Detailed guides to painful problems, treatments & more

Singing, Breathing, and Scalenes

Connections between singing, breathing, neck pain, and a strange group of muscles

Paul Ingraham • 10m read

Spencer Welch teaches people to sing comfortably. “Singing should be as easy as talking,” he says. “Yet most people get tired quickly when they sing.”

As a massage therapist, I often try to teach people to breathe freely and easily — and I see exactly the same kinds of limitations that Spencer finds while trying to teach people to sing freely and easily. I believe these issues are also related to some common problems, like neck pain and Stuck in My Throat, and may be relatively easy to self-treat by massaging the scalenes muscle group on the side of the throat.

So what do breathing and singing have in common?

Challenges in Singing

A 19th century etching/lithograph of a human throat dissection during an autopsy.

A 19th century etching/lithograph of a human throat dissection during an autopsy.

According to Spencer Welch, many singers suffer from trying too hard to sing. They try to shout musically. They lift their larynx up high, much higher than when they speak. This positioning of the voice box is inefficient: it tightens the vocal cords and requires more force for less singing.

“Singers that overdo it will probably eventually suffer from vocal dysphonia, usually some kind of hoarseness,” Spencer says. “All that muscle use will eventually catch up with them. So I teach people to sing using their voice more gently, more like they do when they talk.”

Most of the differences between talking and singing are organizational: when we sing, we use a wider range of pitches, arranged in a musical fashion. But the physical act of singing is (or should be) virtually identical to talking — the same anatomy is doing pretty much the same thing. What distinguishes them is that syllables are generally sustained, and are usually louder.

Yet people wear out their voices when they sing quietly for a few minutes, even though they can probably talk loudly for hours with no trouble at all. Spencer points out this contradiction to every new student. Helping people understand that singing easily is as easy as talking is the foundation of his teaching technique — and it is quite successful.

Challenges in Breathing

I use breathing therapeutically in my work every day. My goal is usually not as simple or clichéd as “relaxation.” Instead, I ask people to breathe hard in many different patterns in order to blow off steam, alter blood chemistry, fully experience sensations, release trigger points, and blast through emotional stagnancy. And it’s all difficult.

Just like Spencer’s students, my clients usually “try too hard” to breathe. More accurately, they make it hard. I observe the same lifted larynx that Spencer sees, which constricts the voice, but that’s just the beginning: when people are struggling to breathe therapeutically, they have a full bag of tricks that control and limit the breathing. They also avoid using their diaphragm and breathe with the upper chest; they close the throat and wheeze; they swallow, yawn and cough frequently; they purse their lips like they are breathing through a straw. They even get suddenly sleepy or chatty or fidgety! Sometimes, when trying to teach breathing, I am reminded of a small child who has a million ways of avoiding bedtime.

Just like there’s not (or shouldn’t be) much difference between singing and talking, there’s not (or shouldn’t be) much difference between breathing over here and breathing over there. Nevertheless, the same people who can huff and puff just fine for an hour at the gym seem to struggle with therapeutic breathing.

What on earth is going on here? And what does it have to do with singing?

You Are Now Leaving The Comfort Zone

Both singing and breathing take us out of our comfort zone, and we resist.

Most people, even most singers, are self-conscious about singing. Singing falls well outside the normal range of day-to-day human behaviour (in Canada, anyway). Most people, most of the time, limit their expressiveness to talking, hand-waving and email. They don’t sing.

Most of us live in a smallish comfort zone. We are only comfortable with a narrow range of environments and behaviours — not just the behaviour of other people, but our own behaviour. We were age two the last time we behaved any way we wanted.

The prudent limitations that we learn to place on our behaviour when we are young gradually turn into the borders of our comfort zone. The longer this goes on, the more the comfort zone gets to be like a cage. What started out as avoidance of socially unacceptable behaviours gradually turns into a problematic inability to express yourself — or to adapt to new stresses. For most people, by the time they are teenagers, the comfort zone has rules like this:

Human beings are born breathing deeply, diaphragmatically, all the time. Virtually all self-imposed limitations begin with holding the breath a little bit. Long before we ever think that it might be embarrassing to sing, we are already holding our breath. We do it because we sense just how dangerously expressive and vitalizing deep breathing is. In fact, part of the reason singing is so expressive is because it involves so much breathing!

Not only is breath the engine of the sounds we can make, of course, but deep inhalations and exhalations are inextricably linked with emotionality and altered states. To the Chinese, breath has the metaphorical importance that we give to blood — breath is life. To breathe is to be, and to breathe deeply is to move your qi, your soul.

When you exercise, there is a strong metabolic demand for intense respiration: your body needs oxygen, and even more urgently needs to get rid of carbon dioxide. The breathing “makes sense” physiologically. When you breathe hard just for the heck of it, something completely different happens: you are in grave danger of feeling things! When breathing, you may actually experience vivid body awareness.

Breathing whips up an altered state in which emotions are heightened and it becomes much harder to hold onto all of those rigid limitations that define the edge of your comfort zone. In fact, breathing hard helps to expand your comfort zone by booting you out of it. No wonder people resist! No wonder people struggle with breathing even more than they struggle with singing. It’s about as comfortable as a bathtub full of razor blades.

Spencer’s experience with vocal training is interesting to me because it’s easy to understand why and how people struggle to sing. It’s a great demonstration of why people also struggle to breathe, and to thrive in general. It also suggests some new directions for therapy.

From a massage therapist’s point of view, a human being is basically a complex knot of rigid limitations that show up in your muscles. Soften the muscles, soften the limitations. Soften the limitations, soften the muscles.

No muscles demonstrate this better than the scalene muscle group.

Scalenes From Hell

Every vocal student struggling with excessive effort or vocal dysphonia probably has scalene muscles from hell. Wherever Spencer Welch sees an elevated larynx, my hands would probably feel scalene muscles with the texture of dump truck tires.

Your scalene muscle group fills a triangular area on the side of the throat that I call the “Anatomical Bermuda Triangle,” because I can get lost while I am working in there. Seriously, this is a strange area. The scalenes fan out from the neck bones to attach to the top of the rib cage, behind the collarbones. Sometimes, they even reach between the ribs and attach directly to the top of the lungs!

The scalenes move the neck, but they are also breathing muscles. And, like organized criminals, they always have something to do with anything that goes wrong in the whole region, and many other areas besides. The scalenes are notorious for generating widespread and exotic “referral pain”: radiating sensations throughout the head, neck, shoulders, back, arms, chest, and even into the hands and fingers.

Scalene referred pain patterns are not vague. They are consistent enough from one individual to the next that they can be charted, and they are vivid! Usually, the first time I press on someone’s scalenes, they say something extremely predictable, such as “Hey, I can feel that in my pinkie finger.” So the scalenes are as weird as snake sneakers.

Scalenes are closely associated with breathing, both mechanically and emotionally. Mechanically, scalenes are used as pinch-hitters when the diaphragm isn’t doing its job. Normally they are only recruited for emergency breathing procedures, such as a sneeze. They should otherwise stay out of the breathing business.

However, when the diaphragm is dysfunctionally underactive — common with emotional and expressive stagnancy, by the way, and this means most of the people you see on the street and probably the person you see in the mirror every morning as well — the scalenes are recruited to do workaday breathing. And they hate it. These muscles are powerful for their size, but they are not designed for lifting an entire rib cage several thousand times per day. They get utterly worn out, sensitive and rigid, and it gets difficult to do anything efficiently or comfortably with the neck and throat. Such as sing. Or breathe.

The scalenes are also what I call an “emotional” muscle group, with unusual sensitivity to emotional states and an unusual ability to generate and control emotional states. Together with other throat musculature, the scalenes determine the pliability of the head-body connection and the vitality of your voice. Want to say or sing something? Better ask your scalenes for permission. Want to get an idea from your skull to your torso? It’s got to go through scalenes. If you do not wish to say much of what you think, or express much of what you feel, the easiest way to achieve it is to quite literally choke it off at the neck. Not only are there literal nerve and blood vessel impingements possible here, but it’s just hard to be groovy when you’ve got a stiff neck.

Given their privileged position and peculiar significance, the scalenes are powerful agents of both change and the status quo. We use them to establish and maintain our comfort zone. When we try to leave it, they try to bring us back. But they are also a great place to try to break limiting habits. Change the scalenes, and you change not-so-subtle limitations on your voice, breath and life.

A Continuing Experiment

Considering how much trouble people have with them, both singing and breathing are surprisingly simple physical activities, requiring no exceptional skill. It is revealing and fascinating that children do both of them comfortably and well. “Children may not organize their notes very well,” says Spencer, “but their vocal technique is perfect!”

If grown up people get tired or struggle to do something simple but expressive, it’s usually a dead giveaway that they are resisting the experience. This is much easier to understand about singing, which is why Spencer’s observations interest me. They capture, in a much more understandable way, the problems that people have with breathing, and with life in general.

About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter., or subscribe:

Related Reading


linking guide

2,500 words