Did you know that singing or playing a musical instrument is good for your respiratory system? Don’t get me wrong: I’m not talking about the drums, piano or guitar.
From the trumpet to your vocal cords, any instrument that takes lung power may help you maintain or improve breathing.
If your respiratory muscles are strong enough to let you speak, you can probably sing or play a horn, say respiratory therapists who work with people served by MDA. Plus, it’s fun, easy, and it beats the heck out of any other form of exercise. And you don’t even have to be musically talented to receive respiratory benefits from this type of exercise.
“Anything that I can do to get my patients to take a good sustained breath is good for them,” says Jerry Reynolds, a respiratory therapist (RT) at Ohio State University in Columbus who’s seen people with neuromuscular diseases benefit from singing or playing an instrument that requires lung power.
“That’s a known, proven fact,” Reynolds says.
In order to sing or play a wind instrument, you have to continually take deep breaths. This expands your lungs, promoting healthy clearance of mucus. If you’re a shallow breather, small portions of your lung can collapse, interrupting the circulation of mucus out of your lungs, eventually leading to respiratory infections such as pneumonia and bronchitis.
Inflating your lungs all the way also enables your chest wall (the muscles and other tissue surrounding the ribs) to fully expand, giving the muscles a healthy range of motion. Elasticity (flexibility of the chest wall, which some therapists call elastance)is important, especially if you have muscular dystrophy, so that you’re able to take normal size breaths without overtiring your respiratory muscles.
You don’t want your chest wall to lose its elasticity and get stiff because your respiratory muscles (the diaphragm and the muscles between the ribs, called the intercostals) will have to work harder to allow you to breathe. These muscles enable you to exhale and inhale, and weakening of them also increases the chance of infections in the lungs or respiratory system.
|Dennis Sieloff: "The more I sing the more I can sing."|
|Kyle DeVilbiss: It's a fun exercise that has probably prolonged my ability to breathe.|
“If you have a stiff chest wall and weak respiratory muscles, those weak respiratory muscles are trying to make that stiff chest wall move, and that’s a really bad combination,” Reynolds says. “By doing exercise to maintain the elastance of the chest wall, it makes it easier for those muscles to work.”
That’s why singing or playing a wind instrument is great exercise for the chest wall. It’s not going to make your respiratory muscles stronger, but it will make it much easier for them to function because they won’t have to work so hard to move a stiff chest wall.
“The more I sing, the more I can sing,” says Dennis Sieloff of Pompano Beach, Fla., who sings every Sunday as part of his church congregation and for fun at home alone or with his wife, Tammy.
Sieloff, 43, who walks with a cane because of myotonic muscular dystrophy (MMD), says that singing strengthens and slows the deterioration of his respiratory system, giving it more stamina. He’s also noticed that bronchitis and respiratory infections are less common now that he’s increased his singing.
Reynolds suggests that everyone with muscular dystrophy be checked by an RT or pulmonologist at least once a year. His suggestion applies even if you have strong lungs and appear to be doing well; the therapist wants to make sure there’s no decline in breathing function. Maybe you don’t even have a lung doctor and need to ask your neurologist for a referral.
Kyle DeVilbiss, 18, of Troy, Ohio, has Duchenne muscular dystrophy (DMD) and has been Reynolds’ patient for five years. Soon to be a senior at Troy High School, DeVilbiss plays the clarinet in concert band and has been playing since fourth grade.
DeVilbiss, who uses a power chair, has never had any respiratory problems but started seeing Reynolds every six months as a precaution because DMD is associated with respiratory issues. He says that playing the clarinet is a fun exercise that can keep his lungs functioning and is probably prolonging his ability to breathe. His brothers, Ryan, 20, and Aaron, 12, also have DMD and have benefited from playing the clarinet.
Aside from the clarinet, DeVilbiss uses a small plastic device called an incentive spirometer that measures lung capacity and encourages deeper breathing. He does this twice a day. After years of playing the clarinet, his lung capacity has increased.
If you experience respiratory problems such as shortness of breath or frequent infections, you’ll need to see the therapist more often or consult a doctor. If your pulmonary function declines, the RT probably will start you on breathing exercises twice a day.
You should ask your RT or pulmonologist if singing or playing a wind instrument would be beneficial to you. Are your lungs in good enough shape to do it effectively? And if your therapist has given you breathing exercises, can you substitute some of the sessions with singing or playing?
Reynolds never substitutes breathing exercises completely with singing or playing an instrument, but he does allow clients to count their music practice as some of their exercise sessions.
“Say you have music lessons in school and you do them every day at school Monday through Friday. That could replace one of your breathing exercise sessions on those days, but you would still need to do your two exercise sessions on the weekend,” Reynolds says. “Now say you have singing lessons a couple times a week. Well, the days you have singing lessons then you could use that singing lesson as one of your exercise sessions for the day.”
The benefits you’ll receive from the deep breathing you need in order to sing or play a wind instrument depend on the progression of your disease, says Reynolds, who’s also assistant professor in the OSU Department of Neurology and a regular host on MDA’s online “Ask the Experts” chats dealing with respiratory issues.
He most often sees people with DMD and amyotrophic lateral sclerosis (ALS) try this type of exercise, but it can benefit most people with neuromuscular disease as long as they have enough lung power to perform.
If you’ve experienced problems such as shortness of breath, singing or playing an instrument should increase respiratory function. The same rule applies if you’re prone to respiratory infections, but as always, check with the professionals before getting started.
|Ryan Roberts and his choral group|
Ryan Roberts of Sapulpa, Okla., has DMD, uses a power chair, and is prone to asthma and pneumonia. Ever since he began singing in seventh grade (an activity that he could enjoy with peers), Roberts, 19, doesn’t have asthma attacks or get pneumonia anymore.
Singing with a barbershop choral group and with friends at church has allowed him to continue being able to breathe deeply and sustain his notes. Singing is his breathing exercise.
“My doctors and physical therapists have encouraged me to continue singing, both as an interest and continued exercise for my lungs and diaphragm,” says Roberts, who graduated from Sapulpa High School in May 2004 and plans to attend Tulsa Community College in the fall, majoring in music.
On the other hand, if you haven’t had any problems, the hope is to keep you at that point. If a neuromuscular disease is diagnosed after you’ve been singing or playing for some time, you usually come to the disease with a stronger respiratory system.
Jackie Barnette of Pasadena, Md., who uses a power wheelchair and a walker for mobility, received a diagnosis of ALS last year. She’s had asthma most of her life but says she's had fewer and less severe attacks partly due to medication and partly due to playing the French horn for 32 years.
In December, she stopped playing because she’s losing arm strength and doesn’t want to drop the instrument. She still has the lung capacity to play.
A recently retired preschool teacher, Barnette, 45, is used to singing all day. She also sings twice a week in a women’s church group and hasn’t developed the respiratory problems associated with ALS such as shortness of breath.
Lora Clawson, nurse practitioner and director of ALS clinical services at the MDA/ALS Center at Johns Hopkins University in Baltimore, says that Barnette’s breathing is at 100 percent of capacity and attributes her healthy respiratory system to all the horn playing she’d done over the years. Doctors have also told Barnette that singing and playing the horn have reduced the effects of her asthma.
“Had I not played, I don’t think my lungs would be as strong now,” Barnette says. “The horn is one of the hardest instruments to play because it does require so much air to get through all the tubing. By playing as much as I have it has kept the lungs strong and open.”
Even though there may not be any scientific studies proving the effects of singing or playing a wind instrument on the respiratory system, affirmations of people with neuromuscular diseases speak for themselves.
|Jackie Barnette: Playing as much as I have has kept the lungs strong.|
Maybe you’ve always wanted to play the trumpet. Does the flute or clarinet excite you? Then again, you can always get a harmonica (see “Health in the Harmonica”). Any of these instruments can help strengthen your respiratory system because you’ll be repeatedly taking deep breaths.
Depending on your physical strength, you might want to steer clear of large and bulky instruments like the tuba. Besides being difficult to carry, tubas require even more wind power to play than the smaller instruments. If your voice is your instrument of choice, you don’t have to worry about being able to haul it around.
Keep in mind that as your disease progresses, you may need to switch to a smaller instrument that’s easier to play and transport. If you lack the arm strength to hold the instrument but you still have plenty of lung power, you can simply exercise your lungs by blowing on the thing. (You may want to ask your housemate’s permission first.)
“I can still pull [the French horn] out and hold it and just blow long tones,” Barnette says. “Now that I’ve stopped working, I plan on doing that a couple times a week.”
Since Barnette’s husband, Kim, is a musician, there’s never a shortage of musical instruments to exercise her lungs. Though she’s not teaching anymore, Barnette plans to go to school once a week to sing and play with the children. She has three children and three grandchildren.
Don’t overdo it, Reynolds cautions. With most forms of exercise, there’s a fine line between doing too little and doing too much. With a neuromuscular disease, too much exercise can actually weaken your muscles, but you need enough exercise to keep them active. Singing or playing an instrument is no different.
“Overdoing it” causes your respiratory muscles to weaken. To prevent this from happening, Reynolds suggests that you pay attention to how much you can do before you start feeling fatigued. When you start to tire, it’s time to stop.
There’s no one set time limit for everyone. If you can sing or play for a half hour before your respiratory muscles get tired, then a half hour of singing or playing each day may be just what you need.
DeVilbiss plays the clarinet every day during the hour-long band period at school. He gets out of breath, but he can soon catch his breath and resume playing. The high notes require more air, which is why he tires faster when the music has more high notes.
Also playing the keyboard in Troy High School’s marching band, DeVilbiss hopes to keep up the clarinet as long as he’s able. He plans to major in music education at Wright State University in Dayton, Ohio.
Above all: Have fun! As long as you don’t push yourself, singing or playing a wind instrument puts you on the path to respiratory health.
by James Leitsch
I’ve been playing the harmonica for 30 years. I have spinal muscular atrophy type 2, and I received my diagnosis when I was an infant. The harmonica has helped my respiratory health as well as my spirit, and it can help yours too.
Blowin’ the wind
It’s easy to play. Just follow these 10 short lessons:
The simplest type is a diatonic. Light, plastic and easy to handle, a Special 20 diatonic manufactured by Hohner (about $25 in a music store or online) is my suggestion.
Plastic harmonicas tend to last longer than wooden-interior harmonicas. Buy one in the key of G, the lowest-toned harmonica, which allows you to avoid higher-pitched, less pleasant notes.
Anyone — anyone — can learn. No musical background is required, nor natural talent or lengthy lessons. You just need lips, lungs and leisure.
Carry it around with you. Treat it like your high school class ring that you show everyone at least twice.
Just fooling around with the harmonica will get you used to its feel. Special 20s are very difficult to break even when dropped.
In our case, the letter G should be visible on the top right-hand side. When you’re playing upside down, the higher-pitched keys will be on the left-hand side.
Just stay at one place on the harmonica and play until you only sound one note.
Take the harmonica away and bring it back to your mouth to try again. Skip a few holes to the right or left and try again. Keep adjusting your mouth and your breath until you can avoid a chord and make just one note audible.
“Bleeding” is when you hear two or more notes at the same time. Notice the position of the harmonica and the shape of your mouth that best allow you to blow only one hole. By shaping the mouth differently or using the tongue, many people develop techniques to prevent them from bleeding during transition.
Sounds easy, right? It’s not. Here lie the bones of many a would-be harmonica player. Only cross this hurdle and your harmonica will be transformed into a great source of entertainment. When you can play one note and transition to another single note, you’re ready to play songs.
With each hole on the harmonica numbered, you can easily follow the songbooks. Arrows pointing up or down demonstrate whether to breathe out or in. As long as you know the tune, you’ll have no trouble playing it. You don’t even have to be able to read music!
Because folk songs are rather simple, they match nicely with the harmonica. “O Susanna,” “O When the Saints,” “Rocky Top” — these are typical songs in an intermediate book.
Songs you hear on the radio pose a much greater challenge. They commonly include sharps and flats, which are out of reach for most harmonicas. You’ll have to buy an expensive chromatic harmonica, which has a button you push to play sharps and flats, for these complicated songs. Unfortunately, playing a chromatic requires a bit of strength as well as coordination.
One strategy is to pretend you’re trapping air in your harmonica by cupping your hands. The tighter the seal, the greater the variation you’ll hear as you open and close the trap.
Because quite a bit of dexterity is required to cup the hands, you may instead hold the harmonica with one open hand while using the other open palm to rapidly wave back and forth behind the harmonica. Either way, you should notice the pitch of the note change with the movement.
This is the note distortion most commonly associated with the harmonica. Select one note (the easiest is hole no. 6) and suck in hard while changing the shape of your mouth. By changing the air flow as it passes over your tongue, you create a different sound that makes you an official “blues brother.”
Here’s a bonus lesson: Talk like a harmonica player. Don’t call it a harmonica; if you’re “cool” it’s a “harp.” If you make up a tune, it’s a “lick.” A repeated melody is a “riff.” If you’re making up things and playing fast, you’re really “wailing.”
So take my advice. Spend about $35, practice the 10 steps each day for a month, and instead of sighing, you’ll be wailing.
F&R Farrell & Co.
Harptown: The Virtual Harmonica Museum
If you type the title of a favorite folk song plus the word harmonica into an Internet search engine, you’ll frequently find all the instructions you need for playing the song, often with an audio sample in the background.