Stop Hoarsing Around! by Deborah Southard Tips to keep your voice from going to the frogs print article      send to a friend

The voice is an important tool for public speakers, teachers, actors, singers, politicians, and lawyers.  For people who rely upon the continued health of this instrument, voice changes can be devastating.  Going hoarse is the bane of every singer and actor throughout the world and can ruin the effectiveness of a political speech.

Julie Andrews experienced voice problems while appearing on Broadway and when doctors examined her, they discovered nodules on her throat.  But singers and actors aren't the only ones that can suffer from voice changes.  Are you at risk?

Cause of the Frogs

Vocal stress refers to changes in the voice, such as hoarseness, as a result of improper use.  "People come in with a change in their voice, and they feel that they are not able to use it as easily - they can't achieve the tones that they want to use.  When in stressful situations they feel their voice falters more," says Daniel Deschler, MD, an Ear, Nose, and Throat specialist at Massachusetts Eye and Ear Infirmary. 

These changes are caused by improper use of the voice, what Dr. Deschler refers to as "stressing the system."  Improper use can be attributed to a number of factors, such as speaking for long periods of time without giving enough time to rest between sessions, trying to project in a large room to an audience, even having a conversation on an airplane where the air is dry and the environment is noisy. 

Generally speaking, when someone is suffering from vocal stress, they are most likely using their vocal muscles in an incorrect or unbalanced way.  "What frequently happens, we think, when patients get out of balance, is that they end up using too much effort in the muscles of the larynx and not enough respiratory effort.  They end up squeezing the larynx to compensate," says Michael Karnell, PhD, of University of Iowa Health Care.

In addition, when the voice is slightly overused, one might have the tendency to alter speaking habits in order to compensate for the injury, and this can cause a person to develop techniques that could be harmful in the long run.  Dr. Deschler likens it to someone who has sprained an ankle.  "In order to limp around, you learn to use different muscles, but when the ankle eventually heals, you still have a limp.  And that limp can cause other problems, such as pains in the hip."  In other words, your voice may still be hoarse even after the original laryngitis has cleared up.

Continued misuse can result in serious damage to the vocal cords.  While most people think of laryngitis as an inflammation of the larynx caused by a viral infection, it can also be attributed to tobacco smoke, acid reflux, and voice trauma (inappropriate use of the voice).  "If the trauma is severe and repetitive, you can develop a callus-like swelling on your vocal cords, called a nodule.  If you use your voice inappropriately, loudly, too long, or when it is inflamed (such as an allergy or cold), you may burst a blood vessel in your vocal cords, creating a hematoma that can further mature to become a polyp," says Henry Hoffman, MD, an otolaryngologist at University of Iowa Health Care.

There are many professions in which a person could be susceptible to vocal stress.  Singers, actors, and public speakers are the most obvious.  But teachers, lawyers, and salespeople can also be affected by this condition.  Even someone who isn't in one of these professions but is extremely outgoing and talks incessantly (ring a bell, anyone?) can suffer from vocal stress.

Steer the Hoarse Off Course

So what can you do to prevent a good voice from going bad? 

The first step is to recognize that you may be at risk for vocal stress.  Avoiding noisy environments that will require you to raise your voice, keeping yourself well hydrated, and facing the person you're talking to so that they can read your facial expressions as well as hear your words, will help limit that risk.

Dr. Karnell recommends that you look at using your voice like an athletic event.  "Nobody who is about to run a race will get off the bench cold.  There is a period of warm-up that is necessary," he says. There are a series of exercises that both Dr. Karnell and Dr. Hoffman recommend to patients when they come in for treatment.  "The exercises involve stretching the muscles in the larynx by varying pitch and loudness," says Dr. Karnell.  "And just as you'll need to warm up your voice, it's also important to cool down."  He adds that inserting pauses while you are speaking keeps you from straining your voice and gives it time to rest.  And for professional speakers, singers, and actors, vocal training is extremely helpful.

Click here for additional tips from the National Center for Voice and Speech