Why Valsalva Problems Get Worse the Harder You Try to Fix It

If you've been dealing with the Valsalva maneuver for a while, there's a good chance you've already tried to fix it.

You've read about it and researched ad nauseam.

You've worked on your breathing exercises on the instrument.

You've adjusted your technique.

You've practiced slowly, more intentionally, and more mindfully.

And fast forward 1+ years, here you are.

Not because you haven't tried hard enough, but because trying harder, in the way most players try, is part of what keeps the pattern going.

Why does this happen? Is this simply a "this needs more time phenomenon," or is there a more effective approach?

What the data shows

In a recent survey I conducted of brass and wind players experiencing Valsalva symptoms, the majority had been dealing with this issue for 2 or more years, and a significant portion for 3 or more years.

These weren't beginners who hadn't yet thought about their playing, but musicians who had developed a foundation in fundamentals and technique.

These are the graduate students writing dissertations, professional orchestral musicians, and college professors.

People who, by any measure, know how to work on something and develop a skill.

They've spent the time in the practice room, reflecting, asking questions, and repeatedly going through the process of practice, performing, and getting better at their craft.

One respondent described spending all two years of graduate school addressing it, finding workarounds, mastering air attacks, and developing alternative articulations just to get through auditions, but still felt they hadn't moved past the fundamental issue.

Another musician described their valsalva response as debilitating, while others used the word "terrifying."

One even described developing what they called a deep resentment toward playing, ultimately putting away their horn and pursuing other crafts.

This is not a group that gave up.

This is a group that is deeply dedicated to their craft.

Given that this group is deeply dedicated and aware of this problem, and given the period over which these problems have occurred, this problem isn't about effort but rather about approach and direction.

The awareness trap

Here's where the approach can get counterintuitive.

For many players, the moment they finally identified what was happening, when they put a name to it, understood the mechanism, and started paying close attention, things became harder.

One respondent described it as,"

"Becoming aware of it was a double-edged sword. I figured out what was happening, but now that I knew, I couldn't help but focus on analyzing it more."

This is not an unusual experience, but a predictable one.

Here's why.

We've discussed that the Valsalva maneuver is a natural bracing reflex influenced by activity, movement, and the overall resting state of the ribcage and pelvis (aka the nervous system).

One of the nervous system's roles is to respond to perceived threats, whether mental, physical, or life-threatening, including the possibility that something will go wrong.

When you become hyper-aware of a pattern, your attention sharpens, and focus increases. If we think about a nervous system that's already running hot, increased focus means increased monitoring, which in turn means increased tension, furthering the very response you're trying to stop.

Awareness → tension → bracing → escalated symptoms → more awareness.

It becomes a loop. And the harder you focus on breaking it, the faster it spins.

Throw in the mental spirals associated with this, and you have a constantly moving target with too many variables to gauge progress.

Why technique adjustments don't hold

One of the first approaches players address is technique.

And this makes sense!

After all, we can experience a one-of-a-kind Valsalva-like response, or go through short periods when the fundamentals of playing become uncoordinated, especially during equipment changes or when working on underdeveloped techniques.

From this perspective, working on fundamentals, changing the attack, adjusting the air, or trying a different tongue position makes sense!

But what if these only temporarily help? What if these only get you so far?

Several survey respondents described finding ways to manage symptoms enough to function, using air attacks, adjusting timing, or modifying their approach to high-stakes entrances.

But the majority of reported participants, the underlying pattern didn't change.

The workaround became the new normal, and the original issue remained beneath it, waiting until the system started to build pressure and break down.

If you are unfamiliar with how pressure ramps up in the body and its relationship to the Valsalva response, check out this post:

Why Brass Players Can't Relax: The Hidden Cause of Valsalva

Short summary:

If the resting state of the body (ribcage and pelvis) is already braced and pressurized before you pick up the instrument, layering a new technique on top of it isn't going to change the fundamental state of your body.

In fact, it just adds another layer of compensation on top of an already compensating system.

For example, imagine you are squeezing a tube of toothpaste. Just because you use a different way of squeezing the toothpaste out, doesn't change the underlying principle - you are compressing the tube to get more toothpaste out.

Your body = a tube of toothpaste.

Squeezing the toothpaste = resting pressure of your body, creating force, resting muscle tension, playing your instrument (instrument dependent).

Lastly, the state of your nervous system will fluctuate depending on a wide range of variables. This may be why many feel their Valsalva response comes and goes, while others feel it's there to stay.

One respondent said, "The hesitation response got worse and worse over the years and completely controlled my playing."

Another described it coming in waves, better for a while, then back again. Never fully resolved.

Why breathing cues backfire

"Breathe from your belly."

"Expand your back."

"Take a bigger breath before you play."

"No pause at the top, just blow right away."

These are well-intentioned instructions, and in a body that can manage pressure, they work!

But several respondents described anxiety or discomfort when focusing on breathing itself, meaning the act of paying attention to breath became its own trigger.

When the ribcage and pelvis lose the ability to manage pressure, it's reflected through the entire body. Accessory muscles such as the neck, upper back, and abdominals will start to work during tidal volume breathing. Overall muscle tension and effort to perform regular movements and activities also increase. You may even see this in a visual representation of posture, often described as an "anterior pelvic tilt," "sway back posture," or someone who is "slouching."

Breathing cues have their place and are helpful, but if the body cannot manage pressure, these will be temporary cues that can actually drive up pressure and compensatory strategies. Context matters.

What this means for recovery

If technique, instrument exercises, and awareness alone only helped you get so far, the answer isn't to try less or give up: it's to start somewhere different.

The body's resting state has to change before anything else can. I have the same conversation with people who come to me wanting to release certain tight muscles or "muscle knots" in their fascia. Nothing can change unless we involve the nervous system.

This means decreasing overall system tension, restoring ribcage and pelvic position, training the body to effectively manage and release pressure, and developing the capacity to maintain these conditions under duress and stress (periods of high stress).

Once that foundation shifts, then it makes sense to bridge the work back to the instrument.

At that point, the breathing cues actually have somewhere to land and become helpful tools. The body can follow them. The attacks stop being a source of dread, not because you thought about them differently, but because the system underneath finally has room to move.

And once the body has room to move, you can stop thinking about your breath and start thinking about air, sound, and music.

That's the difference between managing symptoms and actually resolving the pattern - focusing on the foundation.

One last thing from the survey

One respondent, a professional orchestral player, shared something that I think reflects the experience of many players reading this:

There is actually no clear and good guide through that problem.

That's what this is being built to address.

The Breathing Foundations: The Valsalva Method program launches in June.

If years of effort haven't moved the needle the way you expected, it's not because you've been doing it wrong. It's because you've been starting in the wrong place.

The program starts where the problem actually starts, before the instrument is ever in your hands.

Join the waitlist below to be first to know when registration opens, and to access the early-bird discount when it does.

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