Vocal health tips- looking after the voice

Welcome to the first blog post for my new clinic! I'm Daniel and this is Dan Turnell Physio. I have spent a lot of time working with some very high level professionals in the performance world's of the West End, Opera and Pop, and as such want to pass on some of my knowledge to help combat some of the myths out there and to also explain why some things are recommended for vocal health.

Stay Hydrated

When you are under hydrated the vocal folds will also have less hydration than they need, so a well hydrated person will have well hydrated vocal folds. If the vocal folds are not hydrated then the protective mucosal lining of the folds is compromised meaning less moister through the mucosal lining, less vocal flexibility and an increase in friction and swelling. this is likely to reduce the compliance and quality when vocalising, and also potentially increasing the risk of ongoing problems if repeated often.

So what do you do for optimum hydration? Most people are aware that 6-8 glasses of water are recommended per day to maintain hydration, what a lot of people don’t release is that dehydration starts on the day or days preceding; so, although it is important to keep topped up on the day of a performance, audition or rehearsal it is also key to remember to do the same on the days before, its all about building fluid intake into your lifestyle.

Time to warm up, but do I really need to?

I often have a conversation with my clients about their voice and discuss that it is like any other athletic activity and must be treated in the same way. No one plays football even a 5-a-side kick about with friends without even having a token jog up and down or a few jumps on the spot as they know before exercise a warm up is important. The warm up is key for many reasons, the most obvious is it is increases blood flow to muscles, in this case the vocal cords, the internal vocal muscles, supra-hyoids and infra-hyoids. This increases the muscles flexibility and ability to active the muscles, it also helps to clear excessive mucus from the region. Now, this is important as it gets the body physiologically prepared, but the often-overlooked part of a warm up is the psychological benefit, as a performer it lets you know that you are about to sing or vocalise in some way, giving confidence and helping you to focus.

A cool down.....?

I regularly also like to chat about cooling down, most of the time this is met with a blank look and a sheepish shake of the head. The principle again is to start to treat your voice like you would the bigger muscles in the body, remember its an athletic performance, and any top athlete or make that even sensible athlete will always push themselves through a cool down. The cool down is physiologically important for the body as the de-oxygenated blood travels back to the heart through our veins, the veins don’t have the capability of returning the blood without a little help, and this help comes from the muscles. As a muscle contracts it squeezes the veins and pushes the used blood and all the waste products away. So, for a singer what does this actually mean? It means clearing away lactic acid and other waste products from the voice muscles helping them to not feel so tired the following day, it also means lowering the larynx back to a good resting position to avoid the fearful high riding larynx and the issues that can arise. So with that in mind what should you do? Pretty simple and it’s the opposite to a good warm up, it only needs to be gentle or of a low intensity, and the same exercises can be used; for example a siren would go from high to low rather than low to high, and a few minutes is all that’s needed to make the world of difference.

Have that feeling of something stuck in your throat?

The temptation for us all is to keep trying to clear this sensation, this is quite an aggressive act on the vocal complex, and can lead to increased vocal irritation and more mucus production; which I’m sure you have clicked means more throat clearing and as such the circle will continue. So instead of trying to clear the throat, think about trying to swallow or if you have some water to hand take small sips. Must less abrasive and will help break that bad habit.

Whispering…..

Whispering also comes up a lot when clients present to clinic. When we have pain or problems we understandably try to shield ourselves from the symptoms, and vocally for most this means whispering! Whispering for most of us seems harmless, as its not intense and feels like we should be helping. The reality is this way of vocalising actually puts a larger stress the vocal folds, by changing the way they come together, it can also reduce the vibration of the folds all of which can increase irritation and prolong any symptoms. The best advice is to perform full voice rest, or when having to speak, use your normal voice with softness.