Friday, July 27, 2018

My Visit to a Physical Therapist for Singers

    Chances are if you’ve gone to a vocal coach you’ve been told that you had tension in your throat that was affecting your voice. That’s what I was told at my first voice lesson, and that’s what I frequently tell singers when I first work with them. Throat tension is a common problem for singers that can affect tone, pitch, range, and endurance. There are many things you can do on your own or with a coach to ease the tension and free up your voice. But sometimes those methods aren’t enough.
    I worked with a singer who sounded great and got the lead in several musicals, but she developed intense pain on the right side of her neck when she sang for a long time. Another singer I worked with had so much tension in her throat and shoulders that she couldn’t sustain a note, no matter how big a breath she took. Another singer could not get his vocal strength back after an illness, despite time and traditional vocal therapy (which includes breathing and resonance work). I suspected that these singers needed to see someone who could work deeply in the muscles that were contributing to their problems. 
    Strong vocal technique, like good breath support and resonation, are vital to a singer. But sometimes technique isn’t enough. That’s when visit to a physical therapist who specializes in working with singers can be helpful. Think about it: singers are like athletes, using their bodies and vocal cords in complex and demanding ways. Athletes see physical therapists regularly, so why shouldn’t singers?
    Gena Thurston is a physical therapist who loves working with singers and performers. In her Chicago practice she has worked with numerous singers including cast members from Hamilton and Book of Mormon. She’s growing a new practice in her hometown of Nashville, so she invited me in for a complementary session so I could see what she does. While I’m not experiencing any vocal problems, I’m well aware of tension in my face, neck, and shoulders that I’m sure are not helping me sing. I’d heard of miraculous results from working with a PT for vocal issues, and I was curious what Gena would do.
    Here was the status of my voice and body pre-session: I’d been playing a lot of guitar recently, which puts unequal strain on the neck and shoulders. I slumped through most of my childhood and have spent my entire adult life trying to remember to sit or stand up straight. Like most people who have had their wisdom teeth pulled, I have TMJ and frequent jaw tension. The day of my session I’d slept poorly and was feeling a bit zombie-like. 
    Gena had me lay on my back and started working on my neck, explaining what she was doing as she went. She found tension in all my usual spots, plus a lot more tension on the left side of my neck, jaw, and face than on the right. That’s the kind of imbalance that can lead to irregular closure of the vocal folds, which can cause problems. It felt like Gena was giving me a very detailed neck and shoulder massage. The difference between what she did and a regular massage was the specificity: she found and worked on muscles I didn’t know I had in my neck, shoulders, and jaw. She worked near my glottis (where the vocal folds are housed) and just under my jaw near the hyoid bone, a prime spot for muscle tension in singers. Towards the end of the hour (which flew by and felt like fifteen minutes) she worked on my jaw joint from the inside of my mouth. The pain from that was very intense--if I’d known any state secrets I would have given them up easily. But afterward my jaw felt looser.
    With my permission Gena also used dry needles on my trapezius muscles. These are longer than acupuncture needles and only go in for a second or two, unlike acupuncture needles that are usually left in for 10-30 minutes. Gena said my trapezius muscles would be sore for the rest of the day and they were, but that the muscle release from dry needles can be long lasting. When the needle went into my right muscle there was a weird popping feeling that she said was a good thing, since it signals a deeper muscle release. The following day I noticed that that right shoulder did indeed feel more relaxed than my left shoulder.
    After my session my jaw muscles were as relaxed as they had been in years. I headed for Trader Joe’s to shop and found that I didn’t want to smile at anyone and lose the loose feeling in my jaw. It also felt easier to stand up straight. I felt very relaxed and a little spacey. As I drove home I sang and it felt easy--not much different than the day before, but there was a subtle difference.
    The next day some of my jaw tension was back, but overall my neck, jaw, and shoulders felt pretty good, better than before my session with Gena. I’ve had massages where it seemed that the beneficial results disappeared as I drove home. This deeper work appeared to have a more lasting effect. I sang that day and my voice still felt good. Again, there were no earth-shaking vocal results, but I felt a noticeable ease in singing.

    I didn’t have any dramatic results from my session with Gena, unlike a singer friend in Los Angeles who added several notes to his range after doing similar work with a physical therapist there. But I didn’t have any vocal problems when I saw her, so I couldn’t experience firsthand the healing properties of her work. Plus, I’m sure it takes more than a few sessions to really see benefits. Gena said she always gives her clients homework and exercises to speed the healing. She said clients who do their homework rarely need to see her more than once a week.
    The vocal-oriented physical therapy that Gena does could help many singers. Learning and maintaining proper technique is still essential, and singers in need of vocal therapy still need to go through that process to bring their voices back. But if muscle tension has contributed to or exacerbated any vocal problems, this kind of deep muscle work will accelerate improvement, and may very well be the missing link if a singer isn’t improving. Doctors at some vocal therapy clinics like The Vanderbilt Voice Clinic have realized this and now include deep muscle work as an option for patients.
    As Gena worked on me I thought of several singers I’d worked with who I suspected would benefit from seeing her. If you are experiencing long or short term vocal problems, or feel that your voice is stuck, this kind of work could be worth exploring. Make sure to see a licensed physical therapist, and make sure they’ve had special training for working with vocalists.


  1. Great idea! I'm sure I need to see one. I'm a singer and vocal instructor and also teach piano and guitar to a lot of students. For about a month now, I've been experiencing a slowly-growing, now-fairly-severe (for a singer, certainly) tightness and even slight pain on the R side of my larynx/throat. Swallowing has felt weird, tight, and noticeable, and singing has felt labored in my lower and middle range. With teaching ramping up now, I believe I need to get on this. I was checked by an ENT who specializes in singers just a few months ago and everything was fine at that point. So, maybe it's mechanical and needs some release. Worth a try! Thanks for the prompt!

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