Skip to content
Ep 39

What signs should singing teachers be looking out for that signify something isn’t right physically? What are the red flags that someone has a physical problem affecting their voice? Singing teacher and osteopath, Chloe Spencer joins host Alexa Terry on this week’s Singing Teachers’ Talk podcast to answer these questions. They also talk in-depth about osteopathy, how it can help the body and in turn help the voice too.


  • Osteopathy is manual therapy along the lines of physiotherapy and chiropractic therapies. It is based around the holistic view of the body that if everything is working together in harmony the body will be healthy.
  • Chloe sees people who have a range of problems that affect the voice. For example, any problems with your legs or back will affect your balance, which will affect your voice. If you have pain in your shoulder, which is causing tension in your neck, then that has a bearing on how well you can sing.
  • As a singing teacher, you need to be looking for signs that someone might have a physical problem. It might sound obvious but if someone tells you they have neck pain from sleeping poorly, then it might affect the voice. Be on the lookout for bad posture too.
  • You need to guide your students into body awareness. Get them to stand with good posture and ask them what they can feel and where. If you can teach them to recognise when something may be wrong or impacting their voice you are helping them before the problem gets any worse.


“You don’t come to an osteopath to be fixed, you come to an osteopath to fix yourself”

“The voice is not solely held in the larynx”

“The only bad posture is the one you’re in for too long”


  • BAST Training
  • Stephen King
  • Myofascial Release & fascial trains
  • Hypermobility Baten Score


Following a varied career in music, archaeology, forensics, TV and finance, Chloe retrained and graduated from the University College of Osteopathy with a Masters in Osteopathy (MOst). With a background in sports massage, drama and singing (both in teaching and performance) Chloe has a unique insight into manual therapy for the voice. Her approach is both holistic and patient-centred: she treats the whole person, not just the voice, and actively encourages the patient to engage in their own recovery through education and home-based ongoing exercises. Her treatments include standard osteopathic techniques of manipulation and soft tissue work, alongside more gentle interventions depending on the individual case. Chloe has also trained in cranial osteopathy with the Sutherland College of Cranial Osteopathy and breathing therapy with Dr Rosalba Courtney and is interested in optimising breath and respiratory health for the voice. She currently works as a resident osteopath for the Voice Care Centre in London, and at Still House Clinic in Egham, Surrey.

Guest Website:


Link to podcast presenter’s bios


iTunes | Spotify | Stitcher

Ep.39 Osteopathy for Singers (and Joint Farts) with Chloe Spencer



posture, bit, singer, singing, people, affecting, sound, joint, voice, stiff, osteopathic, point, lovely, neck, stretch, find, hypermobility, osteopathy, called, muscles


Alexa Terry, Chloe Spencer

Alexa Terry  00:06

Hello, it’s Alexa here and welcome back to the Singing Teachers Talk podcast, which brings you great interviews, insightful discussions and advice on the topic of singing and teaching singing. And joining me today is someone with quite an eclectic career. She is now a singing teacher and osteopath for a clinic in Surrey and also the Voice Care Centre in London, and she is here today to chat osteopathic bits. It’s my pleasure to welcome Chloe Spencer. Hi, Chloe, how are things in your neck of the woods?

Chloe Spencer  00:36

All good here. Thanks, Alexa.

Alexa Terry  00:38

Great. It’s really lovely to have you today. Thank you so much for giving up some of your time to chat bones and whatnot with me. So, I’m just going to start with the big question. What is osteopathy?

Chloe Spencer  00:51

So you’d choose the biggest question to start with wouldn’t you? “What is it?” Osteopathy it’s obviously a system of manual therapy. In the same realms as physiotherapy and chiropractics, maybe a bit sports massage, they all cross over a little bit, they’ve got different philosophies, different ways of approaching the same problem. People with muscular skeletal issues (and) using manual therapy to approach that. The principles of osteopathy are based around a holistic view of the body, fundamentally that the body can if you get everything working correctly, the body can fix itself. So it’s not a guiding fixing modality, you don’t come to an osteopath to be fixed, you come to an osteopath for an osteopath to help you fix yourself. That’s, that’s sort of the goal. Get the blood flowing correctly in the right places allow everything to find its own balance. That’s the goal really.

Alexa Terry  01:55

So you mentioned clicks there. And I’m a bit obsessed with kind of watching videos on, I don’t even know what the who the person is but they click and it just seems so very satisfying.

Chloe Spencer  02:09

Sound on for the click those kinds of videos. So the click… What the click is, it’s a bit of under discussion, really, the best working theory is that you are producing a gap between the surfaces of a joint. And what makes the noise again, this is one of the theories is that it’s either gas bubbles popping, or gas bubbles forming, we’re not quite sure which because it’s very difficult to tell there’s been MRIs of this, somebody’s clicking their fingers in an MRI machine and things like that. But it’s still very difficult to tell. But the process of it, you get the click. And what then happens and again, this is a theory is that in that very small local area, a small amount of the body’s natural opioids are released, which obviously creates an analgesic a pain killing effect in that small local area that last probably four to six hours. And in that time, the reason it will then help to have the click is that you increase the range of motion where that effect happened. And allow the healing to take place.

Alexa Terry  03:31

Right. So I mean, I’m no scientist. And you know, I’m going to put something out there. Is it a bit like a bone fart?

Chloe Spencer  03:42

I love it. I love it. If it’s more like a joint fault, than a bone fart, I would say yeah,

Alexa Terry  03:51

I’m gonna just say we’ve coined that here and now

Chloe Spencer  03:55

A joint fart I love this. This is this is awesome.

Alexa Terry  04:00

It’s very satisfying when it happens so…

Chloe Spencer  04:04

It is and I do get patients that get obsessed with it. I’ve got some patients who don’t believe they’ve had a treatment if they haven’t been clicked. Equally, I get some patients who hate it and won’t be clicked. You know that  it’s a very individual thing.

Alexa Terry  04:21

Yes. I chased the click. I’m one of those I chased it

Chloe Spencer  04:25

A click addict as you’re known.

Alexa Terry  04:27

Absolutely. Joint fart and a crack addict. Love it.

Chloe Spencer  04:32

There you go. You can add that to your CV. 

Alexa Terry  04:34

Yeah. So you feature in a Vocal Health Education’s vocal habilitation professional level where you presented a really great webinar on the benefits of osteopathy, particularly for muscle tension dysphonia suffers. So why else might a singer actually benefit from having some osteopathic intervention?

Chloe Spencer  04:57

So, to be honest with you, the majority of singers that I see it’s probably 50/50. The muscle tension dysphonia singers, where it’s quite a direct technique, and it’s all focused around the larynx and the neck. But even with them, we’ll be looking at outside of that area, because the voice is not solely located in the larynx, as we know. I mean, you could go as far as to say that it’s global. You can look at the feet, you know, if you’re not standing straight, if you’re not standing grounded, if there’s a problem with your feet, if there’s a problem with your ankles, knees, hips, back, anything like that will affect the balance, will affect the voice. Pain is another issue. So I will see singers for things like… particularly performers, singer-songwriters who’ve got sore shoulders, or who’ve got tennis elbow from playing the guitar, well, not necessarily, that’s from playing the guitar, but pins, needles and tingling in their fingers that’s affecting the way that they’re performing. It may not be directly affecting the voice. But if you’ve got pain and tension and the shoulder that’s creating pain and tension in the neck on that side, that will be affecting the voice. So it’s a sort of a chain link effect. And that’s again, that’s very much the osteopathic way of looking at it, I’m not just going to treat your voice, I’m going to look at where it’s coming from.

Alexa Terry  06:32

And all of that I find it such a cool concept. And I remember my first myofascial release experience with Stephen King. When I felt like I had some jaw, you know, related issue. And he was like, “Well, I’m going to look, you know, at your leg or your knee.” I can’t remember where he went. But it was, I was like, “oh!”, and it then started to click this whole kind of holistic, whole person thing. And it’s so interesting. And seeing kind of the fascial chains through the body is awesome. So obviously, as a voice teacher, a lot of us aren’t osteopaths, but there might be some visual clues for us in the studio with the singer, which we can look out for which therefore we might be able to advise maybe seeking some osteopathic intervention, or maybe we could do something ourselves which is within our remit. So what firstly, what are the things that we can be looking out for in our singers?

Chloe Spencer  07:39

So, I mean, really basic stuff, I would say is, is your singer in pain. I know that sounds a bit simplistic, but they come in and because you tend to know your singer quite well we’re working with emotions and identities and that connection, you’ll know immediately if they’ve got a problem, you’ll see the way they’re standing. So the first thing to say is, you know, “Have you got a problem? Is there something hurting today?” Hip issues, knee issues, back issues, stiff necks, I’m seeing an awful lot of stiff necks at the moment, people sleeping funny on them. A bit more complicated than that but you know, they wait, they go, “I just woke up with it, I must have slept funny on it”. Headaches, those sort of things are going to affect the way that they’re singing. Then you could obviously, we’ll probably come and talk a bit more about this. But posture, you know, is there something affecting the way that they’re standing? Do they have a habitual way of standing that is affecting the way they’re singing, or not optimal for the way that they want to sing. And something as silly as fatigue, tiredness, you know, when that person comes in, and they just look flat as a pancake. And you say to them, “Are you sleeping all right?” And probably in your experience, you’ve said this to somebody and then you get this like verbal diarrhea of no I’m not and why? Quite a lot of the stress response and the affected sleep cycles, we can actually treat quite a lot of that with some of the cranial techniques. So that’s a basic starting point. Posture, pain, sleep or fatigue levels.

Alexa Terry  09:28

Yeah. And then what can the voice teacher do in the lesson other than you know, listen quite well to those responses from a singer. But physical stretches or guided self massage, what is it that we’re able to do and can you describe any kind of useful stretches that we can take on maybe for the neck I’m also, one, really suffer with my neck in terms of it’s where I tend to feel stiff, but I’m also a see that in In singers, they generally complain about their neck.

Chloe Spencer  10:04

Yeah, from a stretching a movement point of view, I think one of the biggest things you can do for a student. And again, this all links back to why, to what osteopathy is, it’s not about fixing somebody, it’s about helping them get inside themselves, is to guide somebody into body awareness. So if you if they’re standing in front of you, in a sort of a Neolithic man position, you want to say to them, Look, let’s just move around, let’s see what different positions, so get them to stand weight balanced on both feet on the in the center of both feet, get the hips over the heels, get, you know, get the body nice and straight. Yeah, shoulder, hip, heel, if you like, and ask them what it feels like. Because if, for example, you’ve got somebody’s hypermobile, that will feel horrible to them, because they will have to be recruiting muscles constantly to keep them in that position. But if you’ve got somebody who isn’t hypermobile, I’m not going to say normal, but isn’t hypermobile that will feel possibly quite different from what they used to, but quite nice in a kind of an actually, I can relax here, nothing’s hurting. Or if they’ve been habitually cramped, shoulders forward, neck, chin stuck out, it might feel horrible again. So it’s just getting them to feel “This is good, this is a nice place to be for singing.” What does it feel like? Is this something that you think you could practice day to day, almost like a body scanning kind of thing. And then in terms of stretching, again, I keep coming back to the word hypermobility, if you’ve got somebody who is very, very mobile, getting them to stretch will look very different. The stretch will look very different from somebody who isn’t hypermobile, because they will just keep going and going and going and going. And their heads will go all the way around, and they look like an owl. Whereas you get somebody who is the opposite end of the spectrum, and they’ll just it’ll be a tiny movement, from a teacher’s point of view it’s having an awareness of what I’m looking at, you know, is that normal for you? Or is that? So for example, if you’ve got somebody who you know, is very mobile and their heads only moving a tiny bit, you’re thinking “Hang on a minute. That’s not right.” Or if you’ve got somebody who, equally who is normally quite stiff, and suddenly their necks moving an awful lot, you think that’s not right, either, you’re going too far, you’re going to over stretch those muscles, you’re going to be sore. So it’s a balance. It’s about understanding and knowing what you’re looking at.

Alexa Terry  12:48

Hmm. Can we delve into the hypermobility area a little bit more? Can you can you explain to us kind of what that is and how that might affect a singer? Generally.

Chloe Spencer  13:01

Yeah, I mean, I’m not a huge specialist on the effects of hypermobility on singing because it’s it’s a subject that still very much under studied. There are a lot of very interesting studies that moment being done on this. So hypermobility, it’s a spectrum. On one end of it, you’ve got people who are a bit bendy and on the other end of it, you have a condition called Ehlers Danlos Syndrome, which is a severe connective tissue disorder within it has lots of different varieties, if you like lots of different flavours, you can have visceral stuff, so where your internal organs don’t work correctly, you can have skin related ones, you get people with very, very wrinkly skin. But the most common one that singing teachers will come across is a sort of a mid-range connective tissue laxity and it’s a ligament is a ligament laxity, it’s not muscular. So it’s where the joints are joined together, there is a little bit of extra stretch than, more stretch than there would normally be. Right? Avoid using the word normal. And what that means generally, is that a person who is hyper mobile will generally have to work a little bit harder, their muscles will have to work a little bit harder to keep themselves in a socially accepted posture. And you tend to find those people will be more inclined to be tired more often. And they will stand in the in the traditional banana position because that’s very comfortable because they don’t have to then recruit the muscles. So you get this sort of sway back, locked back knees. The chin will stick out and you’ll get this this it will look odd. But that’s their relaxed position and that feels comfortable for them. And so trying to change that might not work for them. And what I was, you know, I would say that you would see, if you’re working with young musical theater singers, you’ll see quite a lot of it. Because it’s very, it’s a good thing to have, if you’re a dancer, it’s a great thing to have, because you can put your joints in positions that less flexible, people can’t. And so they tend to gravitate towards that kind of occupation. But in terms of how it will affect singing, again, jury’s out a little bit.

Alexa Terry  15:33

Okay, and there’s a kind of scale isn’t there that we can use to measure how hypermobile somebody may be. And I forget the name, but I think you mentioned it earlier to me.

Chloe Spencer  15:47

It’s the BS, it’s called the Beighton score. So what you would be testing, it’s a nine point scale or scoring system, you would look to see if they can bend their thumb. If you flex the wrist, and you can bring the thumb back to the to the forearm. I can probably demonstrate that there. So both sides, so you’d get one point for each thumb, then you’d have the same for the fingers, some some do the little finger. If you can bring that right back. It’s what we used to call double jointed. It’s basically that. So again, one point for each each thumb, one point for each fingers, that’s four, then you’d hold the elbows out in front. And if they I can’t really demonstrate this, but if they sort of banana, you can see mine bend back yep,just like yours. Yep, bent back a little bit, you can see it going up and down. One point for each elbow, and then the same for the knees. So if you see someone standing and the knees are really locked back, one point for each knee, so we’re up to eight. And then the final point is can they bend over and put their hands flat on the floor? Right? That one tends to drop off as people get older, because they just naturally get stiffer in their back start to get problems and things like that so there’ll be reluctant to do that. But the question to ask is, could you do that easily when you were younger? And if the answer is “Oh, yeah, it definitely used to be able to do that”, then that’s your point nine. 

Alexa Terry  17:15


Chloe Spencer  17:16

And so that’s how you get your scale. And again, you can be nine out of nine on the Beighton score, but still not be very, not have it affect you that badly. But it just depends on that’s just a starting point for you to say, “Oh yeah, that’s pretty mobile.”

Alexa Terry  17:34

Yeah, that’s really interesting. And of course, on the opposite end of the spectrum, you have what hypomobility?

Chloe Spencer  17:41

Yes. I mean, general, sort of, inflexibility, I suppose you’d call it, I don’t see a lot of that, to be honest. Tends to happen in older, I mean, it tends to, as people get older, and they just get stiff naturally. I don’t see it in younger patients, really.

Alexa Terry  18:02

And we must talk about, you know, posture. And, and kind of what’s coming out a little bit more now in terms of how much we have to change it or manipulate it or whatever. What are your thoughts on that?

Chloe Spencer  18:20

Yeah, posture. It’s a bit of a dirty word round the water fountain, I have to be honest. But I think that the guiding principle that I love and I always stick with is that the only bad posture is the one you’re in for too long. Which if you take that into every aspect of daily life, works. As in, if you sit at your computer without moving for eight hours, you’re going to be stiff and sore. And you could then come to me and say I’ve got a terrible posture when I work. Like, yeah, I’d probably agree with you there. But if you come to me and you’re active daily, you know, you go out, you walk the dog in the morning, you do a bit of work, you get up, move around, have your lunch, go and do a bit more work, get up move around. So normal daily activities of daily living, and don’t experience pain on a day to day level, and then come to me and say I’ve been told my posture is terrible. Right? Well, where is your posture actually affecting you? It’s not affecting your daily life. So what’s wrong with it? And generally speaking, the pain or the issues that the restrictions that I would be treating come from when a posture is maintained for too long. If you sleep badly, you know you sleep on a bad pillow or in bad a bed that’s uncomfortable. You will wake up in the morning, stiff and sore. And if you don’t do anything about that for a few days, you’ll be even stiffer and even sorer at which point you’ll come and see me and I’ll hopefully help them fix it. But we then got to address why that happened in the first place. Quite often happens, people go on holiday and they sleep in or fall asleep on the plane. You know that one, you see a lot of that one falling asleep on the plane or in a car with a head drop forwards or drop back and then, and then the muscles will go into spasm and all sorts of fun times. So posture, yeah. And again, you know, come back to this idea of having mobility, one person’s normal posture is different from another person’s normal posture. It just depends where they’re comfortable and do they have free movement in that position?

Alexa Terry  20:36

Yeah. Yes, that’s really useful to keep in mind. And as we said, In the beginning, you have this quite eclectic career. And I’d really like to delve into your experiences when you were training as a forensic archaeologist, because that sounds so, so interesting. And I know we were speaking before a little bit about kind of the things you had to do, which may or may not have grossed you out.

Chloe Spencer  21:05

I’m not sure I want to gross your listeners out with anything.

Alexa Terry  21:10

But you mentioned how you went to a site, which was, you know, 1000s of years old. And kind of what you found there, and I’d love to know, you know, about the bones and if anything that you were studying with, with animals, how that may have been linked or is familiar to the human voice and the and the way we are as, as humans, so yeah, can you give us kind of a little journey through your experience there.

Chloe Spencer  21:42

Yeah. So the cemetery we were working in was in Cyprus, it was up in the mountains in the Troodos Mountains near Paphos. And the graveyard was on top of a mountain, and it was rock, and they were rock cut tombs into the rock face. Each tomb has had one or two people buried in it. Well, actually, some of them had no people buried in it, because they’d been robbed years ago. But a lot of that goes on. And these were 3000 years, 3000 BC. So a pretty long time ago. Most of the bones were, by this point, almost indistinguishable from the chalk that they were buried in. But there was one that I will never forget. It was obviously beautiful. It was a double burial. And they were lying. They were spooning. Male and female. And one of the things that I found absolutely fascinating about it was that you could see the shapes of the jaws. And you could see this beautiful curved jaw of the female and this really absolute right angled jaw of the male. Such an incredible difference and seeing them lying side by side. Like that was just stunning. And you thought that’s like a gender anatomy lecture right there in stone. It was fantastic.

Alexa Terry  23:05

And that’s so lovely. That’s so lovely as well. I really am interested to know who was the big spoon and who was the little spoon?

Chloe Spencer  23:13

I wish I could remember. But it was a long time ago. I’m talking… Oh, I don’t even want to think about it. But we’re probably about 20 years ago now. So it was a while back. So yeah, that was that was really the high point for me that one.

Alexa Terry  23:28

That’s lovely. That’s really lovely. And out of the animals that you have dissected, was there anything particular, you know, that was totally away from… Obviously, we’re not all going to be like each animal, but it was anything that was totally away from what you expected, or something that surprised you being quite familiar with with our own setup.

Chloe Spencer  23:51

Um, I think that one of the things that I found really fascinating, I used to do a lot of work with horses, was a dissection of a racehorse, which I have to admit I watched I wasn’t part of, but I watched it. I was looking at how their bodies are adapted to what they do. So we look at how our bodies have have adapted to use the voice in a way that it wasn’t necessarily ever intended for, you know, I mean, really, when you look at this system, it’s to stop you aspirating food. And it works great for that. But then we find that we can do all this amazing stuff with it. When you look at a racehorse, which we’ve bred selectively for a function, ie to go as fast as they possibly can. And you look at the enormous lungs, and you look at the way that as they swing their back, legs forward and a gallop, the gut content will slam forward against the diaphragm, which will expel the air. 

Alexa Terry  24:55

Oh, wow. 

Chloe Spencer  24:55

And as the legs swing back, they pull everything back and the lungs will inflate. And so they’ve got this sort of swing effect to the bellows that we don’t have, we don’t do it like that. We do a bit when we’re running, but it’s not the same mechanics. And so the larynx will be developed differently because it’s having to having to accommodate this completely different mechanics of the air. And they don’t need to make sounds. I mean, they do make sounds. But it works completely differently. And I just found that absolutely. Mind blowing, looking at the complete, almost sort of designed way of creating that airflow. That is so different from our way of doing it.

Alexa Terry  25:44

Yeah, it’s all really mind blowing. When, if I think about the body, and I remember when I first had a scope for the very first time, and I looked inside, I got really, like, teared up and I was like, they’re my vocal cords like this, like this detachment. So, so cool. And it was, you know, we don’t see anything that keeps us alive yet it’s working. And it just felt really odd to see that. And I was like, hello, hello in there. It was a really surreal moment. So yeah, I can imagine seeing, you know, big animals like the horse, and seeing how their mechanism is made for them. And what they need is bonkers seeing everything in the MRI. There’s so many videos of that on YouTube, which are pretty stunning as well. Pretty incredible. Do you have a favorite thing to work on in the studio? Do you have like a real fascination or, are you being drawn to a particular area?

Chloe Spencer  26:48

I think to be honest with you, it changes every week, I have this weird thing that happens every week, the first student of the week will come in with something. And it will be like “Oh, so this is what we’re working on this week with everybody.” And I think in the last few weeks, it’s all been about resonance. It’s about finding space in the head and playing around with and I really with my students, it really is about playing around and discovering new things. And what happens if I put my tongue out? What happens if I drop my jaw? And what happens if I do this? And what am I gonna do that just to change discovering the changing sounds. And that’s one of the things I really love. I love to get them working. So one of the things I find with my my amateur students. That’s a bit of an unkind way of describing them, but they are, is they have this obsession with what they think it should sound like. Like, I open my mouth. And I think it should sound like ABC. And I try to change that perception of if I think about XYZ out of technique, and only about XYZ technique, abc will take care of itself. And I’ve had so many lovely moments where I’ve guided them back to their technique back away from what they think it should sound like, back to a grounding in the body. What’s my breath doing? What’s my tongue doing? What’s my body doing? And suddenly the sound happens, and they have this absolute lightbulb moment. And they go I got that sounds amazing, right? Yeah. And you didn’t even need to think about it. For me that as a singing teacher that is, that’s the goal. It’s not, it is seeing them perform on stage, that’s lovely. But I get so much joy out of those moments. I’ve had tears in those moments where they make that sound and just go, “Oh my God, I’ve never sounded like that in my life.” That was worth it.

Alexa Terry  28:39

It’s been such a privilege. I had such fun chatting to you. Thank you so much and where can people find you and get in contact with you if they want to know more?

Chloe Spencer  28:47

So I work three days a week in Egham. Monday, Wednesday, Friday. And that is a place called Still House Clinic. So you can find it online and I have appointments available. And if I don’t, I can find you one. And I do Monday afternoons in London, which is the Again, appointments available and more if you can’t find one. And I teach Tuesdays and Thursdays so kind of a lovely life really it’s finally bringing it all together.

Alexa Terry  29:23

It’s lovely. Well, I think I’ll come and make a visit and come and do some joint farts with you. 

Chloe Spencer  29:32

I’ll never forget that one. 

Alexa Terry  29:33

Yeah. scientific paper by Alexa Terry “Joint Farts”. I can see it now.

Chloe Spencer  29:40

And they’re important for a singing teacher.

Alexa Terry  29:44

Chloe, thank you so much.

Chloe Spencer  29:46

It’s been a pleasure. Thank you so much.