On Tongue Out Exercise

As with all vocal exercise, understanding the WHY is the most important first step in effective application.

There’s been criticism on ‘tongue out’ exercise in pedagogical circles recently, and largely from classical voice teachers and singers who may misunderstand its purpose. Some have gone so far as to label it ‘the worst vocal exercise ever.’ While I’m not quite that hyperbolic, I admit I don’t use the exercise on a regular, consistent basis. However, before one throws the baby out with the bath water, understanding the purpose of the exercise counters some of the criticism leveled at it.

One of the most sensitive areas of voice training is dealing with constriction in the larynx, specifically in the muscles of the superior, middle, and inferior constrictors. Constriction can be insistent and linger in different areas of the throat. It’s very much a personal matter from singer to singer, so we should all proceed with an eye and ear to detail.

Because I am a teacher that believes in solving vocal problems indirectly as opposed to directly, a means must be used by which these pernicious swallowing muscles can be coaxed to relax and lessen their influence in the sound of the voice. One way to encourage these muscles to ‘let go’ can be accomplished through tongue-protrusion exercise.

The laryngeal constrictors (Superior, Middle, and Inferior) provide the most challenging work for the teacher of voice when they remain active. Strategies must be given for releasing these muscles in a way that is indirect and gradual. (Note the relationship of the lower constrictor to the cricothyroids. Is it any wonder that these swallowing muscles interfere with the phonation if not free and soft?

I first became aware of tongue-protrusion exercise through coursework in Jeanie LoVetri’s Somatic Voicework™. I traced it back to the work of Daniel Boone, PhD, CCC-SLP in his book Voice and Voice Therapy, Pearson Education, 2014. I’m including his thoughts on the exercise and its purpose and direction its execution. Boone’s remarks are in their entirety:

Kinds of Problems for Which the Approach is Useful:

Many hyperfunctional voice problems are improved by the tongue-protrusion approach. This approach is especially useful for patients with ventricular phonation (dysphonia plicae ventricularis) or “tightness” in the voice, such as when the laryngeal aditus (laryngeal collar) is held in a somewhat closed position. When the tongue is held in a posterior position or the pharyngeal constrictor muscles are contracted to constrict the pharynx, the voice sounds strained or “tight.” A patient with such symptoms is asked to produce [i] with the tongue extended outside the mouth (but not far enough to cause discomfort). This tongue-protrusion [i] approach capitalizes on the physiology of the production of [i] whereby the tongue is shifted forward and raised toward the hard palate. This works to offset the squeezing of the pharynx. The tongue must not protrude so far outside the mouth that it causes muscle strain in the area under the chin. The [i] is produced in a high pitch either at the upper end of the patient’s normal pitch range or at the lower end of the falsetto register. This approach can be used simultaneously with the glottal fry or the yawn-sigh.

Procedural Aspects of the Approach:

  1. Demonstrate to the patient what is expected by opening the mouth and protruding the tongue while producing a high-pitched, sustained [i]. Stress that the jaw is to drop open comfortably and that the tongue is to be extended comfortably. Many patients are reluctant, at first, to stick out the tongue in the presence of a stranger, so demonstrate and reassure them that this is just what you want. You may touch the patient’s chin with the index finger to encourage a little wider jaw opening and say, “Roll the tongue out a little farther.”
  2. The patient should go up and down in pitch while sustaining the [i] vowel, with the mouth open and the tongue out. Listen for improved vocal quality. When this is achieved, ask the patient to sustain the tone.
  3. Have the patient chant “mimimimimi” at this level with the tongue still out of the mouth. Then instruct the patient to slowly slip the tongue back into the mouth while continuing to produce the “mimimimimimi.”
  4. At this point, the pitch is usually still high. Demonstrating a sustained [i] lowered by three steps from the pitch that the patient was producing often achieves a good quality on the first step or the first two steps, but a return to the poor voice may occur on the third step. Repeat the procedure, but only go down two steps. Sustain the second step. Repeat until the tone is established. You may need to return to the original open mouth and tongue protrusion if the target tone is lost.
  5. When the new tone is established, gradually add words and phrases, for example, be, pea, me, see the peach, and easy does it, to the sustained [i].

Typical Case History Showing Utilization of the Approach:

Tammy, a 15-year-old girl, was referred with ventricular phonation of more than 18 months’ duration. Her voice, which was consistently hoarse, rough, and low in pitch, was effortful to produce and made her sound like an older male speaker. Tammy had undergone a prolonged bout of flu prior to the onset of ventricular voice, and she frequently coughed and cleared her throat violently. Strong glottal valving could be heard at times during connected speech. After seven sessions of individual voice therapy using the tongue-protrusion approach just described, Tammy’s voice was normal in all situations at home, school, and at work for the first time in more than 18 months.

Evaluation of the Approach:

The tongue-protrusion [i] approach appears to work because the tongue, when protruded, pulls its root out of the pharynx and opens the laryngeal aditus. Also, the high pitch is made with a light, breathy approximation of only the true vocal folds. The production of voice with the tongue outside the mouth is sufficiently novel that it does not trigger the typical pattern of phonation that may have become habituated.

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