vancouver physio

Playing Music – It’s Like Fireworks in Your Brain!

This video is a great illustration of how playing music engages practically every aspect of the brain. Whereas listening to music results in certain parts of the brain being activated, playing music is like a full body workout to the brain. It engages the visual, auditory and motor parts of the brain and increases the size and activity in the corpus callosum.

Singers & Speakers: Caring for your Vocal Instrument The 6 Top Tips for Vocal Hygiene – Part 2 of 2

In The 6 Top Tips for Vocal Hygiene – Part 1, the first three tips for vocal hygiene were outlined: Hydration, Warmups/Cool-downs, and Avoiding Stressing the Vocal Folds. Read on to finish off the top tips to keep your voice in its best condition!


i) Rate of speech should be legato (or smooth, flowing and slow).

ii) Try to keep your speech around the pitch where you naturally say ‘Umm-hmm’; this can be assumed to be your most comfortable speaking pitch and the range in which injury is least likely.

iii) Avoid starting your speech with a glottal attack: going from zero vocalization to a forceful expulsion of air and sound. Instead, begin releasing air before initializing voicing, thinking of it as easing in to sound production.


i) Practice silent, deep breathing, allowing the air to expand and contract the lower torso, abdomen, back and sides. This encourages relaxation in the throat and less risk of injury.

ii) In daily speech, try to take breaths at natural breaks (it can be hard on the vocal folds to squeeze the breath out beyond what feels natural).

iii) See a vocal professional to learn proper breathing techniques for singing and vocal projection, as improper technique can do damage to your vocal folds!



Figure 4

i) While singing or speaking, be attuned to your overall body balance and signs of muscle tension in the neck and shoulders. Hint: try videotaping yourself singing/speaking to assess improper balance and tension.

Posture assessment by a physiotherapist can also be very helpful if you think this may be an issue for you. If you are singing or speaking while seated, use a comfortable chair suited to your build, with good lower back support.

ii) Music, scripts or notes should be at eye-level (and on a stand, if possible), and it’s best to have clear sight-lines to your accompanist and audience.

iii) Keep your upper and lower teeth separated and relaxed; avoid clenching, to allow the jaw to remain passive.

iv) Improving singing posture is showing correlations with improved vocal production!  A case study of a classical singing student who underwent physical therapy for breath support and lack of stability. In nine physiotherapy sessions over four months, the patient experienced significant improvement and satisfaction with her resulting vocal production. [It should be noted that this patient was very well motivated to make postural changes and follow her physiotherapist’s recommendations. (Staes, 2011)]

v) A healthy body promotes a healthy voice! Regular exercise, good nutrition, regular eye and ear check-ups, and times of relaxation are going to support extended use of the vocal instrument. Note that obese singers face poor respiratory and abdominal conditioning, a limiting factor in a discipline that relies on strength and stamina.

Exercise tip for optimum vocalization: 

Focus on free movement exercise with cardio (running, swimming, dancing). Avoid diving and underwater swimming (risks of nasal congestion and ear issues), and limit weightlifting and overdevelopment of the neck muscles.


As with many things in life, awareness is half the battle; hopefully these tips can help you highlight areas in which your vocal hygiene can improve! If you find you have more questions or need further help in applying good vocal habits, please feel free to give us a call at 604-568-4628 and book in to see physiotherapist and musician injury specialist, Grace Cheung.



Contributor: Tracy Schaan is studying at McGill University in the Masters of  Speech-Language Pathology program.



“Advice for Care of the Voice,” Texas Voice Center, (2002). Retrieved from

“Fit to Sing; Factsheet 3” British Association for Performing Arts Medicine, (2007). Retrieved from

Mathis, B. (PhD). “Singers, Let’s Prevent Vocal Problems!” The Voice Teacher, (2003). Retrieved from

“How to Get the Best Mileage from your Voice: Vocal Hygiene,” Canadian Voice Care Foundation.” Retrieved from

Staes, F.F., & Jansen, L., & Vilette, A., & Coveliers, Y., & Daniels, K., & Decoster, W. (2011). “Physical Therapy as a Means to Optomize Posture and Voice Parameters in Student Classical Singers.” Journal of Voice, Volume 25 (3).

Figure 4. Posture types (vertebral column) classification by Staffel, from Image Creator ru:User:V-Ugnivenko; Posture Types (Veterbral Column); Wikimedia Commons, the free media repository; Russian Wikipedia; 2008; Web:; Accessed March 21, 2014.

Singers & Speakers: Caring for your Vocal Instrument – The 6 Top Tips for Vocal Hygiene – Part 1 of 2

‘Hygiene’ is a term reminiscent of habits and prevention and health. It is not a far stretch then, that vocal hygiene is a term used to refer to habitual behaviors for preventing injury and promoting vocal health! The following practices are especially important to singers and professionals who depend on good vocal health on a daily basis.

1. HYDRATION is very important to overall body function, and makes a significant difference to vocal fold operation. Adequate water intake allows the mucus covering of the vocal folds to act like a lubricant, rather than like glue; this creates more efficient vocalization. Eight cups (two quarts) of water is the recommended daily intake. In additional, herbal teas have also been suggested to soothe the vocal folds, with some additional hydration.

2. WARMUPS and COOL-DOWNS are going to help prevent vocal strain and injury. It’s important to remember that in many ways, vocalists (both singers and speakers) are like athletes; the muscles of the body are being used repeatedly, and can be prone to injury when overused or abused.

Figure 3

Figure 3

  • Vocal warmups get blood flowing to the vocal folds, and gently stretch and contract the vocal folds in preparation for extensive use. Physical warmups also are beneficial to loosen the muscles of the neck, shoulders and upper back.  Examples are: humming, vocal ‘fry,’ shoulder shrugs, and gentle neck stretches.
  • Cool-downs have been suggested so as to ease vocal muscles into cessation, rather than an abrupt stop.  An example of this is gentle vocal slides up and down the vocal range.
  • It may be interesting to note that recent research on Vocal Exercises is showing:
  • –> Vocal exercises may mitigate age-related effects on singing (Tay, 2012). This preliminary study had a group of aging choral singers undergo 5 weeks of daily vocal exercises (warmups, stretching, contracting, strengthening) partially supervised by a Speech-Language Pathologist. Preliminary and post-trial testing showed improvements across several technical measures* as well as perceived improvements in self-evaluation, when compared to the control group.
  • –> Specific muscle training can make it feel easier and more comfortable to sing, as well as produce sounds with more efficiency and superior quality across several variables. Ideally, there should be some muscle action in the back, head and neck while singing, while the chest, abdomen, and throat should be relaxed – a combination that may require specific muscle training to achieve. **


i) Avoid clearing the throat or coughing (causing extra friction and putting additional stress on the vocal folds). Typically, thick mucus is the culprit behind throat-clearing and coughing. Adequate hydration is key to keeping the mucus at a good consistency, and decreasing throat-clearing and coughing!

Good alternatives to throat-clearing are: 

-> The Sniff- Swallow Technique to clear mucus in the throat: sniff gently… swallow, and repeat as needed. (Clark, SLP)

-> The Gentle Breathy Productive Cough: take a deep breath, hold for a moment, and then produce a sharp, silent H sound as you expel the air and mucus. (Texas Voice Centre)

ii) Avoid speaking at vocal extremes: both shouting and whispering put stress to the vocal folds! Try to avoid noisy, windy and cold environments where you need to strain your voice to be heard, attempt to speak within 3 feet of your conversational partner, use amplification when necessary, and use a lowered quieted tone without whispering.

iii) Avoid polluted air and air with less than 30% humidity, as both can make vocalization more effortful (note that airplanes have especially dry air, and the vocal folds will require even more hydration)

Stay tuned The 6 Top Tips for Vocal Hygiene – Part 2 to find out more tips for vocal use!         

_______________________________________________________________________________Contributor: Tracy Schaan is studying at McGill University in the Masters of  Speech-Language Pathology program.


*[Perceived roughness, maximum phonation time, jitter, shimmer, and noise-to-harmonic ratios all showed improvements. Perceived breathiness, strain and frequency range did not show significant differences.]

**[Study on “Voicecraft” training has shown that simply telling singers to ‘relax’ while singing is a misdirection; there are correlations between specific muscle use and perceived exertion (some muscles relaxing, while increasing exertion of others). Optimum vocal production is found with muscle action in the back, head and neck, with less muscle exertion in the chest, abdomen, and throat. Results showed that Voicecraft Training:

  1. Made it feel easier and more comfortable to sing: singers rated higher levels of comfort and ease of singing after training of using certain muscles.
  2. Noticeably improves singing quality: 100% of the time judges (Speech-Language Pathologists and Singers) could differentiate between audio recordings before and after training, and 80% of post-training recordings were judged as superior across several variables (roughness, breathiness etc).
  3. Vocal quality was more efficient as measured by the noise-to-harmonic ratio and jitter and shimmer, which had all significantly decreased post-training (Bagnall, 2005)]

—————————————————————————– References

“Advice for Care of the Voice,” Texas Voice Center, (2002). Retrieved from Bagnall, A. D., & McCulloch, K. (2005).

“The Impact of Specific Exertion on the Efficiency and Ease of the Voice: A Pilot Study.” Journal of Voice, Volume 19 (3). Clark, E. (CCC-SLP). “Vocal Health Tips,” Speaking of Speech. Retrieved from Tay, E.Y.A., & Phyland, D. J., & Oates, J. (2012).

“The Effect of Vocal Function Exercises on the Voices of Aging Community Choral Singers.” Journal of Voice, Volume 26 (5). Figure 3. Self portrait by Sebastiaan ter Burg made for his presentations about his business model for Creative Commons photography and video production and his open content/data projects. For more information:; from Image Creator Sebastiaan ter Burg; Meezingen/zingen/zang/singing along/sing; flickr; flickr; Aug 31, 2007; Web:; Accessed March 24, 2014.




The notes I handle no better than many pianists. But the pauses between the notes – ah, that is where the art resides!

-Artur Schnabel (Austrian pianist)

The pause is as important as the note.

-Truman Fisher (American composer)

UBC Symphony 2013 Fall

The more I grow as a musician, the more I have come to understand that the pauses and spaces in a composition are equally important as the notes played. As a young musician in an ensemble or group improvisation setting, the temptation for me was to play all the time, often to exercise my zeal in a recently new found skill or technique. But how much more there is to the musical experience when one stops to listen to not just the individual parts but to the piece as a whole, including the spaces and pauses in between.

Which leads me to this. The pause.

What are you doing your pauses when performing and practising?

You are likely listening to the music or perhaps counting measures.

Here are a few other tips I encourage the musical athletes I work with to practise:

  • Reset your posture: Find that neutral position again where your head and shoulders are sitting on top of your pelvis, with equal weight exerting through both legs or both sides of your buttocks when sitting
  • Deep breaths: Take a deep, slow belly breath (diaphragmatic breathing). This helps you relax any nervous tension that may have developed when playing.
  • Shoulder rolls:  No matter what instrument played, most musicians will carry some sort of tension in their shoulders. A simple way to reset the muscles is to roll the shoulders forward and backwards a few times during your break.

These few practises will help to prevent unnecessary tension in the muscles. This will benefit you by decreasing your chances of injury; easing your tension when playing, both from the physical and mental aspect.



Violin-related Neck and Back Pain

Many injuries I see amongst the novice  to intermediate violinist are quite easily preventable. Watch this video for a few practical tips to include when you are next playing your violin. Many of these principles apply to the high performing violinist as well as other instrumentalists too!

There are SO many things to think about when playing, and these are just a few to prevent neck and back pain when playing violin.

Here are a few things to think about:

  • Equal weight through both legs
  • A neutral, elongated spine
  • Knees unlocked
  • Head on top of shoulders
  • Shoulders on top of hips

Happy playing!