“Zoom fatigue has been real for my voice.”
“Wow, I really noticed I was straining at the end of my workday.”
“My voice seems to get weaker the more I use it.”
“Oh, all of us teachers are very familiar with losing our voices, especially at the start of the new school year—we call it Speechless September!”
“My voice is so exhausted by the end of the day I just don’t feel like talking to anyone.”
These real-life statements are frequently heard among voice specialists and speech-language pathologists, but very often those spouting such phrases have no idea that they are potentially causing significant damage to their voice by continuing to speak through the pain, hoarseness, or discomfort. Maybe even some of these statements sound familiar to you. So what might be going on behind the scenes here, and why is it noteworthy? This article will dive into five reasons why paying attention to your voice is important, some tips on what to look and listen for, and what you can do about it!
#1 - Your voice problem can get worse.
This may seem obvious but ignoring the problem may actually make it worse! Our bodies are usually extremely resilient, self-healing, strong, and capable. We are used to “bouncing back” …until we don’t! Voice problems caused from phonotrauma, often stemming from misuse and/or overuse of our voice, can lead to benign vocal cord lesions and/or muscle tension dysphonia (MTD). MTD is a surprisingly tricky condition as it stems from forming maladaptive habits of strain and muscle tension in our throat—the larynx (“voice box”) and surrounding muscles—and sometimes the upper body including the neck, shoulders, base of tongue, and jaw. These patterns of strain and tension caused by “pushing through” voice symptoms or using the voice incorrectly can actually cause our voices to sound and feel worse, and may take much longer to “unlearn” than it did to set in. Additionally, acquired vocal cord lesions may warrant surgical intervention. The good news is voice injury is often completely avoidable by being proactive about your vocal health. You can start by applying vocal hygiene techniques and learning healthy voice use with preventive voice training or rehabilitative voice therapy.
#2 – Your job may depend on it.
If you are a professional voice user, you rely on your voice daily to perform job duties—anything from talking to customers, public speaking, teaching, running a business, to gigging and performing—you may not be able to afford to ignore your voice, and I mean literally! Losing income because you can’t work is a real risk for those who are struggling with voice complications. And it’s not just income that is lost. Some have made the difficult decision to change careers to help combat their “new normal” with a position that requires less of a vocal demand. Teachers and other professional voice users are at a higher risk for developing voice problems—be vigilant and take care of your most indispensable asset!
#3 – Your voice is personal.
Our voices go with us everywhere. As we’ve mentioned, you may need it for your job. But you also use it to socialize, to complete verbal transactions and for daily interactions. To call for help. To say, “I love you” and to connect with family and friends. To sing in the shower—or in an opera! To cheer and show support for your little athlete or rep your favorite team. To read bedtime stories to your children or grandchildren. Our voices are deeply personal and help us express ourselves. We often take our voice for granted. We don’t realize how taxing it can be when our voice feels unreliable, and how much not having a voice can impact your quality of life, even temporarily. Think of it this way—voice care is self-care!
#4 – Your voice may be trying to tell you something.
Listen to your body: your voice changes or symptoms may be the cause of a reaction or an underlying medical condition. Often times certain medications may cause hoarseness. You can check your meds here and speak with your physician about any possible adjustments. Additionally, underlying medical issues such as thyroid disease, hormonal imbalance, acid reflux (LPR), Lyme disease, neuromuscular disorders and many other medical conditions are known to often cause a variety of voice symptoms, commonly with hoarseness at the forefront. It is important to undergo a medical evaluation with an Otolaryngologist (ENT) who specializes in the voice, where they will run tests and examine the full picture of what may be causing your voice symptoms.
#5 – Addressing your voice may save your life.
Setting aside the figurative “lifesaving” factors, such as increased quality of life by way of a successful career and a full social life, paying attention to changes in your voice quality may quite literally save your life. Chronic hoarseness, pain in the throat, difficulty swallowing, and trouble breathing can be signs of a more serious medical condition. It's recommended that if you experience hoarseness lasting more than 2 weeks, you should schedule an appointment to have your throat visualized by an ENT physician. They will look to see if anything in your throat looks suspicious for cancer. Sometimes early detection of tissue changes called leukoplakia, which is generally considered to be precancerous, can be monitored or managed surgically if needed. In more advanced cases, ensuring proper treatment is necessary, time sensitive, and potentially lifesaving.
Notably, any sudden change in vocal quality or effort, as well as difficulty breathing and feeling like something is stuck in the throat, is cause for evaluation. Some other sudden and/or gradual voice symptoms to listen and feel for may include but are not limited to:
· Hoarseness
· Roughness
· Strain or effort to talk
· Tightness in the throat
· Severe breathiness
· Vocal fatigue
· Lack of vocal stamina
· Loss of vocal range
· Pitch instability or wavering voice
· Loss of voice
· Trouble swallowing
· Difficulty projecting or achieving appropriate volume
· Pain or discomfort at rest, when talking, or when swallowing
So, what can you do for your voice? Educate yourself about vocal health practices, risks of phonotrauma, and learn and apply vocal hygiene techniques. If you are experiencing prolonged symptoms, go see an ENT specialist (read my post How to Prepare For Your ENT Voice Evaluation for tips! ). For professional singers, a laryngeal evaluation when you feel healthy can be important to understand your baseline voice, as well as establishing care with a laryngologist. The famous quote “Knowledge is power” stands true in a sense, but I prefer to say, “Knowledge is empowerment.”
Preventive voice training and rehabilitative voice therapy both offer exercises and strategies to help maintain or improve your voice quality, strength and stamina, empowering you both personally and professionally.
Jessica Schwartz Smith, MS, CCC-SLP is a licensed and certified speech-language pathologist in Pennsylvania and North Carolina. She is the owner of Resonate Voice and Speech Services, a speech therapy practice based in Philadelphia that specializes in voice disorders, chronic cough, VCD/PVFM, gender affirming voice therapy, and adult dysphagia.