As every singer knows, we’re only as good as our voices sound on a given day. Whether it’s allergies, fatigue, or a cold– or something more serious– our performance success is largely at the mercy of our instruments.
The good news is that most voice problems– even the most seemingly troublesome ones– are usually nothing to stress over.
Even when we lose our voices, rarely are things so serious as to warrant surgery. Polyps (watery sacs often caused from a single, powerful vocal blowout) and hemorrhages (resulting from the bursting of a blood vessel in a vocal fold) are often exceptions to this rule, but incidents of both are few and far between, and rates of surgical success are extremely high.
Much more common when it comes to vocal pathology are vocal nodules and ‘pre-nodules’ which, unlike polyps and hemorrhages, are caused from prolonged vocal strain and misuse. Ongoing tension causes the vocal cords to swell and become irritated, resulting in microlesions and eventually small, callous-like growths (think scabs) on those spots. These growths interfere with the natural vibration necessary for a healthy vocal sound, resulting in a raspy, throaty tone, particularly in certain areas of the range. While nodules are sometimes removed surgically, vocal rest, therapy, and retraining usually allow them to diminish, and the vocal cords to return to their healthy state.
If you have voice loss or discomfort, schedule an appointment with an ENT.
While vocal pathology sometimes results from a cold or bronchial infection (mainly due to the related coughing and throat clearing), a sure sign that something more significant is going on is that your voice still doesn’t sound or feel right when you’re otherwise healthy. If your voice isn’t working normally, you’ve lost parts of your range, or you have any pain, schedule a visit with an Otolaryngologist (ear, nose and throat doctor) who can look at your vocal cords to see exactly what the problem is.
In the interim, consider resting your voice as much as possible. This includes resisting the temptation to whisper, clear your throat, or cough. Hydrate and have lozenges on hand, which will keep the post-nasal drainage off your cords thanks to the constant swallowing.
As I mentioned earlier, even when pre-nodules and nodules are present, in my experience complete vocal rest for two weeks is a good start to treatment and often resolves issues that some medical professionals would perhaps try and surgically resolve. That said, while sustained vocal rest will certainly help, and sometimes even get rid of the growths, it won’t fix whatever caused them. Working with a voice coach and/or a speech therapist is usually necessary to help you learn how to use your singing voice correctly, as well as to discover whether something in your daily speaking might be creating or exacerbating the problem.
In addition to nodules and pre-nodules…
one of the most commonly diagnosed voice issues is acid reflux. Caused by stomach acid coming back up through the esophageal sphincter and into the larynx, reflux, or GERD, results in the reddening and swelling of the vocal tract. Unlike indigestion, many people don’t feel reflux, only the symptoms of it… itchy and irritated throat, hoarse voice (especially in the morning), and an inability to ‘clear the cords’. These issues tend to cause singers to overcompensate by working harder through the ‘thickness’ to produce sound, often in unhealthy ways.
On its own however, reflux is rarely an issue that will put your voice at serious risk. That said, any resulting voice clearing, pushing, and strain can lead to the creation of pre-nodules, nodules, and other vocal challenges.
As you may already know, there are some practical things you can purportedly do to avoid or limit reflux*, including to not eat too much at one sitting or too close to bedtime, avoid intensive exercise right after eating, and limit caffeine consumption and spicy, acidic and other triggering foods (including, sadly, chocolate!). As well, birth control pills and other hormone treatment therapies can loosen the lower esophageal sphincter, causing reflux (click here for an in-depth discussion about the causes and treatment of GERD). Of course, everyone is different so please take this and all ‘data’ with a grain of salt. Play around to discover what does and doesn’t work for you.
In my experience, however, anxiety and acid reflux usually go hand in hand.
Certainly, there are physical and dietary causes of reflux. That said, insecurities, personal and professional stress, and other emotional issues– whether or not we’re conscious of them– can also be huge contributors. Fear tends to cause us to push our voices as we hold ourselves and our breath rigid, resulting in less than optimal vocal sounds and health, as well as increased anxiety and frustration. Add reflux to the mix– often caused by the stress itself– and things can start to feel pretty overwhelming.
Fortunately, true vocal pathology isn’t as common as people think.
Whatever vocal troubles you may be having– whether nodules, reflux, a cold, or something as yet diagnosed– keep things in perspective. Stay calm, stay confident. You can handle and heal anything that comes your way.
Remember too that vocal issues, even serious ones, are not the result of normal, powerful, and even prolonged, healthy practice or training. In fact, favoring your voice– going easy on it for fear of causing damage– may often cause more problems than singing in a full, supported, and confident voice. This is particularly true when you’re coming off of voice rest and/or healing a vocal injury.