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The Mechanics of Breathing as Applied to Different Vocal Tasks

May 2007, Novartis Foundation, London

British Voice Association event report – by Cheryl Hawkins

This was one of the most focused BVA day courses I have attended in recent years.

Six well prepared presentations given by those at the cutting edge of their profession guaranteed a wealth of information, participation and discovery throughout the day.

Dr John Costello, Respiratory physician of Kings College began with The Lungs, Chest Disease and the Voice with a Power Point presentation in awesome but fascinating detail. I was grateful for the copies of these slides in my folder!

He described the respiratory system as the gas exchange, (O2 uptake, CO2 excretion), the carriage of gasses in the blood, cellular respiration, filtering of the venous system, interface with the environment and 'bellows' for the voice.

Think of our unconscious breathing activity as 'tidal breathing' but that neck and abdomen are abused on excess demand. We rely on compliant elasticity of our lungs and chest wall. Imagine blowing up a balloon, not a stiff football. Interestingly an allergy can be carried from the lining of the nose right into the lungs which are made of 300,000,000 air sacs, alveoli.

Spirometry is the 'new' science of being able to monitor dynamic lung volume, vital in being able to diagnose chronic bronchitis, pulmonary fibrosis (stiff lungs), the deadly emphysema and hyperventilation, which many of us have observed in ourselves or in our clients. Incidentally hyperventilating does not give us extra oxygen.

There followed a graphic description of the symptoms of these conditions, the narrowed, inflamed mucous hypersecreting airways and 'Swiss Cheese' lungs of an emphysema sufferer i.e. smoker, the asthma suffering clients who are advised to wash off the becatide from the back of their throats, to use a long slow breath with their inhalers and not to take beta blockers.

Amongst other nuggets of information it was useful to be told that acid reflux is greatly under diagnosed and that cocaine damages the nasal septum.

Then followed physiotherapists Ed Blake of Harley St., and Jane Grey who both work with dancers and performers.

They demonstrated, with the help of volunteers the advantage of Real Time Ultrasound in assessing abdominal muscular patterns while voicing, and consequently the effect of poor support. This is new.

The guinea pigs who were prepared to expose midriff, be spread with ultrasound gel and then sing, showed us graphically, via Ed's and Jane's Real time monitors exactly which abdominal muscles were firing to generate subglottic pressure or not. The transverse abs., those used in Pilates are most important. The obliques, the muscles with which we pick up a suitcase cause too high subglottic pressure.

Phasic.Trans.Abs (PTA) is a typical problem for dancers who are reluctant to release the abdominal wall. But don't forget the pelvic floor contractions.

The overriding clinical presentation is of overactivity of the sternocleidomastoid musculature and secondary tightness of the suprahyoid soft tissue resulting in an elevated larynx in resting position and poor cricothyroid mobility.

This Real Time approach is ground breaking in its speed to diagnose and see the problems. One wonders how soon it will become a standard treatment and at what cost.



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