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Respiratory Therapy

Respiratory Therapy

Breath Management

Now that you have established noble posture your next goal is breath management. Most of us breathed perfectly as little babies, especially when crying; but with aging or neurological disorders, breathing often becomes less and less efficient. The lack of lung power is evidenced in decreased vocal sound and changes in voice quality.

How It Works

It is an amazing, but simple process: Air (oxygen) is brought into and released from the lungs, which are assisted and protected by the ribs, and activated by muscles. There are two ways to breathe: Clavicular or Diaphragmatic/Costal.

1. Clavicular breathing is shallow and fills only a small upper portion of the lungs. Unfortunately, older adults are often shallow clavicular breathers.

2. Diaphragmatic/costal breathing fills the upper, middle, and lower portions of the lungs. Singers, wind instrument players, professional speakers, and athletes use this type of breathing.


Think of your lungs as two balloons. Filling balloons with a small amount of air results in small, limp balloons. Filling balloons fully creates greater air pressure on the insides of the balloons, providing more energy (air) available for release. To fully energize the vocal mechanism for healthy speech or song an adequate amount of air is necessary. As a general rule breathe deeply (low) and slowly rather than rapidly and shallow (high).

Your Power Pack

A good name for this system of available lung power is power pack. Most of us rarely use the power available for speech or song because we fail to breathe deeply and utilize the energy supplied from air-filled lungs. For restoration and maintenance of a healthy voice, a person must use the power pack effectively. Filling your power pack has additional benefits: a healthier cardio-vascular system, a lower heart rate, stress reduction, and relaxation.

Four Stages of Your Power Pack

There are four stages to healthy breathing for speech and song: inhalation, suspension, exhalation, and rest.

1. Inhalation: Inhalation is the act of breathing air deeply into the lungs; it is done either through the nose or mouth. It fills the power pack with oxygen/air (energy).

2. Suspension: Suspension occurs when air is suspended for a split second or less immediately following inhalation. The moment suspension occurs, energy (air) from the power pack is ready for use in speech or song. This is an automatic process. It happens so quickly you need not concern yourself. Never try to “hold your breath” before you start to sing or speak as it can cause unnecessary tension.

3. Exhalation: Exhalation is the act of releasing air (energy) from the power pack (lungs). Exhalation occurs the moment speaking or singing begins. The power pack is at work supplying breath to the vocal folds (cords) to create sound.

4. Rest: Rest occurs the moment sound stops, just before the next breath or inhalation takes place. Momentarily, the power pack is empty and ready for refilling. Many years ago, when all gas stations had service attendants, a common expression was “fill it up.” That’s good advice for speakers and singers, especially those with Parkinson’s, stroke or aging voices. When it comes to using your power pack efficiently, think “fill it up.”

Strengthen Training for Your Power Pack

The exercises below are designed to help you feel your power pack working and strengthen diaphragmatic/costal breathing.

1. Ribcage Expansion

a. Establish noble posture.
b. Place your hands on the sides of the rib cage, above the waist.
c. Inhale slowly and deeply. Feel the ribs expand.
d. Suspend the breath for a split second.
e. Release the breath. Sense the inward movement of the rib cage but
do not let the chest wall collapse.
f. Rest for a moment and repeat several times.

The sketch below shows a side view of the rib cage before a breath (dotted lines) and after a breath (solid lines). It also indicates the area of lift for noble posture.

2. Panting Like a Dog

a. Place the palms of your hands flat on your upper-abdominals and allow your middle fingertips to touch; this area of the torso is called the epigastrium. Internally, an unopposed muscle called the diaphragm will move downward as your lungs fill: You will not feel this happen.

b. Open your mouth and pant like a dog, first pant slowly and then pant rapidly. Notice the mid-abdominals moving in and out.

Warning: Doing this for too long a time may cause dizziness.

3. Drinking Straw

a. Place one end of a drinking straw between your lips.
b. Slowly draw air through the straw. Do you feel the expansion of ribs and abdominals?
c. Suspend the breath for a second.
d. Exhale slowly through the straw. Although your ribcage will move inward as you expel the air, do not allow the chest wall to collapse.

4. Puff on Voiceless “Puh” breathing at arrows.

a. Create voiceless puffs on “puh”.. “puh” “puh”.
b. Notice the movement of the mid-abdominals.

5. Blow Out the Candle

a. Inhale deeply; allow the ribcage to expand.
b. Blow out the candle using a long, steady stream of air.

Did the candle go out?


The epigastrium is the area of the torso above the navel and below the breast bone. 
The diaphragm is an unopposed muscle which separates lungs and viscera. As the lungs fill with oxygen the diaphragm moves downward and allows the lungs to expand. Current emphasis on maintaining a flat, hard, belly will not allow the diaphragm to move through its full range of motion, thus inhibiting maximum breath intake.