Vocal Injury

Thursday, March 21, 2019 by Rebekah Keogh | Uncategorized

Dancers, and athletes injure themselves on the job all the time and have a team of people ready to rehabilitate them. But what about singers? Well, we injure ourselves too! It is not uncommon to end up with a vocal injury but we often don't do anything about it out of fear of being judged or being worried we are over reacting. There are qualified professionals who are there to help us when we need it. Trust your gut and if you think something is wrong go to your GP and tell them your concerns. They will refer you to the right person when the time comes. 

Last year I struggled on and off with hoarseness having been out socialising in noisy pub environments where I was pushing my voice to be heard. Singing actually wasn’t an issue, although the two combined along with a busy teaching schedule, taking very few breaks, and working long days, didn’t help. Winter then gifted me with laryngitis on top of all this so I went to my GP and asked to be referred to a laryngologist for a stroboscopy.


A stroboscopy is basically where they put a camera down your throat and take a short video of your vocal folds in action. I had a rigid scope done (one that goes straight into your mouth) but it is  possible to get it done with a flexible scope too (one that goes up your nose and down your throat) This will give you a clear image of the vocal folds, meaning you are less likely to miss something due to bad visibility.


It turned out I had pre nodular edema (swelling of the vocal folds). Which can be caused by a number of things including; overworking your voice, illness, stress, fatigue, poor hydration, smoking, allergies and coughing to name but a few. Below is a screen grab of the actually footage taken of my vocal folds where you can see the swelling in the centre of the vocal folds. They shouldn't have a gap above and below the swollen bit.


In Reena Guptas article ‘Bad Technique and Vocal Injury’ she talks about this, saying that the most common cause of vocal injury is caused by upper respiratory tract infections. Where the vocal folds become swollen and then the person talking, or singing with the swollen vocal folds can cause bruising. She also talks about ‘vocal perfect storm’, which is where a number of things combined lead to vocal injury. You can read her article here: https://www.ohniww.org/bad-technique-and-vocal-injury/


Once I had this information I was able to make a vocal recovery plan. I cut back on talking A LOT over December and even ordered a badge for when I go out which says ‘I’m on vocal rest’, (so people don’t think I’m just antisocial). In January I reduced my teaching hours and added more breaks and made an appointment with an SLT (Speech Language Therapist) who would help me find a better way to use my speaking voice, especially in noisy environments. 


Thanks to the help of my laryngologist and SLT I now have a clear picture of what changes need to be made to get my voice to a healthier place. Coincidentally I went to a jazz gig the night before my first appointment where I was chatting away for the night unaware that I would wake up hoarse again. So we focused on reducing extrinsic muscle tension which was contributing to my hoarseness. I was amazed how my voice lifted from a dulled husky sound to a freer brighter tone after just a few minutes of working on the throat and neck area. She is trained to do this, but she was able to give me some exercises that I could do at home in between appointments.


If you think you may have a vocal injury, go to your GP and ask them to refer you to a laryngologist.


Keep an eye on my blog for updates on my vocal recovery journey. Happy and healthy singing!


Useful links;

Stroboscopy video (Singing Vocal Folds);

https://www.youtube.com/watch?v=-XGds2GAvGQ&t=112s