How does a pop star avoid choking at the Grammy Awards? She gets a voice box massage from a singing voice pathologist, according to an expert.

Singers do voice preparation before any live performance, and especially so before an awards show of this magnitude.

Aaron Low, a singing pathologist and the founder and CEO of the Voice Clinic in Toronto, is often part of that equation. He's worked with Grammy-nominated performers in the past.

"In all genres, singers have different problems relevant to what they do with their voice. Often times, they need therapy just like any other sport," Low said.

There is an athletics and musculature of the voice, according to Low. He said he doesn't necessarily teach anyone how to sing, but more like the fundamentals of singing. For example, a physiotherapist can't necessarily teach you how to skate, but can make you a better skater using knowledge of human physiology. 

"We focus on strengthening their musculature and their breathing and we focus on the flexibility of their muscles, keeping everything lubricated properly and at top health," he said. "We take all the voice apart and put it back together, trying to find the one missing piece that will make them a better performer."

2016 Sundance Film Festival - Sting Performance

Sting was a consistent performer in his younger days, but now has shifted to a different style that isn't as dependant on his voice, Low said. (Arthur Mola/Invision/AP)

Because performers are human, the stress and pressure of singing at an event like the Grammys can affect the way one sings. Singers will sometimes perform in bare feet to make themselves more comfortable, which ultimately can affect their singing voice, according to Low, who adds another determinant of voice is age.

"As we age, we can't carry water in our body as well as we should, our vocal chords will dehydrate a little bit faster," he said.

Low will give older singers voice exercises to reclaim their vocals, but other singers have to adjust to their voices as they age.

Sting, a past Grammy winner and the act chosen to perform at the 2016 NBA All-Star Game halftime show in Toronto, is an example of how a performer must change styles to adjust for their voice. Sting was a consistent performer in his younger days, but now has shifted to a different style that isn't as dependant on his voice, according to Low.

But for events such as the Grammys, singers will have already prepared with warm ups and exercises — sometimes even in their Grammy outfits.

Low said for instance, if a singer is going wear a heavy coat, he or she should practice in that coat to get used to singing with that weight on.

It may seem odd to some, but Low said it appears to work for the stars.