Vocal conditions and how to prevent them

Hi everybody, this post is a must read for any singer, public speaker or any profession that relies on the effectiveness of their voice to make a living (like school teachers, drill sergeants, executives or salespeople). If you regularly experience vocal discomfort, a loss of voice, pain or an inflamed throat when singing or screaming, this post is for you.

⚠️ Chances are if you’re experiencing any of these symptoms, you could be ignoring vital warning signs from your body that are the earliest indicators that you can be causing damage to your vocal cords and/or the supporting muscles, tendons and ligaments that are responsible for proper vocal production.

In the interest of providing you with the very basic need-to-know information, I have compiled a list of the most common vocal cord disorders, with a brief description to help you recognise when you might be overdoing it or require a vocal tune up from a knowledgeable coach or singing teacher.

Dysphonia

One of the very first warning symptoms that a singer or public speaker will experience when they are not vocalising and/or supporting their voice correctly is dysphonia. This basically means having the voice sound abnormal.

Dysphonia (hoarseness) is very common and everybody in their lifetime will experience some form of hoarseness or abnormal sound in their voice. The term dysphonia is used to characterise changes in your voice, or changes in the quality of your speaking or singing pitch. This may include changes to your normal volume production capability.

The symptoms of hoarseness may include raspy, weak vocal production or excessive breathiness that makes it difficult or impossible to close the vocal cords all the way up to produce a clean pitch. While it is usual for people to experience a hoarse or raspy voice, or even a tired voice when they’re getting over a cold or a flu, singers and professional public speakers must be more vigilant that they don’t consistently develop these symptoms over the long term from excessive vocal strain.

In the longer term, these are the telltale signs that your vocal cords and your breath support are out of balance and headed for a train wreck.

Nerdy fact 🤓: Dysphonia can be related to muscle tension, vocal tremors in your voice (where the voice just breaks for seemingly no reason at all), and can also be related to vocal cord paralysis. If symptoms persist, see an ear, nose and throat specialist and/or contact an experienced vocal coach as soon as possible.

Laryngitis

Laryngitis is usually associated with a raspy or hoarse voice. It is caused mainly by creating too much heat and pressure at the vocal cords. This in turn produces or creates swollen or inflamed vocal cords that are no longer able to close properly to produce clean sung or spoken pitches.

Singers that incorrectly support their voice by singing through their throat are much more prone to developing laryngitis. A very easy way to identify this is by looking for an abnormally breathy voice.

When your vocal cords are inflamed and you’re experiencing Laryngitis, your voice will be very weak and you may end up sounding like your grandma or grandad!

Vocal cord lesions

Vocal cord lesions are typically non-canceous growths that include nodules, polyps and cysts. All of these lesion conditions can cause hoarseness, raspiness, excessive breathiness and more serious symptoms. They can cause excessive fatigue and prevent normal vocal production.

Vocal cord nodules

Vocal nodules are normally non-cancerous callouses that usually form on the mid-point of the vocal cords. These callouses form when the vocal cords are repeatedly brought together through excessive force. This can be caused by incorrectly supporting your voice using excessive volume as a strategy to be heard over the band.

Vocal nodules are formed when the vocal cords are slammed together violently. This kind of reckless singing can lead to serious consequences.

This can be especially bad if you’re a singer with a habit of singing through your throat. These kinds of singers and screamers run the risk of creating permanent callouses on the vocal cords. Once these nodules harden on the vocal cords themselves, they interfere with the vocal cords’ ability to close and correctly sing proper pitches and can also affect the strength of your speaking voice.

Vocal nodules once developed, and once they harden, become increasingly more difficult to resolve naturally and often require surgical intervention. Definitely something to be avoided if possible!

The most obvious sign of vocal nodules is loss of vocal range in an existing singer’s voice, and excessive “breathiness” when singing or speaking.

It is reasonably common for vocal nodules to develop and resolve themselves with the assistance of correct vocal breathing and singing exercises/coordinations. It is much harder to resolve vocal nodules once those callouses have fully hardened and become sizeable.

Nerdy fact 🤓: Female singers between the ages of 20-50 tend to be more susceptible to vocal nodules, however it is very common for both male and female singers and public speakers to develop nodules when they try to produce excessive volume incorrectly from their throats.

Vocal cord polyps

Vocal polyps are usually characterised as a soft, non-cancerous growth. For ease of understanding, you can think of a vocal polyp as a blister. A vocal polyp can include blood within the “blister” and sometimes the blood will disappear over time, leaving the singer with a clear blister on their vocal cords.

Symptoms of vocal polyps are very similar to vocal nodules, because in both cases they interfere with the voice’s normal production. The voice has a lot more excessive air and breathiness, leaving the singer feeling hoarse and raspy (but not the good kind of raspy!).

When you have a vocal polyp and your voice has excessive raspiness, you can’t clean up the voice and the blister will severely interfere with your ability to sing up into the higher notes within your range, because your vocal cords are unable to operate normally.

Unfortunately for smokers, there is a type of vocal polyp called Polypoyd Corditis (Reinke’s edema) , which is exclusively a condition that develops through smoking and/or acid reflux issues.

Nerdy fact 🤓: While causing similar symptoms, vocal polyps differ from nodules because polyps can form on either one or both vocal cords. A polyp has more blood vessels than a nodule and polyps have more variation in size and shape, while typically growing larger than nodules do. Visually, they look like soft blisters, while nodules form hard callouses on the vocal cords.

Vocal cord cysts

Cysts are growths that have a fluid filled sack. They have a semi-solid centre which prevents the vocal cords from being able to open and close with the normal characteristic rippling effect that we associate with maintaining a consistent pitch. Vocal cord cysts are less common than nodules or polyps.

There are two types of vocal cord cysts. There are mucous retention cysts, and there are epidermoid cysts.

Torn vocal cords

When someone consistently places an excessive unhealthy pressure on their vocal cords or the walls of their throat, they will first start off with either mild laryngitis or loss of normal voice. If the unhealthy practices are continued, the singer runs the risk of developing nodules or polyps. In the worst case scenario, they can actually tear vocal cords and damage nerves. The big one for us is the recurrent laryngeal nerve, which is a branch of the vagus nerve (cranial nerve).

As you can imagine, a torn vocal cord is a very serious issue for singers. Without the assistance of an extremely experienced and capable ear, nose and throat surgeon, this is not an injury that a singer can recover from just by having some time off.

An example of a torn or ruptured vocal cord was James LaBrie from the band Dream Theatre. James was on tour in Cuba and had violent food poisoning. In the act of vomiting, James tore or ruptured one of his vocal cords. I believe he still went on stage and performed his set with the band shortly thereafter, and the damage was so bad that they had to cancel shows, with James travelling straight back to the United States to seek urgent medical treatment. It took James 7-8 years to recover from his injury.

Vocal cord paralysis

Paralysis of the vocal cords is defined as when one or both of the vocal cords aren’t able to open and close properly. When one vocal cord is not opening or closing properly, it can be either paralysed, or partially paralysed.

If you have vocal cord paralysis, one or both of the vocal cords might remain open. This is a very severe condition for singers, speakers, or anyone for that matter. If the vocal cords remain open, they leave the air passage and the lungs unprotected from foreign objects from entering the airway.

Vocal cord paralysis can be caused by extended bouts of viral conditions, or by blows to the head, neck or chest. It can also be caused through various lung or thyroid cancers or tumors. In extreme conditions, for example operating with extreme screaming, it is possible to impact the main vocal nerves and impair normal function.

If you are suffering from any kind of vocal condition, or you’ve noticed that you’ve lost strength or vocal range, don’t delay and contact me immediately so that we can identify appropriate forms of coaching treatment, or I can put you in touch with an ear nose and throat specialist.

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