Put your best voice forward on World Voice Day

Newswise — Many people strain their vocal cords on a regular basis due to the way they sing or speak. Whether you’re a lawyer, teacher, parent or even a star-in-the-making on “American Idol,” experts at the University of Michigan Health System say it’s vital to focus on the well-being of your voice.

In recognition of World Voice Day (April 16), three U-M experts offer some tips for protecting your voice and recognizing problems. A focus on vocal health is particularly important because 7 million Americans have some type of voice disorder, according to the American Academy of Otolaryngology – Head and Neck Surgery. Read more about World Voice Day at http://www.entnet.org/news/voiceday.cfm.

The three experts from the U-M Health System’s highly regarded, multi-disciplinary Vocal Health Center are: Norman D. Hogikyan, M.D., F.A.C.S., director of the center and associate professor of otolaryngology and music; Freda A. Herseth, M.M., D.M., a voice training specialist at the center and chair of the Voice Department at the U-M School of Music; and Marci Daniels Rosenberg, M.S., CCC-SLP, a speech and language pathologist at the center.

“Your voice is your ambassador to the outside world,” Hogikyan says. “It portrays your personality and emotions. People make assessments about you based on your voice, so it is very important when you’re speaking or singing to think about what people are really hearing. Problems with your voice also can have a tremendous impact on your life – think of it as voice-related quality of life. Particularly if your job depends upon a clear, reliable voice, the impact of a voice disorder can be very significant."

10 tips for maintaining a healthy voice
1. Drink water to keep your body well hydrated, and avoid alcohol and caffeine. Your vocal cords vibrate very fast, and having a proper water balance helps keep them lubricated. Important note: Foods containing large amounts of water are excellent hydration-conscious snacks, including apples, pears, watermelon, peaches, melons, grapes, plums, bell peppers and applesauce.
2. Allow yourself several “vocal naps” every day, especially during periods of extended use. For instance, teachers should avoid speaking during the breaks between classes and find quiet ways to spend the lunch hour rather than talking in a noisy staff room with colleagues.
3. Don't smoke, or if you already do, quit. Smoking raises the risk of throat cancer tremendously, and inhaling smoke (even secondhand smoke) can irritate the vocal cords.
4. Don't abuse or misuse your voice. Avoid yelling or screaming, and try not to talk loudly in noisy areas. If your throat feels dry or tired, or your voice is getting hoarse, reduce your voice use. The hoarseness is a warning sign that your vocal cords are irritated.
5. Keep your throat and neck muscles relaxed even when singing high notes and low notes. Some singers tilt their heads up when singing high notes and down when singing low notes. “The high notes are on the ceiling and the low notes are on the floor,” Rosenberg says. “Over time, you’ll pay for that” – not just with strained vocal muscles but also by causing future limits on the vocal range.
6. Pay attention to how you speak every day. Even performers who have good singing habits can cause damage when they speak. Many skilled singers don’t continue their healthy habits when they speak; indeed, says Herseth, “many people – including singers – should have much more breath flow when they speak.”
7. Don't clear your throat too often. When you clear your throat, it's like slamming your vocal cords together. Doing it too much can injure them and make you hoarse. Try a sip of water or swallow to quench the urge to clear. If you feel like you have to clear your throat a lot, get checked by a doctor for such things as acid reflux disease, or allergy and sinus conditions.
8. When you're sick, spare your voice. Don't talk when you're hoarse due to a cold or infection. Listen to what your voice is telling you.
9. When you have to speak publicly, to large groups or outdoors, think about using amplification to avoid straining your voice.
10. Humidify your home and work areas. Remember, moist is good for the voice.

Warming up your voice is not just for singers. Taking time to warm up your speaking voice can help optimize it and avoid problems. Think of it like stretching and loosening up before exercise.

Easy, daily warm-ups for your voice
1. Do lip or tongue trills in the morning (try it in the shower or on your drive to work) to facilitate better use of airflow and breath.
2. Perform gentle humming and cooing to warm up your voice in the morning.
3. If you do more vocally complex warm-ups too, such as vocal scales, do the simple warm-ups first.
4. Repeat these exercises throughout the day to reduce muscular tension in the neck, shoulders and jaw.
5. At the end of the day, perform a cool-down of the voice with similar vocal tasks.

If you become hoarse, and your voice does not return to its normal characteristics and capabilities within three to four weeks, a medical evaluation by an ear, nose and throat specialist (otolaryngologist) is recommended. This is especially true for smokers or heavy drinkers, who are at high risk for throat cancer, Hogikyan says.

The cause of voice symptoms could be one of many possibilities – some benign, some dangerous. For example, it could be a side effect of acid reflux, which can harm your vocal cords with acid from your stomach. It could be a polyp, nodules or a cyst on your vocal cords.

Other possibilities include that the nerves connecting to your larynx (voice box) could be weak or damaged – a condition called vocal cord paresis or paralysis. If you're a smoker or a heavy drinker in particular, it could be laryngeal cancer. That's a serious diagnosis, and treatment options include radiation, surgery and chemotherapy, but survival rates are excellent if it is caught early. Hogikyan is an expert in laser surgery for early vocal cord cancers.

Less commonly, you could have a condition called spasmodic dysphonia, which results from spasms in the muscles that open or close the vocal cords when you speak, Hogikyan notes. This condition can be treated with repeated Botox injections that prevent the spasms, and University of Michigan research has demonstrated improved voice-related quality of life using the Botox treatment.