Eliminating the Soft Palatal Air Leak (Velopharyngeal Insufficiency - VPI)

There is no more terrifying feeling than experiencing the Soft Palatal Air Leak during a performance. What is it? How did this happen? Why is this happening? Why right now during this performance? What do I do?

Many wind players struggle with the soft palatal air leak or Velopharyngeal Insufficiency (VPI) and are unsure of why it happens and how to eliminate the problem. Once the soft palate is fatigued, it can become a chronic condition if not addressed, particularly in younger players. Often the soft palatal air leak presents itself at the most inopportune of times. I experienced VPI as a graduate student during a recital, though the symptoms were most likely there prior to my onset. After my experience with VPI, I began exploring the nature of the soft palate and sought to discover how to conquer the problem.

Causes of the VPI range from:

· Lacking fundamentals

· Faulty equipment or resistant set-up

· Equipment change (mouthpiece or increased reed strength)

· Sudden increase of playing time

· Stress

· Underdeveloped musculature in the palate

· Any combination of the above

Having overcome this condition personally and having assisted students, educators and professionals, I have found the following strategies successful in leading others to create their own pathway for dealing with and overcoming VPI. We as players and teachers need to become sensitized to the warning signs and head the VPI problem off before it starts.

When experiencing onset of VPI, players may after a long practice session or intense performance, feel a sore throat or a great deal of pressure in their nose or in the sinuses. These sensations are a sign that the player is forcing sound production due to a lack of proper fundamentals of playing or faulty/resistance in their equipment. If VPI occurs after an equipment change, return to the old equipment and see if the problem persists. An instrument that is leaking, even slightly, can also change the resistance and lead to soft palate fatigue.

Faulty equipment can lead players to form detrimental habits that cause VPI. If not attended to, these habits can take hold and exacerbate problems with VPI. If an instrument is leaking, players will often feel pressure in the sinus cavity behind the bridge of the nose and feel like the reed is too hard. Because of this, players expend more effort to produce the sound, causing fatigue, and compromising fundamental technique.

Practice and performance are stressful, deadlines make them even more so and in our haste to prepare, we become stressed and try to take shortcuts in our preparation. Through our stress, we feel we have to work faster and harder which precipitates a host of physical actions detrimental to performance. In these situations, we revert back to old habits that will cause onset of VPI.

One of the primary reasons wind players experience the soft palatal air leak is one or more fundamental elements of playing is out of place. These items range from:

· Inefficient embouchure (bunching chin, lips too loose, cheeks puffing)

· Tongue position isn’t high enough

· Air support is not engaged properly

· Poor playing posture (causing other fundamentals to be lacking)

· Tension in neck, throat, hands while playing

· A breathing plan is not in place for the work being prepared/performed

These elements affect the ability to produce sound efficiently and if one element is deficient, the soft palate can become fatigued.

Particularly important is having an established breathing plan. Players who struggle with soft palate often find they experience the problem at the ends of phrases. Players often attempt to finish the phrase by squeezing out the remaining air and as a result drop their support and/or tighten their throat. These two issues can very quickly fatigue the soft palate, particularly if the throat remains closed, a full breath is not taken, and support is not engaged for the next phrase. Rather than breathing only when needed, players should plan every breath to guarantee they can complete phrases and have air leftover. Though simple, this element will prove helpful in alleviating the VPI problem.

When preparing for a big performance, series of performances or auditions, players may suddenly increase practice time without working up to longer durations. This sudden increase in activity can cause a sudden onset of VPI, particularly for players who have never experienced the problem. A gradual increase of playing time, perhaps by adding 10 minutes a day until ideal durations of practice are reached, will help avoid practice fatigue. VPI can also appear when a player is getting back in shape and returns with initial practice sessions that are too long for their endurance.

Warm-Up Routine

A good thorough warm-up routine is vital before any practice session and performance. During a warm-up, it is essential to focus on efficient fundamentals of playing and eliminating any unwanted tension. Long tones, slow scales and slow technical exercises are extremely helpful in isolating and eliminating tension. Slow practice with air alone is a great strategy for diagnosing unwanted tension. The speed and intensity of the air creates dynamic gestures and nuances, rather than tension in the throat, oral cavity and tongue position. While playing with the air alone, players can also focus on finger tension and the amount of pressure being used to close the keys. If the fingers can be heard hitting the keys, strive to relax the manner in which the fingers approach the instrument until there is no finger noise. Taking the time to warm-up daily and focus on efficient fundamentals assists players in eliminating VPI through a heightened awareness of how they are approaching the instrument.

Vocalists and Speech Therapists have numerous exercises they use to strengthen the soft palate such as "Ng" or "kuh" sounds. They also discuss feeling the inner smile while having the mouth closed. These exercise the palate but should be done for only a couple minutes daily.

In practice and performance situations, at the first sign of fatigue, ask yourself the following:

· Are the muscles below belly button in the lower abdomen engaged and supporting the sound?

· Is my embouchure working efficiently or am I biting/bunching?

· Is my tongue in the proper position?

· Am I tightening my throat and forcing the sound?

· Is there over effort anywhere in my body?

If this happens to a student during a recital, what can a teacher do to help them through it?

· Check instrument for leaks

· Change to a softer reed

· Do some yoga breathing exercises to ease anxiety and tension

· Place the tip of the tongue on the top teeth and drop the back of the tongue, and inhale and exhale slowly for 5-10 breaths

· If any remaining works have repeats, cut the repeats

· If fatigue is serious enough, end the recital to not risk further damage

In some situations, removing the symptoms allows the performance to continue unaffected, however in some situations, the symptoms are so acute, the best solution is to suspend the performance instead of risk further injury.

Ultimately, if the soft palate gives out, stop playing. Do not push through it as it will only further damage the muscle and lead to longer recovery. Rehabilitating a fatigued soft palate requires a disciplined return to full playing, beginning with short practice sessions focusing on proper playing fundamentals, and gradually increasing playing durations. Even if you feel better, only add 5-10 minutes per day as you work back into playing. The slow and steady return to playing minimizes the formation of detrimental habits.

For Teachers

Teachers, please address this with your students before it happens. Warning signs include:

· Hearing little pops or snorts while a student is playing, particularly during intense technical passages or long phrases

· Face turns red or purple as they become shallow on air or at any time while playing

· Hearing an explosive nasal sound upon releasing air pressure

· Audible, effortful inhalation vs. a silent inhale

· Any improper fundamentals of breathing or embouchure (biting/bunching/puffing)

· Raising shoulders when breathing

· Postural problems that cause any fundamental issues

The Velopharyngeal Insufficiency is solved and prevented when players strive for healthy fundamental elements of playing, keep equipment in good working condition, and are mindful during set up changes, warming up, breathing planning and duration of practice routines.

Articles for reference and more information on VPI:

Seattle Children’s Hospital

Behel, Kensley, Velopharyngeal Insufficiency In A Clarinet Player: A First Hand Case Study. FSU Honors Thesis. 2013.

Gibson, Chris, Megaslides

Dr. Julianne Kirk Doyle serves as Professor of Clarinet at the Crane School of Music – SUNY Potsdam, holding an MM and DMA from the Eastman School of Music and a BM from University of Oklahoma. She directs the Crane Youth Music summer program and plays regularly with the Aria Reed Trio, Orchestra of Northern New York and Northern Symphonic Winds. She is an artist with Backun Musical Services and DANSR/Vandoren.