What is Vocal Physio?

Vocal Physiotherapy? What’s that I hear you ask.

Like any muscle and joint complex of the body, vocal physiotherapy encompasses treatment of the myofascial and cartilaginous structures of the larynx and the surrounding perilaryngeal region. Have you heard of singers cancelling concerts because of voice issues, huskiness, losing vocal range, general vocal fatigue or even losing their voice? These are all symptoms that can be treated with vocal physiotherapy and can make a substantial difference to your singing/performing voice.

Figure 1 External Pteragoid muscle, involved in jaw related vocal issues.

The technique principally involves manual therapy techniques to the throat, including soft tissue release, stretching, and when clinically reasoned internal release of the jaw and mouth. The larynx is mobile – the vocal folds are encased within the thyroid and cricoid cartilage and are mostly soft tissue. Noise is produced by the vocal folds vibrating very fast as air passes them, and to be able to change pitch when signing the thyroid cartilage needs to tilt on the cricoid cartilage. The problem we commonly see is that often the muscles of the larynx often become tight, and therefore restrict larynx mobility.

Reasons for this may include tongue root tension, neck problems or muscular tension, jaw issues – such as clicking, pain, clenching or tension, poor dietary habits and poor support mechanisms.

When working with vocal clients, it’s important to not only treat the symptoms, but identify any underlying issues affecting the voice. We often work closely with vocal technique teachers who can identify these weaknesses and help you achieve new strategies and develop your voice; this is the key to maintaining a healthy voice.

Figure 2 Sternohyoid muscle, commonly overworked with excessive loading of the voice.

Another area that is involved in voice production is the abdominal activity levels, this directly dictates the laryngeal muscle tension levels and therefore is critical to assess when getting the balance right for a mobile and healthy larynx. A demand we see a lot in the West End is the ‘triple threat’ of dancing, singing and acting... at the same time. The challenge we often see here is that the abdominal activity levels vary significantly with singing/voice production whilst  dancing. For example, when dancing, the abdominals are engaged and held, but when singing the abdominals are relaxed and free, creating the optimal balance between those two states can be difficult and thus cause problems when the volume of the shows are high. We feel that education and training of the performer are crucial to ensure optimal voice production in a safe and sustainable way, especially when there are the demands of 8 shows per week. Trying to prepare the voice like we do movements related to dancing.

We will be delving further into the topic of Vocal Physiotherapy, we just wanted to give you a little overview to start the process of helping inform you of an aspect of performance physiotherapy you may not have known too much about. Furthermore, here are a couple points to think of; do you warm up before using your voice? If so, how long does your warm-up take? Do you cool down after using your voice? Finally, have you had Vocal Physiotherapy before, how did you find it? We would love to hear your stories.

Thanks for reading this.