Abby Barnes, M.S., CCC-SLP
Did you know that your vocal cords are actually a muscle? They’re quite small, too–only about 1.25 to 2.5 centimeters. It’s amazing how something so small can play such a large role in our body.
Vocal cords are sometimes called your vocal folds or “voicebox.” They are the tissue in the larynx that moves to create voice. Just like any other muscle in the body, we should be mindful of how we use our vocal cords and take steps to keep them functioning well.
Some injuries to vocal folds aren’t within your control. But other injuries are preventable, as long as you know how to care for your voice holistically. This article explains how the vocal cords work, how to take care of your voice, and the signs of damaged vocal cords. We also explain how speech therapy can help your vocal cords if needed.
How do the vocal cords work?
Your vocal cords are within your larynx, at the top of your airway. They vibrate in your airstream to create sound and produce your voice. They remain open when we inhale to allow us to breathe, and they close to produce voice and to protect the airway during swallowing.
What causes vocal cord damage?
Anything that prevents or disrupts your vocal fold movement can cause vocal cord dysfunction or a voice disorder. There are many factors that can interfere with this normal function. Some of them are within our control, and others aren’t.
It’s important to note that voice disorders can carry a stigma, especially among performers and other professional voice users. Any blame placed on the singer or speaker is harmful and unfair, and it can prevent people from seeking timely medical attention and support. If you are experiencing pain or tension with vocalizing, your experience is valid and real. It’s important to prioritize getting the care you need! Let’s take a look at some common causes of vocal cord injury:
Vocal abuse
Vocal abuse is any type of behavior that can strain, harm, or injure your vocal folds. This might be excessive talking or screaming, inhaling irritants, smoking, coughing, or clearing your throat. Vocal abuse can cause nodules, polyps, or other growths to form on your vocal folds, which can change how your voice sounds and affect your voice quality and function.
You may not realize these behaviors can cause vocal injury, but as you learn more about taking care of your voice, you’ll be better equipped to prevent vocal cord damage!
Abnormal growths
Some people develop extra tissue on their vocal folds that can affect vocal cord function. As mentioned above, these growths can be caused by vocal abuse, but also by injury, cancer, or illness. They can take many forms, including nodules, polyps, cysts, papillomas, lesions, and more.
Nerve problems
Your central nervous system controls your voice and swallowing abilities. There are several health conditions that can affect these nerves, including multiple sclerosis, Huntington's disease, Parkinson's disease, or amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease).
Inflammation and swelling
When your vocal cords become inflamed, it can affect your natural airflow. Inflammation and swelling of the vocal folds can be caused by surgery, respiratory illness, allergies, smoking, vocal abuse, substance abuse, and more.
Hormones
Voice disorders can be caused by disorders that affect your hormones, including thyroid hormones and growth hormones.
What are the signs of damaged vocal cords?
Some common symptoms that may point to a vocal cord injury include:
Pain or tightness in the throat
Running out of air while speaking
A strained, hoarse, or tired-sounding voice
Difficulty projecting your voice
Reduced vocal range
Periods of vocal aphonia (times when you can’t speak at all)
If you notice any changes in the sound or feeling of your voice, you may want to seek care from an otolaryngologist, also known as an ear, nose, and throat (ENT) doctor. The otolaryngologist can help determine what’s causing the problem. If you have any of these symptoms and they don’t get better after two weeks, it’s important to seek a diagnosis.
How do you fix damaged vocal cords and heal your voice?
After you see an otolaryngologist, working with a certified speech therapist will likely be the next step in fixing vocal cord damage. You will want to find a speech therapist who specializes in voice treatment. Your speech therapist will start by conducting a voice evaluation. This includes a review of any laryngoscopic exam results and measurement of your voice and airflow in order to determine the right treatment plan for your vocal recovery. The voice therapist may give you exercises to complete right away to offer some immediate relief. Voice therapy will teach you about vocal health and hygiene, along with techniques and tools to help you speak and/or sing in a healthy, efficient way. Therapy sessions will include exercises to help heal your voice and prevent further vocal injury. The speech therapist may offer guidance on posture, breathing, and reducing tension in your upper body, if needed. Above all, you’ll learn vocal techniques that can be carried over and used in your everyday speaking or singing.
How can you protect your voice?
Practicing good vocal hygiene can help maintain healthy vocal cords and, therefore, a healthy voice. Here are some ways you can take protect and take care of your voice:
Stay hydrated. Hydration is essential for vocal fold functioning. It helps lubricate and protect your vocal fold tissues. Be sure to drink plenty of healthy fluids like water throughout the day.
Treat dry mouth or dry throat. If you have a dry mouth or dry throat, try using a humidifier or steamer. Drink more water, and decrease your use of antihistamines and mint. Check any medications you take for possible drying effects. If your dry mouth is severe, or does not go away with these simple changes, speak with a medical professional.
Be aware of your breathing. The breath is to the voice as gas is to a car. The breath turns the voice on! Be sure to take replenishing breaths as you speak. Try to avoid speaking on “empty air” at the very end of your breath. In addition, try to breathe in through the nose rather than the mouth. Breathing in through the nasal passages cleans and moistens the air before it reaches your vocal cords, and it can help with dry mouth as well.
Avoid speaking in noisy environments. Instead, try using nonverbal forms of communication, such as hand gestures or facial expressions. Or use proper amplification to increase the volume of your voice, such as a microphone.
Take time to rest. Include vocal rest in your daily routine. At least 10 minutes of vocal rest (not using your voice) per one hour of speaking or voice use is recommended.
Treat allergies or reflux disease. If you clear your throat often or suffer from a chronic cough, these could be signs of allergies or reflux disease. See your doctor to get to the root cause. If you have acid reflux, try these dietary and lifestyle changes to see if your voice quality improves!
Practice speaking with less vocal effort. This could mean lowering the volume of your voice, or trying not to “push” your voice out but rather speaking with ease.
Try to avoid exposure to allergens, toxins, or smoke in your environment. Anything you inhale touches your vocal cords!
Take care of your whole mind and body. If you’re dealing with chronic stress, you could be holding tension in your body, which will carry over to your neck and throat muscles. And when you’re feeling tired, your voice feels fatigued, too. This might lead you to “push” your voice out with increased vocal effort. Explore ways to reduce your stress and improve your health, such as developing an exercise routine, getting plenty of sleep, and eating a diet rich in hydrating fruits and vegetables, antioxidants, and whole foods.
Prepare before speaking or singing for a long amount of time. If you know you’re going to be speaking or singing for awhile, it may be useful to complete a vocal warm-up and cool-down before and after the vocal activity. You can explore vocal exercises with lip trills, tongue trills, or humming with pitch glides. Straw phonation is a great exercise for preventing and combating vocal fatigue.
Don’t hesitate to reach out to us here at Expressable if you have questions about treatment for damaged vocal cords. You can schedule a free consult call and speak to one of our licensed speech therapists anytime!
