Finding a Solution to Voice Problems

The importance of up to date information on the singing and speaking voice

The solution to any problem experienced in the voice is too often prevented by the belief that good voices are 'God-given'. If you can accept that there is no perfectly tuned, perfectly functioning voice that performs each vocal task just as and when you imagine it should, it will open two important doors to voice management.

• You will always work towards maintaining stability of the instrument which, like the rest of you, benefits from exercise, encouragement, respect and a lot of fun. This regular attention will eventually give you a central 'core' of vocal pitch, resonance, quality and flexibility which will respond as you expect. This is the vocal stability that you can extend to discover the exciting limits of your voice that you are always working towards. "Man's aim must exceed his grasp, or what's a heaven for?" Robert Browning.
• You will not become paranoid when the voice does not respond as you expect. Instead you will behave in the same way as when anything else goes wrong. You will check your voice maintenance system to make sure you are doing what you think you are doing. Then you will check for postural alignment and if necesssary consult a clinincian who knows about voice (see links at the bottom of this page).

These two principles generally provide the key to the problem, but they are dependant upon whether you can identify whether the problem is one of  playing the instrument (voice and body mechanics) or is to do with with the material (performance related).

While all other instrumentalists understand that the instrument and the material you play can be separated, singers who believe in the 'God-given' voice find the concept difficult. You also have an instrument, in this case the voice, upon which you can play all manner of material in speech and singing. The instrument itself must operate efficiently, as must a clarinet or a cello. That instrument can be compromised by the way you learn the material, or by ways in which you may alter mechanics in the erroneous belief that you are merely adapting to particular styles of speech or singing.

Voice problems beyond your own knowledge and understanding, and what to do

Posture, dentition and voice and intelligence develop interdependantly in early childhood and go on affecting each other throughout life, so work at the Voice and Body Centre crosses the barriers of many different disciplines. Voice Gym has introduced many singers and other musicians, actors, teachers and other voice users to the dangers of ignoring functional anatomy, dentistry and skeletal alignment in their professional advancement. By exploring the muscle systems required for efficient breathing and voice function it is possible to also expose those which have been developed to compensate for skeletal and dental misalignment, for example a bite problem or a skeletal shift in body posture.

A network of clinicians experienced in voice problems

Through her membership of research groups and the study of voice stress, Angela Caine has established a multidisciplinary network. This involves dentists, orthodontists, chiropractors, osteopaths, physiotherapists and sports therapists, who are experienced in treating voice problems in musicians, singers and other professional voice users.

Interdisciplinary work among clinicians is relatively new and links between dentition, structural misalignment and voice problems are only just beginning to be established. It is still not considered necessary, for instance, for a student in any field of Performing Arts, to be checked either dentally or skeletally to ensure that voice and movement are not compromised by structural misalignment before embarking on a professional career.

Early in her professional singing career Angela suffered recurring voice problems. Various voice specialists failed to solve them. She subsequently discovered that the voice problems were a symptom of other more serious structural problems. These were eventually corrected by collaboration between a cranial chiropractor and a dentist/orthodontist, but the muscle systems still required specific reprogramming exercises before the voice problems went away. Because these problems were not detected early in her training the journey back to performance, via rigorous daily exercise has been a very hard one. Many performers prefer to just give up, not able to cope with peer pressure and a profession geared only to success. See 'The Devil Within', Voice Gym's latest publication.

It is Angela's experience that professional musicians with problems of muscle tension and loss of confidence are usually directed to consultants within the medical establishment, supplemented by work from teachers of the Alexander Technique, speech therapists, or occasionally, an osteopath. These clinicians do not usually work in collaboration with other disciplines. links with other clinical disciplines.  The Voice Gym can offer information about a variety of alternative clinicians who all work at the 'sharp end' of current research into performance and, more importantly, who are prepared to work together. This cooperation between disciplines is important in accurately diagnosing the underlying cause of a problem

Angela taught voice for five years at the Highgate Alexander School in London (Directors-Paul Collins and Elizabeth Rajna) as part of their teacher training course. She subsequently studied The Alexander Technique on a full time course with Don Burton in Fellside Alexander School, Kendal. She now applies the principles of good use, as promoted by Alexander himself, but only within a more interactive system of training based on up-to-date information about functional mechanics.

Angela is a member of Cranio Group, and a member of the Society for the Study of Cranio-Mandubular Disorders, international organisations of dentists and other clinicians who promote the understanding, function and management of the whole body. Angela is the first voice teacher to have written a chapter on voice in a dental text book, "Complementary Therapies in Dental Practice", published by Butterworth-Heinemann in 1999.

All work at the Voice Gym begins with an introductory consultation and planning session of at least one hour, where anywhere solution of problems through referral can be dicussed

Alternatively, you can arrange a two-day workshop for your clinical practice to introduce voice exercises that aid inter-disciplinary treatment

Book a consultation session or workshop by calling or emailing the Voice Gym.

Clinical Aspects of Tongue Position

Importance of nose breathing

Dentists and orthodontists are fully aware that successful and attractive facial development is only possible in children who breathe through the nose, using mouth breathing only as an emergency 'top-up' system. The group of muscles that plays the greatest role in the development of nose breathing is that group of muscles that move or change the shape of the tongue. When these muscles operate in an efficient and balanced way not only is nose breathing the most comfortable way to breathe, swallowing, speaking and singing also develop natural efficiency and the lower teeth are found to be in a good relationship with the upper teeth both for chewing and when at rest.

To understand how to simply and quickly change a poor tongue position into a good one it is necessary to know that the tongue has two different kinds of muscle responsible for two different actions.

The intrinsic tongue muscles that form the tongue shape

These are involuntary. We access them through the right hemisphere of the brain, which is responsible for learned reflex patterns, the imagination and a sense of play. The intrinsic muscles of the tongue change the shape of the vowels in speech. They also push food between the teeth during chewing. If we were in control of that we would continually bite our tongues!

The extrinsic tongue muscles that enable us to put the tongue out, pull it back and down and pull it back and up

They rise in structures away from the tongue and insert into the tongue shape. They are voluntary - we access them through the left brain hemisphere, which is also responsible for most of the other functional things we do.

Appliances for changing tongue position

Many and varied devices in both hard and soft materials have been designed to exercise muscles to change the position of the tongue in the mouth and change mouth breathing to nose breathing.

What is the difference in position that these devices are trying to achieve?

If the tongue lies flat in the floor of the mouth with the tip against the bottom teeth you will breathe through the mouth every time you open it, and you open it to talk. For the tongue to facilitate nose breathing in all situations it must rest against the palate and not in contact with the lower teeth. The picture on the right is what you should see when the mouth is open. To train for lip seal is to limit communication, which is one of the fundamental evolutionary drives of Homo sapiens. This is working against natural forces, thus making change much more difficult.

All creatures before Homo sapiens had the tongue in the floor of the mouth - see the chimp and also the result to the palate of this tongue position, but this was not a problem unless the tongue had to fit up there. When evolution added speech to supersede chewing the tongue had to dramatically change its position and the palate had to change to the shape of a spring board.

Why?

Our nearest ancestor, the chimp, has a very high larynx. It is suspended from a hyoid bone that rests just behind the mouth and because the tongue rises from the hyoid bone the whole tongue is forced to occupy the mouth, the front pressed against the front teeth. Although the chimp can be taught all of the vowels that we can make, the high larynx and flat tongue cannot make consonants because for that you need to be able to spring the tongue backwards or off a wide flat surface, only possible if the palate changes shape, the larynx moves to a much lower position in the pharynx and the tongue takes up the position of a right angle, with its main weight and bulk in the pharynx and only one third in the mouth. This one third then bounced off the hard palate, gradually changed the gene structure to flatten the palate so that its shape encouraged the tongue to form a wedge at the back of the mouth from where I could spring both forwards into a tip and backwards into a stronger wider wedge that also served as a brace against the soft palate to seal off the mouth and allow only nose breathing when the mouth was open for communication.

This tongue position stimulates the soft palate to pull laterally as well as elevate, thus activating the muscle that links it to the Eustachian tubes (Tensor Palatin). When a child speaks or sings using this back spring of the tongue the Eustachian tubes are pumped by the rhythmic action of the vocal mechanism. Provided there is sufficient encouragement to speak and sing using the tongue in this good way this child is unlikely to suffer middle ear infection.

This shift of the tongue should occur in every child between the ages of two and six years old and therefore should be completed before the onset of mixed dentition. The maturation of the central nervous system at approximately seven to eight years old 'cooks' this early developmental information, which can then be accessed for sophisticated learning programmes. Possible interferences with this development are described on the children's singing page and in the introduction to Early VoiceGym, which is designed to encourage the shift of the tongue in all children.

Devices that are designed to reposition the tongue without the use of speech or singing are unlikely to succeed long term as the very reason for the tongue shifting to this position was to facilitate speech in Homo sapiens. The larynx must be stabilized before attempting to shift the tongue if it is not to lose its developmental shift downwards. It is not successful to solve one problem by creating another. Neither is it relevant that the lips be sealed d in order to breathe through the nose. The seal in Homo sapiens is at the back of the mouth between the tongue 'wedge' and the activated Tensor Palatin to facilitate nose breathing when using the voice, not at the lips.

Successful repositioning decouples the muscle systems of tongue and mandible for nose breathing, swallowing, speech and singing. The tongue becomes the activator in all of these activities. Only in chewing do the muscles of tongue and jaw 'couple', when the mandible becomes the activator.

Using this information

Dysfunction of the tongue is always accompanied by some developmental impediment. There may be underdevelopment of facial bones, mal-positioning of the mandible or teeth or any combination of these requiring dental, orthopaedic or other structural intervention. A combination of disciplines - a multidisciplinary approach - is increasingly found to be the most successful, both in speed of required result and long term stability.
When changes of this kind are needed in an adult there will be a learned reflex pattern for speech and maybe also singing, that has long established accommodation for a high larynx, forward tongue and many other related interferences that impede the main treatment protocol.

In such a case a change of tongue position requires a whole body exercise programme to adjust head balance, increase pelvic stability and upper body strength. As this inevitably brings dramatic improvement to the voice there is also the consideration of personal and emotional challenge.

Early VoiceGym and VoiceGym are designed to provide a secure and structured pathway to these changes and a way for the patient to take responsibility for them. It is useful to begin VoiceGym, and thus access reprogramming of tongue and face muscles, in advance of dental or structural intervention.

Links to people who work with VoiceGym

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