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To control their voices, singers rely not only on auditory feedback but also on proprioceptive feedback supplied by internal voice sensitivities (IVS). IVS, which are essentially pallesthetic (vibratory) and kinesthetic (muscular), provide singers with precise landmarks for controlling their emission. This means of control is more reliable than auditory feedback in which the voice is substantially modified by the acoustics of the environment.

A systematic X-ray study of the cervical spine of three populations of subjects (professional singers, beginning singers, and non-singers) who exhibited no vertebral column pathology or postural disorders provided evidence of abnormalities in the shape of the cervical spine in all of the professional singers studied. The disorders observed included hypolordosis, and more frequently, cervical rectitude or hypocyphosis without functional hindrance. The findings can be explained in terms of deformations undergone by the cervical spine after many years of intensive singing. The resulting functional postures are memorized and become an integral part of the singer’s corporal schema. The considerable amount of anterior-posterior movement of the cervical spine in singing explains why lesions which prevent its mobility have an overall impact on the singer’s voice, particularly in the upper pitch range.

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