PUSH TECHNIQUE

Respiration consists of 2 parts: inspiration (air entering the lungs) and expiration (air leaving the
lungs).
The human being has two types of respiration, which are internal (tissue respiration) and
external (air entry into the lungs, chemical changes between air and blood and air exit from the
lungs).
Respiration has alterations that are involuntary acts carried out in response to different stimuli such
as: Hiccups, sobbing, coughing, yawning, sighing and sneezing.

· Now that you know a little more about breathing, try doing the following exercises 10 times each
in the morning and at night; a different one every day. Remember to breathe in and out slowly.

Exercises lying on your back

1.) Inhale through your nose, making sure that the air you take in pushes the muscles of your
abdomen and then exhale through your mouth slowly.
2.) Breathe in through your nose, hold your breath first for 5, 6, 7 up to 10 seconds and then breathe
out through your mouth slowly.
3.) Inhale through your nose in 2, 3, 4 up to 10 counts and exhale through your mouth in 3 counts.

standing exercises

1.) Inhale through your nose and exhale with the sound ssssssss
2.) Inhale through your nose and exhale with the ha ha ha sound
3.) Inhale through your nose and exhale with the sound kis kis kis
4.) Breathe in through your nose and out with the sound his his his

NECK RELAXATION

Improve muscle tone

*We perform circular head exercises from right to left.

*Exercises from left to right looking at the shoulders in 2 strokes, 3 strokes etc.
*Exercises tilting the head laterally touching the shoulders

IMPOSTATION

Imposition consists of taking advantage of expiration to produce sounds.

Vowels are the result of a certain placement of the lips.
The use of vowels and consonants is called articulation. From this point of view we find three
groups that are auxiliary, mixed and attack sounds.
AUXILIARY SOUNDS: The vibration is produced without intervention of the vocal cords
(nostrils, tongue, mouth and pharynx), among which we find m, n, l, r, s, j.
MIXED SOUNDS: Derived from the association of phonemes such as: ll, ñ, x.

ATTACKS: They are ways of initiating sounds and are produced by releasing the column of air,
which can be soft or strong, among them we have: bp, dt, vf, sh ch, g k.

* Now practice doing the following exercises one each day, trying to perceive the vibration they
produce.

1.) ma ne li ro su ja me ni lo ru sa je mi no lu ra se ji mo nu la re si jo mu na le ri so ju.
2.) data dete diti doto dutu vafa vefe vifi vofo vufu, shacha sheche shichi shocho shuchu gaka geke
giki goko guku llañe xillo ñuxa lleñi xollu ñaxe lliñoxu.
3.) flabby flabby fructiferous favorite favila favencia persimmon kilogram kinkabak katiuska
nañigo ñaño ñiquiñaque ñoñez ñoño xanthine xenon xiphoid xion.

VOCALIZATION

Speaking is not about making sounds and moving the tongue, when you sing the whole body
intervenes, from the way you stand to the position of the head, with the voice being the end of this
process.
For this reason, you have to exercise the facial muscles for the correct articulation of sounds, for
this perform these exercises one each day.

1.) Open your mouth keeping the natural oval for 10 seconds 5 times.
2.) Pronounce the separate vowels AEIOU and then prolong aaaaaaaa eeeeeee iiiiiiiii oooooo
uuuuuu

TUNING

Tuning is very important in singing, therefore you have to know the musical notes in their different
forms such as: Natural major scale (tritones, semitones, tretachords, octaves and intervals).
If you have a guitar, flute or piano, you can do the following exercises until you reach the correct
pitch of the notes.
1.) Do re mi fa sol la si do / do si la sol fa mi re do
2.) Dodo rere mimi fafa solsol lala sisi dodo / dodo sisi lala solsol fafa mimi rere dodo
3.) mi fa mi / mi fa mi / si do si / si do si
4.) fa sol la si / si la sol fa
5.) do re mi fa / fa mi re do
6.) sol la si do / do si la sol
7.) each note with its octave: do do re re mi mi fa fa sol sol la la si si do do
8.) do e sol si re fa la do / re si sol mi do

RESPIRATORY PRACTICE: EXERCISES

INTRODUCTION:
The practice of breathing exercises is a common factor in all voice therapies, whether during the
functional re-education of the spoken voice or the singing voice. The purpose of this exercise is to
readapt the patient's respiratory mechanism, increasing the amplitude, speed and inspiratory silence
and conscious and precise control of the phonatory murmur.

Currently, vocal therapists agree on the importance that breathing has in relation to the voice. Its
primary objective will be to obtain greater control and flexibility of the respiratory muscles to favor
the control of the murmur in speech, achieving vocal production without effort for the larynx.

It is common to observe in practice voice professionals with a significant decrease in their vocal
performance with consequences of laryngeal lesions, the causal factor of which is due to respiratory
failure. Breathing and relaxation are two fundamental principles that must be acquired and used by
those people who use their voice to carry out their profession, a learning that is achieved through
adequate vocal training.

COSTODIAPHRAGMATIC BREATHING:

The costodiaphragmatic respiratory type is the most required not only for speech but for singing. It
is the breathing most frequently used in vocal rehabilitation, in which the lower costal area and the
diaphragm, which is the inspiratory muscle par excellence, intervene.

During inspiration or air intake, the expansion of the lateral and dorsal ribs and also the frontal
expansion of the abdomen can be observed. When exhaling, the patient will notice how the
abdominal muscles return to their resting position and also how costal closure occurs (rib closure).

In order for the subject to perceive the costodiaphragmatic movements, we instruct them to place
their arms akimbo with their hands open at the level of the last ribs, with the thumbs backwards and
the remaining fingers open forward, lightly pressing the area or massaging. Learning breathing will
be a process, through which the patient will gradually incorporate the correct technique during the
sessions, with the therapist being a guide and permanent model of functionality.
THE MECHANISM OF BREATHING: INSPIRATION AND EXPIRATION
EXECUTION: the following instructions will be given so that the patient can practice breathing
outside the consultation.
In a lying or sitting position with your back straight, take a gentle inhalation through your nose,
dilating its wings and without noise, or through a half-open mouth, hold your breath for a few
seconds (pause) and exhale through your mouth, placing your lips in the /u/ position. Repeat the
exercise for 4-6 minutes.

We said before that the use of the hands (during the first sessions) favors the perception of muscle
mobility; they can loosen during inspiration while the ribs open and the diaphragm descends.
During expiration, press gently while noticing the reduction of the costodiaphragmatic-abdominal
area with the release of air.

To avoid hyperventilation that can cause dizziness and headaches, it is recommended not to exceed
several minutes of practice and to do it 2 or 3 times a day. At no time can you raise your chest,
shoulders, tense your jaw or neck.

During the training, the mobility of the articulatory organs will be observed and in case of signs of
tension, relaxation and mobilization techniques will be applied depending on the alteration detected.
The usual patterns of tension usually occur at the level of the tongue, jaw, between the eyebrows,
shoulders, cervical advancement, contracted extremities, strain in the neck that manifests itself with
engorgement of veins, etc.

The intervention of accessory respiratory muscles (surrounding the laryngeal area), used in a
compensatory manner by the patient in his speech, should be evaluated and, as appropriate,
minimize or cancel their action. Under physiological conditions such auxiliary respiratory muscles
such as e.g. For example, the sternocleidomastoids do not intervene in phonation, therefore their
activation and/or excess use can induce the installation of muscular patterns of effort or vocal
pathology.

Regular exercise of this type of breathing facilitates body relaxation and helps release tension.
and favors the learning of the expiratory murmur for speech with a minimum of effort for the
larynx.

THE PHONATORY BLOW: EXERCISES

The murmur in speech will be determined by adequate diaphragmatic support and conscious control
(gentle push) of the abdominal muscles inward during phonation, releasing tension from the closure
of the vocal folds and thus achieving optimal vocal function.
In the article BREATHING IN VOICE THERAPY explained the benefits of respiratory support to
achieve correct function of the larynx, avoiding excessive muscle tension and effort that can lead to
vocal pathology, the reader is suggested to consult said article.
Exercises to improve the use of the phonatory murmur during vocal emissions can be performed in
a sitting position or lying supine, although the latter position favors muscle relaxation and is the one
recommended at the beginning of re-education. These exercises can be practiced in front of a wall
mirror and are indicated to the patient as follows:
In a standing or lying position, inhale silently through the nose and direct the air to the
costodiaphragmatic area, briefly pause, exhale with a continuous /s/ pair: sssssss.
The same exercise in a sitting position, with your back free and a gentle rocking movement of the
head, from right to left to avoid cervical tension.
The first exercise can be repeated by walking, with arm swing movements slowly, while producing
the sustained /s/.

TRAINING: To establish costodiaphragmatic breathing, there are a variety of exercises that are
personalized for each subject and require the supervision of a speech therapist or speech therapist
who specializes in voice or a vocal clinician. However, you can start the practice by modifying the
times of the inspiration and/or expiration phase. These variations in respiratory times will be aimed
at making it easier for the patient to manage air during the phonatory murmur. Some examples are
listed below:
Inhale slowly through your nose-pause-exhale (blow) through your mouth slowly and regularly.
Inhale through the nose silently-pause-exhale in 2 counts with a mouth blow.
Inhale through the nose in 2 counts-pause-exhale in 2 counts with mouth blow.
Inspiration through the silent nose in 2 counts-pause-expiration in 3, 4 and 5 counts with continued
mouth blowing and lips in /u/.
Inspiration through the silent nose in 2, 3 and 4 counts-pause-expiration in 4, 5, 6, 7… counts with
continued mouth blowing and lips in /u/.

Variations of expiration: The same series of exercises can be repeated by modifying the air outlet,
that is, exhaling with a nasal breath, exhaling with /s/, /f/, /ch/, /j/, /y/, etc.; remembering to use
pauses and the regulated rise of the diaphragm controlled by the abdominal muscles, to ensure a
tension-free emission at the level of the glottic sphincter (vocal cords).

To exercise the expiratory breath, you can use vowels without sounds (hoarse) one by one and in
combination, as well as hoarse syllables, words and phrases. This dynamic will subsequently favor
the use of the phonatory murmur in conversational speech. Between one series and another you can
rest for a few minutes and gently let the air in through a yawn that favors oral-pharyngeal opening.

It is well known that yawning frequently throughout the day expands and relaxes the oropharynx
and supraglottis, while exercises with snorts (/ch/ sound) activate the abdominal muscles necessary
for the phonatory murmur.

You can continue exercising the phonatory murmur in this way:

Inhale quickly through the nose-pause-exhale (blow) through the mouth very slowly with U-shaped
lips.
Inhale slowly through the nose-pause-exhale through the mouth quickly with U-shaped lips.
Inhale through the nose silently-pause-exhale with the /ch/ sound, maintaining the intensity until the
air is exhausted.
Idem to the previous exercise with sound /f/, /s/, /y/, /j/ maintaining the intensity until all the air is
exhausted.
Inhale through the nose silently-pause-exhale with the /ch/ sound and increase the intensity from
low to high and vice versa (with another inhalation).
Inhale through the nose-pause-exhale, raising and lowering the intensity (volume) of the /s/ or
/ch/:ssssSSSsssSSSSssssssssss until the air is exhausted.

Combined exercises: The practice of combined breathing and articulation exercises can be included,
which favor the smooth beginning of the emission, that is, the normal attack and allow the air flow
to be dosed during phonation. Voiceless expiration (without sound) with a half-open mouth and
different vowel molds and voiced expirations with variations in tone and intensity would be
indicated, e.g. e.g., vocalizations in different tones (2-3) next to the piano or similar, emission of
syllables, words (short and long), etc.

Obviously the therapist's creativity will be essential and he will adapt the exercises based on the
requirements of each clinical case and in order of increasing complexity. The exhalations are
carried out while maintaining diaphragmatic support and the costal area open, an ideal situation that
will also avoid excess effort or tension to the glottic level (vocal cords). Some examples are
described below:
Inspiration-pause-expiration with voiceless vowels one at a time and also combined in groups of 2-
3-4-5… vowels.
Inspiration-pause-expiration with voiceless syllables.
Inspiration-pause-expiration with voiceless words.
Inspiration-pause-emission of a sustained vowel in the same tone one at a time: uuuuu, ooooo,
aaaaa, eeeee, iiii.
Inspiration-pause-emission of groups of vowels: 2, 3, 4, 5, etc.

These exercises are common in vocal training and the professional has an extensive speech therapy
bibliography that describes them widely. We must consider that when receiving the consultant our
mission will be to address the functional alterations they present due to their dysphonia and train
their respiratory function with the aim of optimizing vocal function.

PHONORRESPIRATORY COORDINATION:

The work begins with voiceless expirations and simple sounds (vowels) and once the patient has
acquired air-voice coordination, syllables, words, phrases, etc. are added, until different types of
emissions are achieved with adequate respiratory support. To promote phonorespiratory
coordination (breath-voice) in speech and use what has been learned, automatic series can be used
that represent a variety of material and do not require memorization effort: counting numbers,
repeating the alphabet, days of the week, months of the year, etc.
During respiratory exercise, it is advisable to use nasal inhalations and also get used to short oral
inhalations and with little oral opening, since they are frequent in conversational speech and in
speech due to its speed. Remember that these air intakes during speech pauses will be accompanied
by a slight abdominal displacement that will be the indicator of the descent of the diaphragm with
the entry of air, in this way the upper part of the thorax and neck remains relaxed, ensuring proper
phonation. fluid and free of muscle tension.

THE AUTOMATION PROCESS:

To make this respiratory dynamic effective, achieve its automation and use it in daily life
(generalization), it is suggested to perform the exercises daily and progressively to promote mastery
of the phonatory murmur and air-voice coordination. During this training it is essential to control
the relaxation of the neck and shoulders with visual resources (mirror), gentle head swing, arm
movements, walking, etc., to guarantee vocal production without laryngeal muscle tension.

These breathing exercises are a common factor in voice therapies and each person can adapt them to
their particular needs, remembering that they do not constitute a treatment that must be planned and
supervised by a vocal therapist (speech therapist or speech therapist) based on the diagnosis. of each
patient.

CONCLUSIONS:
Respiratory training during voice therapy will promote coordination between respiratory muscles,
phonatory and articulatory activity. This process will be aimed at enhancing the functionality of
these muscle groups, a task that the vocal therapist will address during the intervention.

Using an adequate respiratory technique with sustained diaphragmatic support for the entire vocal
emission, keeping the face, neck and body relaxed, will facilitate chordal adduction without
laryngeal muscle tension or effort.

Practicing breathing and proper use of your voice will help you maintain the health of your
speaking instrument and obtain efficiency in communications.

"Efficient breathing will allow you to use your voice at maximum performance and with minimal
effort, promoting fluid phonation and preserving your larynx from ailments and injuries"

Pushing
By making an effort, it seeks the approximation of the CV. Increase the
height and quality of the voice in patients with problems of
approximation of the CV. Unilateral CV paralysis. severe paresis
Pushing technique Perform blows in the air with closed fists, while emitting sound plosive
syllables. Pushing or lifting weights when making noise emissions. Place your hands firmly together
while uttering sustained vowels. -Achieve an approach of the hemilarynxes, which may include an
approach of the vocal cords, by performing blows in the air. -Achieve firmer adduction of the vocal
cords in the midline, by placing the hands in a hook. Unilateral vocal cord paralysis. Hypokinetic
dysphonias. Large glottic clefts. Postlaryngectomy. García-Tapia, R. & Cobeta, I. (1996). Diagnosis
and treatment of voice disorders (pp.353). Madrid: Garsi Editorial. It belongs to the Techniques
that promote coaptation of the vocal folds. This procedure is also classified as a coaptation
technique with other functions of the larynx, which promote glottic closure by extraphonatory
compensation.