Can Trumpet playing Cause Stroke?

I’m sitting here with black coffee in my hand and my trumpet on the table after just having played something in the upper register and this time I was getting pretty dizzy from the high notes again. How big are the risks really ? Are we playing with fire ? I know that trumpet playing can indeed cause a stroke and I have been thinking about the risks before, but this time… I decided to take a deeper look at it.

Are there any research behind playing the trumpet and getting a stroke?

Can trumpet playing cause a stroke?

Apparently some German researches has identified a few cases where the musicians have caused so much damage to the blood vessels inside the brain that it caused a stroke and in most of the cases the musicians were indeed trumpet players.

Dr Stefan Evers, of the University of Munster in Germany, said this can happen due to the amount of pressure being applied to blood vessels as the person blow forcefully into the trumpet. He said pressure on the chest and neck affects blood vessels in the brain and that can cause them to rupture.

There are two main types of stroke

1 Blood Clot

The first one is where a blood clot gets stuck in a vessel in the head and prevents parts of the brain getting enough oxygen. This is the kind of stroke that happens in most of the cases (85% of the time).

2 Rupture

The second one, responsible for only 15% of the cases is where a blood vessel in the brain bursts, causing major damage to the brain. This is more likely to happen to younger people due to the fact that their vessels may not yet have formed properly. An estimated 350 people under the age of 17 suffer a stroke every year in the UK.

Obviously the kind of stroke we trumpet players are at risk for is the second one, the rupture, due to the increase in blood pressure. But is this something that happens often? …

…I mean, should we walk around and bee thinking about this stuff?

How common is getting a stroke and should we be worried?

I remember a TV-documentary about a trumpeter named “Jörgen Petersen” who was popular in the 50s and 60s playing dance music in Scandinavia. In that documentary he said…

..I use to get dizzy when I played in the upper register from time to time, but it always passed as soon as I stopped playing, and I never gave it much thought. Then one day when I was playing in the higher register, I got dizzy again, and this time it did not stop. I went to the hospital and found out that I just suffered a stroke.

Jörgen Petersen lived here in Finland, like me, and somehow that makes it feel a bit more scary and “real”. I also know a local trumpeter living not far from me that has suffered a stroke, but in that case it is not proven that playing the trumpet caused it, although it is highly suspected.

What does the data show?

Dr Evers, from the German study I just mentioned, says that there are  not enough data to claim that “trumpet playing is dangerous” and that trumpeters that have suffered a stoke might have had a predisposition to stroke, with some form of weakness in the arteries to begin with.

So there is just not enough data however, as we all know, lack of evidence is not the same as evidence of it NOT being dangerous.

There are indeed strokes connected to trumpet playing, but as far as my online research can tell, it is far from a significant number and it really does not happen that often.

Did Johan Sebastian Bach’s court trumpeter die from playing high notes?

Gottfried Reiche, 1667 – 1734 was Bach’s own chief trumpeter at Leipzig. Gottried suffered a stroke and died while walking home from a gig at night. Rumor has it that he had been playing the Brandenburger Concerto No. 2 earlier that night. That’s right…

…the piece that is famous for going all the way up to A above high C and one of the highest and most demanding pieces to play when in comes to trumpet baroque literature.

Did he die from playing all those high notes? Of course, no one can tell for sure, but it certainly is possible. Again, there is just not enough data.

What causes the dizziness from playing high notes on the trumpet?

It is very common for trumpeters to suffer from dizziness and even black outs when attempting to play loudly in the high register…

The back-pressure from the air hitting the small aperture, that is required to produce higher frequencies, causes the heart valves to, temporarily, collapse so blood cannot enter in an efficient manner. As a consequence this causes the blood pressure to drop and not enough blood flowing to the brain…

…so when  we suddenly stop blowing, the blood pressure rises quickly, causing the dizziness. It is literally like we are squeezing blood out of our brains when we play high notes….temporarily.

Another take on it

According to another doctor this is what happens when we get dizzy playing the high notes:

The whole procedure starts when we tighten our chest and neck muscles (for sure other muscles may be involved as well) and some of us even close off our glottis. This can trigger the valsalva. If we keep pushing with pressured grunting we can cause the vagus nerve to signal to the heart that it should decrease the left ventricular filling volume. When this happens the heart slows its cardiac output drastically and less oxygenated blood flow to our organs and brain.

Ok so we now have two different doctors giving a somewhat similar explanation, but not exactly the same.

I’m summing up the doctors views on dizziness

In my mind I’m thinking the explanation the first doctor gives is sounding more likely, but of course, I’m not an expert on this. However, with keeping what they said in mind, it is very clear that it is the tightening of the chest and neck muscles in combination with the back pressure from that air that starts it all.

So what can we do to prevent the dizziness ?

Well the first thing we can, and should do, as trumpet players is to learn how to play the trumpet as efficiently as possible. By efficient I mean “putting no more air and energy in than absolutely necessary”. We want as much as possible coming OUT of the bell with as little effort as possible. I talk more about this in my article how to improve sound quality on your trumpet.

Don’t push too hard

Wayne Bergeron said in a master class that he learned to play almost as loudly while still backing of with the air significantly and that this greatly helped  his endurance. I have also noticed this.

It IS possible to learn how to “back off” yet still get  the same big and loud sizzling sound out of the bell. This is an something we should experiment with and practice in order to master because I think it is truly wort it. Not only for avoiding things like dizziness or getting a stroke, but also because it improves our trumpet playing.

So should we be worried?

Like the first doctor said “so when  we suddenly stop blowing, the blood pressure rises quickly”…

…well, as a trumpeter, and gym exerciser, my take on the whole situation is that yes, we are temporarily having high blood pressure issues when playing the trumpet….

…but so does a lot of other things in life give us. This is also exactly what happens in the gym when we lift weights. Or when we sprint up a hill in the forest for example.

During the heavy lifting sets in the gym our blood pressure is nowhere near stable and the similarities does not end there, as trumpet playing in a way is also a bit like physical exercise. Of course it will temporarily do things to our blood pressure, but as long as we are smart about it, it shouldn’t be a problem really…

…and chances are that it might even do good in the long run, making os physically stronger.

My personal view on the risks

My personal view on the whole subject is that, sure, I think more about risks and my own mortality in general, now that I have passed 40, but I also think that if I had any predisposition to weak blood vessels in my brain, they would have bursted by now…

That said I am cautious about it

…that said I do try to approach high register playing with caution and I would NEVER try to play high notes using all my strength and force just to try to get them to sound “a little louder”. I don’t even need to as most of the music I play is classical music and there is no need for “screaming” lead…

Steps to take to minimize the risks

• Make an appointment with your doctor

For the trumpet players that do need to put the hammer down and play loud and high on a regular basis it for sure wouldn’t hurt to make an appointment with the doctor, just to check that the blood pressure is fine under non playing circumstances, and that there are no other factors that would increase the risk of getting a stroke.

There is also something called “Vascular screening” where they can, with the help of ultra sound, check your blood vessels for any abnormalities or weaknesses.

During a screening, they will perform a number of painless tests that check your blood vessels to judge if they are healthy, or if they have signs of disease or any form of other issues. Vascular screenings are provided by specially trained technicians. This is something I would personally consider if I had to do a lot of lead trumpet playing today.

• Play smart 

As I already said, learning to play efficiently is incredible valuable both for our trumpet playing in general and also for our physical health. This is a lifelong process and when it comes to efficiency, we never get fully learned. So be patient and adapt a mindset that, playing with as little effort as possible, is something you’ll always bee working on… and find ways to improve it more and more.

• Don’t take on a lot of gigs that are too demanding

Sure it’s good to push the limits for us too keep growing, but having too many gigs that are just way too hard will increase our anxiety, stress and blood pressure. If the gigs also have a lot of upper register playing,that goes above and beyond what you are commfortable with, this could be a bad combination…

…especially if you are sleeping poorly and are having a crappy diet due to the stress. Again, be smart about this and adjust your life and gigs to best match a more healthy trumpet life.

Final words on trumpet playing causing a stoke

At the end of the day we are playing trumpet because we like it. It is something we do because we think it is fun and, for many of us, it is even more than that…

…it is a lifestyle.

Now, we can not be walking around having anxiety about this because that will take all the fun out of the trumpet playing. Of course we should know about the risks and I think taking the steps we can do to minimize them, is a smart thing to do, like I just said…

…however after having done so, we should let the anxiety go and just be aware of it!

Anxiety kills the passion and no one should have to live in constant fear. So make an appointment and go talk with your doctor if you are worried, practice efficiently and be wise with what gigs you accept and lastly…

…enjoy every minute of your trumpet playing!

Thank you for reading the article “Can I get a stroke from playing the trumpet”

-Robert Slotte-

P.S. Have you or any of your trumpet playing friends suffered a stroke as a direct desult from playing the trumpet. If so, please comment in the comment section and let me know.