Diagnosing Damage

by Mark Baxter

Bumps and bruises, aches and pains are common occurrences for those of us who use our muscles with passion. Whether you’re an athlete or a singer, strength and conditioning allow professionals to rebound quickly, along with a host of experts to

accurately diagnose a problem. This is why it is important for every singer to exercise their voice and make occasional pit stops into a doctor’s office. There are career-altering differences between a bump, a bruise, a rupture, and swelling when it comes to the muscles of the larynx.

What doctors observe most is swelling or edema. Friction from singing too hard makes your vocal folds enlarge and sound hoarse. This is called laryngitis. A little swelling is okay. You should become concerned, though, if the condition does not dissipate by three o’clock the following afternoon. If you’re rolling your eyes because your voice is always hoarse (or maybe because you’re never awake by 3PM), you should inform your doctor that you are suffering from chronic laryngitis. This may be a symptom of allergies, respiratory infection, acid reflux, or vocal abuse, but - more importantly - it sets the stage for bigger problems. I understand that many of you like to sing with force. Just be aware of the difference between sounding dangerous and being a danger to yourself.

The next level of damage is a hematoma, or bruise, on the edge of the fold. If a doctor warns you that your folds appear very red, it’s time to take the warm-up and warm-down routines seriously. You’ll notice a big reduction in flexibility (range) and control (pitch) when your folds are bruised. Do not ignore this condition. If you continue to irritate the area, a lesion (bump) will develop which may possibly require surgery. A vocal nodule, or node, is basically a callus (think of the tip of a guitar player’s finger) that interferes with the functions of the voice. If caught in time, therapy can reverse them. If you opt for surgery, however, just remember that an operation does not remove the offending behavior. Another type of growth is a polyp, which can turn up anywhere inside your mouth, nose and throat but only cause problems when they block a sinus or form directly on a vocal fold. Although it’s hard to pinpoint their cause, early detection is always the best medicine.

The worst type of damage usually occurs in a mindless moment. Occasionally, screaming from a cold start will rupture a blood vessel within the vocal fold. If unattended, scar tissue will build around the injured area. Imagine if you could never change the strings on a guitar or the head of a drum, that’s what scarred folds mean to a singer. I don’t want you to be paranoid; I do want you to treat yourself as a professional. The permanent vocal loss your parents warned you about is 100% avoidable. Pro athletes are very aware of the risk of injury. Instead of backing off, though, they train hard and surround themselves with experts. I recommend the same for singers who want to stay in the game.