Vocal Pathology

What happens when someone gets a “nodule”? What is a “polyp”? How can your voice be “ruined”? What happens when someone’s voice gets “damaged”?

There has been much ado lately about injured singers. Adele, age 23, is currently more successful than Justin Bieber and Lady Gaga combined. She is expected to sweep the Grammy’s and has recently become famous for her cancellation of her tour due to her vocal problems. She had surgery, I believe in Boston, and is now about to go on live TV at the Grammy Broadcast so we can all hear how her vocal folds have healed up.

Since this young woman seems very talented and has a great instrument, how is it that she got into such trouble?

One likely reason is that she taught herself to sing. She may have had absolutely no idea about vocal production or vocal ability, which is not at all unusual in someone who is abundantly talented and can “just do it”. Since she was not alone in this, and since other famous singers have recently had vocal problems that were well publicized, one can only hope that vocalists of all persuasions finally understand that training is a necessity if you intend to have a high-level, high-pressure career. AND, you need to have management that understands what healthy singing is, and what it takes to maintain it because if you do not the way your career is handled can be as much of a problem to overcome as is the actual singing.

As singing has become more and more demanding over the years, with expectations rising along with the glamour and the money, singers have been pressed to keep up with all sorts of things that can impact performance. The things that can derail a young vocalist who has not yet learned how to pace herself are many. Too much rehearsal, too much loud or full-out singing, poor acoustics, too much volume from the band, a bad monitor, an unskilled sound technician, not enough fluids, too much acid food, eating too late at night, allergies, environmental factors like dust and dryness, chemicals in the air, and physical fatigue or lack of sleep. Prescription drugs for other conditions one might have, and, first and foremost, lack of training and skill to sing with the least amount of stress possible.

If the music is too high or too low, if it is very emotionally wrenching, if it is complex, if it is poorly arranged, if it has many repetitive phrases or if it is just plain demanding, or if the vocalist has to dance while singing, it can cause vocal problems. If the vocalist is also talking a lot in between performances (to the musicians, the tour management people, family members, the press and fans) or has little down time to be quiet, vocal problems are more likely.

If singers could see what really severe damage does to the vocal folds and understand that not all vocal fold issues “just go away” even with the highest level of care and attention from medical and clinical professionals, or singing teachers, they might be frightened enough to be careful. They may not realize that in addition to allowing them to speak and sing, the vocal folds are responsible for protecting their lungs from foreign bodies and for helping the body do strenuous tasks. If the vocal folds do not close firmly, it is hard to lift something heavy, to do vigorous exercise or to climb the stairs.

The vocal folds are VERY small. Every sound we ever make has to come from these two small ligaments stretched across the trachea in the larynx, which is cartilage and can be damaged in an accident, can become arthritic, can become dislocated or can gradually be squeezed or immobilized over time from various causes. There are all kinds of ways the vocal folds can become “unhealthy” and many illnesses that can effect them including throat cancer and thyroid illnesses, pulmonary diseases, and various kinds of partial or full paralysis of one or both folds.

A voice that does not have healthy vocal folds is damaged. If the damage is severe enough and cannot be remedied the voice can be ruined. A nodule is usually from wrong use, and often affects both folds so that there are two nodules. A polyp can occur from a “one time only” event like a severe sneeze or cough or from many other causes. There are cysts and other growths that can be biological and hormonal changes can effect the folds as well. All of these things interfere with normal vocal fold function. The voice just doesn’t do what it needs to do. It feels and sounds “off” or “bad”.

In fact it is miraculous that most of the time, most people’s voices work well for their entire lives and do the things that voices need to do without problem or issue. When one sings professionally, however, the ante goes up radically and the responsibility for the artist to know what’s what goes up just as much. If you teach singing and you do not yourself really know what vocal health is and how healthy vocal folds operate, you must educate yourself. You owe your students nothing less. There may come a time when you are the first person to hear “something wrong” in someone’s sound and sending them for evaluation by a qualified throat specialist could even save their life.

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2 thoughts on “Vocal Pathology”

  1. I find your comments here helpful and would like to understand more about preserving the voice when coaching students in CCM. I am classically trained and teach classic technique, but have been more and more to teach students in high school musical theater productions. The chance of contributing to damaging these young singers is one of my fears. I’d love to hear more specifically how to teach CCM safely.

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