Interview with The Voice Forum...

December 12, 2019

Sharing today's post from The Voice Forum for this week's blog!! Completely honored to have been interviewed by Christina Kang and Sara Charney from the Mayo Clinic Arizona.  It was so wonderful sharing our time, passion for VOICE, and stories... and they are such incredible women and voice-specialized speech pathologists! Check out the full interview below, on The Voice Forum, on @voxfit_, or on the VOXFIT Facebook page!!
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I am excited to introduce Sara Davis, MA, CCC-SLP of @voxfit_ She is a professional fitness instructor who is also a voice pathologist. My colleague Sara Charney from Mayo Clinic Arizona helped me with this interview. We were super excited to pick VOXFIT’s brain! #voicepathology#fitness #fitnessandvoice #fellowshipofthelarynx #laryngology#vocalspice #VoxFit #voicetherapy

TVF: Please tell us how VOXFIT came to be.
SD: I have always worked in the clinic setting since I completed my clinical fellowship around ten years ago. It’s mostly been ENT related (voice and swallowing) and more recently working at the voice center at Cleveland Clinic Florida and now at a voice/swallowing outpatient clinic in Atlanta. I had a passion for voice and swallowing since graduate school. I have also taught indoor cycling for 12 years. I cheered in college and professionally and have always been very involved in the sports media world; in addition I’ve taught barre classes and currently Lagree fitness. I was always heavily involved in the fitness world in addition to my full time job as a clinical speech pathologist in the ENT world. Initially I have kept the two worlds very separate because I wanted to be taken seriously in the clinical setting. But one of the doctors happened to spot me cheerleading in one of the NBA games and everyone soon found out...so that was end of that secret. To my surprise, everyone thought it was cool and I would get them tickets to games; in addition, co-workers would come to my group fitness classes as well. For about two years I also traveled around the nation as a master instructor for indoor cycling (which I LOVED so much—training, teaching, and sharing my passion to help others evolve and achieve dreams of their own), but also quickly realized that most fitness instructors are never trained on VOICE related to vocal health, vocal efficiency, and vocal dynamics. Cycling instructors are trying to motivate 50 plus people in a workout setting on their bikes with loud music but they are not instructed in how to prevent vocal injuries. So many instructors have voice pathology so it was very obvious to me that vocal education was sorely missing in this population. I also saw this in singers who rise to success in relatively a short period time without good understanding of how to care for their instrument, their voice (or use it efficiently in all settings). Since I am involved in both the fitness and voice clinic worlds, it became very apparent to me that I had to do something about it to merge the two passions together because there was a definite need. I am always spontaneous and creative so I decided to conduct research. I created a twenty-question survey 2 years ago and received about 230 responses; I analyzed this data and presented at the Fall Voice conference 2 years ago as a poster in Seattle. The survey results confirmed what I suspected all along: 100% of the respondents agreed that voice has a significant impact on every class, 93% consider themselves occupational voice users, ~78% affirmed they have never had a vocal training, but over 81.94% teach three of more classes per week and quality as vocal athletes, and 92% feel a vocal training would be beneficial for their work in the fitness industry with 85% stating they would be interested in attending such a training. The prevalence of self-reported voice difficulty was high with 70% stating they have experienced hoarseness at some point related to their jobs instructing fitness classes, and over 51% of these individuals have never been trained on how to use their voice for instruction. Of those who answered “yes” to experienced hoarseness, only approximately 9% sought help from a medical professional regarding the change in voice quality. Close to 40% affirmed their voices have generally “changed” since becoming a fitpro. When asked if amplification (mics) were used during instruction, 98.68% answered “yes” but only 26% of these respondents reported that the microphones always work (with 74% reporting less reliability of the amplification). In addition, when asked if they instructors felt they were “hydrated well enough”, over half of the respondents answered “no” or “sometimes” versus “yes”. 60% reported being social/talkative individuals outside of class instruction, therefore displaying a consistent use of voice in and outside of their “work” setting, implying high vocal demand and full vocal schedules with reduced time for vocal rest. Other data were also collected including concepts involving posture, reflux, projection, strain/vocal effort, and throat clearing. I received overwhelming suggestions from colleagues and friends to create a LLC based on the poster presentation, so I went ahead and did that. The business slowly developed over a year and now I have clients all of the time in both group presentations, seminars, and therapy/coaching engagements. I receive inquiries from singers, business people, fitness instructors, etc. and they appreciate that I appreciate and understand their “world”. I have learned that many fitpros can be quite apprehensive of the medical community, and many of them have gone to voice therapy and been told to turn down the music volume but that is not legit because music is movement and it’s a very integral part of fitness….so the clients disconnect from therapy when they are given suggestions like that. This year I was also honored to give a podium presentation at the Fall Voice conference in Dallas to present my passions, the data, and evolution of VOXFIT thus far.

TVF: What is VOXFIT’s mission?
SD: My mission is related to occupational voice users who use their voices for living. To spread the message of vocal health, vocal efficiency, and vocal dynamics…To educate, coach, rehabilitate, and inspire occupational voice users and transform their voices and lives. My original goal was to provide group seminars but it has evolved to also include individual clients who need voice therapy, voice coaching, and training on public speaking. VOXFIT is now trademarked and registered. I think the Latin name “vox” is a great combination of the medical and fitness worlds.

TVF: How did you choose to become a voice pathologist?
SD: I knew that I wanted to do Speech-Pathology in high school. I studied sign language for 2 years in high school and our teacher was deaf; it was a really cool experience and she exposed us to the related fields and I became obsessed with speech pathology. I knew I wanted to be in the medical field and wanted to work with adults. My sister is a doctor and being in the medical side of things has always made sense to me. Then in grad school I knew I wanted to specialize in voice, swallowing, and head and neck cancer. I dedicated myself to learning as much as I could about voice, even as a student. I spent whatever I could save to attend courses like Vanderbilt and Emory stroboscopy courses because I knew I didn’t training out of a voice center (although I received great experience from the VA but I knew I had to go get the needed voice experience and hands-on training myself). I am obsessed about continuing education and doing more than what may be necessary but I feel that the money and time is extremely well spent. I have become more passionate over the years. I got more involved in singing for myself so that I understand what singers go through. It’s not good enough to just work singers. It’s more encompassing when I am singer myself.

TVF: A lot of singers go into speech pathology thinking that they want to be singing voice specialist. What advice would you give someone?
SD: Training in speech pathology, vocal pedagogy experience, and singing experience in general are important but I believe musicianship is important as well. I taught myself to play the piano a couple of years ago. Having a good musicianship also helps understand how to use music for fitness. Making sense of music is really important to leading a good fitness class. Music creates movement, energy, and feeling; movement is medicine.

TVF: What are some things you have been able to problem solve with fitness instructors who have vocal trouble?
SD: Always focus on vocal health first. Warming up before teaching classes is important. Doing a vocal reset with specific voice exercises between each class even for two to five minutes throughout the day is important and way more effective than 30 minute or longer practice sessions. I am a proponent of ultrasonic nebulizer use with .9% isotonic saline for immediate external laryngeal hydration. That is immediate help for them, and especially important for 5 or 6am classes. Helping them understand about efficient vocal production in resonant voice with abdominal support is important. I would use flow phonation and semi-occluded vocal tract exercises as well as negative practice and conversation training therapy. I have formulated a concept called “vocal spice” related to teaching fitpros the many elements of dynamic voice use specific to class instruction and promoting client connection (and again, these also can carryover to the corporate voice setting). The power of the pause, vocal inflection, emphasis, melody, rate (slow versus fast), intensity (loud versus soft), not to compete with music, the beauty of silence, crisply articulated voice, and more—all of which is individualized for the specific client. So many people speak with monotonicity and are not aware of how to use their voices efficiently or dynamically. Many people hold tension within the vocal mechanism and its subsystems and myofascial release and massage have proven very beneficial as well. Also, many fitness studio owners are not even sure what kinds of microphones are best to teach the classes; there is so much to cover. My goal is to create an online course for fitness professionals and I’m in the process of its creation now.

TVF: For the readers, you can contact VOXFIT directly to sign up for sessions, seminars, or soon the online course. It’s great that there is someone who understands both the fitness and the clinical voice world. I will definitely sign up for your online courses when you launch them.
SD: Hahaha, I certainly appreciate that. I am really passionate about vocal education and grateful for the unique position that I am in to merge the two worlds: fitness and vocal science.
I never knew what to expect from doing the survey research to creating my own company but it has certainly grown far bigger than I expected in a short time. I have a 9-5 clinical job here in Atlanta so it takes all of my spare time to run VOXFIT…but I am powered by purpose and passion (and so thankful!).

TVF: I hope it grows fast so that you can run just VOXFIT solely. I absolutely love your unapologetic passion. That said, where did you do your SLP training?
SD: I went to Miami, OH for undergrad and University of Cincinnati for graduate school. Then I worked in Atlanta for 8 years, then Cleveland Clinic South Florida, and now back in Atlanta, GA.

TVF: What are some of the things the public misunderstands about what voice therapists do?
SD: I think our title as speech therapist really makes the public misunderstand what we do. So often they will show up to therapy sessions confused about why they are seeing a speech therapist because their speech is fine. It takes a lot of explanation to help them understand that we are speech pathologists that specialize in voice before they even get assessments. A lot of education goes into starting patient care on the right foot.
TVF: That’s true. Often patients don’t follow through the initial referral for voice evaluation for the same reason.

TVF: A lot of people want to know how to even get into the field. You mentioned improving musicianship, taking courses, and being proactive in gaining knowledge and experience. Is there any other specific training that you’d recommend for people who are just getting into the field?
SD: Anything and everything to just dabble in “voice.” Keep singing, attending concerts, learning an instrument, reading research journal articles, taking stroboscopy courses, UPMC voice therapy courses, Medbridge courses, there’s so much one can do. Be your advocate and be powered by your passion. Surround yourself with people who know a lot more than you do because that’s how we learn. Seek out all opportunities, even volunteer at cancer screenings, and do not be afraid to approach people about it. Ultimately this is all about passion, not status or money. Your patients and colleagues can tell if you don’t have passion. For me it is all about sharing knowledge and I give as much as I can.

TVF: You are right. You can do other things to make more money. (LOL) I always say that if you don’t have passion for voice, you are better off doing something else. Otherwise this job can drain you easily. I mean, how many people with muscle tension dysphonia have tension only in their throat? We are addressing the whole person. It takes an open mind to be a comprehensive voice therapist. That is why voice pathology is also intimidating to a lot of SLPs who are not specialists.

TVF: What advice would you give to voice therapists who want to work with fitness professionals?
SD: I would say teach vocal health, strategies to reset their voice multiple times a day, negative practice so they can catch themselves and actively reset, teach them breath support and healthy vocal dynamics, healthy projection with resonant voice even with microphone use, crisp and clear speech, and don’t tell them just to turn the music down! Loud music is needed in a dynamic boutique fitness class. But a helpful suggestion would be that the mic should be louder than the music, even by a little bit. Teach them correct mic placement right in front of the mouth, on the left corner and facing towards the lips. Tell them not to hesitate to adjust the mic placement throughout the class (as it may move easily dependent on their movement). There is a huge power in “pause” by using the music to motivate the class. You don’t have to talk all throughout the class. People actually want to hear the music and they definitely don’t want to hear you yell. Loudness and fast rate are what I consider as “activators” because they push people to do things. But if you slow down and go softer, it changes the room dynamic and pulls people in. So one must think of how to use the voice to create the “journey.” These are some suggestions that can be beneficial to fitness instructors with voice problems.

TVF: About you, what brings you joy? You are so very joyous person but what fuels your joy?
SD: I love the quote that says to do what brings joy to your heart. Pursue those things with abandon and you know that you are living the life that you are supposed to live. I am strong in my faith and it reveals things to me that bring me joy. I am passionate about helping people. Even as a little kid, I always stuck up for people with disabilities or any kinds of disadvantage. I hated it when people made fun of others. I really believe in the power of building people up and it doesn’t matter what others think of you but it’s how you can help others shine (and shine the brightest yourself by pursuing your purpose!). And movement brings me joy. If I have not worked out or rode on a bike myself to music and moved to the rhythm, then I am also different myself—I need movement. I listen to my heart and keep pursuing what brings me joy.

TVF: You are a pure gem Sara. Thank you very much for being you.