This title makes me laugh because… maturity.
My mind is traveling many different directions these days, but one area of inquiry that my brain tends to revisit is “support” in singing. Which of course brings me to the pelvic floor… which then leads me to the dreaded “I” word:
INCONTINENCE
One peculiar thing I heard this year is that incontinence (and therefore, continence) is hereditary. End of discussion. Hmm… peculiar… end of discussion. I did not know that, and when something peculiar surprises me or intrigues me, I look into it. I don’t want to tell other women who have incontinence that they’re screwed because of genetics. “Sorry, tough luck for youuuuuuu.” Or… “Oh, you don’t have incontinence issues – you’re so lucky to have good genes. Carry on!!” I also want to have some scientific back-up for what I believe to be true. You can probably tell that I have problems with both over generalizations.
I’ve not done an exhaustive search into the issue of hereditary incontinence. I’m not sure there’s much out there. If you’re curious about this, perhaps check here and here. This one too! Then look at who these articles cited and see what similar articles pop up in the past 10 years. Nada mucha.
How did my colleague and I begin discussing urinary incontinence and pelvic floor health in the first place? Good question – not gonna answer you right now. Instead I have a personal story for you.
I’d gotten fat. I was having trouble picking myself up off of the floor and getting winded going up the stairs at work. My blood pressure was climbing. My cholesterol was borderline bad. So… I decided to run a 1/2 marathon. Yep, I’m that idiot. Oh, and I began my training with a cold 10K and jumped into the training at week 4 (not week 0).
I loved training for that 1/2 marathon. I actually loved the “me” time. I trained without music or audio books or anything. I ran and thought and soaked in the splendor of my surroundings. The only sounds coming from my cell phone were the beeps telling me when it was time to walk, when it was time to run, and what my split pace was mile after mile. But my knees ACHED. I’d experienced this aching for the first time ever a few years earlier. I didn’t understand where it was coming from and ignored it by no longer running. Problem solved. Until it wasn’t.
It came time to run my 1/2 marathon. I did it and was pretty smart about it, all things considered. I didn’t bonk at mile 11 like many many many people. I didn’t have debilitating leg cramps or injuries to nurse. I finished. And a few days later, I sought help from a local PT group.
Fast forward through amazing therapy sessions. I had a few issues – including “support.” My PT wanted me to knit my ribs together and minimize the vertical space between my rib cage and hips. This would be the appropriate way to lock down and stabilize my physical support. I felt this would be bad for my singing. I showed him what I do to stabilize my torso for singing, and he was perplexed. He was certain that he could knock me off of my center with me supporting the way that I did. Haaa, he didn’t. I did have a height and weight advantage though he was significantly stronger. Still – he did not disrupt my balance or knock me off of my feet.
He told me that one of their offices was using ultrasound to visualize muscular contractions in the abdominal core. I was geeked, and I booked an appointment. I learned many things from that appointment. Basically (if I remember correctly), we have a structural core and a moving core. [If that’s not quite right, srrry.] The transversus, pelvic floor, and multifidus are part of the structural core. Your obliques and rectus abdominus are the movers. COOL! I hadn’t even heard of the multifidus before and hadn’t had my core explained in this manner. It made sense.
So the ultrasound begins. I did gooooood. I was able to contract my transversus independent of the obliques (though it took a lot of concentration). Anyway, I guess I have good kinesthetic awareness, so yay me. After doing what they wanted me to do, I showed them how I support for singing.
They were concerned.
They couldn’t believe how strongly I contract my obliques and transversus together to support my singing. They said that this could damage my pelvic floor. Ok, so I tucked that away in the back of my mind, but I also questioned it.
If…
- I’ve been supporting my singing (and professional speaking voice) this way since 1998
- I’ve had 4 children (including a set of twins)
- I’ve had a child vaginally
- I’m of a certain middle age
- Many of my girlfriends have incontinence issues
- I do not have incontinence
Then…
- Isn’t it also possible that the way I support my singing and speaking voice day in and day out for multiple hours a day is protective against pelvic floor disfunction?
CONFLATION happens when we take a few things that aren’t really related and mash them together and say… “SEE, THAT’S A THING.” If you read the abstracts (or better yet the studies) I linked above, you might agree that perhaps the person that insists that pelvic function is wholly hereditable has conflated factors to derive that conclusion. I have to assume, until I can prove otherwise, that I’m at fault for the same.
Likewise… (lemme drop this lil bomb here)
I believe that modern beliefs about support in classical singing are conflations of scientific understandings of normal respiration with abnormal demands on the pulmonary system to achieve appoggio.
More. Later.
Evidence Informed singing 