Vocal Health Basics

Vocal Health Basics – How to Properly Care for Your Voice

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Vocal health is often taken for granted, but problems can stop you dead in your tracks, so it’s important to understand how to keep your voice in good health.

It seems that hardly a month goes by where a top singer isn’t forced to interrupt a tour, take a break, or undergo a medical procedure due to problems with their voice. Vocal health is often taken for granted, but once problems develop, they can stop a singer dead in his or her tracks, and in some cases require surgery and a lengthy post-surgery period of rest and recovery.

While we don’t normally think of singers as world-class athletes, some medical professionals are making the case that the demands put on one’s voice when singing one to three hours a night is as intense as those made by an Olympic marathon runner on his body. Additional factors such as nutrition, smoking, drug use, noisy environments, and proper voice training (or the lack of it) all play a role in a singer’s ability to hit the stage night after night and perform at their best.

Like many health-related issues, prevention is much easier and less expensive than having to undergo surgery, so it’s important to understand how to keep your voice in good health.

Superstars Losing Their Voices
In 2011, three major recording artists dropped out of circulation due to vocal health issues. Each developed a slightly different voice problem that required rest and eventually surgery.

Adele's vocal health issuesArguably the most valuable voice in pop music, that of the talented British pop singer Adele, was silenced when she was required to cancel seventeen US dates mid-tour and have laser surgery due to the condition of her vocal cords. Her condition is just one example of a high profile artist facing problems maintaining their vocal mechanism. Adele’s condition, reported in the press as two hemorrhages of the vocal cords (the terms vocal cords and vocal folds are often used interchangeably), was likely exacerbated by the stresses of touring.

Steven Tyler's vocal health issuesSuch hemorrhages are often the result of phonotrauma, the physical stresses caused by vocalizing, upon the tiny blood vessels of the vocal fold. Loud singing or pushing the voice when it is tired or if one is ill may predispose a singer to such vocal hemorrhages. The latest news reports suggest that as Adele’s recovery progresses, she will start back very slowly taking what she has described as some “very basic voice lessons.” She will likely take the first half of the year off from performing to help ensure a full and complete return of her famous voice. Aerosmith’s Steven Tyler was reported to have struggled with the same condition in 2006, requiring a similar surgical procedure as Adele. Noted voice expert, Dr. Steven M. Zeitels, a Harvard Medical School doctor who practices at Massachusetts General Hospital in Boston, treated both artists.

Keith Urban's vocal health issuesCountry icon Keith Urban also underwent surgery in November 2011 to remove a vocal polyp, a lump that may develop near the midpoint of a singer’s vocal cord. (According to the glossary found at voicemedicine.com, a polyp is a specific and clearly demarcated mass – the word polyp means “lump” and does not imply a cancer or pre-cancerous lesion). The midpoint location of such a polyp suggests that it too may be the result of phonotrauma. Urban was ordered to take three months off from singing as his recovery was monitored by a team of health professionals.

Singer/songwriter John Mayer was another major artist to recently face vocal health problems. In October 2010, his manager announced that after a series of extended rest periods, Mayer’s voice was not improving and he decided to have surgery. Mayer’s condition was described as a granuloma, a benign growth that results from irritation or trauma to the vocal fold. It’s often found at the back of the vocal fold, over a part of cartilage called the vocal process, which lies just underneath the membrane covering the larynx. As with Adele and Keith Urban, Mayer stopped work on his album, taking the advice of his doctors to not resume singing until his voice has fully recovered from the trauma and surgery.

While it may seem like there’s an epidemic of vocal health issues affecting the music industry, there are various common-sense factors that play into the increase in high-profile artists addressing these challenges.

First, awareness and treatment options have increased dramatically since the 1990s. Dr. Zeitels was quoted in the New York Times as stating that the use of fiber optic cameras to scan performer’s vocal cords for abnormalities and miniscule injuries has become more common over the past fifteen to twenty years. At the same time, vocalists have become more aware of the possible long term consequences of letting small problems go untreated and now consult more readily with health professionals.

Another factor is that, since recorded music sales often represent a smaller part of an artist’s overall revenue stream, touring schedules have become more extensive. To further maximize touring profits, concerts are often scheduled back-to-back on consecutive nights, placing greater stress on the vocal instrument, which can benefit from having a day or two rest between performances whenever possible.

Paul Stanley's vocal health issuesTo prove the point, Paul Stanley, front man for the legendary rock band Kiss, had vocal surgery to tweak blood vessels in his vocal cords. Commenting on his forty years of touring in which the band’s shows were packed as tightly together as possible to maximize profits, he offered that “the nature of rock singing is a strain on the voice, and when you compound that with [the number of shows we play], you’re not giving yourself enough time to recuperate and the problem is compounded. I was finding myself working harder and harder to do what was once effortless, and having passed through puberty, I was surprised to hear my voice cracking.”

How to Properly Care for Your Voice
While there is no doubt that singing in front of a rock band requires practice and stamina, vocalists who sing for hours at a time with no amplification, over a full orchestra in a packed house holding 4,000 people, place even greater demands on their voices. Enter the opera singer and those who train them, such as Dr. Lynelle Wiens, Professor of Voice at the University of the Pacific Conservatory of Music in Stockton, CA.

Dr. Wiens is a former faculty member at the Symposium on the Care of the Professional Voice in Philadelphia, and at the Pacific Voice Conference in San Francisco. She was also a recipient of the prestigious “Van L. Lawrence Fellowship” that is awarded jointly by the Voice Foundation and National Association of Teachers of Singing in order to foster interdisciplinary education among laryngologists, voice scientists, singing teachers, and speech pathologists. Dr. Wiens has taught aspiring classical singers for more than thirty-three years and offers a number of simple, common sense tips that can help any singer to reduce the risks to their voice.

Like any other musical instrument, the voice needs proper care in order to be ready when called upon to perform. Wiens counseled, “In order to function properly, the voice needs to be well lubricated. The effects of alcohol, cigarette smoke, marijuana, and other drugs cause dryness of the vocal instrument and can lead to vocal fold edema and inflammation.”

Wiens advises that “It’s essential to drink lots of water before, during, and after performances. It’s also very important to get plenty of rest and exercise and eat properly between performances. To the extent that is possible, try to avoid noisy places where you will have to shout to be heard.” For example, trying to be heard above the sound levels backstage during an opening act or in a typical van traveling for hours on the freeway come to mind as situations that might lead to further strain on one’s voice.

Dr. Wiens cautions that “throat clearing, yelling or screaming, singing too loudly for an extended period of time, singing a song that is pitched too high or too low, or putting too much pressure on your voice, all increase the strain on it. If it hurts, you’re doing something wrong. Listen to what your voice is telling you.”

Over-singing on stage, especially when the monitor situation is not optimal, is another potential cause of vocal strain. Especially for musicians on tour, Wiens counsels, “You have to prioritize what you absolutely need your voice for and then make the best decisions to protect it.” So if you are out on tour and have been nursing a sore throat, maybe the band’s guitar player can give the interview and appear at the local record store for autographs while you stay back at the hotel to rest your voice for that night’s show. Wiens added, “Taking care of your body and learning to manage your physical and emotional stress are also key factors in maintaining good vocal health. Perhaps the best preventive care is good training. Finding a good coach is the best thing you can do for yourself.”

Dr. Wiens advises that a singer should seek a professional if they have a concern about their own vocal health. “If there is a sudden change in your voice from what is normal, or if you experience persistent hoarseness and/or vocal fatigue for more than two weeks, I would suggest you see an otolaryngologist (Ear, Nose and Throat doctor) who is experienced in caring for singers. Be sure to ask for a strobovideolaryngoscopic examination in order to get the most thorough assessment of the health of your voice.”

If there has been damage, a singer should ideally be treated by a team of professionals that may include an ENT doctor, a voice teacher/vocal coach that can help a singer avoid any techniques that may exacerbate problems, and if appropriate, a speech pathologist who can assist with proper rehabilitation of the voice.

“The voice is a delicate mechanism,” Wiens concludes, “so it makes sense to take preventive measures in order to help ensure a long and productive singing career.”

Keith Hatschek is a regular contributor to Disc Makers Echoes blog and directs the Music Management Program at University of the Pacific. He’s also written two music industry books, How to Get a Job in the Music Industry and The Golden Moment: Recording Secrets from the Pros.

Special thanks to Casey Newlin for assistance in researching background information for this article.

Learn How to Maintain Your Voice

Read More
How to Sing Better Right Now
A Vocal Warm Up Is Key To A Great Vocal Performance
Don’t Tax Your Voice Before a Vocal Performance
Stop Shredding Your Vocal Cords
Vocal exercises – Vocal warm ups for singing to connect breath, vibration, and resonance

89 thoughts on “Vocal Health Basics – How to Properly Care for Your Voice

  1. Try not to avoid the warm up. Warm up your voice everyday, Famous Vocal Coaching said that Finding a voice is not an easy task. Know your reach and its limits. When singing, your breathing ought to be profound, low, and supported. spend as much time practicing as you will in front of an audience.

  2. Classical techniques focus on lifting of the soft palate and maintaining an open throat as in a yawn. Classical Trained Singer have technique that existed for a very long time. In comparison, it is fairly recent that contemporary singers have begun enhancing themselves with voice training.

  3. Hi there! I work in the education department at a large zoo and, as such, use my voice a great deal. I find myself losing my voice a great deal and this has me concerned. I drink plenty of water, at least 48 oz. A day, have green tea regularly, do vocal exercises, and am an actress with plenty of knowledge on how to use my voice appropriately. My vocal chords don’t hurt, but by voice is coming out raspy and low. Any ideas/ advice?

    1. Green tea is drying to the vocal cords. unless it is decaffeinated! if you drink decaffeinated, you much drink plenty of water to rehydrate and make up for any loss from caffeinated beverages…but it is best to avoid such drinks. supplements can be very helpful…! definite vocal warmups and a mic and amp to avoid overtaxing your voice or trying to compete with musicians/music. good luck!

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  16. This is a very good article, but the author forgot one very important detail — SINGING CORRECTLY. If you sing correctly, using your diaphragm and not singing out of your throat, standing up straight and projecting the sound out of the top of your head, it makes a WORLD of difference. Besides preserving your voice, you sound WAY better. That is my pet peeve with music today. Pretty much nobody sings correctly any more. And then they wonder why their voices blow out.

  17. Smokey bars, late nights & dehydration had my voice cracking by the end of the night. To keep the old vocal chords lubricated try pineapple juice. Works for me…

  18. I was raised in the honky tonks and lumberjack bars in the 1070s and I am lucky to still have my voice and most of my hearing, though I have some highs missing from my right ear it was in Vietnam that I lost that. I have just turned 63 and I still have a good range and my voice is still strong, but I do notice some tingling if I happen to push it just a bit early on in the night; I still do four to six hour shows in the clubs. Thanks for the article I have been looking for some good advice.

  19. I’ve been singing for 42 years and have always maintained control of my voice. The bottom line for me as a vocalist is to never, ever, eat or drink sugary or salty products before a gig or a rehearsal.
    Also, breathing exercises work best in the morning, afternoon and evening hours. The more you breathe in and out, the better the exercise for your vocals. This will contribute to controlling your sounds as they exit your body. The breathing exercises alone will help you many times over and will strengthen your diaphragm. Making it stronger as your voice becomes eventually better with time and experience. Water is great and so is Tea without any sugar or honey. Don’t let your friends control you by letting them tell you to go ahead and scream it out, shout it out, especially if they don’t know how it’s done. I’m a trained professional and will tell you first hand, that there’s a special way for those who use their vocal chords for a way to scream and shout without hurting your voice.

    1. Respected
      Sir/Madam my voice gets quickly and easily chocked in airconditioned room, after talking much, and due to sweating on the chest. Music is my life and saving me from tension.
      Pl. help, pl. give all your valuable advise for taking care for throat before singing in front of public. People appreciate my singing , but today I could not sing ( although started ) beacuse my voice got chocked due to airconditioner. I am 55 and try to sing with feeling and from deep of my heart and I can not explain how closest is music to my heart.
      Pl. help.



  20. I have stumbled upon a seemingly miracle cure its an old remedy called Bells Bronchial Balsam  (Mentholated) this product has saved my bacon on more occassions than I can recall! It is available at http://www.semichem.co.uk/p-1723-bells-bronchial-balsam-200ml.aspx and no I don`t have any connection with this company It`s a totally impartial opinion… Hope it helps someone else the way it has helped me….

  21. I have been singing for 30 years and found a diet low in mucus producing foods helps alot The worst is dairy foods The mucus caused by this coats the respiratory tract and and leads to hoaseness and the need to strain in order to produce a clear sound

  22. being a vocal coach, i have been teaching and have written a book regarding the way that the body naturally creates sound. many things factor into proper singing.

  23. Great article!  I have just started to record & get ready for gigging out…..my voice is not conditioned as it has been. Your article woke me up to take special care……..thank you Linda

  24. the style and sound  of vocals for today’s modern music sounds like damage has already been done….it’s a result of competing w/ loud electronic instruments. only operatic performers had vocal problems back in the day…once the microphone was invented, singers were allowed  to relax and sing in a natural speaking tone of voice….leave it to the brits to get plowed and scream into a mic while trying to oug gun the marshall amps

  25. Excellent article! I found some great info on all this the chapter “The 8 Pillars of Vocal Care” in the eBook: “Singer’s Guide to Powerful Performances” by Jeannie Deva out on all eReader bookstores and her “Deva Method Vocal Warm-Ups and Cool-Downs” CD. http://www.JeannieDeva.com

  26. Very helpful posting. One thing, you quote Dr Wiens telling singers to drink water while performing. I wish he would have said warm water. The vocal cords, like any muscle, work better when they’re warm. It’s best to drink herbal teas like ginger or fennel. I bring a thermos of tea to performances. As well as keeping my pipes warm and soothed and moist, it’s a great curiosity for the audience. They often ask what I’m drinking. Because I am a mature singer and very energetic, they suspect it’s booze. I tell them it’s gin (dramatic pause) ginger tea.

  27. Thanks for this article. I have been doing many of these things for over 40 years but there are others I had no idea about. So thanks again. Rich

  28. When I was in the 8th grade I was in the Bob Mitchell Boychoir the year they made Going My Way with Bing Crosby.  Then for 3 years in High School I was in the Glee Club, directed by Roger Wagner.  But I was never given instruction on how to sing.
    Years later I had a 1-hour lesson with a singing teacher from a local community college.  Nearly the whole time was spent on posture, relaxation, and breathing.  He told me that if you watch a dog when it is lying down asleep you will notice that its whole abdomen is involved as it breathes.  Likewise, our lower abdomen  should extend as we inhale, and contract we we exhale.  Thus we do not merely breathe from our lungs or diaphragm.  
    Furthermore, he told me, we should not form the sound with our vocal chords.  To do this strains the vocal chords, and we will quickly get hoarse and loose our voice.  The sound should be formed without strain by the air passing through the vocal chords.  Singing this way, he told me, one can be out in the mountains singing at the top of one’s voice all day long, and this will strengthen our voice, rather than straining it.     

  29. I have had laryngitis for over a month and I am a singer can’t seem to get my voice back using hot lemon and honey teas what else can I do been on two sets of antibiotics and predozone Olajuwon if anyone can thanks jacqueline

    1. Jacqueline, three things you can try: Homeovox – a homeopathic medicine for laryngitis; very hot wet towels around the throat – several times a day; and steam with oregano oil – boil water, pour into a bowl, add 3 drops oregano oil, put a big towel over your head like a tent and breathe – oregano oil has really worked for me – it’s antibacterial, antiviral and antifungal. And avoid coffee, citrus, dairy, and eating or drinking cold anything. Good luck. I know how frustrating this can be. Pauline

    2. Lemon (Citrus) is absolutely the worse thing you can do to treat your laryngitis or for a vocalist to consume especially right before a performance.  Lemon/Citrus is a natural astringent and is very harsh on the vocal cords.  Its a natural cleanser (great for colds) and usually with cleanse the cords of phlegm but it dries them out at the same time.  As a seasoned vocalist keeping the cord lubricated is key to healthy vocals.  Try pure honey and ginger or mint teas they will soothe the cords and keep them moist. Also go to you local health food store Whole Foods and get the tea called Throat Coat there is a syrup as well.  It will soothe and lubricate and help to heal you vocal cords.  Hope this info helps.  

  30. Good article, especially for those of us “in the trenches.”  But someone should speak to the music sweatshop business that too many young, talented performers become subjected to… newly signed talent with hit records on the charts are managed to death.  In the attempt to maximize returns from their “property,” managers are booking young singers for far too many performances in too short a time.  Most stars rise and fall quickly, so they wring every cent out of them they can before the next star rises.  They risk losing a swath of bookings this way due to voice loss, so it’s a stupid business strategy anyway.

    Paul Stanley (who naturally has a voice like a tank) has more control over his schedule than most performers.  I think it should be law that performers under agency contract who are asked to do too many shows in a row can amend their contracts under the advice of a doctor BEFORE they lose their voices.

  31. Wjy 90% of performers today track to tape and mime live. Anyone who’s ever tried to sing or even play an instrument in an arena with even the best PA would understand why in five seconds. Even Garland and Sinatra had notorious probs singing with a full big band at one-half the volume of today’s concerts. Even under the best of conditions you cannot hear yourself. Add to it any running around if your genre demands it, and forget it. Live is only live if the artist and management want to destroy the voice. Not worth it.

    1. This may seem strange to some but I put in ear plugs when I sing…sometimes in both ears, sometimes not. Competing with all the instruments has been an issue at various gigs and I don’t always have a good (cooperative) sound man. Aside with helping to keep pitch, you don’t sing as hard! Having a good vocal coach is Helpful too!! Yes WARM WATER is Key.. Not ice cold…No booze, No Dairy…don’t eat for a few hours before the gig. Happy singing Ya’ll

  32. Drink lots of water, absolutely. Also a great many rock and pop singers seem to think that proper vocal training, ie learning to sing from the diaphragm and resonating through the nose instead of putting all the strain on chest and throat, will somehow spoil their style and turn them into would-be opera singers. Absolutely not true. Correct vocal exercises give you more musicality, volume and stamina and you will be a better rock singer. Your tone and expression will change for the better, whatever genre, and your range will improve. The problem with singers like Adele and other young modern ‘soul’ artistes is that they have learnt to pastiche proper singing, which is convincing to those who haven’t heard the Dusty Springfields and Roberta Flacks of this world. But the singers mentioned damage their voices because they didn’t start right in the first place. Notice that very overweight people tend to sing better because their lungs are so constricted they have no option BUT to sing from the diaphragm.

  33. Arden Kaywin is great teacher in the Los Angeles area. She basically saved my voice. I had no idea how to really support and was trashing my voice every night out on the road. She gave me some great tools. There’s no way I’d still be recording and touring without studying with her – or at least, my voice would definitely not be as healthy and strong. Her website is http://www.ardenkaywinvocalstudio.com/vocal-lessons.html

  34. This is all very good information. I too have had a vocal cord injury and I see that my doctor, teacher and speech therapist led me the right way. It was very painful and difficult but I did recover stronger that ever. Now I pay very close attention to how I use my voice. For me this is a great reminder

  35. I was singing with a group recently and was told to avoid certain foods before singing — for example, dairy products supposedly cause the body to produce more phlegm and should be avoided.  Any truth to this?

      1. I noticed that I need to avoid other foods too, like popcorn, nuts or seeds. These types of foods can leave little bits in your throat and can sometimes make you cough. If I’m already a little nervous before a gig and I’m eating carelessly, or talking whilst eating, I could start to cough.  And if I cough too hard right before I have to sing, it ruins my voice.

    1. Absolutely.  Consuming too much dairy even days before a performance is a vocal detriment. Almond, Rice or  even Soy (if you don’t have hormonal issues) is a better option to go with as a dairy substitute.

    2. That is absolute nonsense.
      I am an opera singer, and while singers have many superstitions…….

      Smoking, drugs, alcohol, lack of sleep or food, sickness and too much singing (or talking) are all bad.
      I sometimes find cold air bothers my voice…..

      but all the other advice is rubbish.

      As long as you are in good health, there is no need for paranoia around the singing voice. I can have a big glass of milk and sing my way through an opera with no difficulty. I hear these things all the time about chocolate, dairy, etc. and have colleagues who eat all these with not the slightest problem (and of course, some who think that they need huge intakes of water to able to sing). Ha.

  36. This is new school ignorance blah blah.  How come old school singers never had this problem??  How come Tony, Frank, Michael, Marvin, Stevie, Caruso.. etc…  sing effortlessly all night, loud, soft or emotional as they want and always in total pitch and control???  Because they sang correctly – completely bypassing any strain on their vocal cords.  Wheverever there’s any stress, tightness or strain… is where you’re doing it wrong. 

    1. Because their music style is effortless they are not screaming or growling they are softly speak / singing I could sing that all day with a soar throat no comparison at all I am a singer of all genre’s and I experience problems as well schooled or not schooled even the ones you mentioned had their problems. When a singer gets sick it goes right to his or her throat!! Why??!! It will for ever be one of those things…so any tips are most welcome after all even the old time singers were not robots they felt the pain as the new singers do!!

    2. Tony Bennett was silenced for two years, due to vocal chord problems. He needed surgery, treatment, and careful follow-up vocalizing training. He’s back in shape now and singing, bless him. But he freely acknowledges his problem and the help he got.

    3. All vocal use, speech or singing, is cumulative, and takes its toll on the voice. Of course, bad singing is worse for the voice, but …..

      It does not matter whether the technique is perfect, all use is stressful, and rest is required.

      The problem is simply this: Modern singers perform more frequently and have less time for vocal rest than old-school singers, thanks to the airplane.

      Therefore, modern singers have more vocal stress.

      And by the way, even Caruso once told his wife that only she heard him at his best, due to the stress of rehearsals and multiple performances. Having written that, Caruso on a bad day would be better than me on my best.

      You are correct that modern singers push too much. If everyone had the technique of Tito Schipa, there would be less problems.

      But he would suffer in our modern world faced with louder orchestras, modern repertoire, and too-frequent engagements.

  37. All very informative.  As a singer for 30 years and trained by the Maestro David Kyle, I find all of this information spot-on.  It seems that doctors finally recognize the gruelling, physical regimen of prolonged touring and singing for vocalists.  Unlike olympic athletes, vocalists have careers that can span 4-5 decades so the health of the singer is not just something to consider for a short career in their youth.  It is a life-long issue of performance.  Thanks for such a great article.

  38. This is a well-written, comprehensive article! I’ve forwarded it to my son who is on tour with his college A Capella group. They don’t teach this stuff in school, and he sure won’t listen to his mom – so it is a great resource to forward along! Can I cite this link and your website on my blog for parents of creative kids: LauraLamere.com?

        1. Hey Laura!  I’m a voice teacher and we DO teach this stuff in school.  Vocal health is absolutely the first thing we teach in voice lessons and voice pedagogy classes.  It’s by far the most important element in learning how to use the voice properly.  Unfortunately, most singers don’t feel it’s necessary to learn these things.  Hopefully these major artists’ problem will serve as a lesson…
          Check out http://www.SingingTV.com and http://www.VoiceStudioLA.com for more info.

        2. I used to perform in a band with a Pianist, He would sing maybe two songs a night and then his voice was out for the rest. I would have to sing for the rest of the evening. It was great training. It´s like a muscle that gets trained.If I compare it to swimming. If I trained 3 or 4 times a week, it was not difficult, but I would be able to tell a difference. Oh, but if I stopped for a week, the first 400meters were killing me. Back to singing. For years I had to perform 4 or 5 times a week. It was my bread and butter. I got better at it. Of course I had to watch out not to lose my voice, people ask me where I learned, studied to vocalise. I never had any singing training, well actually I did have the training of doing it for years. One more thought. If I felt physically tired, I could not sing as good as if I was well rested.  Somebody once said, there is nothing worse then a tired musician on stage.  How true.

        3. Thanks for the additional info Sara! Hope you’ll keep sharing info like this – stop by my blog; LauraLamere.com, where I share info with parents. 

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