The Role of Physiotherapy in Vocal Health: How Performers and Professional Voice Users Can Protect Their Voice

When we think of physiotherapy, most people picture sports injuries or sore backs. I didn’t even know Vocal Physiotherapy was a thing before I started studying physio. It wasn’t until I started working in the UK with the Kinky Boots musical that I was exposed to vocal unloading. I thought going into that contract it would be ankle injuries from the high heels, but it ended up being vocal overload that was one of the most common complaints from the performers. The nature of the show, singing eight shows a week with microphone pack in their wig, plus a wig, plus the weight of a headpiece, dancing and moving around the stage took its toll.

You might not be in the cast of Kinky Boots, but physiotherapy can still play a vital role in supporting and protecting your voice for singers, actors, teachers, and anyone who relies on their voice in their profession.

What is Vocal Physiotherapy?

I often get asked, what exactly is vocal physiotherapy? How is it different to Speech Therapy?

Vocal physiotherapy is a particular area of physiotherapy that focuses on the muscles around the neck and larynx, posture, and breathing patterns that support healthy voice production. It looks at the whole body, particularly the neck, jaw, shoulders and core, to support optimal vocal function.

We work closely within a team of ENTs, speech therapists, and vocal coaches to provide a holistic approach to voice care. Each profession has it’s particular role. You’ll be given specific exercises from the speech therapist to help with speaking, vocal coaches can help with more specific singing exercises and singing technique and the ENT can use a scope to see your vocal cords, help with any medication or surgeries. This team-based model ensures that every aspect of your vocal health is considered, from medical to muscular and technical.

Common Vocal Issues Treated with Physiotherapy

Many performers and professionals experience voice problems at some point. Some of the most common issues I see in clinic and can help with include:

• Muscle tension dysphonia: Excess tension in the neck and laryngeal muscles disrupts normal voice production.

• Vocal fatigue: Tiredness or loss of vocal power after speaking or singing.

• Neck, jaw, and shoulder tension: Muscular tightness can affect the movement of the larynx and breathing patterns.

• Poor posture: Slouching or forward head posture can place strain on the larynx.

• Breathing pattern: apical breathing pattern can increase tension in the muscles around your neck

  
  

How Physiotherapy Supports Vocal Health

A typical vocal physiotherapy assessment involves a thorough look at your posture, breathing mechanics, and any areas of tension in your neck, jaw, shoulders, and upper back. I use a range of techniques to address these issues, including:

• Manual therapy and massage: To release tight muscles and restore normal movement.

• Breathing retraining: Helping you find efficient, relaxed breathing patterns that support strong voice production.

• Strengthening deep neck flexors and scapula muscles: These muscles provide stability and support for the voice.

• Postural retraining: Simple exercises and awareness strategies to improve alignment and reduce strain. By addressing the physical contributors to vocal problems, physiotherapy can help you recover faster, prevent future issues, and perform at your best.

  
  

Tips for Maintaining a Healthy Voice

Here are a few tips to keep your voice in top shape:

1. Take regular movement breaks: Avoid staying in one position for too long, especially if you’re working at a desk or playing an instrument.

2. Hydrate well: Drink water throughout the day to keep your vocal folds hydrated.

3. Practice good posture: Imagine a string gently lengthening your spine as you speak or sing.

4. Release tension: Gentle neck and shoulder stretches can help, especially after long rehearsals, performances, or long days at work.

5. Rest your voice: After heavy use, allow time for your voice to recover.

6. Address any reflux: a GP or ENT can help you with this as well as dietician to help identify which foods are a trigger.

   
   

When to Seek Help

If you notice ongoing hoarseness, pain when speaking or singing, loss of vocal range, or persistent tension in your head, jaw, neck and shoulders, it might be time to get professional help. Early intervention can make a big difference and prevent more serious issues down the track.

If you’re experiencing voice problems or want to stay proactive about your vocal health, I’m here to help! You can book a vocal physiotherapy consultation or reach out with any questions. Let’s work together to keep your voice strong, healthy, and work or performance ready.