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Have you ever tried getting through a day, or even an hour, without saying a word? It’s no mean feat, especially if one of your first tasks is to order a life-restoring coffee at your local café! Despite how much we rely on our voices to navigate our days, many of us give little thought to keeping our voices healthy.

>> By Kathleen Connell and Lana McCarthy <<

In celebration of World Voice Day on April 16, we’re sharing what you can do to maintain a clear and functioning voice. Not just to ensure a caffeine fix, but for all the ways we use our voices – to speak and sing, for our daily working lives and to connect with the people we love.

To use our voice, we rely on the delicate bands of muscle called vocal folds that stretch across our larynx. They’re only about two centimetres long and vibrate when air passes through them. On average they vibrate 220 times per second in women and 120 times per second in men or tens of thousands of times during half an hour of speaking or singing.

That’s a lot of work for such small muscles!

So it’s important we take care of them, but let’s first look at what can go wrong when we don’t.

Vocal nodules are the most common problem caused by continuous vocal abuse.

They are single, whitish lumps that develop on the edge of your vocal folds and prevent them from vibrating properly. The nodules create bulk on the vocal folds which disrupt their vibration pattern resulting in a lower speaking or singing pitch, hoarseness and lack of resonance.

People with vocal nodules often feel compelled to clear their throat, which further exacerbates the vocal abuse and they often report vocal fatigue as the day continues.

The good news is that vocal nodules are treatable through voice therapy with a speech pathologist. However, it’s important to seek help early as there is a greater chance of success when nodules are in their early stages.

Larger, more established nodules may require surgery, but it’s still important to seek voice therapy to resolve any vocally abusive behaviours and optimise your vocal technique.

So what are the abusive behaviours we often unwittingly inflict on our voice and how can we best take care of it? We’ve devised a list of Dos and Don’ts:

• Drink plenty of water
• Limit alcohol
• Avoid cigarette smoke
• Use clear articulation
• Use a variety of different sounds, including a low, slowed-down pitch and a louder, faster tone. Learn where emphasis and pause are needed when speaking and singing.
• Avoid foods that are high in acids especially before bed
• Avoid pollen and dust
• Laugh!
• Warm up before a singing performance or speaking presentation.
• Use amplification when speaking or singing to larger groups

• Clear your throat or cough excessively
• Use excessive tension in your jaw, throat and tongue
• Scream or use your voice at high volume for long periods
• Speak in the lower range for too long
• Sing or speak with an inflamed sore throat

At the top of each list are the two most important behaviours to keep in mind. It’s critical to keep hydrated, as lubrication of your vocal folds will prevent them from becoming irritated. Drink plenty of water to ensure adequate saliva. A dry mouth is common for singers and presenters, particularly due to nerves, but a good tip is to gently bite your tongue; this will help get your saliva going.

On the flipside, it’s best to avoid clearing your throat or coughing excessively, as it can irritate your vocal folds. Often throat clearing becomes habitual, so it’s important to break the habit and swallow your saliva instead.

Do you suffer from acid reflux?

Reflux is common amongst the general population and presents as two main types. Gastroesophageal reflux disease (GERD) is the flow of even very small amounts of stomach contents back up into your lower oesophagus (the tube connecting your throat to your stomach) and laryngopharyngeal reflux disease (LPRD) is where these stomach contents move up the oesophagus and overspill into the larynx (voicebox). LPRD is often linked to voice problems and may impact your speaking and singing voice.

Signs of LPRD may include: hoarseness in the morning, sour taste in the mouth, frequent coughing or throat clearing, voice quality issues, burning in the larynx or choking. Some people may have LPRD but complain of no symptoms.

Ear Nose and Throat specialists can diagnose reflux by viewing your vocal folds and larynx.

Treatment options may include a behavioural, pharmacological or surgical approach. The latter two are best managed by your doctor. Behavioural management facilitated through speech pathology sessions may involve:

• Remaining upright for one hour after eating or drinking
• Avoiding spicy foods
• Cutting down on caffeine, chocolate, high fat foods and alcohol
• Giving up smoking
• Wearing loose clothing around your abdomen.

Kathleen Connell is a Sydney-based singing teacher and vocal coach who trains both aspiring and accomplished singers in technique and vocal skills. She is a writer, PhD candidate at Griffith University and pursues regular professional development.

Lana McCarthy is a Sydney-based communication coach and speech pathologist. Lana can help you manage voice problems effectively for speaking and singing including tension, fatigue, hoarseness, nasality and vocal nodules.

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