Singing with Asthma
I apologize for the delay in posting -- I wanted to compile all information as succinctly as possible. Thanks, as always, for the outpouring of responses.
Director of Middle School Choral Activities
Hayfield Secondary School
There is a student in our high school program who has
> been singing for several years with asthma. She and
> her mother are concerned that she is not reaching her
> full vocal potential because of her asthma -- that she
> has to compensate breath support (and consequently,
> tone) because of her difficulty breathing. Have any of
> you encountered this problem? What advice would you
> give to this singer? I will post an abbreviated
> compliation if there is interest.
> Thanks in advance,
1. Drinking PLENTY of water to counteract the effects of medications
2. Controlling the amount of air released early in a phrase, for the push of breath to make it to the end of the phrase will cause irritation in the bronchial tube
3. Purchase a humidifier
4. Physical activity to help lung power -- swimming, walking, etc.
5. Playing the trumpet
6. Having lung function tests performed, including spirometry and lung volume measurement to show any show any decrease in the student's vital capacity and help assess obstructive lung diseases such as asthma.
One person recommended a combination: "A) A bronchodilator(inhaler) to loosen the aureoles, B) A chortico steroid(inhaler) to reduce the swelling, C) Some method of controlling the sensitivity to pathogens eg. Theochron(tablet) in a sustained release dose,
or other similar medications."
Meds: Singulair; Flo-nase if the singer has allergies; Proventil (repitabs?)
Inhalers:short-term: Proventil (albuterol) or Serevent; Ventolin or Airomir
Inhalers: long term: Flo-vent (recommended by many) & Asthmacort (both 12 hr. sprays)
*Allin Sorenson, however, cautions against long-term use of steroid inhalers, which can waste the body of the vocal fold over time.
Catherine LeGrand is a flutist who has done work on breath. Her website: www.in1breath.com
Finally, two GREAT articles from David Wilson, a singer, conductor, and certified yoga instructor who published the following in "Musica Alberta:"
Yoga and Breath for Musicians 1
Time is Breath
Breath, Body, Mind and Life
The use of effective breathing to improve mental and physical health goes
back many thousands of years. Natural, full-body breathing powered by the
lower belly is essentially our birthright. As infants our bones, muscles,
organs and entire spinal column would undulate with the pulse of our breath.
In The Breathing Book, Donna Farhi states:
Breathing affects your respiratory, cardiovascular, neurological,
muscular, and psychic systems, and also has a general affect on your sleep,
memory, ability to concentrate, and your energy levels.
As we are challenged by the rigors of life, we begin to tense our body and
breath in order to "hold firm", just as we would hold onto a tree during a
strong wind. Dealing with increased levels of psychological stress increases
the tempo of our internal metronomes, and our chemical, cellular and
neurological paces quicken. In an effort to sustain this hurried rate, our
muscles often learn to remain tense, expending valuable energy. Eventually,
we begin to constrict our primary respiratory muscles (the abdominals,
intercostals and diaphragm), flooding the body with adrenaline in order to
cope with the situation. The body then relies on the secondary respiratory
muscles (scalenes, sternocleidomastoid, trapezius, and pectoralis minor) to
sustain the pace. However, the secondary system exists only to assist with
stressful situations; it is not designed to power our cardiovascular system
on a constant basis. Furthermore, the continual tensing of these muscles
weakens their strength, inducing other muscles to overwork in order to pick
up the slack; this often leads to injury. SocietyÂ¹s ideal of the "flat,
rock-hard stomach" also encourages shallow breathing, as we obstruct the
diaphragmÂ¹s natural descent into the abdominal cavity. This creates a lack
of connection to our "font of strength" in our lower belly, decreasing our
efficacy and self-confidence. As we gulp shallow inhalations and truncate
our exhalations, we begin to feel as if we "canÂ¹t get a full breath". These
harmful events eventually lead to the pH balance of the body shifting,
favouring acids over alkaloids, which in turn creates more stress, and
further weakens the immune system. Naturopaths, Breath therapists and
Homeopaths have identified this vicious cycle with Asthma, Sinusitis,
Bronchitis, Ulcers, High Blood Pressure, Depression, Anxiety, Indigestion,
Hyperventilation, PMS, Headaches, and Chronic Fatigue. There is an
alternative to ingesting sugar, caffeine, or other stimulants to
artificially increase our energy levels. Consciously returning to natural,
unhindered breathing allows us to release physical tension and re-vitalize
our body and mind.
Breathing is effortless, but after many years of ingraining unhealthy habits
of tension, the breath becomes effortful; conscious relaxation techniques
become necessary. We should not be forcing the body to breathe, but instead,
learning how to get out of the way, allowing the body to breathe naturally.
This restores the inherent calm of the mind, enabling us to better cope with
the frenzied activity of daily life.
Breath, Body, Mind and Rehearsal
Western society encourages individual expression, yet the practice of
assertion often lacks positive reinforcement. As a result, many people are
not speaking (much less singing) with their true voice. Amateur singers may
have spent days, weeks, or even years breathing shallow, and nervously
speaking from their throat; "using the voice" equals stress. It is
unrealistic to expect the amateur singer to magically change these ingrained
habits exclusively for weekly rehearsals. Kenny Werner, in his book
Effortless Mastery writes:
A person might give up music for reasons of insufficient talent, when upon
closer inspection it becomes clear thatÅ many people are crippled by an
inability to focus and by a sense of
being overwhelmed. These problems are often mistaken for laziness or
The already overwhelmed singer, with her concentration levels pushed to the
maximum, and worried about letting down her conductor or fellow choristers,
works hard to achieve the correct pitches, rhythms and text. On some level,
singing and music has been equated with fear. If this continues, the singer
will exhibit ungrounded behavior. Flighty giggling, lack of concentration,
anger, an overly rigid or slouched sitting posture may all be attempts by
the singer to deal with anxiety. The sound will be inflexible, as many
singers (especially men) will clench their abdominal muscles inward, take
too much breath too high in the chest, and push from their larynx in order
to "lead the section" and create a "full sound". Legato singing will be
impossible. As the secondary respiratory muscles strain, the singer will
begin to feel chronic tension in his upper back and neck. The impetus of the
breath will leave its proper "font of strength" position, rise higher in the
chest, create improper airflow, and lead to over-singing. As breathing
becomes impaired, the singer will feel they have less sustaining power.
Incorrectly assuming they need more air, they will inhale with great effort,
move the abdomen strongly upwards, thrust the chest forward, and lift the
shoulders. Proper support and breath management has now been abandoned.
According to Master Great Nothing of Sung-Shan in the famous Taoist Canon on
As for the proper inner breath, it is called the Embryonic breath.
Since it is naturally inside you, you do not have to seek outside for it.
Standing rigidly during warm-ups will not help release these difficulties,
as they are already tight from the inside-out. Releasing this tension will
facilitate a smoother rehearsal. A method to combat this rigidity is to have
the singers move and stretch before and during vocalizations. Throw the arms
in the air on high notes, stomp the foot to encourage uninhibited entrances,
vocalize with sirens and laughter: anything to activate their energy,
release their physical and mental tension, and bring them back into a calm,
joyful, grounded sense of themselves. The improved tranquility, happiness
and confidence of the singers will allow the focus, concentration and
togetherness of the ensemble to escalate accordingly.
What is Yoga?
Yoga is many things to many people. For our purposes it is a system of
stretching and breathing for increased flexibility and strength. While each
pose has specific physical, mental and vocal health benefits (too numerous
to discuss here), what makes Yoga different from standard exercises is
patience. Our muscles have a natural inclination to remain in their given
state; this is known as the "recoil response." In Yoga one remains gently
in a stretch, attempting to relax more each moment, until the "recoil
response" subsides and the tension eases, thereby lengthening and
strengthening the muscles. This can be a good example for how we can adjust
to difficult situations in our daily lives. One puts oneself in an unusual
pose (asana in Sanskrit) that at first seems tight, tense and difficult, but
with patience begins to soften. Once you have found repose, the body has
learned to turn a stressful situation into a relaxing one. The implications
are innumerable. As the renown yogi B.K.S. Iyengar writes in Yoga: The Path
to Holistic Health:
The practice of asanas have a beneficial impact on the whole body. Asanas
not only tone the muscles, tissues, ligaments, joints and nerves, but also
maintain the smooth functioning and health of all the bodyÂ¹s systems. They
relax the body and mind, allowing both to recover from fatigue or weakness
and the stress of daily life. Asanas also boost metabolism, lymphatic
circulation and hormonal secretions, and bring about a chemical balance in
When one is relaxed, time expands. Every moment spent on relaxing the
singers will save you double or triple the time during the music practice,
as the time wasted with repetition due to unfocussed singers will diminish.
So many musical "problems" disappear when we sing in a healthy and joyful
manner. You will be tuning the bodies, minds and ears of the singers, just
as instrumentalists tune their instruments.
Breath Management for Singers
- Inhale deeply through the nose (when possible). This grounds the
diaphragm, fostering confidence (Anxiety causes pitch to sharpen). This
insures the breath pressure will be in the belly, alleviating air pressure
in the throat, allowing for a lower larynx, more open throat, and therefore
rounder sound. Avoid the quick upper-chest "snatch breath" which causes flat
- Inhale less air. Breath into your lower back and pelvis only. Many singers
take more breath than is required, and create shoulder or abdominal tension
in the process. The "pushing of the voice" or "blowing out the cords" is
caused by the stacking up of tension-filled breath pressure (which also
causes flat pitch), while the "unsupported voice" is that which has too much
loose, unfocused air moving through the larynx.
- The inhalation (especially between phrases, where this is most difficult)
should occur naturally of its own accord, and not be forced as a gasp
through the use of external muscles.
Exhalation / Singing
- Release dead air between phrases. In rehearsal this can be achieved with
the sigh, the Neanderthal "HUH", the "cough-off", or laughter. The ÅHUHÂ¹ is
not about singing low, but speaking/singing with connection, with
undertones, and with confidence (it works with high voices as well Â the
more connected they are to their low, center-of-gravity singing energy, the
higher they will be able to sing). Once they are using their "font of
strength" of support, the task of tone placement will be more successful.
- Conserve air. Learn to manage the breath; do not blow it through the cords
at the beginning of the phrase.
- Sustaining Power. Fear impairs proper breathing. Practice releasing the
sound gently when your breath is done. Do not push past the natural end of
your air, tightening the abdominals and shoulders in order to sing to the
end of the line. Releasing the exhale without tension will improve your
ability to sing longer phrases, because it takes away the fear. You have
more air than you think you do.
Proper Support for Singers
- Support is the lengthening and expansion of the Neanderthal, or vocal
- The ribcage is lifted and solid (not rigid) and expanded side to side,
like an accordion. Resist the inclination to drop the lift and side-to-side
expansion as you sing.
- Inhale a tablespoon of air into your lower back.
- Breath, diaphragm, larynx, tailbone and feet are all grounded down.
- The head is centered over the spine.
- The lower back (lumbar muscles) is expanded.
- The throat, jaw, tongue and abdominal muscles are relaxed.
- Music doesnÂ¹t sell, heart sells. The more the singer is aroused by
musical inspiration, the more effective the support will be. Focussing
exclusively on technical detail is discouraging and therefore harmful to the
This is who we are
I do not suggest that one can effect a permanent psychological change in all
your choristers in a few rehearsals. This takes time, and is facilitated
primarily by the carriage and attitude of the conductor, who will only help
himself by reducing those things that block music-making, such as physical
tension, and mental anxiety. Is our fear of imperfection obstructing our joy
of making music? Is our aim of excellence based on avoiding "mistakes"? It
is sometimes too easy to forget about the humanity in front of us; you never
know what a person can bring to the table. Above all, we must remember that
music is not simply about music; music is about humanity.
Yoga and Breath for Musicians 2
by David Wilson
If one can focus oneÂ¹s heart on music,
it is just like warming something which has been frozen.
The musicÂ¹s beauty of rhythm regulates the beating of the heart,
which helps restore health of body, mind and soul, and bring them to their
The joy of life depends upon the perfect tuning of mind and body.
(drawing of "Primary and Secondary Respiratory Muscle here, with this
The muscle responsible for most of our natural respiratory effort is the
diaphragm (in combination with the intercostal muscles between the ribs, and
the four layers of abdominals). When unhealthy, stressed, fearful or
confused, our body transfers the bulk of the work to the secondary
(supporting) respiratory muscles, in readiness for our fight, flight, freeze
or faint responses. However, we often use these upper muscles unnecessarily,
our muscle memory fooling our brains into believing we are in jeopardy. As
our respiration quickens, so does our heart rate, making reposeful
performing difficult. Clavicular breathing will eventually cause these four
muscles to ache, as they are being asked to do a job for which they were not
The following postures are selected for ease of use during a normal
rehearsal. The exhalation is the impetus for all movement in and out of
poses; this connects the relaxation response to the poses, convincing the
body that the goals are easy and enjoyable. (Holding the breath convinces
the body that the exercise is "hard; the health benefits then diminish
accordingly). We are often unaware of our breath patterns. When you get out
of your car, or when you pick up a heavy object, are you holding your
breath? If the answer is yes, you may be heading toward injury. Instead, try
exhaling to propel your body through the "effort". You will find you get out
of your car with more ease, and that the heavy object is lighter. This
concept of consciously altering our breath patterns is exactly the same when
dealing stressful mental/emotional circumstances such as performance
A final note: There is a difference between "A Good Stretch" (a broad,
lengthening sensation in the middle of muscle, that focussed breathing
alleviates) and "Pain" (a sharp twinge around tendons or ligaments that
breathing will not soften). All of these postures should be done slowly,
with great thought and breath awareness; rushing causes injury. The ideas
below are only guidelines, any pose can (and should) be modified for those
who require a gentler stretch. These are also not intended as replacements
for other time-honoured activities, only as alternative methods for reaching
the goal for which we all strive: Beautiful Music.
Physical Warm-ups: Standing
Massage Chain Turn to one side, massage the back and neck of whoever is in
front of you. This also encourages a close and more connected ensemble.
After, each person massages their own face, throat, and jaw.
Table Stretch Hands (shoulder width and height) flat on wall, table, or
back of a stable chair. Position feet under pelvis. Lengthen spine, exhale
chest toward floor, stretch into shoulders, upper back and armpit area.
Palmtree 1 For intercostal and abdominal awareness and expansion. Place
left hand on hip, right arm straight up in air. Inhale do nothing, exhale,
bend from hip to the left, reaching diagonally up and out with right hand.
Keep sighing through the sensation for five breaths. Exhale back to center.
Keep outer hip and leg grounded. Reverse.
Palmtree 2 Same, but slide hand down from hip as bending to the side.
Palmtree 3 Same, both arms up, left hand holds right wrist, exhale, bend to
the left. Reverse.
Warrior 1 Left leg two to four feet in front of the right, feet stable and
grounded. Bend front knee. In final position, knee is over heel, so adjust
accordingly. Arms in "fieldgoal position", belly button facing straight
ahead through feet. Exhale, back of the body drops, front of the body
lifts. Come out on exhale, reverse.
Warrior 2 Same feet position, front leg bent, but torso now faces to the
right. Arms and hands are parallel to floor, head facing out over left arm.
Come out on exhale, reverse.
The Warriors are about holding music folders properly. Improper breathing
leads to heavy and stiff arms, inducing hunched shoulders, tight leg
muscles, and bracing the neck, hip and knee joints. The jaws and tongues
then tighten and our singing soon deteriorates. Relaxed breathing in these
poses increases our leg and torso stability, training our arms to be light
Cyclone or Washing Machine This energizer opens the breathing mechanism.
Feet a few inches apart, so the leg bones are straight under the outer edges
of the pelvis. Hips steady; pelvis always faces forward, or the torque of
this pose goes into the knees. Arms at right angles. Turn back and forth
from your waist, raising the arms a few inches every 5-10 breaths, then come
back down slowly. The whole exercise should take about a minute. Again,
hips do not move. (Careful with anyone with lower back problems. These
twists are excellent for lower back-aches, but they are done lying down,
with less movement).
Hippy Shake Many of you know this fun activity. This is a tension breaker,
laughter creator, and energizer; it also aids body awareness. In order,
shake each body part, counting out loud to 8: left hand, right hand, left
forearm, right forearm, left entire arm, right entire arm, left foot, right
foot, left calf, right calf, left entire leg, right entire leg, whole body.
Then count to 4, do the same thing, then to 2!
Physical Warm-ups: Seated
Neck Stretch Calms mind, relaxes jaw, neck and tongue. Tilt neck gently to
the left shoulder, lifting both sides of the face, as if bending around an
imaginary grapefruit lodged between shoulder and neck. Reach diagonally up
and out with the head, while streatching down with the right deltoid
(shoulder muscle). Hold, sigh through the stretch for five breaths minimum.
Come back to center on an exhale. Reverse. Secondly, turn to either side,
chin parallel to the floor, pulling back on the opposite shoulder. Watch
for clavicular breathing and for "Chicken Neck" (esp. in high school males),
as both inhibit healthy, free singing.
Fieldgoal Arms reaching straight up past ears, shoulders relaxed. Hold for
5-10 breaths, set the ribcage, then bring arms down on the exhalation,
keeping the ribcage lifted and expanded. This helps to discourage the
"heave and collapse" ribcage breathing.
Shoulder Rotation Hands clasped behind back, palms facing forward, lift as
high as comfortable, gently roll shoulders. Breathe. Repeat with palms
Double Helix Arms straight out to sides, bring forward, cross elbows, bend
at elbows and see if you can get palms to touch. If comfortable, gently roll
Samson Arms straight out to sides, attempt to point fingers toward ceiling,
pushing through the heels of the hands. This is not as easy as it sounds.
This loosens up the muscles that become constricted due to holding music.
Also excellent for pianists.
Chair Twist For ribcage awareness and expansion. Sit in a chair sideways.
Place right thigh firmly against the back of the chair, feet and knees
together. Exhale, put hands on either side of the back of the chair. Each
exhale, you turn and twist farther around to right. Breath into ribcage.
Neck, jaw, shoulders are relaxed, only forearms work. Reverse.
Breath Comparison Ask your choir to purposefully breath high in the chest,
then change to low in the belly, and ask for comments. Do they feel more
"in their head", or connected to their "gut feelings"? Which method makes
them feel more grounded, which makes them anxious or flighty?
Font of Strength Breath 1 Sit on a chair, eyes closed for inward
concentration, with hand just below belly button. Breathe into this area for
10 breaths, quiet and focused. Check that the impetus of the breath begins
low, then expands outward.
Font of Strength Breath 2 Same, but inhale with hands on side ribs (like an
accordion), then move hands to belly, exhale by gently drawing the belly
toward the spine. Repeat a minimum of 10 times. Over time, this will help
train healthy breathing habits.
Folding Exhale Encourages a full exhale from the abdomen. Seated, bend over
slowly from hips as you exhale. Allow inhale to occur naturally as you sit
up. Repeat for no more than 5 breaths. (This is excellent for asthmatics,
but only under controlled circumstances Â avoid if asthma is acute. Those
with migraines or eye troubles do not do this exercise).
Lower Back Expansion Good to do right after massage. Alone or in partners,
depending on the comfort level of your singers. Seated, hands on lower back
around the kidneys. Breathe, expanding this area. Partners can check for
improper raising of shoulders on the inhalation, and that they fully,
vocally sigh on the exhalation.
Vocal Sigh A full, connected, relaxed vocal exhalation. This sometimes
takes time. Is the voice connected to the breath, or riding on top? Is the
exhalation smooth and complete, or has it got bumps in it, like it is
falling down stairs? If so, this is stress held in the cardiovascular
system. Sigh until smooth, noticing where the exhalation is centered in the
body, high or low. Adding voice will speed up the process. The singers
should feel more peaceful, relaxed and centered almost immediately.
Larynx Awareness Yawn - Do they feel the throat open? Place hand on throat.
Do they feel something drop? Hold the jaw open for a few breaths with the
forefinger. Is there immediate pain? These people need to relax their jaws,
or their larynx with never normalize. We want the larynx to be halfway
between the two extremes of too closed or too open. Some larynxes have been
virtually squeezed shut for years.
Neanderthal ÅHuhÂ¹ Driven by lower abdominal and back muscle energy, not by
the throat. Listen Â where is it centered? Is the belly activated, making
the sound full of undertones and breath energy and body connection? Do it
with each chorister Â they will learn from each other. Is the sound coming
from the "font of strength"? Where in the body in the ÅawÂ¹ focussed Â high
or low? Works especially well with teenage boys, but also helps females
connect their head-voice to their support.
Sirens Play in the upper register with freedom; move, walk around, stretch,
whatever it takes to free their minds and bodies, reaching the high notes
joyfully and freely. Allow the singers to be creative.
Breath Management Take a thimbleful of air in the lower back, and then
vocalize on ÅngÂ¹, ÅvvÂ¹, ÅssÂ¹ or tongue trills. Listen for evenness of tone.
Experience what a steady, focussed stream of air feels like. Have them
notice how long they can sing on a tiny bit of air, and that heaving a huge
inhalation actually hinders a long phrase.
Slack Jaw "Blah" or "Plah" vocal exercises will help achieve the healthy,
Head Resonance Puppy whine, open-mouthed hum, ÅooÂ¹, or tiny siren.
Descending vocalizes are usually best. However, these exercises will simply
turn into sinus-tone if their energy is not first centered low in their
Free first, Soft later Encourage full, confident, nourishing vocalizing
before asking them to sing "piano". They will want to please you at soft
passages, often sacrificing proper technique. Otherwise we run the risk of
unhealthy, unsupported and throaty "half-singing", thereby barely winning
the battle (dynamic contrast!?) but certainly losing the war. Voice is the
expression of our living spirit Â attend it mindfully.
Confidence: Connecting breath, imagination and body
Valkyrie Entrance Especially good for timid teenage singers who yell and
scream in the playground, but clam up upon entering rehearsal. They are
almost always breathing at around 25% of capacity. IÂ¹ve found it is best to
have all the singers take part; the beginners will learn from the more
confident. Ask them, one by one, to take a substantial, full-footed step
forward, throw their arms wide and sing a vowel. Sometimes asking for
"playground voice" works. (This assumes an environment where the singers
feel safe, free from criticism or judgement). Let them laugh, not at each
other, but via the joy of breaking through inhibitions. This will take some
time, but will pay huge dividends, as they develop into a confidant team of
Phrasal Arm Sweep As the singers sing a long phrase have them draw their
arm from across their chests to open position, (i.e. right arm starts
pointing left and comes across to the right) feeling the music in their arm.
The idea here is to feel a phrase as a kinesthetic reality. Then sing same
phrase, take the arm away, ask them, did it feel the same? What changed?
They will respond by moving away from the short, choppy phrases, feeling the
larger musical structure more intuitively.
This two-part article has been about repose. In our age, nervous activity
has increased to the extent that we rarely sit and listen to our selves.
Listening is not only at the core of true music-making, but is also at the
foundation of our harmony (or disharmony) with each other. Our lives today
often lack equilibrium and poise. These "full of repose" techniques offer an
opportunity to deepen oneÂ¹s connection with oneÂ¹s own breath, voice, and
body. Slowing down and sensing the inner world has certainly assisted me in
experiencing both life and music on a more intimate and profound level.
What makes us feel drawn to music is that our whole being is music;
our mind and our body, the nature in which we live, the nature which has
all that is beneath and around us, it is all music; and we are close to all
and we live and move and have our being in music.
David Wilson is a conductor, singer, certified yoga instructor, and breath
therapist. He was the founder and Artistic Director of Spiritus Chamber
Choir. He is currently in his second year of his Masters of Music in Choral
Conducting at the University of Alberta. He can be contacted at (780)
455-0318 or wilsonrd(a)telusplanet.net.