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Tone and Resonance

Tone and Resonance

larynx

Singing is produced by the same anatomical structures.  Sound made by the vibration of the vocal cords as air from your lungs passes through

The vocal cords/folds) are two bands of elastic muscle tissue. They are located side by side in the voice box (larynx) just above the windpipe (trachea).  These membranes are fixed at one end, giving them a  V-shaped and open and close to allow for breathing and sound production.

 

Your larynx sits on top of your trachea (windpipe) and when you are silent, the cords remain open. They create an airway through which you breathe.

When you speak or sing, the vocal cords tighten up and move closer together. Air from the lungs is forced between them and makes them vibrate, producing the sound of our voice.

Vocal Cord

The frequency that your vocal cords vibrate will determine the pitch of your sound. They vibrate faster for higher-pitched sounds, slower for lower-pitched sounds.  Male vocal cords tend to be longer and thicker and vibrate slower within the larynx, giving the male voice a deeper, lower sound. Female vocal cords tend to be shorter, thinner and vibrate more quickly, giving the female voice a higher and lighter sound.

 

If the mechanism of singing is the same for everyone, why do singers sound so different to each other?

It is the tone and resonance of your voice that sets us apart.

Your vocal cords produce the sound wave, but the tone and resonance can be altered by manipulating the different structures of your vocal tract.

Each and every one of our bodies is unique.   We all look different to each other, we come in different shapes and sizes, different hair or eye colour etc, and the same applies to our insides.

With regards to singing, inside your head and throat, there are lots of wonderful shapes and cavities, such as the size and thickness of your vocal cords/fold, the length and shape of your throat, your tongue, soft palate, oral and nasal cavity, sinuses etc.   These all help shape and polish the sound wave before we exhale, thus creating our own unique tone (timbre). From an early age, when we first start to speak, we learn how to shape these sound waves to communicate.

As a singer it is about learning to place and polish each note so that is sounds good.

Facial MaskExperiment with different notes, and try placing them in different areas of your facial mask, pull faces as you try. Some will sound awful, but others will sound great, and this will all help improve the tonal qualities of your voice.

For example.  Try humming.   Feel where it is resonating inside your head.  Try a low note, then a higher note and feel the resonance shift inside your head.

Try playing on the the vowel sounds.

  • Ah as in Apple
  • Eh as in Air
  • Ay as in Sky
  • Oh as in Orange
  • Ee as in Bee
  • Oo as in Room

Different vowels will resonate differently for you.  Choose a comfortable note to begin with. Push the sounds around inside your head.   Move your tongue, purse your lips, open or close your mouth try squeezing the sound out of your ears or push it down to resonate in your chest.   How does it feel?  Does it sound nice?

Now try it on higher or lower notes.  Does it change for you?

Learning to balance all of the factors that go into your tone quality like breath support and control, stability, flexibility, and strength are important when creating a new sounds with your voice.  Working with a singing teacher or voice coach will allow you to explore your voice and will give you the tools you need to work on to developing your own tone and resonance.

 

Tone is what’s known as the colour or timbre of your singing voice. Every voice has a specific colour, which can be described as warm, dark, light or heavy . Two singers singing exactly the same notes will sound completely different to each other. The reason is tone.

Resonance is the amplification of the vibrations that create tone through and within your mouth, throat, sinuses and nasal passages. Large, full resonant tones are desirable in some styles of music but inappropriate in other styles.  In musical terms this is known as timbre.

Chiaroscuro timbre is a musical term that is used universally to refer to the balancing of the light or clear (chiaro) and dark (oscuro) aspects of timbre, or balancing tonal brilliance and depth of the resonance.

 

 

 

 

Voice Registers

Voice Registers

Voice register is a term used to describe the difference in tones produced by the human voice in varied ranges. People who sing may have noticed that they experience sensations in different parts of the body, depending on what range they sing in. This can be attributed to the presence of different vocal registers.

 

We have 3 main voice registers:

  • Head voice
  • Chest voice
  • Middle Voice

 

Head Voice

The higher register of the voice is known as head voice.  Singing in this register you feel the resonance more in the bones and cavities of your face and head.   Head voice is more associated with light, bright singing tones and is higher in pitch. 

Chest Voice

The lower register of the voice, or chest voice, is where our speaking voice occurs Singing in this register is usually accompanied by a resonance in your chest, hence the term.   Chest Voice is often associated with deep, warm, rich sounds and is lower in pitch.

Middle Voice

Our middle register is where we mix the elements of head and chest voice.  Think of it as altering the balance of treble and bass on your sound system to make it sound better. Each singer must learn how adjust their own levels of bright and dark tones, through resonance and blending of the vocal registers.

As we sing from low to high (or vice versa high to low), an untrained voice will experience notes which don’t resonate quite right.  Your voice may become weaker and thin sounding, or you may struggle to secure the frequency of your note (you may be slightly off key).  This is known as the bridge or break point. Also known as Passagio in classical singing.

 

How to master the break

Singing lessons will help you develop your middle voice.   Through vocal exercises, you will improve the tone and flexibility of your vocal cords/fold.  You will understand your chest and head voice registers and be able to connect the two as you increase your voice range. You will learn to adjust (mix) your voice to add the desired tone for what it is you are singing.  You may want to sing a high note, with a darker, more powerful resonance, or sing a low note with a brighter tone to it.

Vowel sounds will have an effect on your middle register.  Some vowels are narrow sounding and are easier to control in a head voice, whereas wider vowel sounds are easier to control in a chest voice.  By adjusting the tone and weight you put on these vowels will help you with mixing the middle voice.

The more in-tune you are with you register breaks, the better able the singer is at anticipating the need for vowel modification and attention to resonance. Much of this knowledge is gained simply by trial and error, and with the help of a teacher who understands different techniques to help ease these transitions.

 

Some more on Vocal Registers:

 

Whistle Register (also known as the flute register) is the highest vocal register, and is so called because the timbre of the notes that are produced from this register is similar to that of a whistle.  Whistle tones are created by covering the opening to the larynx/trachea with the epiglottis, allowing for air to escape through a very small hole.  In whistle register, only the front part of the vocal cords are vibrating together.  Whistle register, although very high, should be able to connect with your other registers.

 

Falsetto is a musical term for a male voice that’s artificially high. Falsetto means “artificial voice” and comes from the Italian word falso for “false.” 

Falsetto is where the vocal cords are not fully connected and adducting along their length, but have blown apart creating a Mickey Mouse sound.  You may be able to produce the same high notes of head voice or whistle register, but true falsetto will not connect with your other registers

The differences between whistle voice and falsetto can be difficult to hear, due to differences in tone between singers, that said in an exaggerated form it’s the difference between Mariah Carey hitting the highest note you can think of (whistle) and Neil Young’s highest notes (falsetto).  Though they are both in the higher register, whistle voice and falsetto are physically different actions of the vocal cords.

Positive Effects Of Singing

Positive Effects Of Singing

Whenever you sing, you’re not only just making a beautiful noise, you’re also improving your health and giving your body a total workout. The positive effects of singing, show it doesn’t matter what level you sing at, whether you sing in the car or a choir, science is proving that singing is good for your overall health.

Improve Your Posture

It’s hard to sing while slouched in a chair, so standing or sitting upright while singing will help straighten your back and shoulders, allowing your chest to expand.  You will naturally pull your tummy muscles in and will tend to lift your head to look forward (when not looking down at your words!)   You’ll find you’ll relax more too.

Healthy Lungs

Singing makes you breathe more deeply so you take in more oxygen.  This in turn will improve your aerobic capacity and release muscle tension.  Breathing from your diaphragm may also help ease chest conditions such as asthma or COPD.  The British Lung Foundation offer singing groups around the UK to help people living with long-term lung conditions. British Lung Foundation Singing For Health.

Boost Brain Power

Music and Singing have been shown to increase brain activity.  It increases your concentration and helps improve your memory.   Over time, your brain will learn to perform more tasks simultaneously without getting overloaded, and you’ll remember information longer.   The Alzheimer’s Society has even established a “Singing for the Brain” service to help people with dementia and Alzheimer’s maintain their memories.

Get An Oxytocin High

Singing in a group such as a choir produces the happy hormone Oxytocin. Oxytocin also enhances feelings of trust and bonding, which may explain why still more studies have found that singing lessens feelings of depression and loneliness.

Reduces Your Blood Pressure

Doctors have found that belting out a song can dramatically lower your blood pressure, even where medication has failed.

Toned Abs

Your abdominal and intercostal muscles are all toned by singing.

Energise Yourself

Singing can be an excellent form of exercise. Even if you’re healthy, your lungs will get a workout as you employ proper singing techniques and vocal projections. As well as the feel-good hormones being released into your system, there will be more oxygen in your blood, leaving you feel energised and uplifted.  You will move around a lot more improving your exercise levels for the day too.  This can help increase your fitness levels and your stamina.

Banish Anxiety and boost your confidence

Singing is good for your mental health.  As well as increasing your oxygen levels, releasing happy hormones,  and giving you a physical work-out, it will de-stress you too by reducing stress hormones such as cortisol.  Singing in a non-pressured environment, such as singing in the shower, your local choir or a fun karaoke session will contribute to a sense of belonging, and will increase in your confidence.   When you’ve had a bad day and you sing along to some of your favourite songs, it doesn’t take long for you to forget your troubles and lose yourself in the music.  If you join a choir or singing group, you’ll also make new friends.

Boost Your Immune System

Studies of people singing in choirs have shown that singing for an hour was associated with significant reductions in stress hormones, such as cortisol, and increases quantities of antibodies, known as Immunoglobulin A of which can boost the body’s ability to fight serious illness.

Helps with sleep

As well as relaxing you, experts believe singing can help strengthen throat and palate muscles, which helps stop snoring and sleep apnoea.

Leaves you feeling younger

Sing makes you feel good.  You’ll have more energy and better health.  You’re going to feel so much younger.

More about singing here

Scales and Vocal Exercises

Scales and vocal exercises

Singing exercises will improve the strength, flexibility and stamina of your vocal cords.  We have included a few here that will help, but they don’t replace advice from your own vocal coach/singing teacher/choir leader.

We use a combination of consonant and vowel sounds when using vocal exercises.

The main vowels sounds in singing are:

Ah as in Apple

Eh as in Air

Ay as in Sky

Oh as in Orange

Ee as in Bee

Oo as in Room

Consonants

Consonants can be hard or soft sounding.    Soft consonant sounds examples are: F, L, M W.  Hard consonant sounds examples are G, H, T and Y.

Combining consonant sounds with our vowels sounds can help improve your singing.   For example the ‘L’ consonant, mixed with the Ah sound – giving us La, La La La La … is using the tongue muscle as well as your vocal cord muscles.   It’s a good consonant vowel combination to start learning with.

 

Try the following exercises in the following sounds to begin with

La

Law

Lie

Leh

Lee 

Loo

 

Singing Exercise No1 – 5th and Octave

High Voice Range

Middle Voice Range

Low Voice Range

Singing Exercise No2 – Chromatic Scale

High Voice Range

Middle Voice Range

Low Voice Range

Singing Exercise No3 – Thirds

High Voice Range

Middle Voice Range

Low Voice Range

Singing Exercise No4 – Arpeggio

High Voice Range

Middle Voice Range

Low Voice Range

Singing Exercise No5 – 12 Tone

High Voice Range

Middle Voice Range

Low Voice Range

As you progress with these exercises, start swapping the consonant sounds

eg

Wah, War, Why, Weh, Wee, Woo or Mah, Maw, My, Meh, Mee, Moo etc.  Try them on just the vowel sounds too:   Ah, Eh, AyeOh, Ee, Oo

Vocal Exercises

The Voice And Ageing

The Voice & Ageing

By Sara Harris, Speech and Language Therapist specialised in Voice Disorders.

voice-and-ageing

How do we change with ageing?


Ageing is natural and affects us all. People’s voices do change with age, but the age at which these changes become noticeable is very variable, and many people weather ageing extremely well. The older voice is different from that of youth, but it also reflects the wisdom and rich experience of a lifetime.

 

Ageing and the body


Ageing changes occur throughout the body and may affect us in many ways. These general body changes can and do affect our voices adversely.

Joints and bones
Joints stiffen so that movement is restricted and often painful. The spine loses flexibility altering our posture. This can affect how the larynx is suspended from the skull and can also impact on free movement of the ribcage, making breathing more difficult.

Bones become brittle and break more easily if we fall. Breaks in the arm, wrist or hip are particularly common as we get older and take longer to heal making it hard for us to get out and about, exercise and socialise.

Muscles
Muscles weaken and lose tone, becoming thin and stringy. We notice we have less stamina and are not as strong as we once were. This loss of muscle tone may directly affect the muscles in and around the voice box (the laryngeal muscles). It also contributes to changes in general body posture. Injuries or other medical conditions may mean long periods of inactivity, which also result in loss of muscle tone.

Hearing
Our hearing deteriorates as we get older. From middle age many of us start to notice that we cannot make out what is being said against background noise. This is because the higher frequencies are lost, making sounds like “s” “sh” and “f” hard to discriminate.

If hearing is more severely affected we may find it is hard to monitor the clarity of our speech. Certain sounds may be omitted or run together making us sound slurred or muffled.

Even if our own hearing survives well, that of our nearest and dearest may not. We may have to shout to make ourselves heard and this can irritate our voices making us hoarse.

Teeth
It is important to keep up regular dental checks. Our gums tend to recede with ageing and teeth may become loose and need removing. Missing teeth or dentures that do not fit well affect the articulation of speech, making it less clear.

Breathing (the respiratory system)
The lungs lose capacity with ageing, making us more breathless. Our vocal folds rely on a steady air stream to vibrate them effectively, so speech may become effortful and we may notice we run out of breath before the ends of phrases.

The digestive system
The digestive system slows down and is less efficient. Disorders such as diverticulitis and hiatus hernia are more common in older people causing abdominal pain or increasing the risk of acid reflux. Abdominal pain can affect the way we control breathing for speech or singing, while acid reflux can irritate the throat and gullet.

Occasionally, acid from the stomach manages to spill over into the larynx causing violent coughing and irritation of the delicate membranes of the vocal folds and larynx. Even the threat of overspill is often enough to cause the larynx to rise and constrict in order to protect the airway.

The neurological system
The neurological input to our muscles changes with ageing. The overall number of nerves we have reduces and the spinal cord and brain shrink. The number of muscle motor pools is also reduced.

A motor pool consists of all the motor nerves that serve (innervate) a single muscle. The motor nerves (neurones) are the nerves that carry electrical impulses from the brain to the muscles, preparing them for movement. Every muscle fibre is innervated by a motor neurone; however, each motor neurone may innervate several muscle fibres.  As these diminish with age our fine movements, coordination and balance are likely to suffer.

This may affect swallowing, making it less coordinate so we are more likely to choke. Any food or drink that ‘goes the wrong way’ and gets into the larynx will cause paroxysmal coughing and irritation of the vocal folds.

It may also directly affect our speech in that movements of the tongue, palate and lips may slow down making speech less clear. We may also develop a tremor that affects the head, neck and voice as well as our limbs.

The brain
The brain also ages, causing it to shrink as it loses nerve cells. Most of us will notice some changes in our memories. We begin to forget things more easily, especially words and people’s names. While this is unlikely to affect our voices directly, these changes may affect our confidence in our ability to communicate easily with other. Conversation is a skill and we need to keep in practice!

 

Ageing and the voice


Normal vocal folds, closed
Normal vocal folds, closed (Photo: Tom Harris)

Bowing vocal folds with false fold recruitment
Bowing vocal folds with false fold recruitment (Photo: Nicholas Gibbins)

Bowing vocal
Bowing vocal folds in phonation (Photo: Nicholas Gibbins)

Our voices, as well as our bodies, alter over time. The most obvious change comes in boys at puberty when the larynx and vocal folds undergo a growth spurt. As the larynx grows, the vocal folds become longer and thicker and the pitch of the voice drops.

Both sexes are likely to notice some lowering of vocal pitch during middle age. Gravity causes the larynx to drop in the neck altering the distance from the vocal folds to the mouth (the vocal tract). The increase in vocal tract length alters its resonant features enhancing lower frequencies so the voice sounds lower.

Towards the end of middle age ageing changes begin to affect men and women differently. In women, the hormonal changes associated with menopause alter the vocal folds in a number of ways. They become stiffer and slightly thickened/swollen. The number of glands producing the mucus that lubricates them reduces, causing dryness, while the quality of the mucus alters becoming thicker and more difficult to clear. These vocal fold changes will significantly lower the pitch of the voice and the vocal quality will be rougher and breathier.
Men are more likely to notice that the vocal pitch rises after middle age. The vocal folds tend to lose their bulk becoming thinner and stiffer. They may lose their straight edges, so that when they close in the midline they no longer meet. A spindle-shaped gap develops between them, through which breath can escape, making the voice sound weak and breathy. This condition is usually referred to by doctors as “presbylarynx” “bowing vocal folds” or “glottic insufficiency”. Although presbylarynx is most common in elderly men, it can also occur in women in their later years.

Presbylarynx leads to a higher, often unstable vocal pitch that may yodel into falsetto. Occasionally two notes can be heard if falsetto and the normal lower voice are produced together (diplophonia). This instability of vocal pitch is most likely to occur when the volume/loudness is increased. The weak, breathy voice is harder to maintain and is physically effortful. Speaking is more tiring and may feel uncomfortable and strained. Changes in the neurological system may result in a tremor which will make the voice sound shaky, tight and strained.

The laryngeal cartilages calcify with ageing and the cricoarytenoid joints involved in opening and closing the vocal folds become stiffer. This may make it harder to close the vocal folds at the back (posteriorly), leaving a gap between the arytenoid cartilages through which breath can escape. Loss of fat and thinning of the vocal tissues may also cause a gap to develop at the front (anteriorly). This may also cause a breathier vocal quality and higher notes to ‘cut out’ in singing.

For most of us, these changes are gradual and never become severe enough to significantly affect our ability to communicate. Some people, however, are not so lucky. For them the deterioration associated with ageing occurs early and does impact on their communication and social activities. When this happens help is needed.

 

My voice has changed, what should I do?


Unfortunately many of the vocal changes associated with ageing also occur with other medical conditions. It is therefore important to eliminate any other cause before assuming any hoarseness/vocal change is due to ageing.

In order to do this you will need to see your GP and ask for a referral to an ENT surgeon or preferably a voice clinic. The general ENT surgeon can give you a general examination of ears, nose and throat, including the vocal cords. They can organise a hearing test and, if it is required, arrange for you to have a hearing aid. They can also refer you to your local speech and language therapist. However, he/she may not have access to the specialist equipment that is needed to see small vocal fold defects, such as scars, that may be altering the voice quality. The general ENT surgeon may not have a special interest in voice or be familiar with the ways in which voice production can cause hoarseness.

Voice clinics, on the other hand, are staffed by voice specialist ENT surgeons and speech and language therapists (SLT), and may have support from other related professionals, such as singing voice coaches or voice specialist osteopaths or physiotherapists. The clinic will have specialist equipment available to rule out the presence of any small or hidden vocal fold problems and the clinic team will be able to identify any ineffective patterns of voice use.

The multidisciplinary voice clinic has a holistic approach to diagnosis and usually offers longer appointments for new patient assessments. This makes it easier to identify patients with other contributing medical conditions such as neurological conditions, chest disease or gut problems. They can then be referred to the appropriate speciality for further assessment/treatment.

 

Treatment


Bowing vocal folds following injection

Glottic incompetance following injection adduction (Photo: Nicholas Gibbins)

Often vocal changes from ageing respond well to voice therapy. The voice clinic SLT will arrange this and monitor the outcome. In some cases of presbylarynx, voice therapy alone is not enough. The ENT surgeon may then offer surgical intervention. The vocal folds can be injected with fat (or some other medically appropriate filler) to increase their bulk so they are able to meet fully in the midline again. This is usually known as a ‘vocal fold augmentation injection’ or occasionally as a ‘voice lift’. The voice is usually lower and louder following the injection and the stamina improves but it may remain a little hoarse in quality.

What can we do to keep our voices good?


It is a case of ‘use it or lose it’. We need to exercise out voices just as we would any other muscle. This can be difficult for older people who may have few social contacts. They may need to be encouraged to keep using their voices and to find new ways to socialise.

We should all make the effort to see or telephone friends and relatives regularly and to talk to people in shops or on the bus when we are out. Even talking to the dog, the cat or yourself will help!

  • Try starting the day with a vocal warm up.
  • Singing has been shown to be effective in keeping the voice working well and improving wellbeing. Consider taking lessons or joining a choir. You can search online to find choirs in your area, and many do not require you to read music or audition for a place. If you don’t have access to a computer, ask in the local library and the librarian should be able to help you find one.
  • Make sure you exercise regularly – this helps keep you stronger, more flexible and improves your breathing and posture. Walking, swimming and cycling are great ways to exercise, or join a local Tai Chi, Yoga or Pilates class.
  • Make sure you eat a healthy and varied diet and try to keep your weight right for your height.
  • Keep well hydrated – eight glasses of water a day is usually recommended in addition to any teas/coffees you may drink. It helps to cut down on caffeine, too.
  • If you smoke, ask your GP for help to give up. Smoking is like taking sandpaper to your voice and puts you at higher risk of cancer of the lungs and airway.
  • Keep alcohol to a minimum. It is irritating to the membranes of the mouth, throat, gullet and stomach. It may contribute to acid reflux and it also has an adverse effect on your brain and neurology.
  • Keep mentally active. Reading the papers, doing crosswords, puzzles and games like Scrabble all help keep your mind active and your vocabulary from shrinking.
  • Make sure your hearing has been checked and use your hearing aid if you have one. It helps you monitor your speech so the articulation stays clear. It is frustrating to have to say things twice!

Although we cannot stop the ravages of time, we can all improve our physical and vocal health by following the simple guidelines above and improving our lifestyles. We are likely to feel fitter and happier as a result.

 

With thanks to: Kristine Carroll-Porczynski, Jackie Ellis, Sophie Harris, Tom Harris and John Rubin for their editing skills and to Nick Gibbins and Tom Harris for the photographs.

 

USEFUL REFERENCES:

  1. CELLULAR AND MOLECULAR MECHANICS OF AGEING OF THE VOCAL FOLD
    Leslie T. Malmgren. In: Professional Voice: the art and science of clinical care. Volume 1: basic science and clinical assessment. Chapter 11: P 205: Ed. Robert Thayer Sataloff, Plural Publishing, 2005
  2. THE VOICE AND AGEING
    American Academy of Otolaryngology-Head and Neck Surgery. Patient Health Information at: www.entnet.org/content/voice-and-aging
  3. THE EFFECT OF MUSIC THERAPY ON MOOD, SPEECH AND SINGING IN PEOPLE WITH PARKINSON’S DISEASE – A FEASIBILITY STUDY
    Elefant C, Baker FA, Lotan M Lagesen SK, Skeie GO. Journal of Music Therapy, 49(3):278-302, 2012
  4. THE INFLUENCE OF GROUP SINGING THERAPY ON THE BEHAVIOUR OF ALZHEIMER’S DISEASE PATIENTS
    Kristine A. Olderog Millard and Jeffrey M. Smith J Music Therapy (1989) 26 (2): 58-70
  5. CRACKING THE VOICE – WHAT REALLY HAPPENS WHEN A SINGING VOICE GETS OLD?
    Justin Davidson, New York Magazine, October 6th 2016 (see also the hard copy edition of 2nd October 2016)
  6. THIS IS A VOICE
    Jeremy Fisher and Gillyanne Kayes. The Wellcome Collection, 2016, wellcomecollection.org
  7. VOCAL WARM UP: PUT YOUR BEST VOICE FORWARD
    American Academy of Otolaryngology-Head and neck surgery. Patient health information at: www.entnet.org/content/vocal-warmup-put-your-best-voice-forward

 

This information is intended for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner. 

http://www.britishvoiceassociation.org.uk/

Vocal Nodule

Vocal Nodule

A Vocal nodule develops as the result of repeated trauma to the vocal chords.  An example would be if you wear shoes too tight, they are going to rub , get sore and eventually will cause a blister or callous. With regards to your vocal chords, a small, soft swelling will develop at the site of the trauma, and this could interfere with the closure and vibration of the vocal chords causing hoarseness.

Signs and Symptoms

Symptoms of a vocal nodule may include: the voice may become husky and less responsive over a certain pitch range, losing clarity and brightness.  The voice may be slow to warm-up and may sound deeper, weaker and more breathy, particularly in the upper range.  The voice may also start to cut out around certain notes.   Over time this may lead to the speaking voice becoming more noticeably hoarse and breathy.

A soft nodule can usually be treated successfully with vocal rest, voice therapy and good vocal care. A singing teacher or speech therapist can help you with your voice technique, and provide you with carefully targeted exercises to ensure your voice muscles are used effectively, and how you can use vocal care to prevent them from returning

If soft nodules are ignored, then more persistent damage may produce more fibrous scar tissue, which is often referred to as a hard nodule.  A Hard nodule doesn’t respond well to voice therapy and may require surgery.

If you think you are experiencing symptoms of nodules, please don’t ignore them.  The sooner you seek treatment, the better the result.  Speak to your GP about it.  The may suggest voice rest, or seek out voice exercises/technique from a singing teacher or vocal coach.  If your symptoms are more severe, then you may refer you to the local ENT department for further investigation.

In the past surgical outcome for vocal nodules was poor giving nodules the reputation of being the end of your career. However, surgical techniques have changed considerably recently, allowing most vocal nodules to be removed safely and effectively.

Vocal nodule (s) are a nuisance, but don’t beat yourself up about it.  If diagnosed early, then you can work at what caused them and how you can prevent them coming back:

Some self-help techniques to help prevent developing a nodule:

Avoid shouting and whispering

Try not to cough or persistently clear your throat

Keep your body well hydrated and avoid irritants such as smoke

Inhaling steam can help soothe irritated chords.

If you are singer, always warm-up  your voice before you start singing, and don’t sing too loud or too quiet for any length of time.

Listen to your voice.  If it starts sounding croaky, or begins to feel tired or sore, then you are probably overdoing it, so take a break.

Rest your voice whenever possible.

This information is intended for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.