Voice Massage: An Introduction

by Maria Berglund. Published January 26th, 2024.

My first experience with voice massage happened at a Scandinavian summer academy for singers in 2012. Dorthe Kirkebække, one of Copenhagen’s renowned practitioners, offered individual sessions to all the course participants in between the seminar sessions. Interestingly she didn’t touch my throat but devoted the entire 25 minutes to a rather small area in my lower back. The manual work she performed felt like a hot iron against my skin. I was pretty groggy for a few minutes after the massage, but when I sang in the masterclass an hour later, I discovered something strange: My inhalation felt much deeper than before. I could suddenly manage with half the number of inhalations I previously needed in my Wagner aria.

Great care is needed in massaging the throat where the carotid artery and vagal and phrenic nerves are close to the skin. Here my hand is close to the trachea where I have less of a chance of stimulating them directly, but still find mobility for the muscles and fascia in the larynx

Twelve years later, I am standing in my own studio, hearing my clients tell me what they experience as they get up from the massage table: An increase in the voice’s carrying power, both in pure volume and overtones. Immediate access to both low and high notes that previously were difficult and unstable. More weight and grounding in the body, making the singing feel less strained.

 Certain clients report that they can open their mouths fully for the first time, others that coloratura or vocal runs flow almost by themselves. Even those that struggle with voice breaks report that the massage treatment helped them manage their register change with greater ease. On my part, I can usually observe that their breathing is easier and that their rib cages move more freely. If I can help a client find a more spontaneous movement of the diaphragm, I know they will also experience greater freedom around their larynx, tongue, and abdomen.

Voice massage, in other words, has to do with a lot more than voice production. It is a way to observe and treat the whole body with improved vocal function as the main goal. For me, it has become important to see the whole person, not just the body. A voice comes into being not only because of mass, length, and tension in the vocal folds, or as a consequence of air flow and compression. A voice is so much more than anatomy and physiology. I’m sure all you singers and voice teachers out there know this to be true.

 The origin of voice massage

Here in Norway, it’s a relatively new treatment option even though it is better known in the neighboring Scandinavian countries. It is either offered as a performance enhancing and/or preventative treatment, or as a part of a rehabilitation regime for singers who have experienced vocal damage, surgical intervention, or other difficulties.

"I've been a solopreneur for eight years, but the past two I've had a colleague-in-training. American tenor Paul Kirby has completed the first round of my newly developed certification program, learning the manual therapies and how to read the client's vocal and physical needs. We work side by side and find great joy in sharing knowledge and experiences!"

In Finland, voice massage is a recognized medical treatment and is offered by therapists who have completed the three-year university training. Today they number more than 100, based on figures from the Finnish labor union.  In the UK and Germany, I know of specialized vocal osteopaths who specifically treat fascia, internal organs, hormones, and both blood and lymphatic networks.

In London’s West End, Ed Blake´s clinics have become the industry standard, where all the practitioners must be trained and experienced physiotherapists before they take on the special education to become registered practitioners. These disciplines combined are called vocal physiotherapy. Here, the treatment is decidedly more bone/tendon/muscle-based and is quite a bit more vigorous than you may find with an osteopath.

In Denmark and Sweden there are several independent practitioners who have created their own individual styles and techniques gleaned from their training and experience. Most of these practitioners combine voice massage with other disciplines like chiropractic, classic massage or naprapathy.

After traveling, studying, and trying out many of the methods mentioned, I would say the word which describes Northern European voice massage most accurately is diversity. There are significant differences in the way practitioners use the tools and techniques at their disposal. With this background I don’t attempt to explain how other practitioners work, their main areas of focus, or how they analyze and determine the needs of the clients they meet. I will speak only for my own practice in the rest of this article.

The Voice Passionista approach

My point of departure is as a performer and teacher of singing, with the add-on of anatomy, physiology, mental and manual therapies. With that comes both strengths and weaknesses. I am, in many ways, lucky to know first-hand what singers go through: What is expected of them and how their work can impede the otherwise healthy functioning body and voice. Having experienced the toll an artistic career can take in my own body for over 15 years, it’s easier for me to see and hear where my clients are overloading their bodies and voices. I have also felt (and heard!) how voice massage can aid the active singer over time – in my own instrument. This is a valuable resource in choosing a path of treatment for my clients.

A possible disadvantage that comes with being a singer myself is closely linked to the advantages. I have found it important to keep my own private experience at arm’s length. I remind myself constantly that each client is different. I must learn to see the individual without projecting too much of our own thoughts and feelings.

Who can benefit from voice massage?

The short answer: Any voice professional. I work with voice students who experience hoarseness and/or discomfort, or who don’t understand why they don’t manage to sing at the dynamics or with the tone quality that they wish. I work with some of our leading opera singers and internationally known pop artists. Some see me because they finally have time to make a technical adjustment, others because their ENT says that they can’t find anything wrong with their voice, but they feel something not quite right. I work with musical theatre artists and actors who want to make sure they are in top form for an opening night, or to free themselves from the stress of having had too many shows per week.

American Tenor, Paul Kirby.

I work with up-and-coming artists who want to build a solid technique and help them understand that the body needs some attention to survive the touring, partying, bad sound systems, and stage smoke. I work with church musicians and choir directors who want to even out their vocal registers or have tired voices from a job that entails a punishing schedule in a variety of acoustic settings. I also work with some that have gotten a medical diagnosis: Muscle tension dysphonia, phonasthenia, globus syndrome, or who have had their vocal cords operated on. I work with extreme care with those hindered by performance anxiety. Even though each of these situations requires different care modalities, voice massage is included in some form or other.

Some clients will need a treatment plan including a certain number of sessions to ensure lasting positive changes. I will meet with them two to three times with 10-14 days between sessions to see how their nervous system responds to treatment. From this information we make plans based on the client’s wishes and perceived needs. Some clients come for a check-in before a big performance or will use voice massage to maintain their technical form once a semester. And then you have the “curious Cathys”, who just want to check what the fuzz is about. Sometimes the biggest changes come when the client has no expectations…!

What happens in a voice massage session?

I try to listen even more carefully to the body, the emotions, and the timbre of the voice than my client’s reasoning for booking the appointment. A client’s goal is often specific, for example to remove “the stiffness in the throat” that they can’t make go away by themselves. These problems can often be symptoms of an underlying issue – habits, movement patterns, or stress that doesn’t always stem from singing. Insight and respect are needed as I choose methods and approaches according to the whole person, not only the client’s stated wishes.

As a rule, I begin with the structures related to the breath. I do my client a great disservice if we haven’t worked on what impairs inhalation first. If I start right away with jaw or throat tension, I risk treating symptoms instead of origin. So, everything I do from the neck up comes last, even though that part is what the client usually first expects! To get the ribs to move more easily, I work with the fascia around the diaphragm and psoas and help the abdominal muscles to release tension. This is vital to the well-being of the voice.

Tense and over-shortened torso and leg muscles (often a result of posture misalignment) are also high on my list of priorities. In the same way free breathing is essential to be able to release tension higher up along the airways, alignment - or directly translated from Norwegian; skeleton stacking - is one of the prime causes of pain and over-activated muscles in any part of the body.

Alignment is almost always part of the problem if there is a pattern of held breathing, and it is important to understand that relaxation can’t do the whole job. Massage is lovely, relaxing, and often necessary, but a single treatment won’t be enough for long-term posture improvement. Our brains and bodies are in constant interaction with our thoughts and feelings. The requirements of movement, physical tasks and coordination in the nervous system can need an “upgrade” to prevent tension coming back.

A voice massage appointment is frequently the first step in building a new skill set for a client. The aim is self-help and self-correction regarding their own patterns of tension. My goal is not to make people dependent on my hands if they can learn how to change their own patterns that create blockages in the body. Those who are interested in specially adapted programs for their individual challenges are introduced to coordination and strength exercises as well as sensory tension relief techniques.

Is it possible to only have a massage on the throat, neck, jaw, or face – if a client comes and is certain “that’s all I really need”? Of course. The client is always the boss in my studio. They decide how much pressure I use and where in the body they want or don’t want to be touched. When that person doesn’t necessarily show interest for having an active role in maintaining their tension-release balance (someone famously bit me off once, saying “I’m paying you so that I don’t have to do exercises!”), of course I won’t force them. But you may nonetheless leave my studio with a recommendation or two.

The million-dollar question: Does voice massage work?

This is a question I must leave unanswered, out of respect for the scientific method. As far as I know there are no peer-reviewed studies that evaluate exactly this specialized type of massage. Massage in general has been covered in hundreds of studies where the conclusions are varied, often depending on the quality of the study. However, massage therapy has been accepted in the medical world alongside physiotherapy and other forms of bodywork. It is also worth noting that a questionnaire sent to my previous clients showed 90,2% having “significant”, “good” or “great” effect relative to the client’s expectations (numbers derived from 85 answers in 2022).

Voice massage has certainly been one of the most transformative tools in the work I have done with my own voice. Bu was it exclusively voice massage that made such a difference for me? No. Good teachers with brilliant technical exercises, precise knowledge concerning the understanding of the body, coordination exercises, work with mental coaching, and studies in different genres and technical areas have all helped me progress. Consciously or unconsciously, I have tried to give my clients what I’ve received through this work: A 360-degree approach to a free voice with a variety of entry points. With this circular model, voice massage would cover about 90 of these degrees. If you haven’t tried it, I would recommend keeping an open mind. Maybe you too will gain easier access to high and low notes, more power or flexibility. Perhaps you can even skip some unnecessary inhalations - much like I did with good ol’ Wagner back in 2012.

BIO

Maria Berglund is a classically trained singer with a bachelor’s degree in Pedagogy from University in Agder, Norway, and Masters in Voice Performance from the Norwegian Music Academy in Oslo. She is a certified Timani teacher and ReVoice voice massage practitioner, and has continued studies in Estill Voice Training, the Anne Rosing method for voice rehabilitation, as well as several somatic and mental performance techniques.