Voicewize Blog

Is It A Vocal Fold Polyp or Cyst? Part 4 – Prognosis

Posted on April 19, 2012 by voicew1 | Leave a comment | Sciency Stuff, Voice Disorders

I’m sure those of you who have been following my series discussing the features of vocal fold polyps and cysts have been itching for me to get to my final point . You’re asking, What does this mean for my voice? If I get a vocal fold polyp or cyst, what is the prognosis for returning to full, normal function? What about singing? The answer to these questions is based on the information I’ve discussed in my previous posts. So, let’s break down some of the considerations.

First, the bottom line in terms of voice recovery is going to be determined by how close to normal the shape and flexibility of your vocal folds are after treatment for your vocal fold lesion. The characteristics of the lesion will influence this recovery.

Size

Vocal fold lesions distort the vibrating cover of the vocal fold. The larger the lesion, the more distortion there will be. This may come in the form of stretching of the cover or hardening of portions of the vocal fold cover, for example. In this sense, the larger the lesion, the greater the possibility of residual scarring. Generally, larger lesions are considered less likely to resolve with voice therapy alone. Therefore, surgery is more likely to be recommended.

Shape

I’ve mentioned that some vocal fold lesions are broad-based, while others are pinched together at the base or are connected to the vocal fold with a stalk. These shape characteristics influence the treatment that will be recommended. With broad-based polyps (that are smaller in size), voice therapy may be recommended before surgery is considered. Polyps that are pinched at the base or on a stalk are often recommended for surgical removal as they are unlikely to be able to be resolved with therapy alone.

Depth

Vocal fold lesions may be found at the outer vibrating edge of the vocal fold, or they may be embedded in the vibrating cover of the vocal fold. Polyps are more likely to be found at the surface, while cysts may form either in the outer edge of the vocal fold or embedded into the vibrating cover. When a cyst is located at the outside of the vocal fold, it is more easy to remove without permanent voice damage.

Sometimes, a cyst is located deep in the tissue of the vocal fold. This is much more challenging for the surgeon to treat, as removal of the cyst may leave a gap in the vibrating tissue of the vocal fold. When there is a gap, then the vocal fold cover will not vibrate well and voice after the surgery may be poor. There may be similar concerns in removing a polyp if the contents of the polyp are pushing in toward the deeper layers of the vocal fold cover.

Encapsulation

In a previous post, I discussed the issue of encapsulation. Cysts are encapsulated fluid in a ballon-type structure, polyps do not have a capsule. Generally speaking, cysts will be recommended for surgical removal. There are cases where the cyst spontaneously deflates, but this is often not ideal as it sets the stage for it to sporadically reinflate. Therefore, the problem is not truly solved.

Bottom Line?

Size, shape, depth and encapsulation all impact the type and amount of damage there may be to the vocal folds. Issues regarding chronic or acute phonotrauma, as discussed in Part 3 of this series, should also be addressed however as vocal hyperfunction (muscle strain) may leave you at risk for recurrence of a voice injury.

Many patients are so eager to get rid of their vocal fold lesion, that they pressure their medical team toward immediate surgical intervention. This is not always wise. While modern surgical techniques are quite good, a risk of surgical scarring still exists. Some would say there is always some surgical scarring in the vocal fold cover, even if it is very small. If there is a reasonable chance that your vocal fold lesion can be treated with therapy alone, it is worth trying that option. What is “reasonable” will be determined by all of the factors I have discussed in this series…and more. A good voice-focused medical team will help you sort through them all.

Is It A Vocal Fold Polyp or Cyst? Part 3

Posted on April 3, 2012 by voicew1 | Leave a comment | Sciency Stuff, Voice Disorders

Recently, more professional singers have been honest with the public when they are experiencing a voice disorder. This has not always been the case. Until recently, and still in some circles, negative assumptions were made about singers’ injuries. Singers were regularly accused of “abusing” and “misusing” their voices. The contempt laid upon a singer who developed a vocal fold lesion was thick. Just the language itself calls up images of having “Laryngeal Protective Services” knocking down the door of some unsuspecting singer and plopping her vocal folds into protective custody.

Geez guys, singers don’t get hurt on purpose.

Okay. We know that certain vocal behaviors are not conducive to optimal vocal health, but singers are not usually the ones who demonstrate a blatant disregard for the limitations of their instrument. Some critics move on to assert that particular styles of singing are inherently “abusive” and proceed to implicate every kind of singing they don’t personally do. I’m sure you see where I’m going with this…

What are we really referring to here is the question of whether or not a particular injury was caused by phonotrauma. This occurs when the forces acting on the vocal folds cause tissue damage of some sort. This damage may occur quickly as in the case of a hemorrhage or over a period of time. The term phonotrauma makes no prejudgements regarding whether or not the singer is some kind of miscreant. A medical team that is oriented around diagnosing and treating phonotrauma, rather than abuse and misuse, will seek to understand the nature of the injury and the factors that led to the vocal mechanism being overwhelmed instead of being sidelined by assumptions about your voice use.

By orienting oneself around the idea of phonotrauma, rather than abuse and misuse, we also open ourself up to the possibility of a lesion being “idiopathic.” in medical jargon this means “out of the blue” or from no specific cause – stuff happens. There are many vocal lesions that are idiopathic.

In days of yore, it also used to be that polyps were considered to be phonotraumatic and cysts were considered to be idiopathic. This assumption was largely based on the observation that there are some people who just tend to get cysts in various parts of their body and others who do not. Vocal fold cysts have been noted in infants, for example. The formation of polyps was always assumed to be due to the shearing forces of phonotrauma.

It appears that this distinction of vocal fold polyps being phonotraumatic and vocal fold cysts being idiopathic, is not necessarily a truism. There are now phonotraumatic theories of cyst formation. So, when we are diagnosing vocal fold lesions, we often do not make this automatic assumption any more.

Stay tuned for the final installation in my vocal fold polyps versus cysts series: prognosis.

Is It A Vocal Fold Polyp or Cyst? Part 2

Posted on March 23, 2012 by voicew1 | Leave a comment | Sciency Stuff, Voice Disorders

This is the second installment of my series considering the diagnostic differences between vocal fold polyps and vocal fold cysts. Since both polyps and cysts present as an outpouching of the tissue of the vocal fold(s), it can be hard to tell the difference between them.

In the first article, I discussed the fact that bilateral lesions don’t necessarily indicate nodules, but may still represent the presence of a polyp or cyst. Today, I will talk about the question of encapsulation. Encapsulation provides a clue that can guide the medical team in planning the best treatment.

The term polyp is somewhat vague, it can refer to any fluid-filled bump sticking out of the surface of the vocal folds. Polyps can be broad-based and hill-shaped, soft or round and taut. They can be filled with clear fluid, or with blood (in the case of hemorrhagic polyps). They can be attached along an entire edge of the vocal fold or attached by a thin stalk. Size is quite variable.

Cysts are somewhat more consistent in that they consist of a balloon-like, fluid-filled capsule – thus the terms “encapsulated.” Size can remain quite variable. Cysts are most always round, though at times there can be surrounding swelling in the vocal fold that hides its true shape.

The cyst capsule may be fully visible at the surface or nestled deep inside the vibrating cover of the vocal fold (called an “intracordal” cyst). The depth of the capsule can have significant implications for treatment. When the cyst is at the surface of the vocal fold, it may stretch and deform the epithelium (the surface layer of the vocal fold) but it is generally easy to surgically remove. When the cyst is sunk into the vibrating gel of the lamina propria, it can leave a disruptive gap if removed.

Historically, polyps and cysts have been considered less amenable to voice therapy than vocal fold nodules. Therefore, surgical intervention is often recommended. Today, the decision to remove a polyp is based more on size, shape and consistency, with smaller more broad-based and soft polyps responding to therapy treatment more easily than large round or stalk-like polyps. Cysts continue to be referred for surgical excision, unless they are very small or so deeply embedded in the vocal fold that removal itself would present a high risk of further vocal fold damage.

Encapsulation also impacts a surgeon’s technique when removing a lesion. Both polyps and cysts are typically removed using microsurgical techniques. Operating on an encapsulated cyst, however, can be quite challenging as it is important not to pop the capsule during removal. If popped, the capsule will deflate and adhere to the rest of the tissue in the vocal fold such that it can’t be removed – but it is liable to re-inflate later. Therefore, working with a surgeon who is skilled in this microsurgery is important.

Stay tuned for Part 3 in this series that examines the role of phonotrauma versus idiopathic lesions.

Is It A Vocal Fold Polyp or Cyst? Part 1

Posted on March 10, 2012 by voicew1 | 1 Comment | Sciency Stuff, Voice Disorders

Since long before I started studying speech pathology and specializing in voice, there has been controversy about the classification of vocal fold lesions. Strikingly, there are vastly different opinions between the ENT’s I have worked with over the years in terms of what to call the various lumps and bumps we see in laryngeal stroboscopic examinations. I get many questions from patients and other interested people about this. So, I thought it would be helpful to outline some of the professional considerations we take into account in attempting to classify vocal fold lesions.

As there are a number of different considerations, I will break this discussion down into several parts. In this post, I will discuss the question of bilateral versus unilateral lesions.

In medical terminology, unilateral refers to something that is present or occurring on one side of a structure. Bilateral means something is present or occurring on both sides of a structure. In the larynx, there are two vocal folds positioned in a “v” shape at the top of the trachea (breathing tube). The top of the “v” opens when you breath and closes when you make sound. If there is a unilateral lesion of the vocal folds, that means there is a lump or bump on one vocal fold. If the lesions are bilateral, there are lumps or bumps on both of the vocal folds.

Prior to common availability of stroboscopic examination of the larynx, the only way a physician could visualize the vocal folds outside of the surgical suite was with a small dental mirror. The image was small, poorly lit and could not reveal what happens to the vocal fold cover during vibration.

It is important to recognize that the inability to see the movements of the vocal fold cover as it vibrates makes it virtually impossible to understand the dynamics involved in the sound. Since the vocal folds vibrate faster than the human eye can see, this information is lost in the absence of a stroboscopic examination. Historically, this was a serious limitation on the ability of physicians to specify lesion types during an office visit.

In that era, any time a physician saw benign, bilateral lesions (non-cancerous bumps opposite each other on each vocal fold) the patient would be said to have “nodules.” Given the information they had, the presence of lesions across from each other on each vocal fold was assumed to be the result of impact stress force during phonation (strain in speaking or singing). The unfortunate side effect of this assumption was the implication that the patient was somehow responsible for their condition; that they had “done something” to injure themselves. If the patient was involved in singing, even on a peripheral or amateur level, they were informed that cause was singing incorrectly. To this day, I receive some physician orders with the diagnosis of “singer’s nodules.”

The availability of stroboscopic imagery for voice allowed us to see the details of vocal fold lesions and their dynamics. What clinicians began to appreciate was the variety these lesions represented. We are now able to see subtle asymmetries and differences in consistency or stiffness in the lesions on one vocal fold versus the other. We are able to witness the impact that these factors have on the vibration of the vocal folds.

One conclusion drawn from this new information is the fact that a lesion can be created on the vocal fold by hitting a lesion on the opposing vocal fold. That is, there may be a lesion on say, the left vocal fold, but the right fold develops a reactive lesion from hitting the lesion on the other side. This is very different than saying a person is misusing their voice and therefore developed bilateral vocal fold nodules.

It is significant for treatment when it becomes clear that one lesion is in fact a unilateral polyp or cyst and the other lesion is a reactive nodule. In treatment then, you would not be surprised if the reactive lesion disappears with voice therapy alone, while the primary lesion needs surgical removal.

So, the question of whether a patient has bilateral lesions of the same type or bilateral lesions of different types is diagnostically significant in terms of discerning polyps, nodules and cysts. It may guide voice therapy treatment as well. Prognosis is certainly impacted by this distinction. It can no longer be assumed that simply viewing bilateral lesions is indicative of nodules, while polyps and cysts are mostly unilateral. If the detail of the vocal fold is not examined in great enough detail to distinguish between the two, the likely outcome will be suboptimal.

Stay tuned for the next post in this series, which will discuss distinguishing polyps versus nodules based on the presence or lack of a surrounding capsule.

If A Child Wants to Sing…Teach Them to Sing

Posted on February 29, 2012 by voicew1 | 2 Comments | Sciency Stuff, Technique, Young Children & Singing

There is a lot of crazy information out there about teaching (or not teaching) children to sing. Outside of the physiological misinformation that makes the voice pathologist in me cringe, the most absurd has to be the idea that children should study another instrument before being allowed to study singing.

Telling children they need to learn another instrument before studying singing is kind of like telling cardiologists they have to spend ten years practicing urology before working with heart disorders. Do doctors need to have a basic understanding of the areas of specialities of other doctors? Sure. Do they need to perfect their neurosurgical technique before opening their dermatology practice? Um, no.

The arguments for forcing children to study instruments that hold no interest to them appear to be based in a number of incorrect assumptions:

1) Most children who study singing will go on to higher level musical training in college.
Many of the well-meaning colleagues I have spoken with about this express concern that children who study singing will be at a disadvantage when they are in college competing with kids who have more experience with instruments and music theory than they have. The problem with this argument is that most children will not go on to study music in college. This is of course true for instrumental students as well, but there is some strange mythology that all young singing students will all go on to study seriously when they are older. This is simply not true.

2) Children can’t learn musicality, if they study only singing.
Related to the previous item is the notion that singing students are lacking in basic musicality skills. This may be true, but when it is, it is either the fault of the teacher or the refusal of the student. A singing lesson is filled with opportunities to teach musicality: reading the sheet music, playing vocalises using alternate scales, and interval training. Harmonization can be performed between the teacher and student, or between students in the studio. Students can be asked to transpose cuts of songs to fit their voices better and be taught how to compose lead sheets, if they are going to be performing in rock or jazz ensembles. Given the way in which the public schools have been cutting back on the budgets for music education, these basics are now part of the responsibility of the private and community singing and music teachers.

3) Kids can’t learn any real vocal skills until after puberty. So, let’s give them something else to keep them busy until then.
Because I have a detailed understanding of pediatric vocal anatomy and physiology and have experience in adapting my teaching techniques to the cognitive and physical level of children, I know what kinds of extraordinary things children can learn to do – many times with less effort than their teen counterparts. Children have a lack of self-consciousness that allows them to engage more deeply in potentially “embarrassing” exercises. They are also a more blank slate in terms of the motor patterns required for singing. Therefore it is easier to elicit an appropriate physical response without interference from unproductive motor patterns. Not everyone enjoys working with children, or even wants to, but it is very different to say I don’t want to work with children than it is to say that no one else should teach them to sing either.

In terms of my own musical development, I have a confession to make. I am a terrible instrumentalist. Over the course of my musical education, I studied flute, clarinet, piano and guitar. My performance in playing these instruments was completely independent of the amount of practice I put in. In sixth grade, practicing flute regularly drove me to tears. I had this problem where I could picture the note I wanted to play, but my fingers would nonetheless play another note. If I had been forced to play these instruments instead of learning to sing (fortunately, I was able to study singing concurrently), I would never have become the voice scientist and teacher that I am today. I would have despaired and quit.

It pains me to think of how many children are lost to developing a joy of and skill in singing simply because the teachers they approach have poor assumptions about their needs and capabilities. Most of these children will not be flying across the country to attend young artists’ programs and studying voice performance at Julliard. They’re going to be singing karaoke at a pub in Brookline with their college friends. Are they going to have the skills they need to have fun and keep their voice for a lifetime? That may depend on who shows them how. So, if a child wants to sing, teach them to sing.

Congratulations to our Lyric Contest Winner – Chloe Goodman

Posted on December 22, 2011 by voicew1 | Leave a comment | Singer Profiles, Uncategorized

Chloe, who is a singing student at Voicewize, was the winner of our 5th Anniversareen Party Lyric Contest. Marianne and Barbara put her words to music and voila!

Hope you enjoy it!

Teaching Your Children About Singing Voice Care

Posted on November 2, 2011 by voicew1 | 2 Comments | Uncategorized

Simon LeBon; by Bolt of Blue (Flikr)

Lately, professional singers have been more open with the public in discussing their vocal injuries and problems. This is a welcome change to me as a singing teacher. In the past, it was considered shameful for a professional singer to have any sort of disorder or injury. Somehow, football players could get away with sitting out half the season with a bum knee, but a singer couldn’t cancel a performance for laryngitis without being accused of “singing wrong”. Finally, the truth is coming to light. Singing, especially high-powered sounds like rock, Broadway and opera, is an athletic activity. Like any athlete, even singers with good technique can have problems from time to time.

The problem in terms of using these stories as teachable moments for your children who love to sing is the fact that historically pop and rock singers have in fact resisted vocal training. There are many more professional and would-be professional singers out there performing with inadequate athletic skill than there are football players. Imagine any other sports star trying to justify that training would somehow spoil the “naturalness” of their game. That would be absurd. It is equally absurd for singers. Fortunately, that is changing as well.

So, how can parents use these stories for help their children learn about singing voice care without frightening them into silence? Below are are few tips to get you started:

Mention stories that you hear about singers who are recovering from an illness or injury talk about what the artist said about it and wish them well in their recovery. Maybe even make a card and send it to the singer’s management company.
Ask your kids about their voices when they engage in screaming behaviors or yell themselves hoarse. Many kids don’t even realize the voice can be injured.
Help your children make the connection between the training that other athletes (such as soccer and baseball players) have to do and the training that is required to have a strong and flexible voice
If you child is particularly interested in singing as a hobby, enroll them in private technical singing training to ensure that they start off with efficient vocal patterns.

Recently, the list of professional singers who are openly talking about their voice disorders and recovery has been getting longer. Examples I can think of are: Ashlee Simpson, Adele, Simon LeBon, Paul Stanley, Steven Tyler, and Lauren Alaina. A Boston Globe article was just published today (link) that reinforces the importance of athletic vocal training for singers. Speaking to your kids using examples of popular singers struggles to stay healthy can be a good first step in helping them to learn to respect and care for their instrument in the best way they can.

Alternative Approaches to Reflux Treatment

Posted on September 14, 2011 by voicew1 | 2 Comments | Reflux, Sciency Stuff

Image by Todd Berman - http://theartdontstop.com/

Reflux is a common source of inflammation in the vocal structures and is therefore a major cause of concern for singers and other heavy voice users. Gastro-esophageal reflux disease (GERD) occurs when stomach contents back up in the esophagus. When the refluxed material makes its way into the throat, it is called laryngopharyngeal reflux (LPR). This coats the larynx and other structures in the throat with acid. LPR is often called “silent reflux” because it is less likely to cause heartburn than GERD.

The most common medical treatment for chronic acid reflux is prescription medication, usually a proton pump inhibitor (PPI) such as Prilosec, Prevacid or Nexium. An H2 blocker such as Zantac may also be used alone or in combination with a PPI. While these medications are effective for many people, they do not cure reflux and a significant portion of the population experiences side effects or breakthrough reflux.

In an effort to learn more about natural approaches to effective reflux control, I am talking today with Kathleen R. Flewelling, ND (Naturopathic Doctor), owner of A Natural Path Integrated Health Services in Seaside, Oregon. For the sake of brevity on the blog, I have edited the responses here. The full interview with more information can be found in the Voice & Speech Library on my web site at: http://www.voicewize.com/alternative-reflux-control

What are some of the physical problems that can be caused by reflux?

Gastroesophageal reflux can cause problems such as sore throat, hoarseness, difficulty swallowing, snoring, shortness of breath, post nasal drip, pain in the center of the chest and a feeling of fullness. Sometimes these symptoms are mistakenly attributed to allergies.

Some of the more serious long-term effects of untreated reflux include gum disease, tooth enamel erosion, vomiting, bloody stools, inflammation, scarring and ulceration of the esophagus and Barrett’s esophagus. A small number of people with Barrett’s esophagus end up with a rare but deadly esophagus cancer.

What causes reflux?

When food is not being chewed or swallowed, the lower esophageal sphincter (LES) should be tightly closed. In reflux, the LES relaxes, allowing the contents of the stomach, mixed with acid, to flow back up the esophagus.

What are some of the problems with the typical medications prescribed to control reflux?

Common side effects of medications to control reflux include constipation, diarrhea, headache, abdominal pain, fatigue, and dizziness. Rarer side effects include rash, itch, flatulence, anxiety and depression.

In addition, blockage of hydrochloric acid may reduce your body’s ability to absorb minerals, especially magnesium, protein and B12. H2 antagonist use is associated with community acquired pneumonia.

Those over the age of 50 who have taken a PPI for over a year have an increased chance of breaking a hip. There may also be a risk of fracture of the spine and wrists. PPI’s may also increase certain heart arrhythmias.

What are some alternative medical approaches to reflux control?

The best approach to reflux control for a given patient depends on the reason why that person has reflux in the first place. I usually work with the patient to implement dietary changes and provide them with appropriate digestive enzymes.

You may want to consider keeping a diet and symptom diary to see if there is any correlation between your symptoms and what you eat. My husband went on a gluten-free diet and his heartburn went away completely. Well, until he ate gluten again.

Consider going on a hypoallergenic diet. Foods to avoid would include dairy, eggs, gluten, citrus, corn, soy, most nuts and nightshade veggies such as potato, tomato, eggplant, green pepper and paprika.

If you have no gastric or duodenal ulcers, I often try giving the patient a pancreatic digestive enzyme with or without hydrochloric acid. These are taken 10 minutes before eating for best results, although some effect if taken within an hour of eating. Dosing is quite individualized, some people need more and some need less. If you get a burning feeling in your stomach after taking hydrochloric acid, you need less. Therefore, I do not recommend implementing this treatment if you are not under the care of an appropriately trained professional.

If the patient is not able to use a digestive enzyme due to pain or ulcers, I often consider using deglycyrrhizinated licorice (DGL). DGL is healing and protective of the lining of the intestinal tract without inhibiting the release of acid. It is important to work with DGL, rather than plain licorice because licorice alone can increase the risk of heart palpitations and increased blood pressure in those who are sensitive to it.

If you suspect or know you have a hiatal hernia, you should be checked out by a surgeon for possible repair. If repair is not needed, consider going to a chiropractor that specializes in adjusting hiatal hernias.

As with many things, try to decrease the stress in your life or at least your response to those stressers.

What’s the difference between a food “allergy” and a “sensitivity” and what’s the best way to go about finding out if you have one of these. Since many of my LPR patients don’t experience heartburn, many don’t know what to look for in terms of symptoms.

A food allergy is an exaggerated response to food and can include anaphylaxis, like when some people have peanuts or shellfish. In a true food allergy, the immune system produces IgE antibodies and histamine in response to the specific food.

A food sensitivity or intolerance is a negative delayed reaction to food such as rashes, constipation or diarrhea, breathing problems, gas, mouth ulcers, etc. This can be due to malabsorption or errors of metabolism, such as lactase deficiency or celiac disease. There can be an antibody reaction, but it is not IgE antibodies. There are blood tests for some of these antibodies. http://www.alcat.com/store/index.php?main_page=index&cPath=1

How can people go about finding a qualified person to consult for natural medical care? In particular, are then any suggestions for people who live in a state like Massachusetts where there is no licensure for naturopathic MDs?

Start with a national professional association such as American Association of Naturopathic Physicians. http://www.naturopathic.org/index.asp There are several naturopathic clinics in Massachusetts. Vermont, New Hampshire and Connecticut are all licensed states and close by. Last I knew, Massachusetts does or did have legislation pending on naturopathic licensure.

Make sure the physician went to an accredited four-year residential program. There are only a few schools like that in the United States: NCNM, Bastyr, University of Bridgeport, Southwest College and National University.

I feel it is important to find a natural treatment for reflux because in the long run the medications cause problems and at the same time leaving reflux untreated is also a problem.

For more information on natural health solutions, visit Dr. Flewelling’s blog at http://commonsensekat.blogspot.com/

You Study Piano with a Piano Teacher; You Study Singing with a…

Posted on September 1, 2011 by voicew1 | Leave a comment | Musings, Understanding Singing

You would be surprised how many people get the end of that analogy wrong. I’ve written before about the perils of listening to unqualified advice in regard to voice disorders. Now I must weigh in on the training of healthy voices.

Maybe it’s because when most people open their mouths sound comes out that everyone thinks they’re a voice expert. Perhaps it’s simple human tunnel vision that makes people think that the singing strategies that are helpful for them will work for everyone. Or…

Maybe it’s just ignorance of the real problems that can be caused when vocal technique is incorrectly applied.

Maybe it’s ignorance that there actually is such a thing as vocal technique – even for pop, rock, country, gospel, etc.

I’m trying to give people the benefit of the doubt here, but it’s difficult to see so many singers led astray by unqualified “teachers”.

What is prompting me is a recent experience of having one student decide they would not take singing lessons with one of our teachers because the {other instrumental} teacher gives them advice on singing when they are at that lesson. What are the chances that this instrumental teacher knows anything about the vocal mechanism, vocal training strategies or pedagogy, or appreciates the extent to which vocal training is like athletic training? Not likely in my estimation.

It’s my opinion that this student is being mis-served in two ways:
1) They are being denied access to training for higher level singing skills by a qualified person who can help them safely navigate to the highest level of their potential.
2) There is time being wasted “giving advice” on singing in a lesson which primary purpose is to teach the student how to play a different instrument.

Perhaps I’m being too stodgy. I play a little guitar and a little piano. Perhaps I should start telling people they don’t need lessons on these instruments because I can “give them advice” on how to play. Maybe I should just hang my shingle out as a jack-of-all trades, even though I don’t know much about how to design the most efficient fingering patterns or how to adjust the hands and wrists for maximum performance with minimal strain. It’d be fine, right? How much damage could I do? Probably lots.

By necessity, music teachers often end up giving tips here and there on things related to the performance that are not entirely in their domain. It is the nature of the beast that I need to speak with my singers about using a guitar strap and how to hold their posture given the weight of the instrument in the front of their bodies. It is inevitable that I need to work with a singer whose shoulders crunch up and down as they are playing the piano. I have even suggested chord phrasing from time to time when we a problem solving a song we are working on.

What I would never do, however, is give a student the impression that I am able to instruct them in how to develop their playing skills on these instruments. And I also would not spend enough time on that in a singing lesson that the student would get the impression that I was teaching them another instrument. I feel quite strongly that teachers should stick within the scope of their expertise in terms of what they teach.

Perhaps this teacher is a fully qualified singing teacher. Some day, if I find this person on the member list at nats.org then I suppose I will have to post a correction. In the meantime, I stand by my assertion that:

You study piano with a piano teacher.

You study guitar with a guitar teacher.

You study bassoon with a bassoon teacher.

You study singing with a singing teacher.

Contemporary Commercial Music Requires It’s Own Singing Technique

Posted on August 23, 2011 by voicew1 | 1 Comment | Technique, Understanding Singing

At my Somatic Voiceworks™ Lovetri Method training this summer at Shenandoah University, I had the privilege of connecting with an amazing group of people who are all as committed to the appropriate and authentic teaching of contemporary commercial music as I am.

When most of us were growing up, we were ingrained with the myth that if a singer studies classical technique they will then be prepared to sing anything else. Intrinsically, in our muscles and bodies we knew this was not true as we all struggled to glean the supposed connection between the use of the voice for classical music and the use of the voice for contemporary commercial music. Yet the mythology continued (and to a certain extent continues) to be propagated.

As the scientific and teaching community learns more about the true physiology of the vocal mechanism and how it functions in singing, there is increased evidence that a different method is appropriate for classical and contemporary commercial music. In 2008, the American Academy of Teachers of Singing, an elite group of master voice teachers formally acknowledged this in their publication, In Support of Contemporary Commercial Music (nonclassical) Voice Pedagogy, which was presented at the conference of the National Association of Teachers of Singing that year. This was a big step, considering how contentious the debate has been among singing teachers. The announcement of the publication was met with both celebration and contempt.

Subsequent to my adventures at Shenandoah this year, there was a discussion regarding this topic in the group listserve. A teacher posted regarding some difficulty that she had been having in her institution regarding the teaching of contemporary commercial music as it related to her doctoral studies. She asked for advice in terms of how to best communicate the rationale behind why the teaching method for contemporary commercial music should be different than that for classical music.

Dr. Robinson-Martin

One response came from one of my new best friends Dr. Trineice Robinson-Martin. She is Assistant Professor of Music, Jazz Voice, Mercer County Community College, NJ and Adjunct Instructor, CCM Voice, Teachers College Columbia University, NY among other things. I found her post to be both cogent and very useful for explaining the differences between singing training for classical versus contemporary commercial music. She has given me permission to post her response below:

While I solely work as an instructor and performer of CCMstyles, a large majority of my own formal voice training has been with a classical teacher, learning the standard vocal training for classical singing. Due to my training, I can speak on both the benefits and limitations of having a classical-based vocal technique, as a professional CCM performer.

Benefits of Classical based training:

1. Established solid breathing technique for singing at various volumes

2. Established a stable tone production, great for ballads (which is actually my strongest characteristic).

3. Developed my head voice

4. Increased my overall range by an octave or so.

5. My chest voice became smoother.

Limitations of Classical based training:

1. I ended up with two different voices; one that I used in voice lessons, and one that I used to perform.

a. By the time I graduated I had a solid head voice, with a decent working range, but could only produce it with a classical tone. Thus I didn’t use it outside of voice lessons.

2. I still could not sing nor belt above A4

a. For jazz this wasn’t too problematic at first, I would just transpose the key. Yet as I musically matured and became aware of how a half or whole step transposition effects the mood of song, it became agreat limitation. It also became problematic when I started sitting in with other performers.

b. For gospel and R&B, it limited my repertoire. That is until I started getting paid to sing a certain repertoire, then I starting pushing my instrument, which got me into vocal trouble. I didn’t know there was another way and the information at the time wasn’t readily available.

3. Stylistically, I could never integrate my style of singing with what I was learning in the voice studio.

a. Whenever my classical teachers would try to coach me, the result tended to lose a level of authenticity in terms of its execution.

b. I never learned how to incorporate the stylistic aspects of my classical sound into my jazz or R&B sound, even though there were other popular artists doing just that.

When I graduated IUB, I was convinced that I was going to find answers. I figured there were too many singers that were successful, vocally healthy, and that were singing the styles and sounds I wanted to create, for there not to be any research or pedagogy on the topic. Thus I began my research and vocal application journey. What did I learn?

The standard classical voice technique as a sole technique for a vocal foundation is NOT conducive to CCM singing styles.

WHY?

1. First and foremost, the vocal parameters that constitute what is a “good singer” are different for classical styles than for CCM styles. For example:

a. In the female voice, classical prefers a head dominate/CT dominate sound, CCM typically prefers a chest dominate/TA dominate sound. This is also evident in the manner in which they create the mix.

b. In terms of timbre and vocal color, classical tends to prefer a fuller, darker, rounded, formal sound that results from a larger pharyngeal space towards the back of the mouth and throat. CCM advocates the opposite, not only for aesthetic reasons but for functional reasons as well. This is the area I felt most limited by my classical technique. Trying to take the chest or even a chest-mix up in range while keeping space in the back of the throat and the larynx down is EXTREMELY taxing on the throat. I know from first hand experience. But it did help me to understand why people said chest voice is damaging, because it is if one executes chest voice using a pharyngeal landscape that is structured forthe optimal amplification of a classical sound. It’s also damaging if one doesn’t learn to execute the appropriate mix.

c. The use of vibrato is different. When I started competing in jazz vocal competitions in graduate school, too much use of vibrato was a common criticism.

2. Articulation is different, in terms of dialect and execution.

3. Stylistically, there are many in the classical teaching tradition that believe one must have a great command of technique to effectively express emotion. This train of thought makes the acquisition of technique greater in importance than the developmentof musical expression. In CCM styles, especially those based in a more folk tradition, the authenticity and believability of the artist’s emotion is much more important than their command of vocal technique.

There are many more reasons that are not listed. A more comprehensive list will be provided with the work of your doctoral candidate.

Classical technique is a solid, proven, and extremely effective technique for classical singing. However, a solid CCM vocal technique will not only provide the benefits of the classical technique, but also provides a technique that helps students to produce vocal sounds and nuances that are not in the classical repertoire, in a healthy and efficient manner.

Dr. Robinson-Martin can be found at: http://www.trineicerobinson.com/

Scientific & Philosophical Musings on Voice, Speech & Singing