Injured Voices

When is my voice injured?
What do you do if you think that something is wrong with your voice? This is a frightening situation for a singer to be in. Fortunately, there is now hope and help for singers from within a
field called Performing Arts Medicine. This large umbrella field encompasses performing artists from a variety of disciplines including dancers, instrumentalists and singers. Professional Voice Care is a subspecialty branch of Performing Arts Medicine. In the field of professional voice care, there is a team approach to vocal health much as you would expect to find in the related field of sports medicine. The current voice care team consists of a laryngologist, a speech-language pathologist and a singing voice specialist. Additional members may include a voice scientist, acting-voice trainer, and a nurse or a physician’s assistant. Consultants such as a stress manager/speaking coach, a medical psychologist, a neurologist, a gastroenterologist, an endocrinologist, and a nutritionist may also be part of the team.

When a singer schedules an appointment to see a professional voice care team, there is a patient protocol which consists of a medical diagnosis, objective measures analysis, and a functional diagnosis of both the speaking and singing voice.

Diagnostic findings may include medical issues, general vocal health issues, and/or functional issues such as:

  • Medical
    • Pathology
    • Nodules, cyst, polyp, hemorrhage
  • General Vocal Health
    • Laryngitia sicca, reflux, allergy
  • Functional
    • Muscular tension dysphonia, singing in the wrong range, choosing inappropriate keys to sing in, singing all of the voice parts when directing a choir, yelling from the back of a room at the show choir on stage with a full band

The singing Voice specialist was defined by Heman-Ackah, Sataloff and Hawkshaw as a singing teacher with special training equipping him or her to practice in a medical environment with patients who have sustained vocal injury (2002 Journal of Singing.) There must also be an apprenticeship at an Arts Medicine Center. Currently, for the consumer, it is critical to find a singing voice specialist trained with the appropriate credentials.

This same Journal of singing article reiterates that there are still no formal training or fellowship programs that assist singing teachers to become singing voice specialists, and that the training is acquired by apprenticeship and observation. The article states further that the fundamental approach to training (rehabilitating) singers with vocal injuries is different from the approach used commonly with training (habilitating) healthy voices. Therefore, it is possible for harm to occur if an excellent and experienced voice teacher works with an injured voice but does not know the special considerations for this population.

To find out more about the process necessary to become a singing voice specialist consult the article “Preparing the Singing Voice specialist revisited . . .”




vocal fold hemorrhage

Internal views of the larynx courtesy of
Dr. C. Richard Stasney MD,
Director Texas Voice Center

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