To put it simply, the sound that we call voice is created when air flows out of our lungs and through our larynx past our vocal cords, making them vibrate. As the vibrating air travels out of our throat, nose, and mouth, the individual shape and size of these cavities is what gives us our unique sound, or our ‘voice’.

Bigger spaces tend to make bigger sounds, and musculoskeletal issues such as tight muscles, weak muscles, stiff cartilage, or joints which aren’t gliding, can make your vocal tract smaller, or not move as efficiently, which affects the quality of our voice.

I obtained a Bachelor of Science in Physiotherapy from Curtin University, graduating in 2001.

In 2018 I travelled to Victoria to complete 2 Modules in Vocal Physiotherapy at Performance Medicine in Melbourne. This comprised 8 hours of pre-reading and online recorded lectures in anatomy, followed by 28 hours of face to face learning and practical training, and a further 4 hours of post course conference calls, with ongoing mentoring to this day.

I am also a comprehensively trained Pilates Instructor, having completed my training initially in here in Perth in 2002, and again in 2006 in London UK.

2012 - Lead Physiotherapist, Mary Poppins, Perth season

2014 - 2015 - Lead Physiotherapist, Les Miserables, Perth season

2015 - Physiotherapist, Fleetwood Mac Australian Tour, Perth leg

2018 - Lead Physiotherapist, The Curious Incident of the Dog in the Night Time, Perth season

2019 - Vocal Physiotherapist, The Book of Mormon, Perth season

2023 - Locus Physiotherapist, Moulin Rouge, Perth season

Muscle Tension Dysphonia, or MTD is one of the most common voice disorders. It occurs when the muscles surrounding the vocal cords tighten up to prevent voice production from occurring normally.

It can be caused by a number of things including stress or anxiety, over use or misuse eg. lots of shouting, or after an upper respiratory illness.

It is characterised by abnormal changes to the quality of your voice and can make your voice sound hoarse, raspy, breathy, weak, or strained.

Vocal Fatigue is best described as when you, yourself feel that there is increased effort to vocalise, which may have a resulting loss of voice quality.

Quite often people will complain of difficulty in controlling their voice, or that it may suddenly cut out.

Vocal Fatigue can be a symptom of MTD, as not every client who experiences vocal fatigue may have changes in the quality of their voice, only in the effort required to produce voice.

Prolonged periods of increased or counterproductive vocal fold closure can lead to your larynx becoming irritated and inflamed. Activities such as continuous coughing, or throat clearing can cause your larynx to become sensitive to stimuli such as cold air, strong smells, or other airborne irritants, which in turn leads to increased symptoms.

Other causes of ILS include reflux (and silent reflux), muscle tension dysphonia (MTD), or psychological reasons.

Some of the common symptoms include globus (the sensation of something in your throat), or the feeling of mucus in the throat.

Also called cysts, or polyps of the vocal cords, these are basically little growths like calluses which arise from chronic ‘abuse’ of the voice such as straining, yelling, high load singing including ‘belting’.

When your vocal cords are used excessively in this way, they can become inflamed, so when they close, they rub together excessively, leading to growths, much like how you would develop a blister from an ill-fitting shoe, or calluses on your hands from the gym or manual labour.

If diagnosed early enough, rest and vocal unloading ie. significantly reducing the rubbing/friction of the vocal cords can result in the nodes settling down, or even disappearing, but if the problem is ignored, surgery may be required.

Symptoms of Vocal Strain as a precursor to nodules include a hoarse or raspy voice for several weeks, pain in the throat when speaking or singing, sudden changes in the pitch or quality of the voice, a loss of vocal range.

Also termed Globus Pharyngeus, it is the feeling of having a foreign body (or mucus) stuck in your throat, causing the need to swallow or clear your throat. Sometimes this sensation can be triggered by anxiety or holding back emotion, it can also be caused by the muscles in your throat causing a tightening sensation as a result of muscle trigger points, or tension.

If this feeling becomes associated with pain, or actual increased mucus production, then there will be another cause contributing such as reflux or a post nasal drip.

Our tongue is actually a muscle, so when it is overworked, braced, or used in an unusual way, it will behave like other muscles in our body and can become tense and tight.

When our tongue is tight in can affect the way we make sounds when speaking or singing, we may start to feel tight in our jaw or throat, and it can even result in a choking type sensation at the back of your mouth.

Tongue tension may have its basis in a tongue tie, breathing or swallowing problems, or jaw issues, to name a few examples. I will work with your other healthcare providers, or point you in the right direction to receive the additional support you need.

Teeth grinding or jaw clenching that occurs involuntarily is termed Bruxism. It can occur when you’re awake, or asleep.

Whilst Physiotherapy treatment can relieve and headaches you may experience, and tension in the jaw muscles that you are using to clench, and in some cases help to resolve mild cases, there is often deep issues that cause Bruxism and the management requires a team approach often involving a splint or guard from a Specialised Dentist, Botox Injections from a highly trained medical professional, Psychology or Counselling, and even medication from your GP to relax your muscles.

For some clients, their voice issues can arise following a growth spurt, period of illness or inactivity, or even due to an increase in sitting, or change in sports or leisure activities.

Part of your assessment involves looking at your posture, in particular your head and neck position to see if this plays a role in your vocal dysfunction.

If required, I will give you exercises and coaching to help improve these areas as due to my background in Pilates and Musculoskeletal Physiotherapy, I look at your body holistically.

Also known as Laryngeal Dystonia, this is a neurological condition of unknown origin which causes sudden, involuntary spasms of the vocal cords which can cause the voice to cut out completely, catch during words, or sound strained or strangled.

It is often worsened by stress, but stress is not always the initial cause. It can occur following illness, injury to the throat, or due to an unknown cause that triggers a change in the brain.

Whilst there is mo known cure, Vocal Physiotherapy, along with Speech Therapy can be useful treatments for managing symptoms, and some patients find benefit from Botox injections.

Your Comprehensive Initial Consultation.

This includes gathering background information from you regarding your current situation (relevant medical history, voice use profile, medical procedures, scans), a physical assessment to observe your posture, breathing, and structures of the mouth and larynx, and the use of questionnaires to measure the extent and severity of your symptoms. Depending on the length of time this takes, and how your body responds, we may or may not progress to treatment during this appointment.

Allow 60 mins

Follow up consultations for performing individualised treatment techniques tailored to your individual concerns and physical issues, as determined in the Assessment, and ongoing as part of your treatment regime.

These sessions involve manual therapy - ‘hands on’ techniques for the soft tissues, education and advice to help with managing your voice issue day to day, rehabilitation exercises, and problem solving to work with your unique set of circumstances.

Allow 45 mins

A maintenance treatment, or tune up, for clients who have already had a treatment course with myself, or another Vocal Physio, and are wanting some ‘hands on’ due to some symptoms returning, or as a preventative measure due to an upcoming, or current increase in vocal load.

30 minutes

Extended consultation 45 mins

‘Hands on’ treatment can include massage techniques, joint and cartilage mobilisation, dry needling, exercise therapy, and postural re-education.

Education about your condition, and explanations about the techniques, and the ‘why, what, how’ is all part of how I roll. I strongly believe that having an understanding of the process is incredibly empowering.

Where appropriate, onward, or cross referral will be made to other practitioners who can help with your condition. This includes other expert Physiotherapists, ENT’s, Dentists, Speech Pathologists, Voice Coaches, and Counsellors.

Standard communication with your care team is included as part of your treatment program eg. brief letters, phone calls, emails.

Small equipment that you may require for your rehabilitation exercises can be purchased at the clinic.