Care of the professional voice

Robert T. Sataloff, MD, DMA, Associate Editor

The Value of Vocal Warm-up

and Cool-down Exercises:
Questions and Controversies
Rima A. DeFatta and Robert T. Sataloff

I
n singing and other athletic endeavors, the value of warm-up
and cool-down exercises has not been defined clearly. Relatively few
studies have researched the effects of these exercises on muscle function
and even fewer have studied their effect on singing-specific outcomes.
The value of warming up before singing is accepted widely despite the paucity
of scientific evidence to support its benefit. Singers often report increased
pitch range, smoother transitions, and overall improved ease of singing after
warming up. Warm-ups are a component of most voice pedagogy programs
and many voice therapy regimens. The importance and use of cool-down
Rima A. DeFatta
exercises after singing is more controversial, just as it is in sports medicine.
Studies in exercise physiology literature both support and refute their value.
Although no consensus can be reached based on available scientific evidence,
singing teachers and voice therapists should be familiar with the current
literature in order to guide and counsel students appropriately.
The findings of exercise research can be applied in broad terms to singing.
Through a comprehensive review of the literature, Hoh showed that laryngeal
and limb muscles share several properties.1 Fast and slow twitch fibers are
found in both locations. Slow twitch fibers (type I) generally are considered
Robert T. Sataloff
to be fatigue resistant. They can generate a steady flow of energy (adenosine
triphosphate, or ATP) by oxidative metabolism that is supported by a rich
blood supply and high mitochondrial content. Fast twitch fibers (types IIa,
IIx, and IIb) generally lack the endurance of slow twitch fibers. They possess
a wider range of speed and power made possible through glycolysis (sugar
metabolism to lactic acid). Each set of muscles in the larynx possesses unique
functional capabilities owing to the variable composition of fast and slow
twitch fibers. The thyroarytenoid (TA) has a high type II fiber content that
gives it the shortest contraction time of all the intrinsic muscles. The crico-
thyroid (CT) contains a much higher ratio of type I fibers, which slows its
contraction rate four fold. The range of TA contraction speeds parallels those
of very fast extraocular muscles, whereas CT contraction speeds approximate
Journal of Singing, November/December 2012 those of fast limb muscles. Beyond the mentioned similarities, additional his-
Volume 69, No. 2, pp. 173–175
Copyright © 2012
tochemical specialization gives the larynx exceptional speed and endurance
National Association of Teachers of Singing that are absent from extremity muscles of the same species.

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Rima A. DeFatta and Robert T. Sataloff

Before warm-up and cool-down exercises can be with stretch injury. This compliance theory may explain
applied clinically, basic biochemical and physiologic also the anecdotal benefits of warm-up before singing.
effects should be understood. Bogdanis and colleagues Motel and colleagues specifically studied the effect
studied the effects of cool-down on metabolic, cardio- of warm-up on the soprano voice.7 Their experimental
pulmonary, and power output changes during repeated design was based on the assumption that submaximal
sprints.2 Thirteen young healthy male volunteers com- exercise leads to increased viscosity of the superficial
pleted two 30-second cycle sprints. The sprints were vocal fold. Although the viscosity of the underlying voca-
four minutes apart and separated either by passive lis muscle may decrease as a result of metabolite con-
recovery (sitting still) or active recovery (cycling at 40% centration and water influx, the shear and compressive
of maximal oxygen uptake). The active recovery group forces from vocal fold oscillation limit water transport
showed an expected higher heart rate during the recov- to the mucosa by temporarily collapsing the capillaries.
ery interval and a greater power output retrieval during Ishizaka’s vocal fold oscillator model predicts that a vis-
the second sprint. Despite these findings, blood lactate cosity increase should increase the phonation threshold
and pH levels were not significantly different between pressure and make singing more effortful.8 They found
groups. It has been suggested by Harris et al. that blood that phonation threshold pressure (PTh) increased in six
flow to recovering muscle is critical for the clearance out of nine soprano study volunteers. These findings
of metabolites (such as lactic acid), which are assumed seemed to contradict the common observation that
often to cause clinical muscle pain and fatigue.3 A recent warming up permits less effortful singing. The authors
study by Tenan and colleagues demonstrated no correla- recognized that standardizing the warm-up might not
tion between lactate levels and muscle fatigue as mea- have prepared each of the variably experienced subjects
sured objectively by a decrease in the median frequency optimally. The singers’ different rating of their readiness
of electromyographic tracings.4 Although Bogdanis’s to perform following the prescribed warm-up regimen
study did not assess subjective fatigue, Tenan’s findings supports this. Although the study did not detail whether
call into question the correlation between metabolite low readiness scores correlated well with an increase in
buildup and muscle soreness. However, the study was PTh, none of the singers perceived a worsening of their
small and cannot be considered definitive. vocal quality. This variability in response to similar train-
Law and Herbert attempted to quantify the effects of ing routines is predicted by the individuality principle
both warm-up and cool-down on delayed onset muscle of athletic training and should be kept in mind when
soreness.5 Healthy, untrained runners were randomized recommending exercise routines for vocal performers,
into four groups: warm-up and cool-down, warm-up and when evaluating the results of research.9
only, cool-down only, and neither warm-up nor cool- In an attempt to answer questions regarding cool-
down. When cool-down was used, it was targeted specifi- down, the majority of authors have focused on studying
cally on similar muscle groups fatigued during exercise. its immediate effects on muscle physiology. In contrast,
At 48 hours, muscle soreness was measured subjectively Spencer and colleagues investigated the long-term effects
using both a numerical and a visual analog scale. Soreness of active recovery.10 Nine healthy male participants
was measured objectively using a force transducer that completed a cycle sprint trial every seven days over a
applied increasing pressure to the gastrocnemius (calf) four-week period. Each trial consisted of six four-second
muscle. The study concluded that warm-up reduced repeated sprints separated by either passive or active
muscle soreness by a mean of 13 mm on a 100 mm visual recovery. Capillary blood samples and muscle biopsies
analog scale, but that cool-down had no effect on muscle were collected to supplement performance measure
soreness. Several authors have suggested that delayed findings. Final peak power and muscle phosphocreatine
onset muscle soreness results from damaged, poorly (a high energy molecule) were significantly lower in the
compliant myofibrils.6 Law and Herbert hypothesized active recovery group. Despite the suggested negative
that because warm-up increased muscle temperature, effect of active recovery in this study, it is important to
it may have improved myofibril compliance and con- note that no difference was found in work decrement
sequently limited the damage and soreness associated between the active and passive recovery groups.

174 Journal of Singing

 Care of the Professional Voice

We can safely draw some conclusions about vocal per- 2. G. C. Bogdanis, M. E. Nevill, H. K. Lakomy, C. M. Graham,
formance based on exercise physiology literature, but it is and G. Louis, “Effects of Active Recovery on Power Output
important to keep in mind the limitations. Many experi- During Repeated Maximal Spring Cycling,” European
Journal of Applied Physiology and Occupational Physiology
ments utilize repeated sprint cycles to tailor the applicabil-
74, no. 5 (1996): 461–469.
ity of results to team sports. Virtually none have studied
3. R. C. Harris, R. H. Edwards, E. Hultman, L. O. Nordesjö, B.
warm-up and cool-down in long distance running, which Nylind, and K. Sahlin, “The Time Course of Phosphoryl­
is more similar to singing than are sprints. So, application creatine Resynthesis During Recovery of the Quadriceps
of various studies to singing must be made with caution. Muscle in Man,” Pflügers Archiv 367, no. 2 (December 1976):
For example, one study asked subjects to walk backward 137–142.
downhill on an inclined treadmill for 30 minutes. The 4. M. S. Tenan, R. G. McMurray, B. Troy Blackburn, M.
intent was to fatigue the gastrocnemius muscle. It is McGrath, and K. Leppert, “The Relationship between Blood
Potassium, Blood Lactate, and Electromyography Signals
difficult to similarly isolate muscles of the vocal tract in
Related to Fatigue in a Progressive Cycling Exercise Test,”
singing, as they typically work in unison to produce a Journal of Electromyography Kinesiology 21, no. 1 (February
particular sound.11 The same is true of warm-ups and 2011); epublished ahead of print (October 2010): 7.
cool-downs, since they typically represent performance 5. R. Y. Law and R. D. Herbert, “Warm-Up Reduces Delayed
of an exercise at a submaximal threshold. Warming up Onset Muscle Soreness but Cool-Down Does Not: A
or cooling down a group of vocal tract muscles may pro- Randomised Controlled Trial,” Australian Journal of Physio­
duce different short and long-term physiologic effects on therapy 53, no. 2 (2007): 91–95.
the voice than can be predicted by experimental results 6. J. Fridén and R. L. Lieber, “Eccentric Exercise-Induced
Injuries to Contractile and Cytoskeletal Muscle Fibre
that test an isolated extremity muscle, or even a group of
Components,” Acta Physiologica Scandinavica 171, no.
muscles performing activities that differ from singing. 3 (March 2001): 321–326; D. L. Morgan, “New Insights
This variability in the type of muscle exercises tested into the Behavior of Muscle During Active Lengthening,”
makes comparison of the results challenging. In turn, Biophysical Journal 57, no. 2 (February 1990): 2090–221; U.
a range of recommendations can be made regarding Proske and D. L. Morgan, “Muscle Damage from Eccentric
specific warm-up and cool-down exercises based on Exercise: Mechanism, Mechanical Signs, Adaptation and
Clinical Applications,” The Journal of Physiology 537, no. 2
these results. Although some studies failed to show
(December 2001): 333–345; S. Gray and M. Nimmo, “Effects
benefit from warm-up and cool-down, no study has of Active, Passive or No Warm-Up on Metabolism and
shown measurable adverse outcomes as a result of Performance During High-Intensity Exercise,” Journal of
these maneuvers. Scientific studies specific to singing Sports Science 19, no. 9 (September 2001): 693–700.
are needed. Until reliable scientific evidence is available 7. T. Motel, K. V. Fisher, and C. Leydon, “Vocal Warm-Up
to guide our recommendations, the continued use of Increases Phonation Threshold Pressure in Soprano Singers at
warm-up and cool-down exercises based on anecdotal High Pitch,” Journal of Voice 17, no. 2 (June 2003): 160–167.
observations of experienced voice pedagogues seems 8. N. Elliot, J. Sundberg, and P. Gramming, “What Happens
During Vocal Warm-Up?” Journal of Voice 9, no. 1 (March
appropriate and prudent. The choice of exercises should
1995): 37–44.
be individualized based on the singer’s classification,
9. O. Friedman and R. T. Sataloff, “Laryngeal Papilloma,” in R. T.
type of performance and range expected, general fitness Sataloff, ed., Professional Voice: The Science and Art of Clinical
level, and individual response to various exercises and Care, 3rd ed. (San Diego: Plural Publishing, 2005), 1087–1092.
approaches to training. Singers should recognize the 10. M. Spencer, D. Bishop, B. Dawson, C. Goodman, and R.
existence of a knowledge gap and welcome opportunities Duffield, “Metabolism and Performance in Repeated Cycle
to participate in research on warm-up and cool-down Sprints: Active Versus Passive Recovery,” Medicine and Science
exercises so that we all can learn more. in Sports and Exercise 38, no. 8 (August 2006): 1492–1499.
11. Elliot, Sundberg, and Gramming.
Notes
Rima A. DeFatta, M.D. completed her residency at Albany Medical College.
1. J. F. Y. Hoh, “Laryngeal Muscle Fiber Types,” Acta Physio­ Dr. DeFatta completed her fellowship under Dr. Robert Sataloff’s mentorship
logica Scandinavica 183, no. 2 (February 2005): 133–149. in Philadelphia and is currently practicing in Eau Claire, Wisconsin.

November/December 2012 175