Hello, I'm Dr. Robert Bastian of Laryngopedia and Bastian Voice Institute.
Our topic is muscles, general idea of muscles, and more specifically, vocal muscle. Well how in general
do you keep muscles strong? Everyone knows it's by using them. You do some sort of exercise regimen
or you use them in the course of your daily life, and they usually rise to the challenge and become
able to do what you ask them to do repeatedly. Well, think about three sort of typical kinds of people
and their muscles. Think of the bodybuilder who goes almost every day to a gym and works
with a trainer to build and sculpt muscle. But there's a second group of people who are active
and their work requires muscular use. Think of a carpenter lifting 2x4's climbing up and
hammering and lifting sheets of drywall. Or in this same second group, think of a daycare worker
who is lifting children all day, getting down on the floor to play with them, getting back up.
So those are all people who would have quite good muscular strength.
But then think of the third group of people, sedentary people. Think of an individual
who drives to work to a desk job, uses the elevator, even to climb one flight of stairs.
He or she drives home, walks into an apartment or condominium—there's no yard work to do—
and maybe spends evenings reading, or in front of a TV, or social media. That third person—the
office worker—might not have sufficient strength to lift a husky child, or to put a heavy suitcase
in the overhead rack of an airplane, or in trying to do those things might injure him or herself.
Well, let's switch from this concept of muscles in general, to those we don't think about as much that
help us make voice. The larynx and vocal tract is a muscular system too—let me show you. Here
on a model, this is the larynx, my larynx is right here, this is the adam's apple—or eve's apple—
sitting here with the windpipe going down into the lungs. And you'll notice there are muscles
on the outside. This is only part of them. There are muscles in the larynx; this is on the back
side. But down deep inside where the vocal cords live there are muscles as well, and I'll show you
using this drawing. You can see here inside the voice box, these are the vocal cords. Here's one
and here's the other, and they are made up of muscle. This is the open or breathing position, and
when this person produces voice, those vocal cords need to pinch together firmly with those muscles,
sufficiently strong, to produce a strong voice. If a person has a strong larynx when those vocal cords
are pinched together—here's an example—you can see that the vocal cords are firm and they come
together completely, creating this little dark line between them. By contrast, here's someone with
very little vocal cord muscle, and you notice now that there's a large gap between the vocal
cords don't pinch together as well. And when that happens, weakness within the laryngeal
muscles, the vocal cord muscles and the muscle surrounding, then, the person begins to have
difficulties vocally. They may say, "My voice becomes faded as the day wears on." "I can't be heard in
noisy places." "It sounds thin." And that kind of thing. Why would they have that kind of weak vocal tract?
It could be because of introversion and extremely little voice use. It could be
due to aging. A person who's 80 or 90 might have weakening. Just as they have some weakening of
general muscles, they may have some weakening in the larynx. Or think of the person who's been
very ill at any age, has been in a hospital bed and very weak, and they may also develop
that weak fuzzy gravelly voice can't be heard in noisy places with people asking you to repeat
all the time. Well, what I want to talk about is how to respond to a weak voice, and I'm
assuming (of course) that you've been examined and other conditions have been ruled out. Things like
nodules, polyps, various growths (benign and malignant) and neurological disorders.
So all of that's been ruled out, you've been told your voice is weak, and you need to build it.
well what would be a do it yourself strategy that you could safely apply without oversight
Now, obviously, it's great if you could do this with a speech pathologist, but I'm thinking of people
who live 30 miles from the nearest one, or you maybe have to work, wait several weeks to get in
and start the process, and this is something you could begin on your own while you wait.
The regimen is three simple vocal tasks, each done very briefly several times across the day.
Each of the three tasks needs to be done assertively and even aggressively. You're
not going to do vocal tasks like this little pink barbell, but you're going to do something
more aggressive, more effortful, like this one. And just as if can use this barbell
to strengthen my arm in different ways, this would be slightly different strengthening task than this,
sort of works a slightly different set of muscles. And maybe maybe this works yet another set of
muscles. And so in that sense, we're going to do three different vocal tasks to build the voice in
different ways. First one is what I call the "voice of authority" or the loud low angry voice. It's, "LONG
AGO, PEOPLE FOUND THAT IS WAS EASIER TO TRAVEL ON WATER THAN ON LAND!" It's emphatic and it's loud and
you should have this sense that you're really exerting yourself. The second is what I call
the "ship ahoy" voice. Now you're calling across the street, "SHIP AHOY! NEIGHBOR, LOOK OUT!" You know, you're
going to step in a hole or something. You would use a quite different but also loud voice. And
the third is simply a siren from lowest possible to the highest possible pitch in your voice like a—
and I'm not doing them quite as loudly as I would for fear of disturbing the audio system here.
Well, how when and where would you do these exercises? You would find times like when you're
in the shower, driving to work, in the basement. And remember, I didn't tell you, but each task is only
done for about 20 seconds. That's not a long time. So each episode of voice building is one minute.
You could do a minute per exercise, but let's begin with 20 seconds. So it's one single minute
in the shower, driving to work, driving home and so forth. How do you perform them? You imagine
you're standing like an oak tree, or you're thinking of yourself as the incredible hulk.
And if you're in a car, you're gripping the wheel like this, and you pick some series of words. It
could be counting, it could be reciting a poem, it could be narrating the drive that you're taking,
and you do the tasks—20 seconds—really loudly. Now, if you're by nature a very quiet person
and not really in touch with your big voice—and keep in mind, there are people who have basically
never made a loud vocal sound in their entire lives. So if that's you, you might need an observer,
a family or friend to observe you doing these three tasks, because they might surprise you by saying, "Oh
come on! That wasn't very, you know, convincing." Keep in mind it's not necessarily the actual
loudness that comes out, it's the attempt to be loud. It's the effort. You need to feel that your
muscles are straining, that your veins are bulging, that your eyes are bugging out. It's got to be
very intense. And as an aside, it's good also to o-ver-ar-tic-u-late. Because part of intelligibility
is articulation. So we're going for loud, but more than for loud; we're going for that sense of effort.
Now, purely to get across to my patients the idea of how aggressively I want them to do this,
I humorously tell them that if they live in an apartment or townhome, they should
warn the neighbors so they don't call the cops. And people who travel
can still do this, because in their hotel room they can take a pillow, put it directly onto
their face and do their voice building directly into the pillow, and you won't bother anyone.
Now, what can you expect from this voice building process? Well, not much for the first week or so. If
I do my very first exercise session with this barbell, I'm not going to finish and then say
to myself, "Wow, my arm feels stronger!" In fact, right after the initial episode, I might say
it actually makes my arm feel weaker. It feels tired and weak. It's similar for voice building;
your voice can seem worse immediately after doing one of your sessions. So we suggest that you just
commit to doing this voice building. Remember 20 seconds, 20 seconds, and 20 seconds. But we'd
like you to do that four to six times a day. Don't even think about it—whether it's helping or not—
for a minimum of two weeks. At the end of two weeks, you can take stock of what has happened.
Now, if you notice even a small improvement, you can keep it up, and some people choose to increase the
time a little bit. Maybe they'll do a minute, a minute, and a minute instead of 20 seconds,
20 seconds, 20 seconds. But at some point, at the level that you're willing to do—the amount of
time you're willing to do—you're going to plateau. You're going to say, "Okay, I don't notice anything
changing." That's when you take final stock of what you've accomplished. Now, if zero improvement occurs—
because there will be a few with severe bowing or other issues where you don't hear much difference.
But that group has still accomplished something, because you now know that voice building by itself
possibly has no real potential for you. Or you will say, "Okay, I tried it on my own, now let me go see
if a speech pathologist can help me additionally." So, but much more commonly people
will say, "Yeah there is some benefit." Well what do they describe as the benefit? Many of them say, "My
speaking voice sounds more or less the same, but I have more voice to call upon in loud circumstances."
I remember—for example—a man who said, "I used to finish the church worship service and I would get
out of there because I found that when I was in the narthex and people were trying to visit with
me, they were straining and I felt awkward and it just was very stressful. And so I would just leave."
Now, he said, "I don't have that problem." In addition, some people will say that
"I still have a sort of fuzzy voice, it's not as good as I'd like it to be but I
have better stamina. I used to really fade and have not a lot of voice left by mid-afternoon
and now I can kind of make it through the work day I have a little better stamina."
So after voice building, it could be that your voice is still not great, but it might be better
enough to meet your needs. Now if not, then we can begin to think about that next option. Again,
the speech pathologist. Or you could go to a laryngologist like me, or one of my colleagues,
or someone near you and talk about surgical implants through a little one inch incision on
the front of the neck, or by injection through the front of the neck, (a plumping material)
or through the mouth. Now at this point, you may say, "Okay I get it, I get the idea
and I don't need to hear any more." So feel free to stop now. But if you would like a summary—eight
part summary—here it is. Number ONE: just like arms and legs, vocal tract muscles can be strengthened
by challenging them. The larynx, the neck, the chest wall, the abdomen. TWO:
short bursts of intense and even aggressive voice use, several times a day—four to six
times a day—can effectively build vocal tract muscles. Not instantly, but across a few weeks.
THREE: while it would be ideal to do this with a voice qualified speech pathologist, it is safe
for you to use your voice very aggressively on your own, even if you don't do it all that well,
even if you're a bit clumsy with it, because the duration of the aggressive voice use is so short.
And in hundreds and hundreds of people who I have suggested this strategy to—in my clinical practice—
I've never seen an injury. FOUR: the three basic exercises are:
that low-loud-low voice of authority, "LONG AGO, PEOPLE FOUND..." like that. The second is the "ship ahoy" "LONG AGO
PEOPLE...people found..." like that. And the third is the "siren," that "oooOOOooo!"
(and much louder than that). FIVE: you don't need to schedule a specific time. Instead, you
do your brief bursts of voice building in the shower, driving to work, during an errand,
in the car alone, at home down, in the basement and so forth. SIX: if voice building helps to avoid
re-weakening of the voice, keep up these short bursts of aggressive voice use as a way of life.
Maybe you'll find that just a couple of times or three times a day are sufficient to keep the voice
at that stronger level. SEVEN: if voice building has helped, but not enough, you can still take your
quest for a better voice the next step; to a voice qualified speech pathologist, or a voice coach.
And EIGHT: if the entire process from having that initial exam to make sure there's nothing other
than weakness, to your own do-it-yourself process, (and maybe process with a speech pathologist) if
all of that together fails to take you where you need to be vocally, a laryngologist like me,
Dr. Richardson, Dr. Hoesli or someone near you will be ready to think about another solution.
And it will help them to know that you've already done a credible
attempt of voice building because that can skip you ahead one step in the process.
Well, thank you for listening to this video. All the best to you, and here's wishing you a strong voice!