Don't Ignore Vocal Strain

In 2016, I was at the 6th Annual Healthy Approaches in the Training of Performing Artists Conference at Chapman University, where educators and practitioners share strategies across a two-day symposium. One such presenter was Dr. Reena Gupta, Center for Vocal Health in Beverly Hills. Armed with detailed slides, Dr. Gupta ran through the basics of vocal injury. She went into visual detail on those dreaded polyps, essentially blood clotting on the vocal cords. Lots of tiny blood vessels line the vocal folds. Shearing forces can cause those vessels to erupt. With blood comes clotting. Apparently, there are two stages to this process: first, clotted blood gets walled off from the vocal cords and then, if that doesn't resolve, a polyp forms as a more permanent barrier. What struck me about Dr. Gupta's talk is that she warned you can't always hear this injury as it forms. But, she also said that the best way to detect an injury is to ask the singer. They'll know if they're compensating, working around the clotting or pushing through it. This tells me you know if you've got vocal injuries and Dr. Gupta warns not to do that. Any minor injury should resolve that same day, but if it persists for more than week, that's a sign of trouble. You'll also hear abnormalities in your speaking voice, experience vocal fatigue, or a hiss of air before you vocalize. Injuries, she says, are most common in the 20s. In fact, it's important to know that your vocal cords dissipate and your body loses resilience in your 20s. If you notice problems, her advice is not to stop the intensity of your training, but to respect your body more. And pay attention to your overall vocal consumption, including intensity, duration, frequency and technique. The earlier you seek treatment, the better off you are. Injuries are almost always reversible in the first week, but by the third, it becomes difficult. When looking for treatment, Dr. Gupta notes there are different types of voice doctors. Anyone who sings or speaks professionally, or plans to do so, should see a laryngologist, not an ear, nose and throat specialist. She also recommends a rigid Videostroboscopy so both doctor and patient can see the vocal cords at the same time and in greater detail. Lastly, unlike others, Dr. Gupta blames demand over technique for vocal cord injuries, along with ignorance. She says all too often singers ignore it.