that our brain gets enough blood supply to keep it alive.
And there are just numerous unbelievable mechanisms within our body that make us work correctly.
And so we needed to get, in order to play correctly, we needed to get in harmony with those mechanisms and not fight against them.
A lot of the erroneous things that have come into the trumpet-playing literature and even into the pulmonary or among medicine literature are erroneous.
They're misnomerous, and they lead us to fight what is the natural process of the body
and what the tremendous virtuosos in brass playing have done is they have either learned or fallen into doing what is natural for the body.
And they have keyed upon that and drilled it and made it second nature.
So we need to really recognize that this body is really the instrument.
The trumpet is the piece of pipe, and it gives us a particular sound, but the body that you have is the instrument.
And if the body's not in shape, you're not going to play well.
You may at one time acquire a great deal of skill and be able to rely on that as you gradually over the years become less and less conditioned.
But one of the reasons I feel that some of the older players begin to tail off in their playing is that they do not have a physical approach to brass playing.
And all of a sudden I'm saying, this really is incredible.
His book is entitled The Physical Approach to Brass Playing.
This really makes sense to me.
So Claude had already done a lot of this kind of thinking.
Most of the players that played with stature had not taken a lot of time to be cognizant of what was making the trumpet work.
They were lucky enough to have good instruction and fall into some of these things.
Claude really was the first person of the many trumpet teachers that I studied with, many of whom were some of the best legitimate players in the LA area,
some of the best jazz players in the Bay area, didn't really know.
And this book that is just out, in my thinking,
capitalizes all the things that have not been printed anywhere and that attracted me to Claude Gordon.
It's called Brass Playing is No Heart of the Deep Reading.
And I was privileged to have written the preface for Claude.
And I really mean privileged because this contains the kind of information that I came to this camp wondering about
and that you can't find anywhere in the literature.
Any of the stuff that you read is not going to be clear and concise about that.
Herbert Clark refers to a lot of these things, but he never did a didactic work like this one.
All the other players, Schlossberg and all of the Smith works and things hint at these kind of things,
but they're not clear about the function of the tongue.
They're not clear about the function of the diaphragm.
They're not clear about the upper register.
They're not clear about the natural way a trumpet needs to be played.
This book puts it all together.
And if Claude had not put out any other book than this one, this would start and would get you to playing correctly.
And there isn't anything that I know of that even comes close to it.
In this book, we do have the version of the study that was done for publishing in the New York Brass Society Journal.
And it outlines our trumpet study.
So you'll be really helped by having this as a reference work as you go on through the years,
especially those of you who are teaching.
What a tremendous thing to have for young people, people who are not full of bad habits
and not full of a lot of neural pathways that will have to be retrained.
I wish anything that I could have had something like this when I started.
What Claude was talking to you about has been hitting on wind power today,
I want you to understand from a physiological approach.
Because what we're doing is talking about training the body to do trumpet playing in the correct manner.
Claude's study, the down study with the pedal tones, is accomplishing many things.
But one of the most important things that it's accomplishing is training the muscles of the chest wall,
the back, the neck, the abdomen to work in concert to move the air effectively.
And as we'll show when we talk about our study, the diaphragm is not going to be very important
in terms of how you train to play the trumpet.
What Claude is really doing as he teaches you the pedals is showing you how to train your muscles.
I stayed here with Dave Evans' class on practical approach because I wanted to see how it was done.
Dave does a really good job of making sure that you understand that it's not necessary how long you hold that note,
it's how you hold that note that really trains you.
As you get down into the pedals and you take the big breath that allows you to fill up the lungs,
Claude is going to have you hold that note to isometrically and isotonicly train the muscles of your chest wall.
That squeeze is really the important part of what I call the chest up Claude Gordon accordion squeeze method.
The reason I call it that is because I want you to get the whole concept with something that you can remember.
Because that really physiologically explains what we're doing.
The chest is up.
I squeeze at the end.
Now this isn't going to just help you to play pedal notes,
but when you play in the upper register you're going to have the strength to play
and give the support that you need with the wind to the upper register.
So while you can't now have all the techniques to play in the super upper register,
you can have, be training the neuron pathways that lead to the muscles
so that when you have the ability to play in that upper register, the muscles will be trained.
And in fact it's the training of those muscles that get you to the place that you can play the whole horn.
Not just the supreme upper register, but the whole horn.
So this down steady, this poo-poo by some people,
is probably one of the most important parts of any basis for trumpet playing that you can imagine.
It trains the muscles to be coordinated.
I don't hold those necessarily real long,
but I hold them long enough so I can feel that squeeze.
When I first started to do this, one of the things that really tricked my imagination
was that my back really got sore.
And I knew my diaphragm didn't hurt, at least I didn't think it did,
but the muscles between your scapula, these wings here, really get a workout.
Your trapezius muscles, your erector spinae muscle of your back,
the rhomboids and all the neck muscles get a tremendous workout.
And if you're playing this method correctly, you should be sore.
And so you have to approach it like an athlete.
The only reason that I even give this lecture is because,
not that I want you to be up on the latest medical terminology of all this,
but I want you to understand why you are learning the down steady.
And it's because the nerves that control these muscles
have to be grooved, if you will, to do this thing by habit,
so that when you play you don't even think about it.
It just happens, because you're going to be out in a situation
where the adrenaline rush is really going.
You don't have time to think, chest up, boy I got to squeeze.
But you can think about, just last weekend I was playing a church gig,
and those things scare me most of all the things that I do.
And 2,000 people out there, and the pianist plays a little dinkly dink up here,
and you've got to come in right on the top note,
and all of a sudden your mouth is dry,
and it feels like your armature is slipping down on your chin.
And the one thing I always think of when that starts to happen is chest up.
And boy that makes a big difference, because all of a sudden I have the support
that I need to carry me through, and all the rest of the things work by habit.
It's just like Pavlov's dogs.
You train them to do certain things,
and you associate it with a ringing of the bell or whatever,
and every time that bell rings they'll do it.
That's what you need to do with your body.
You need to train your body to automatically assume that
you're in the clot board and chest up according to the squeeze position immediately.
You need to assume that every time you get in trouble,
because that's what makes the whole situation work.
Now, we have a skeleton that surrounds the chest,
the ribs, the sternum, which Claude was talking about having been sawed in two.
By the way, when he did this double C thing that you saw here today
that he just let us have about that much of,
I'd like to watch the whole tape myself again and again.
When he did that thing it was just a few months after surgery, as I remember.
And they do saw the sternum in half with a saw that vibrates real rapidly.
They just saw the sternum right half.
Then it's wired together, and it takes about six to eight weeks
for things to start knitting again, just like a fracture.
So when he sat there and did that, or stood there and did that,
what was happening was he was playing so correctly
that he could get away with what if you and I did that bypass surgery,
we'd have tremendous pain from it.
And I think that's tremendously amazing.
I happened to be lucky enough to know Claude before he had his surgery
and to have heard him play on several different occasions.
It was a great amazement.
I was convinced that it can be, one hell can be as easy as the other.
He had done it correctly.
But the sternum provides the rigid support with the ribs,
which attach back here to the vertebrae for the lung to be able to build up pressure.
The body builds pressure by having a rigid container, much like a gas tank.
The muscles which go between the ribs are called intercostal muscles.
And in the past, I've brought specimens that can,
and we have dissected them and looked right at these muscles.
But because I live in Northern California,
it was difficult for me to get some specimens down here.
But Dave Evans has volunteered next year to bring the live specimens
all over 21 years of age.
Anyway, there are muscles.
You know, when you go to the rib house,
and you have ribs for dinner,
you're eating intercostal muscles.
That sounds pretty gross,
but I want you to get a pretty good idea of what those muscles are.
They're muscles between the ribs,
and they're long, short little muscles.
And they're very important to the trumpet player
because they have to be trained to squeeze,
and they have to be trained to work with the whole mechanism.
So those muscles, the muscles of the neck,
what we call the strap muscles of the neck,
they extend the sternum and hold it out
so that you can generate more pressure.
It's important to have as large a container as you can make
to get as much air as you can get into it.
And then once you get that air in there,
to be able to hold it open while the muscles squeeze around it.
So the neck muscles,
and you'll see in the slides that will show
the development of the neck muscles
that the trumpet players can use in the study.
This is something that I never heard Claude talk about,
but it was very impressive to us when we did this study,
that the neck muscles held the sternum up and held this rib cage open.
For every two to three centimeters of increase
in what we call the anterior-posterior diameter,
the diameter between here,
you get another 300 cc of air.
So if you will take a look at most of the trumpet players
who've been doing breathing exercises for some time
and playing for a while,
you'll see this big barrel chested look.
It comes from constantly having the sternum lifted in the anterior
to posterior diameter of their rib cage has increased.
And so they get more.
If you'll say, call a motorcycle at a 700 cc capacity,
when you talk about increasing it by 300 cc,
you're adding a lot of air.
One of the other things that I ran across
in my looking through the literature in this area was that
when we maximally expel air, as in sneezing,
it gets up to around 500 miles an hour.
And one of the things that Claude will talk to you about
in terms of wind power is velocity.
The speed with which you exhale
is very important in terms of playing the whole horn.
And without getting into the other things that make that work,
it's just important to have as much speed as you can get.
So developing these muscles becomes ten.
In addition to, of course, the anatomy of the lungs
and the muscles, there are the soft tissues that make up the lungs.
And that begins right, makes up the respiratory tract
of which the lungs are only part.
That begins right in the nose,
continues down through the mouth and the back of the pharynx,
down through the trachea,
and on down to bronchial tubes,
which divide and go out into the lung sacs themselves
and have smaller branches in the bronchioles.
And then little tiny air sacs.
So we're dealing with a very delicate mechanism.
That's why you need to get real raspy
when people start wanting you to do things
that are going to harm the physical mechanism.
Smoking.
The worst thing a trumpet player can do is smoke.
Unfortunately, a lot of the jobs that people play
give them as much exposure to smoke as if they smoked themselves.
And interesting data now well known
proves that that's damaging almost as much as smoking soap.
You have to protect yourself as much as you can.
You have to take care of not getting respiratory infections.
And in my next lecture I'll get into some of those things
in terms of the care and keeping of the trumpet player's body.
So the important thing about the pedal tone blowouts
for today's wind power information is
that those things train the muscles of the body
to do what you want it to do.
And it's the foundation for the support of your progression
on up into the virtuoso range.
If you don't do those things, you won't play.
I know that when I get down on my running,
breathing exercises if you will, my range drops.
If there's something going wrong like I'm wondering why my ranges drop
or why it doesn't sound like it should,
oftentimes I can say, you know, I've missed four or five days of running.
Interestingly enough, studies with professional athletes
show that if they don't do their training for two weeks,
they completely detune in terms of their aerobic capacity to function
and they have to start building that back up.
So you need to have a regular program
and the breathing exercises are just as important as your Clark studies
and any of the other things you'll do
because they give you the foundation for making the body work.
Interesting in Arvins. Does anybody have Arvins here with me?
Arvins made a statement about breathing
that showed the diaphragm did not really do the work.
And in the edition, the editing goal, I guess it was,
put a footnote down.
You have an Arvins. See if you can find that spot where...
Let me look at it.
Anyway, get out over there if you've got it.
Goldman said something about modern day trumpet players
know that the diaphragm is important.
And what really comes out of this is that like so many other misconceptions,
Arvins was really right.
He was aware of the fact that the wind power came from the chest
and not from the diaphragm.
Let me talk a little bit while Claude's looking that up
about the study that we did.
We recorded this enough time.
Having placed the mouthpiece on the lips,
open the mouth partly at the sides
and the tongue back so as to allow the air to penetrate into the lungs.
In inhaling, the stomach should not swell,
but rather contract in proportion to the chest, which expands.
And then the good old editor puts down here footnote number 14.
When was this done?
Three?
Oh, no, Goldman was before.
It was probably 40 years ago.
Anyway, it says the diaphragmatic system of breathing,
almost universally used at the present time,
teaches the drawing of the breath directly to the diaphragm,
which causes a slight distension of the body about the waistline.
I was really confused.
More complete control, greater power, and more ease in the upper register
with a noticeable lessening of the pressure on the lips
are the advantages to be gained by this system.
Luckily, on the last update, which was done by Claude,
on the last editing, he says the original text is more correct
than the Goldman footnote above.
I'd like to know that I take credit for showing this to Claude,
and I'm glad he signs his name and not mine,
because he's the one that has to get in trouble with all the musicologists.
At any rate, it says it is known that so-called diaphragmatic breathing
is a misnomer.
The power is generated from the chest muscles.
That's really true.
The oval iris, which most of us have, don't have that updated in it.
Okay, what we did in this study was to convince the hospital,
where I spend a lot of my time,
that they needed to contribute to the fund of medical knowledge.
Little did they know that it was really to contribute to the fund
of musical knowledge more than medical.
But you can imagine the politics in a situation
where we wanted to use the radiology department,
we wanted to use the pulmonary laboratories,
and use some expensive equipment.
And we didn't want to pay for it.
So what we eventually did was,
I transferred all my patients to another hospital for about two weeks,
and the administrator was convinced that he needed some more revenue
from those things.
And so he reluctantly allowed us to use the radiology department.
The radiologist was very happy to do that.
A lot of physicians are amateur musicians,
and they're interested in these kind of things.
The radiologist, the chief radiologist, was really happy to work with it.
And we brought him in, and we brought myself,
and we had Claude round up six players that he felt played correctly,
except the one.
And we applied the principles of sports medicine investigation to these people.
When we study athletes,
or when we study people who are rehabilitating after a heart attack,
we often do these same kinds of things.
We put them on a treadmill.
We have them run in front of a grid.
We have them breathe in front of a grid
so that we can measure different movements of the body.
We did all of this,
and came out with a lot of other peripheral information.
The thing that really was interesting to us was we took players like Claude and Larry Susan,
who's a very fine player, one of the leading players in the Bay Area,
into the radiology department.
And we had them play in front of the ferocity machine.
The radiologist and myself observed what they did.
Unfortunately, this is before today's video equipment,
and we don't have a permanent record of it.
And we're unable to get the hospital to allow us to do it again
because of the liability involved in actually exposing persons to radiation
who are not in need of some sort of medical help.
So we observed.
We had the radiologist, myself, and one other pulmonologist
observe the whole process.
And we asked the trumpet players first to stand in front of the philosophy unit
and move their diaphragm.
And when they would try to move their diaphragm,
their chest would pop up,
and the diaphragm would not do a whole lot.
When we asked them to take a big breath,
the diaphragm started to move.
They took a bigger breath, it popped up,
and it stayed in that position.
When they let the air out, it fell back down to its normal, slightly domed shape position.
So this is kind of what we had expected,
that the diaphragm really wasn't under voluntary control
and that thinking about moving your diaphragm could not move the diaphragm.
We said to them, I want you to move your diaphragm,
but don't move the muscles of your chest.
Don't move your chest wide.
I don't want to see any movement here.
I don't want to see you do anything except move the diaphragm.
And of course, they couldn't do that.
Then we had them play an arpeggio from C in the stab to high C,
and we watched what the diaphragm did.
The diaphragm normally sits, slightly domed shape,
and when you breath in, the diaphragm flattens out.
And as they took their breath in, it flattened out.
As they played the C, nothing happened.
As they played the E, you could see some movement, some tensing of the diaphragm,
but not any pushing motion.
As they played the G, on the top of the stab, the diaphragm then popped up.
It didn't gradually go up.
It popped up, and it stayed in that position when they went on to hit the high C.
When they nailed the high C a few times, the diaphragm stayed in that same position.
We had them blow the arpeggio down,
and the diaphragm, when they got to the G on top of the stab,
resumed its normal position just suddenly.
It popped up, and then it would suddenly come down.
So what we were seeing was a response of the diaphragm to the pressures on either side.
The pressures generated beneath the diaphragm, like squeezing a tube of toothpaste,
popped it up, and a squeezing mechanism of the chest wall that we've been talking about
then created the pressures that held it up as they played.
So in fact, what the diaphragm was doing was transducing or transmitting the pressures
from the abdomen and the chest wall into the lung cavity
so that the pressures could be raised in the lungs and the air moved out.
And so a term that may be more appropriate for the diaphragm's function is a transducer,
which is really another word for a way of transferring energy from one area to the other.
Of course, the diaphragm, when it sits below the lungs and separates the lung cavity from the abdominal cavity,
so it transduces that energy.
The slides that we'll show have some medical illustrations,
which were done by a medical illustrator who observed this process.
And we'll also show you some of the things that we did with the breathing,
and you can notice some of the muscles involved and actually see.
I didn't tell Claude, but other things that I was looking for while we took these movies,
action, and pictures of him playing was armature placement.
I wanted to see what happened with the muscles of the face of people playing,
and some of the conclusions that we drew from all these things were that really almost everybody does it a little bit differently,
and that all this concern about the face and the lip is really misconstrued and can foul your way up.
But let's see the slides if we can now and go from there.
Who's going to run that one?
Okay, let's take the first slide.
Claude will stop me if he doesn't like the look of the pictures I'm showing.
The first camp that we had after we'd done this study, I brought an animal diaphragm,
which I kept in formaldehyde and actually showed.
We have Dr. Myron, is that how you pronounce it?
He's a pathologist and he sees diaphragms all the time,
and I talked with him a bit before the lecture and wanted to get his input,
and I'm sure he'd agree that you hold the diaphragm up and you look through it,
and it's pretty parchment-like and pretty thin material except for a periphery of muscle along the outside.
Anyway, we had one of those diaphragms that we showed to the campus.
Really impressive.
We later had a ceremony where we burned the diaphragm,
a symbol of our misnomer that we've all got into.
Anyway, this is a side view of the chest as if I was standing like this and was sectioned down in half by a valve,
what we call sagittal section, and this is sequentially what happens to the diaphragm
as a player takes inter-breath and blows.
This is the position of the diaphragm at rest, slightly domed, rounded like this.
When the breath is drawn into the lungs, the diaphragm flattens somewhat,
as the player begins to blow, the diaphragm tenses somewhat and the fibers are drawn together a bit,
we postulate, continues to tense as he blows higher,
and when it gets to that certain critical pressure, which appears to be G above the staff,
it pops up to apply pressure on the lungs and allow the chest to squeeze around it
and move the air out much like a toothpaste and you're rolling it up at the end to narrow the cavity.
The lungs are squeezed and the diaphragm stays in that position until the breath is relaxed.
That's what I want you to be visualizing as you go through these slides.
Let's see the next one.
This is a front view, which incorporates some other interesting physiological changes,
but for now I want you to look at, this is it, I was facing like this,
and some of you over there may have a harder time seeing it.
Picture of the bottom, let's look at all the B's.
The first picture at rest, the diaphragm is domed shape.
Second picture, with inhalation the diaphragm flattens out, with exhalation it begins to tighten up
and with marked expiration or exhalation it pops up,
squeezes the lungs and allows us to create more pressure around the lungs
and thereby move more air effectively.
Some of the other interesting things that you'll notice and that we noticed during the fluoroscopy was
the heart lies in between the lungs and during the marked expiration or exhalation,
the heart is squeezed and it's made smaller.
One of the things I've been interested in doing here lately has been measuring some of the pressures
in the heart with blowing.
We can do some interesting things with Doppers and measure inflow and outflow from the heart,
but the diaphragm is what we want to concentrate on here.
Let's go to the next slide.
Whoops, upside down.
Oh, I think you got this, I hope we aren't going to be in here backwards.
Go to the next one.
I think that was supposed to be towards the end.
Put it away at the end.
Let's just go to the next slide.
I want you right here.
My audio visual department.
This was Dave Evans last night.
We need to turn these all around on this slide.
Why don't we turn on the lights while he's doing that and we'll just maybe take some questions from the audience.
Yes, sir.
I think that's an important consideration and I want you to come away understanding that's really the crux of this whole thing.
It's the change of pressure that the diaphragm responds to and until that pressure,
pressure created around the diaphragm, the pressures on the bottom being less than the pressures on the top that pop it up.
And it occurs at a critical time.
It appears it does not occur gradually throughout the exhalation.
It just pops up and stays there.
And then the chest and the muscles around it have to finish the squeeze.
His question was about blacking out and that's one of the things I want to cover in my other lecture.
But briefly, the heart being squeezed I think has a lot to do with it.
Playing incorrectly may have a big deal to do with it.
One of the things that I've been doing is measuring the pressures in the external jugular as you play.
And I'm pretty well convinced that the cardiac input, if you will, on the what we call preload of the heart drops.
In other words, the flow of the blood into the heart drops.
And so there's not as much volume in the heart to move.
And so thereby the cardiac output drops.
And that means that you get less blood in the head.
And so you pass out.
It's usually accompanied by some hyperventilation.
But squeezing the heart down like that decreases the inflow of the heart.
And so one of the reasons you may pass out I think is related to increased preload on the heart.
I haven't been able to convince anybody to let me put a swan's hand after them and play the trumpet again.
Because that's what it would take to measure the depression.
Would there be any sort of adults who need to rest playing or is it just one?
Not necessarily.
I think it can occur with long sustained compression of the heart and the inflow vessel.
If you play correctly and easier, less likely I feel to pass.
To that keynote, was the G where the diaphragm flips up?
Was it all in the G or would it depend on the playing experience?
With these two players that we studied, he's asking if it's a critical note G.
It appeared to be for these two players, professional players, Claude and Larry Susan.
And it appeared to be that that's where it would change for them.
I don't know where it would change for somebody else.
But I would imagine the pressure would be the same whether it was a G or whatever it was for that movement.
Yes sir.
You mentioned, well first, you said isotonic please.
I understand isometric, but I didn't know isotonic.
Isometric of course means the movement or lack of movement.
Isotonic means the movement.
The other thing was, you said there were five players that played correctly and one who didn't.
Well one fellow that we felt was in this study played differently then.
Was that on purpose as a control or just?
I'm not going to tell you.
But you guessed it pretty close.
Did you measure it as you were going down to the pedal register with the squeeze?
No, we didn't look at them with the pedal register.
I'm sure that the diaphragm popped at that point.
We were really wanting to just see how the diaphragm functioned.
Nobody ever really looked at the diaphragm and said, does it gradually rise or does it move with each note or what does it really do?
Yes sir.
I bet we were talking about skeletal muscle and striatum muscle and that sort of stuff.
The fast twitch and the slow twitch as I understand it has to do with skeletal muscle and its involvement in spreading as opposed to long distance kind twitch ability.
I don't think that's in play here.
There are a few strands of what appear to be skeletal muscle around the outside of the diaphragm.
I don't know about the fast twitch.
I think fast twitch and slow twitch fibers are present in all skeletal muscle and that skeletal muscle is skeletal muscle whether it contains large amounts of fast twitch or less amounts maybe genetically predetermined.
Can you turn the lights on?
I think this is backwards.
This is supposed to be at the end.
I'll just put that in in the order you want it to be.
Okay.
First of all before we started with all these things since we put these guys on a treadmill and had them go and take a full spirometry test including total lung capacity.
We examined them carefully.
We had to fill out a full history and so we got a lot of data in addition to just the diaphragm study about trumpet players in general.
We did some flexibility studies to see how in shape they are in general.
The six players that we studied were pretty poor athletes except as they approached the trumpet they were not in very good shape and that's a phone of contention.
Tom Rosin was better at that time.
He was much more live and of course he's now slipping into the professional world.
Anyway the hormones were not flowing yet.
So we also had a sign of consent because even though this was a few years ago we were still worried about malpractice and I'm not sure if we could do this study today.
Okay let's go to the next.
We've already seen this.
Alright.
Okay.
This just shows some of the guys outside the rooms where we were doing the exercise testing and the percent body fat evaluation and the flexibility studies and some of the grid movies.
We used an office complex there on the hospital grounds that we used for human performance testing.
Okay.
Harold Meyer, the fellow that you see there, is an exercise physiologist who trained with Dr. Boyer at San Diego State.
He's one of the real early guys to get into sports medicine so I was really happy to have his input as an exercise physiologist.
He did the flexibility testing and the present body fat evaluation and also happens to be a trumpet player and I got to do it for nothing so that worked out real well.
He's a very fine trumpet player and I keep trying to get him to come to camp.
His father's a dentist and he plays the trumpet as well.
Okay.
Again the diaphragm is what we're talking about here.
I'm not going to go through it but memorize this sequence.
Talk to yourself about the Claude Gordon chest up accordion squeeze.
I get those mixed up because they call it the accordion and he plays the accordion awesome.
It's a Claude Gordon chest up accordion squeeze.
When all else fails, think chest up.
Okay.
Here's Tom and the grid behind him was used to measure a much younger man.
A lot less mild on him.
At any rate, the little markers there are not the neural warts.
Markers have been placed on them so that we can measure movement of body musculature in front of the grid and later bring it down to definite figures.
Anyway, interesting things for me and you to note here are look how high that armature is up on the upper lip.
This is a pedal C and I think it's a double pedal C as a matter of fact.
There is some pressure being applied.
The chest is held up by the muscles of the neck.
This is a long muscle called the sternocleidomastoid.
It goes from the sternum and hooks a little bit over here to the clavicle but both bellies of that muscle meet and go up to the mastoid process behind the ear.
And so it lifts the chest wall up and then these muscles are beginning to squeeze.
You don't see any reaching out of the belly as he applies air.
We'll just go through a sequence again from double pedal C to pedal C to C to C of the staff to high C.
And you'll see the changes in the musculature.
Okay, here we have this pedal C still applying pressure.
The same muscles are being utilized.
This really illustrates a lot of the seven things that Claude is talking to you about in terms of what to do with the correct plane.
The wind power is being developed by the squeezing of these muscles.
You can see the abdomen is actually squeezing in here as it creates enough power and pressure to squeeze that to the toothpaste and pop the diaphragm.
Okay, go to the next.
Same thing is happening here.
He's playing with a little less force now that he's on the pedal register it looks like.
Let's go to the next one.
And interesting things for me to look at are the muscles of the orbicularis oris around the mouth that are developed as you play.
The chest is held up continually by the sternocleidomastoid muscles.
When we measured these marks we found that there was about a two centimeter lift in the chest and it never went down during this whole plane.
It didn't go up.
Notice the muscles in the posterior of the neck, trapezius, latissimus dorsi all contribute to the formation here.
Some tremendous power generated there in the neck.
Okay, let's go to the next.
I think this is a high C and you can see he's really squeezing the old accordion.
Boy, that's really being brought down.
The chest is still held up.
Lots of pressure generated here in the neck as he goes up.
Let's see the next one.
This may have been a double high C. Yeah, that was a double high C. I'm sorry.
I didn't think you worked that hard for your high C.
Okay, what you saw was Tom was applying the principles that he learned by doing the down study and the range study to make the muscles of the chest
produce the pressure changes that were necessary to pop the diaphragm and squeeze the lungs.
The diaphragm at rest, inspiration, flattens out, tightens up as he begins to exhale, continues to tighten, then pops up when the critical pressures are met.
Okay, next.
I put this in because Larry is a good player, a great player.
In my estimation, I enjoy his music ability and his technical abilities as much as any trumpet player that now plays actively.
And he has unbelievably done these things correctly.
And for someone who spends his little time practicing, he does things right because he laid the foundation and he played beautifully.
This is the pedal C. Let's go to the C just below the staff.
And same muscles are evident here, but you don't see them as dramatically because there's a little bit of adipose tissue around those muscles or a little bit more fat tissue.
Okay, let's take a look at the next one.
Here we are with C in the staff.
Same social thing, let's go to the next.
Now, interesting things start to happen here.
I don't know if I should even point these things out because they don't necessarily have to do with wind power, but I really looked at these things critically.
His armature has moved all over the place.
They tell you don't move that armature, set the armature, set the quarters.
Boy, I watch him play and he moves that thing wherever it needs to go to do the right thing.
And he's also grabbed the octave key, you can see.
So let's go to the double high C.
And the same sorts of things are happening with the neck, it's held, pulling the chest up, the chest is squeezing.
You didn't ever see any pooching out of the abdominal musculature.
Never done.
Sometimes I'll see players when they take a breath in, it seems like they pooch out.
I think that's more a lack of conditioning of the abdominal musculature than anything else.
I don't think it has anything to do with creating the pressures necessary.
Because when they play, it squeezes in.
Okay, let's look at the next one.
Double high C again.
Lots of conditioning in these muscles here.
One of the things that the down study does for you as you hold that sustained note is it begins to bring the muscles of the face into play
and the strengthening begins without the pressure.
So it's an important part of the whole muscle development.
Oh, that's in baggage.
Let's just go on.
We can go through these next ones rather quickly.
This is Dave Bendica, a very fine player who will be here Thursday night.
Great jazz player.
At this point, he was playing, I believe, was his mouthpiece in?
I think it is.
At any rate, pedal C, no problem.
Let's go to the next one.
Move it up in the register.
Not a whole lot of fighting going on here.
You can't really see the muscles of his neck as clearly as you could on Tom when there's so little time.
Let's go on to the next one.
Same thing.
No abdominal excursion that you can see at all.
Okay.
I think this is high C.
Every one of these guys' facial structure changed in a different way.
There's no absolute right position on the face.
I just really was impressed with the fact that Dave really played even differently than Larry and all the others.
Let's go to the next one.
Finally, we begin to get to see, at the double C, everybody's gone to the octave valve.
We're really seeing a lot of neck muscle stuff going on here in Dave, even though the adipose tissue kind of hit it for us a little while.
Okay, let's go to the next one.
When we got done, Dave did this and said, don't ever do that to me again.
Now, you stop me if you don't want me to show you.
These are old pictures.
These are old pictures when Claude was, interestingly enough, he was having chest pain.
But if you know Claude, you know that he functions without really letting anything in his mind get in the way of what he wants to do.
And if he feels bad, he convinces himself he feels good.
And I'd take my lessons and he'd tell me about these little chest pains and I'd say, Claude, that sounds like angina.
I want you to go be checked out.
Well, he wouldn't do that.
And he went to the University of Washington, Toronto.
And he gave a clinic there.
He said all during that whole session he was having chest pain, but he thought it was just gas.
And so he ignored it and continued to play and do all these things.
And when he got home to the LA International, he just barely got his suitcases through the airport and decided he better get something done about it.
He did the study of his coronary.
He found considerable coronary disease that needed immediate bypassing to prevent him from having heart muscle damage.
So when we did these things, I noticed a few changes on his cardiogram.
No real serious things.
He had a first degree heart block.
But nothing that really led me to believe that he was in serious trouble.
But he did have severe coronary artery disease while we were doing these studies.
And so maybe that will give you some insight into the kind of man we're dealing with here.
A great deal of denial.
I have to trance on him every so often to make sure that he isn't letting his health get in the way of his trouble planning.
Oftentimes his priorities are his trouble planning.
Anyway, let's go on to the next one.
This is the pedal C.
The C of the staff.
Perfect embouchure.
If anybody ever had it, it's right there in the center and right where it belongs.
Claude's changed his embouchure many times.
And I remember when they wanted to change my embouchure, the teachers all got together and discussed it.
And they read the argument where it said that it could destroy a trumpet player and better not do it.
And they were terrified.
So when I did change it, I was really afraid.
But Claude convinced me that it was like long, long, long.
Tom has changed his.
Lots of the guys have changed their embouchure.
With real good success.
Okay, next one.
High C.
Looks like he's playing a pretty sweet tune, doesn't he?
All right, let's keep going.
Double high C.
Claude took off the octave valve on his horn.
But you notice he went for the third pedal.
So if you can play double high C, I guess it's acceptable.
The interesting thing with Claude is the tremendous neck development over the years.
He's not been a weightlifter.
He's not done specific things to develop his neck.
But it's developed because of continual exercise from trumpet playing.
But also the AP, the anterior-posterior diameter, is bullish.
I'm looking at Carl and some of these guys.
Well, it is built in a real robust way.
And I believe that it comes from playing a trumpet in the correct way that they do.
Okay, Claude went on to do triple C with this one.
And he did a couple of them for us.
And I think we got both of them.
What's the next one?
This one even let go of the third valve.
But I was there and can attest to that.
It came out like a siren.
I think I had one more of them doing that.
I took so many pictures of it.
Didn't want to forget it.
And by that time, he thought he had had enough.
And so that was the end of the study there.
It's interesting.
I've watched Claude.
Yeah.
Immediately we put him down and made sure that he wasn't going to pass out.
No, he had no problem whatsoever.
But we did do a thorough examination, cardiac-wise, at that time.
Let's go on and see what happens.
That's essentially, in a nutshell, a study.
I've tried to give this to you in a way that can be understood by the wide range of backgrounds that we have here today.
I'll be glad to answer questions that you may have.
And we'll entertain those pieces at this time.