Injuries to vocal cords include, pre-nodules(soft early stage nodules), vocal nodules, hemorrhage and polyps. Any one of the following factors can cause a singer to become injured, but when an injury occurs, the cause is usually a combination of factors.
These factors include:
- Poor Technique
- Stressful or unsuitable repertoire
- Illness
- Overuse
- Environmental conditions
A singing technique that puts the least stress on the voice facilitates endurance and goes a long way toward preventing injury. That being said, some styles of singing are more high-energy and make more demands on the voice than others. We certainly see more injuries in rock and opera singers than in those who sing gentle folk music and light jazz. Modern Broadway belters put more stress on their voices than those who sing in a more traditional or "legit" musical theatre style. Some voices and singers are more robust than others and more suitable to exploring a more extreme pitch and dynamic range. Singing music that is suited for a particular voice in range and character is very important to sustainable singing in the short and long term. Experienced voice teachers and coaches can assist performers in understanding what repertoire is optimal for them.
Even a singer with a great technique who is singing the music most suited to their voice can become injured if they rehearse or perform while having an illness that is effecting their vocal cords. A singer should learn how to identify the warning signs of swollen, inflamed or infected vocal cords from their voice teacher, and if the singer and his or her teacher is in any doubt at all, a consult with a specialist voice doctor is in order. Recent research indicates that in the case of development of vocal nodules, there is usually the finding of presence of acid reflux as an irritant to the vocal cords. According to an article in Laryngoscope Magazine "Pharyngeal acid reflux events in patients with vocal cord nodules" "Pharyngeal acid reflux events occurred in seven of 11 patients with vocal cord nodules" and concluded "Prevalence of pharyngeal acid reflux events is significantly higher in patients with vocal cord nodules".
Many experts have said that the epidemic of voice injuries seen in recent days amongst recording artists has more to do with the fact that an ailing "star" can't have an understudy replace them in concerts if they get sick, than any flaws in technique they might have.
A singer performing the most suitable repertoire, with an excellent technique and in perfect health can still become injured if they overuse their singing voice or even their speaking voice. Experts agree that the best schedule for singing practice is a few, perhaps three, sessions of about twenty minutes per day instead of long practice sessions that will cause fatigue. Also, days of partial or complete voice rest whenever fatigue or strain occurs. Unfortunately, this is far from what is expected or required from most performing singers in real-life situations. Choir rehearsals are often two or three hours and directors often hold a full rehearsal of an amateur choir right before an extended performance. Musicals rehearse intensely, often with no "dark days" before most opening nights. Only in the opera world is it customary to have quiet days before opening and few consecutive days of performance.
Even a singer with a great technique who is singing the music most suited to their voice can become injured if they rehearse or perform while having an illness that is effecting their vocal cords. A singer should learn how to identify the warning signs of swollen, inflamed or infected vocal cords from their voice teacher, and if the singer and his or her teacher is in any doubt at all, a consult with a specialist voice doctor is in order. Recent research indicates that in the case of development of vocal nodules, there is usually the finding of presence of acid reflux as an irritant to the vocal cords. According to an article in Laryngoscope Magazine "Pharyngeal acid reflux events in patients with vocal cord nodules" "Pharyngeal acid reflux events occurred in seven of 11 patients with vocal cord nodules" and concluded "Prevalence of pharyngeal acid reflux events is significantly higher in patients with vocal cord nodules".
Many experts have said that the epidemic of voice injuries seen in recent days amongst recording artists has more to do with the fact that an ailing "star" can't have an understudy replace them in concerts if they get sick, than any flaws in technique they might have.
A singer performing the most suitable repertoire, with an excellent technique and in perfect health can still become injured if they overuse their singing voice or even their speaking voice. Experts agree that the best schedule for singing practice is a few, perhaps three, sessions of about twenty minutes per day instead of long practice sessions that will cause fatigue. Also, days of partial or complete voice rest whenever fatigue or strain occurs. Unfortunately, this is far from what is expected or required from most performing singers in real-life situations. Choir rehearsals are often two or three hours and directors often hold a full rehearsal of an amateur choir right before an extended performance. Musicals rehearse intensely, often with no "dark days" before most opening nights. Only in the opera world is it customary to have quiet days before opening and few consecutive days of performance.
Environmental conditions that are hazards to vocal health include stress occurring to the voice from having to speak over noise in load conditions or sing without proper monitors, chemical irritants, smoke, allergens or reactions to medication. Often more stress occurs to a voice at a noisy party after a performance than during the show itself. A strategic singer learn to protect him or herself from such situations.
Injuries can also occur directly to the vocal cords during medical procedures or to the nerves that feed the larynx. Endocrine conditions can also complicate professional voice use.
To sum up, it is clear to see that professional or serious hobby singers need to employ a range of strategies to protect their voices, along with having a singing technique that facilitates optimal function. If having your voice in top shape is important to you, seek guidance from a qualified voice teacher who can advise you based on their expertise and experience. A singing teacher or speech pathologist can also teach you identify and reverse any signs of less than optimal singing before an injury occurs!
Most importantly don't forget that a laryngologist, or specialist voice doctor is also an important member of any singer's team and the person to seek out when a singer has any serious concerns. A laryngologist can actually look at the vocal cords and see what is going on so you can get the facts about your voice's condition rather than educated guesses. It is advisable to establish a relationship with such a doctor when you are well so that they can get a baseline of what your cords look like and how they vibrate before you run into any trouble!
If you have any questions about healthy singing for a long and successful singing career, don't hesitate to reach out to me by email at lori@bergenbelcanto.com
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