1.1.2.h.supp The Valsalva Reflex in Singing: Tradition vs. Voice Science

Written By Piero Bonamico

The Valsalva Reflex in Singing: Tradition vs. Voice Science

Understanding the Valsalva Reflex in Singing

The Valsalva reflex (or Valsalva maneuver) refers to a forceful exhalation against a closed glottis, which we naturally do when lifting heavy objects or holding breath. In this state, the false vocal folds (vestibular folds) and true vocal folds clamp tightly shut, allowing chest and abdominal muscles to build up high subglottal air pressure ( Laryngeal Reflexes: Physiology, Technique and Clinical Use - PMC ). This reflex is meant as a protective mechanism – it creates “the highest pressures in the pharynx” and involves maximal activation of laryngeal muscles ( Laryngeal Reflexes: Physiology, Technique and Clinical Use - PMC ). While useful for coughing or weightlifting, engaging this maneuver during singing is problematic. In singing, we ideally want a free but controlled airflow vibrating the vocal folds, not a blocked, pressurized system. If a singer inadvertently triggers a Valsalva-like hold while phonating, the larynx experiences extreme tension and elevated pressure, disrupting healthy voice production. The vocal folds may momentarily stop vibrating under the strain, and the singer might feel as if the voice is “pressed” or choking off. Over time, this habit can lead to increased laryngeal muscle tension, poor breath management, and vocal fatigue. In other words, a singer performing with a Valsalva maneuver is essentially fighting their own anatomy – the body’s reflex to hold the breath clashes with the act of singing, creating unnecessary conflict and effort (The #1 Mistake That Singers are Making Right Now | Vocal Wisdom) (The #1 Mistake That Singers are Making Right Now | Vocal Wisdom).

Misinterpretation by Teachers and Its Consequences

Many voice teachers and choir directors unknowingly encourage a Valsalva-like approach by using well-intentioned but misguided instructions. A common example is telling students to “use more support – like you’re lifting a weight” or “hold your breath and push the sound out.” Such instructions, often born of ignorance about the Valsalva reflex, can prompt singers to brace and bear down in a way that mimics the Valsalva maneuver. The student tightens their abdomen and closes the throat to “hold back air,” generating excessive subglottal pressure. Unfortunately, this perpetuates harmful vocal habits: the vocal folds get pressed together too firmly and the throat muscles strain to contain the air pressure (The #1 Mistake That Singers are Making Right Now | Vocal Wisdom) (The #1 Mistake That Singers are Making Right Now | Vocal Wisdom). One immediate consequence is a pressed, “tight” sound and reduced endurance. Over time, the chronic hyperpressure and muscular tension can lead to vocal fold trauma. Voice clinicians note that phonating with substantial subglottal pressure is highly detrimental to the vocal fold tissues and can cause ailments like contact ulcers and nodules ( Barbell training the voice? - Page 2). In essence, when a teacher’s instructions ignore physiology, singers may end up forcing their instrument in unsustainable ways. What feels like a powerful supported sound to the singer might actually be a high-pressure strain that the vocal folds cannot handle long-term. For example, one voice science expert, Dr. Ingo Titze, has noted that while an average person can generate lung pressures around 10 kPa (≈100 cm H₂O) by holding their breath, an operatic singer at full voice uses only ~0.7 kPa (~7 cm H₂O) ( Barbell training the voice? - Page 2). This stark contrast shows that our voices don’t require anything near Valsalva-level pressure to sing loudly – pushing much beyond the needed breath pressure just wastes effort and invites strain ( Barbell training the voice? - Page 2). When teachers aren’t aware of this, they may equate more force with more sound, inadvertently urging singers into a harmful Valsalva-like mode.

Outdated “Folkloric” Breathing Strategies

Harmful breathing pedagogy often stems from folkloric teaching traditions that have been handed down through generations of singers. These methods persist in studios and choirs despite modern voice science disproving or refining them. Some prevalent outdated concepts include:

  • “Sing from your Diaphragm!” – Perhaps the most common adage, it’s frequently misunderstood. Many students interpret it (or are outright taught) as “stick out your belly and forcefully engage your abs for every note.” This can lead to thrusting the lower abdomen outward and bearing down, which research shows causes excessive resistance to airflow, elevates subglottal pressure, and induces laryngeal tension (Correct Breathing and "Support" for Singing — SingWise). Instead of healthy support, the singer ends up with pressed phonation (a squeezed, over-compressed voice) (Correct Breathing and "Support" for Singing — SingWise). The intent behind “sing from the diaphragm” was likely to remind singers to use the breathing mechanism efficiently, but without proper explanation it becomes a dangerous half-truth.

  • Overemphasis on a “Big Breath” and Breath-Holding. Some teachers fixate on taking in as much air as possible and then “holding” or “controlling” that air aggressively. Students may hear cues like “don’t let the air out” or analogies comparing breath support to holding your breath underwater. This often causes a breath-hold at the onset of sound (a mini-Valsalva), or a habit of clamping the glottis shut at phrase starts. Rather than a free, released phonation, the singer starts with a glottal choke that can lead to a harsh onset or the need to force the voice out against a closed throat. Over time this habit wastes energy and contributes to vocal fatigue and hyperfunctional voice use.

  • “Support = Push Harder” Mentality. In some traditional pedagogy, especially in certain choral settings, supportis misconstrued as pure muscular effort. Choir directors might encourage singers to “sing louder by using your stomach muscles” without clarifying balance. This can devolve into singers driving with too much abdominal force, thinking more push will yield more volume. In reality, forcing the abdominal push can raise the diaphragm too quickly and jam up the breath system, creating a high-pressure blast of air that the vocal folds struggle to hold back (Correct Breathing and "Support" for Singing — SingWise). The result is often a yelled or strained tone. As one modern voice pedagogist quipped, “pressing and pushing does not accomplish what [singers] think it does”(Mix it up Monday: The hair dryer vs. the car | Matt Edwards) – a reminder that tone production is about finesse, not brute force.

These folk techniques persist largely because “that’s how I was taught.” For decades (and even centuries) voice training lacked scientific analysis, so teachers relied on imagery and sensations, which often morphed into mystical-sounding axioms. Ignorance of the actual reflexes and anatomy allows these myths to perpetuate. Singers who lack correct scientific information can be misled into faulty, potentially injurious techniques (Correct Breathing and "Support" for Singing — SingWise). It’s a cycle: a student taught under an outdated method may eventually teach others the same way, passing on the folk wisdom like an oral tradition. The Valsalva-like support myth is a prime example of this cycle – it likely originated from the idea of “compress the breath for power,” which made intuitive sense to some early masters. However, stripped of nuance, it became “hold your breath and push,” a dangerous oversimplification that modern science is now unraveling.

Physiological Impact: What the Science Says

Contemporary voice research strongly challenges these entrenched practices. Studies in voice physiology consistently find that balance – not excessive pressure – is key to healthy, efficient singing. Some key findings from reputable voice scientists and vocal pedagogues include:

  • Excessive Subglottal Pressure and Hyper-Adduction are Harmful: When singers squeeze the vocal folds too tightly (hyper-adduction) and drive up subglottal pressure, the voice becomes inefficient and risk of injury skyrockets. In such pressed phonation, the vocal folds require much higher pressure to vibrate at a given loudness than they would with a freer approach ( The Physical Aspects of Vocal Health - PMC ). The tightly pressed folds collide with more force and can vibrate irregularly, producing a strained or rough tone ( The Physical Aspects of Vocal Health - PMC ). Researchers warn that this combination of “high subglottal pressure, tightly compressed vocal folds, and low tissue pliability” can quickly lead to swelling and tissue damage ( The Physical Aspects of Vocal Health - PMC ). In fact, vocal fold swelling and lesions (nodules, polyps, contact ulcers) are commonly linked to speaking or singing with excessive pressure and muscle tension over time ( The Physical Aspects of Vocal Health - PMC ). The very injuries singers fear most are exactly what the Valsalva-like, push-hard approach can precipitate.

  • False Vocal Fold Engagement Increases Fatigue: One hallmark of a Valsalva maneuver is the recruitment of the false vocal folds (the folds above the true cords) to help constrict the larynx. Voice scientists have observed that some singers (especially those with high breath pressure or those compensating for weakness) unconsciously engage these structures – essentially a mild Valsalva – to “trap” air. While this supraglottal squeeze might slightly enhance acoustic pressure or conserve breath, it dramatically raises the work the larynx has to do ( The Physical Aspects of Vocal Health - PMC ). Studies associate this pattern with muscle tension dysphonia, noting that false-fold adduction increases laryngeal effort and leads to vocal fatigue and a strained quality ( The Physical Aspects of Vocal Health - PMC ). If allowed to persist, it can contribute to long-term voice disorders ( The Physical Aspects of Vocal Health - PMC ). In short, using the false folds for support is a fool’s bargain – the cost (tension and fatigue) far outweighs any benefit. A well-coordinated technique aims to keep those structures relaxed and out of the way.

  • Singing Doesn’t Need Extreme Lung Pressure: As mentioned earlier, the actual air pressure needed for strong singing is moderate. Measurements of subglottal pressure in professional singers typically range from around 0.3 kPa (for soft singing) up to about 6 kPa (for very loud, full singing) ( Barbell training the voice? - Page 2). Even a loud operatic climax stays well under the pressures generated in a full Valsalva (which can exceed 10–15 kPa). One Voice Foundation study noted that a maximal Valsalva can require on the order of 150 cm H₂O of pressure, whereas “very loud singing” was measured around 60 cm H₂O, less than half of that ( Barbell training the voice? - Page 2). In practical terms, this means a singer’s notion of “support” should be nowhere near the feeling of straining to lift a heavy weight. Pushing far beyond what’s needed not only risks the voice, it often diminishes the sound.Voice coach Matthew Edwards uses a vivid analogy here: a small hair dryer makes a louder sound than a large car engine at idle, because the hair dryer moves air freely instead of trapping it in mufflers (Mix it up Monday: The hair dryer vs. the car | Matt Edwards) (Mix it up Monday: The hair dryer vs. the car | Matt Edwards). Similarly, a singer who releases the airflow properly can create a resonant, carrying tone, whereas one who is “all engine and no airflow” (lots of push, tight throat) will paradoxically produce less sound. Edwards explains to students that if you hold your vocal folds too tightly together, you might feel powerful effort, but you’re actually not moving much air or making as much sound as you think (Mix it up Monday: The hair dryer vs. the car | Matt Edwards). Letting some air flow (within a balanced technique) generates more acoustic power with less strain (Mix it up Monday: The hair dryer vs. the car | Matt Edwards). This evidence debunks the old notion that maximum power comes from maximum pressure – on the contrary, too much pressure chokes the voice.

  • Modern Techniques Reduce Harmful Pressure: The voice science community (through organizations like The Voice Foundation, NATS, and PAVA) has promoted exercises and pedagogical techniques that counter the Valsalva habit. One example is the use of semi-occluded vocal tract exercises (like straw phonation) championed by Ingo Titze. These exercises have the singer phonate through a narrow straw or lip trill, which creates a back-pressure that helps keep the vocal folds slightly separated and the throat relaxed. Titze’s research shows that with such exercises, even if lung pressure is increased, the system “self-regulates” to avoid excessive collision force on the folds () (). In essence, the throat can learn to stay unconstricted even as support increases. The widespread adoption of these science-backed methods is gradually replacing the simplistic “force your support” approach. They teach singers to manage breath as a dynamic interaction with the vocal folds and resonance, rather than a static push from below.

In summary, current research underscores that sustainable vocal power comes from a balance of subglottal pressure, efficient vocal fold closure, and a freely resonating tract – not from maximal muscular effort. Excessive abdominal force or breath-holding not only fail to improve sound, they actively undermine vocal health.

Why Do Outdated Traditions Persist? (A Metaphorical View)

Despite the abundance of scientific knowledge, outdated vocal pedagogy traditions can persist like folklore in the singing community. It’s a bit like the tale of the emperor’s new clothes: everyone believes in a method because it’s been repeated for generations, even if evidence has proven it flawed. The situation also mirrors the broader challenge of letting go of “alternative facts” when real facts emerge. Voice researcher and pedagogue Lynn Helding has written about the cognitive dissonance teachers face when science challenges long-held beliefs – some cling to the familiar narrative because it’s uncomfortable to admit that a cherished technique might be wrong. In a metaphorical sense, the voice studio can become an island of tradition, isolated from the mainland of science. The teacher’s loyalty to their lineage (“my teacher’s teacher swore by this, so it must be true”) can override what modern voice science would advise. This is comparable to how some people resisted accepting that the Earth orbits the Sun; the old system was deeply ingrained, and changing it meant reshaping one’s whole worldview.

Another metaphor is the “folk medicine” vs. modern medicine analogy: For centuries, healers used bloodletting for almost any ailment, because it was tradition – despite patients often faring worse. Similarly, in singing, methods like pushing the abdomen or gripping the throat are like bloodletting – old remedies passed down without proof. Even as vocal science has exposed better cures (techniques), the folkloric pedagogy remains appealing to those who trust tradition over research. There is also an element of communication barrier – scientific research is often published in journals or presented at conferences (Voice Foundation symposia, NATS workshops, PAVA meetings) and might not trickle down to every voice teacher or choir director, especially those who were trained decades ago with different information. This lag creates a knowledge gap where myths can survive in the studio long after they’ve been debunked in the lab.

Yet, encouragingly, the metaphorical “bridge” between tradition and science is being built. Organizations like NATS and PAVA are actively disseminating voice science in practical formats (e.g. NATS’s Vocapedia articles that dispel vocal myths (Dispelling Vocal Myths. Part 2. Sing It Off the Chords - Vocapedia)). Pioneers such as Ingo Titze, Johan Sundberg, and their colleagues have essentially written the “textbook” that demystifies singing physiology. And pedagogues like Lynn Helding and Matthew Edwards act as translators, helping teachers apply this knowledge without losing the artistry and empathy that are also vital to singing. The process is slow – changing deeply ingrained habits often is – but the field of vocal pedagogy is gradually shedding its anachronisms. As one Voice Foundation panel put it, we must “reset the default” in voice teaching from folk wisdom to evidence-based practice.

Conclusion

The role of the Valsalva reflex in singing serves as a cautionary tale of how misunderstanding vocal physiology can lead to damaging techniques. Ignorance of the Valsalva maneuver’s impact has caused some voice teachers and choir directors to propagate a pedagogy of excess pressure and tension, inadvertently putting singers’ voices at risk. Outdated instructions to “hold more air back” or “engage your support like a bodybuilder” have been revealed as misguided at best and harmful at worst, resulting in increased laryngeal tension, poor breath flow, vocal fatigue, and even long-term injuries. On the other hand, voice science and modern research offer a clearer, safer path: one that emphasizes balanced breath management over brute force, and facts over folklore. The scientific evidence – from Ingo Titze’s vocology research to clinical findings on hyperfunctional voice disorders – overwhelmingly shows that a free, well-supported (but not over-pressurized) technique produces the best vocal outcomes ( Barbell training the voice? - Page 2) ( The Physical Aspects of Vocal Health - PMC ).

Metaphorically, the world of vocal pedagogy is moving out of the dark ages and into an age of enlightenment. But echoes of the past still linger. It falls on the current generation of voice educators to break the cycle of misinformation. This means continuing to educate themselves on anatomy and acoustics, questioning instructions that stem only from anecdote or tradition, and embracing proven methods even if they upend old habits. By doing so, teachers honor both the art and the science of singing – enabling singers to achieve expressive freedom without the cost of vocal health problems. In the end, dispelling the myths around the Valsalva reflex and related breathing folklore not only protects singers’ voices from long-term issues, it empowers singers to perform with greater ease and authenticity. And perhaps the greatest irony is that when the voice is functioning freely (not locked in a pseudo-Valsalva), the singer can finally accomplish what the old teachers were after all along: a strong, beautiful, and enduring sound that feels as effortless as it truly is.

References (APA style):

Piero Bonamico

http://www.bonamico.net
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