The Voice to Pelvic Floor Connection

A Great Voice (& Core) Can’t Happen without a Great Pelvic Floor

For those of you interested in the voice to pelvic floor connection – or if you are just learning about it, here’s a brief overview, plus lots of resources, on how the voice and pelvic floor are dependent on each other.  

Voice to Pelvic Floor Overview

The respiratory diaphragm has long been linked to pelvic floor health and functioning, but the voice has not. Historically, pelvic physical therapy textbooks and research stopped discussing intervention once you reach the respiratory diaphragm. The same was true for speech therapy. Texts and research alike historically stopped at the respiratory diaphragm. 

That is now rapidly changing as research emerges to link all three diaphragms – the voice, pelvic, and respiratory diaphragms – not just physiologically through the musculoskeletal system, but also through neurological and endocrine system links. 

What does it mean for the voice to be connected to the pelvic floor? 

You can tell a lot about your patient just from listening to them – specifically – listening to the quality of their voice. Listening to someone speak can reveal not just vocal quality, but also breath support, pelvic health, and more. Some examples include: 

• Presence of vocal nodules 
• Ability to manage stress
• Acid reflux risk or presence 
• Condition of digestive system 
• Coordination of core to pelvic floor
• Healthy breath support for voice, dance, and just everyday breathing and movement  
• Risk for chronic pain 
• Parkinson’s disease prognosis 
• Vagal tone 

Singing is a sport, but you don’t need to be able to sing to access the power of the voice in pelvic floor therapy. 

Did you know that you can treat pelvic floor dysfunction – and should treat it – through the voice? Accessing the power of the pelvic floor is about 25% of a whole functioning system.

Core Power Breakdown

I tell my patients true core health is broken down into several pieces, strictly speaking from a musculoskeletal point of view. This is not a scientific estimate, but rather a rough breakdown of how I approach the musculoskeletal portion of physical therapy treatment for core health:

• 25% – Voice and health of laryngeal, cervical, and orofacial area
• 25% – Abdominal wall and respiratory diaphragm health 
• 25% – Spine and low back health 
• 25% – Pelvic floor and pelvic girdle health 

Now there are FAR more factors that contribute to having a powerful voice, core and pelvic floor. Some of the other variable include: 

• Digestive health
• Hydration 
• Sleep patterns
• Environmental factors such as endocrine disruptors (fake estrogens, for example, can wreak havoc on the voice) 
• General physical activity – muscle is an anti-inflammatory biomarker
• Comorbidities – diabetes, estrogen dominance, metabolic syndrome, heart disease, neurological or autoimmune issues
• Mindset and mental health 
• Vagus nerve and cranial nerve health 
• This is just a starter list and is not comprehensive 

Creating sound is a critical part of our ability to connect as human beings. How? 

The voice, whether or not sound is created, is more than just a conduit for communication. It is connected to: 

• Emotional regulation 
• Sexual function
• Reproductive health 
• Stress management and resilience 
• Gut health 
• Pressure management in pelvic organ prolapse and bowel or bladder leakage
• Trauma recovery and self-regulation 
• COVID recovery (for those with respiratory-based lingering problems) 

Focusing on sound in pelvic health is an ideal alternate and essential pathway to treating pelvic floor dysfunction and promoting pelvic floor health. Below are a few resources to get you started on your pathway to better pelvic, core, AND vocal health! 

Voice to Pelvic Floor Resources 

YouTube Videos – These can, for the most part, be done in order. 

• The Voice to Pelvic Floor Connection 
• Breathwork for a Stronger Core, Voice, and Pelvic Floor 
• Orofacial Release , Part 1  for Vocal and Pelvic Floor Pain 
• Orofacial Release, Part 2 
• Orofacial Release for Tension Headaches and a Better Core and Voice
• Are you Psoas Speaking? 
• Improving Lung, Core, and Vocal Power
• Improve Your Lung Power – The Diaphragm Release 
• Improving Vocal, Core, and Pelvic Floor Function with the NAP Meditation 
  Nap Meditation – The NAP Meditation stands for Neutral Larynx, Apposition of the Respiratory Diaphragm, and Pitching (or Creating Sound). Being able to “NAP” properly can dictate the measure of your success in any physical activity or therapy that impacts your pelvis, diaphragm, core, or voice. 

Extra information: 

• Voice to Pelvic Floor Connection 
• How Pelvic Floor Influences Singing 
• How the Voice & Pelvic Floor Connect 
• Voice exercises

Podcasts & Interviews 

• An integrative and lifestyle approach to pelvic health during menopause; On Youtube:  https://www.youtube.com/watch?v=qb-95zpXUhU

• The Glottis and the Pelvic Floor 
• The Pelvic Floor to the Larynx 
• Vocology and Gynecology 
• Stimulating the Vagus Nerve (YouTube)
• Can singing Heal Your Pelvic Floor (YouTube) 
• How does the voice work with the pelvic floor (YouTube)

Professional Courses

• Herman and Wallace Pelvic Rehab Institute – The Voice to Pelvic Floor (6 CEU’s for PT’s and OT’s) 
• Trauma-Informed Care in Women’s Health: The Voice is Queen in the Pelvic Floor Kingdom

Classes for Everyone

• Voice to Pelvic Floor Restoratives 
• Connecting the Core to the Pelvic Floor (Cultivating Core Power while Being Kind to the Voice) 
• The Relationship between the Voice & the Perineum – Class Video 

Blogs

• Stronger Core-Voice-Pelvic Floor with Umbrella Breathing 
• Is there a Voice Role for the Pelvic Floor? 
• How Singing Can Help Your Pelvic Floor 
• Voice Practices 
• The Alchemy of Breathing 

Journal Articles 

• The Role of the Pelvic Floor in Respiration 
• Pelvic Floor Muscle Activation during Singing – A Pilot Study 
• There are too many journal articles to share, but I’m happy to discuss if you want to reach out at info@gingergarner.com.