The Throat Doctor

by Dr. François P. Chagnon

Respiratory dysfunction in vocalists and instrumentalists

Minor respiratory dysfunction tolerable to the general population may be disabling to the performing artist. Respiratory dysfunction undermines the performer's "support" and leads to excessive muscular tension in the throat, face, jaw, tongue and neck. As a result, wind and brass players may complain of lip and throat pain, inability to sustain long notes and general performance fatigue. Singers may sense a loss in the upper vocal range. Various conditions weaken respiratory support, including improper technique, lack of exercise and poor aerobic conditioning. Proper training in breathing technique and abdominal support provides higher tidal volumes of respired air and lower air retention in the lungs during performance.

Pulmonary dysfunction, particularly undiagnosed asthma, produces the same effect as if the performer had not taken in enough air. Classic asthma symptoms (shortness of breath, wheezing, coughing, chest tightness) may be induced by allergies or by exercise and may be exacerbated by sinusitis or bronchitis. Even musical performance is a form of exercise which may induce asthma. In a typical case, breathlessness occurs after 20 to 40 minutes of performance. Attempts to compensate for the decreased breath support by increasing the technical demands on the larynx can result in vocal cord nodules and polyps.

Susceptibility to asthma may be diagnosed by specialized pulmonary function tests. Treatment with inhaled anti-inflammatory or broncho-dilating drugs should be individualized to meet seasonal, environmental and performance requirements. Since even one exposure to one allergen may worsen asthma for several days, compliance with treatment is essential. Treatment of any concomitant nasal allergies may help prevent asthma. Even mild degrees of pulmonary dysfunction should be treated to optimize respiratory function during performance.

François P. Chagnon is the Director of the Voice Lab at the Montreal General Hospital