Singers are athletes, and must approach their craft with the same mindset.
Vocal fatigue is among the most debilitating conditions that can affect singers, however, little is currently known about the actual metabolic mechanisms of vocal fatigue, and because of the very nature of this condition, it can be difficult to accurately diagnose the cause. Traditionally, vocal fatigue has been defined in terms of the symptoms a person experiences i.e tiredness, weakness of the voice, hoarseness, a feeling of not wanting to speak, muscle pain, lost or breaking notes, “holes” in the voice, “ghost notes” which are breathy and fading, and soreness of either a large area of the throat or, more specifically, the area behind the Adams Apple.
” Voice problems occur in approximately 3-9% of the general population at any given point in time” (Verdolini & Ramig, 2001). Although vocal fatigue is not a life-threatening health condition in itself, the consequences can be debilitating and demoralising.
What are vocal cords?
Vocal cords (or, more correctly, “vocal folds”) are two small muscles located within the larynx (voice box) that are responsible for voice production. While the vocal cords lie apart most of the time, forming a “V” shaped opening or when you inhale, during speech or singing, they come together to produce sound by vibrating.
What are Vocal Nodules?
Vocal cord nodules are callous-like bumps which develop on either one, or both of the vocal folds. Generally, they form on the front 1/3 of the vocal cord, and range in size from tiny pin head to around the size of lentil. During normal speech or singing, healthy vocal folds press firmly together all the way down. However, if nodules are present the cords are obstructed by the nodule formation, and extra air escapes, causing the voice to sound hoarse and breathy as a result.
Vocal fatigue is a precursor to vocal damage if it is not checked, and the voice rested or treated.
There are two kinds of fatigue which occur in the larynx. The two main types are Muscle fatigue and Tissue (or Mucosal) fatigue. Muscular fatigue is generally described as a tight or sharp pain in a diffuse area of the throat. Tissue fatigue is likely to be a raw or sore feeling in a more localized area, generally in the area of the vocal folds themselves.
Muscles in the larynx and neck are affected by tension and can become tired by overuse in a similar way to any other muscles in the body. The problem with these muscles is that often, by the time the singer is noticing strain, they are already overtired. Singers may enlist the aid of the larger muscles of the neck for support, thereby compounding the issue. Phonation is normally achieved by using the internal (intrinsic) laryngeal musculature to open and close the vocal folds. When the external (extrinsic) musculature is erroneously engaged due to tension, long periods of singing, incorrect technique, shouting, or singing without warming up the voice, the singer will suffer muscle tension dysphonia, a tiredness generally referred to as “vocal fatigue.” Prevention is always better than cure when it comes to vocal fatigue. As soon as it becomes apparent, a wise teacher will advise complete vocal rest, and if it is evident after two weeks of rest, a consultation with a speech therapist or Pathologist to determine the cause. The other type of vocal fatigue is Mucosal Fatigue, and sometimes, it can be difficult to determine which is at fault. Unlike other muscles in the body, pectoral muscles or quadriceps, the “no pain, no gain” principle is not the way to achieve more stamina as a singer. If the voice is tired, it is time to stop singing, and give the voice rest, rather than power on in the hope of achieving that stamina through exertion.
Tissue (or Mucosal) Fatigue.
Tissue fatigue occurs when the vocal fold tissue swells due to extensive periods of use. The folds will stiffen, and vibrate unevenly, causing broken notes, hoarseness, or in more severe cases, missing notes. Sometimes, rather than hoarseness, the voice will become airy and “ghost notes” can be heard. Generally, with tissue fatigue, higher notes become difficult for the singer to reach. It is difficult to ascertain whether fatigue is muscular or mucosal, but the sound produced is easily distinguished as vocal fatigue.
Whilst vocal rest, and practising or performing less, are desirable, there are many other ways in which a singer can prevent this from happening. Just as an athlete warms up, it is critical that a singer warms up their voice using vocal exercises in combination with physical exercises to relieve tension, and warm and stretch the muscles. Physiological warm ups bring blood to the areas of the body, alleviate tension, and prepare a singer physically, while vocalises and scales warm up the voice and help to mentally prepare the singer, centre and stabilise breathing and support. A student once asked me what she could do if she had forgotten to warm up… the answer would be small sirens, yawns, humming, and vocal glissando. These are good to practise prior to scales and vocalises even when warm up exercises are undertaken. There are warm up exercises on this site which are excellent for this purpose, available in a format of mp3, and easily downloaded. They can be purchased individually or in Zip Files containing anywhere from nine to fifteen different exercises.
Singing for Lengthy Periods of Time.
Singing is a bit like playing a game of football. No beginner can manage a big game with an experienced team, and will risk injury, more so if the game is long or challenging. Do not sing for too long, and only sing for as long as you have been prepared to sing. In other words, a singer who is commencing lessons will find half an hour is more than enough, while a more experienced singer can sing longer. Developing voices must be taken into account here, as well as the type of repertoire, acoustics and dynamics, the size of the orchestra, or volume of accompaniment. Vocal muscles need conditioning to sing for longer periods, but even so, there is always a limit.
For this reason, it is best to practise – when you can – intermittently. Warm up, sing for a while, taking frequent breaks, keeping the voice well hydrated. Do not over sing. (Sing too loudly). Remember that there are many ways in which to practise, and not all involve using your voice. Studying the melody line in relation to the accompaniment, dynamics and the lyrics are all valuable. Listening to the melody line played several times before commencement of study is even more valuable because we can not listen properly when we are singing. It is far better to break practise into shorter intervals throughout the day, than it is to try to hammer through it in one lengthy session. Research has also proven that this is a more valuable way to learn.
Train for the Genre, or a particular Event.
A wise singer will train their voice for the genre or style in which they will be singing, and for the event. Knowing the venue, practising with the accompanist or orchestra, and taking the time for a sound check are essential components to looking after the voice. Singing with a quality accompaniment is critical for vocal health. Long studio sessions, stop/start singing, and singing too loudly all put the voice at risk. Hydration must be maintained, and if the atmosphere is dry, it will need to be even more carefully monitored. Opera is not performed in the same style as most Musical Theatre pieces, Jazz and Blues or Popular. Train for your genre as well as for your venue, and for those who will be singing or playing with you. Do not sing outside of your vocal fach or range, and especially for significant periods of time.
Voices which have become Fatigued need Vocal Rest.
Symptoms of voice change can be as follows: the voice becomes breathy, tremulous, weak, hoarse. There is a loss of the top notes in particular, or an alteration in quality – they become either harsh or hoarse. During periods of vocal fatigue, the voice deteriorates with use, and particularly with extended, or incorrect, use.
Assessment and Treatment.
- Occupational predisposition – singer, teacher, public speaker, and the ways these occupations impact on the voice.
- Precipitating factors- recent chronic or acute conditions and illnesses such as Asthma or Influenza.
- Consumption of Alcohol.
- General fatigue. Sleeping patterns.
- Performance Anxiety.
- Other ENT symptoms – dysphagia, aspiration, throat or ear pain, nasal blockage.
- Reflux symptoms – patients with Reflux will often experience vocal issues.
- Lack of hydration of the body and voice.
- Past medical history, particularly chest disease, thyroid surgery, neck trauma, thyroid condition, thyroidectomy.
- Extensive use of the voice, over use of the voice, singing with poor technique.
- Not warming up before a session of singing, be it practise, recording or performance.
- Inspection of the larynx – by indirect laryngoscopy – this procedure will eliminate or demonstrate the existence of nodules.
- Voice quality assessment.
- Reflux symptom assessment
- Blood tests and Ultrasound to eliminate or discover the existence of thyroid nodules pressing on vocal nerves.
Tests which May be Undertaken Should They be Deemed Necessary.
- Thyroid function.
- Fibreoptic laryngoscopy enables examination of the larynx.
- Stroboscopy (videolaryngostroboscopy) uses fibreoptic images in slow motion to provide pictures of the working larynx.
- Tests by a professional voice pathologist who will measure amplitude, pitch, range and aerodynamic efficiency.
Voices which have become fatigued need complete vocal rest, and a gradual return to singing, if they are to remain healthy. Pushing on with a fatigued voice will eventually see vocal damage, possibly irreversible. All cases of chronic vocal fatigue should be evaluated by a qualified laryngologist. In more mild cases, the following may help:
Adequate hydration, vocal rest, use of correct technique, avoidance of vocal strain through excessive speaking or shouting (See “Vocal Hygiene” on this site), alcohol and caffeine reduction.
As an experienced vocalist, and someone who has never had any vocal nodules or issues, I can only advise other singers practises that I believe to be good vocal hygiene and management of the instrument. As a teacher, I am disappointed when my advice is not taken, because vocal fatigue in students is generally never the fault of an experienced and dedicated teacher. Unfortunately, the general public do not see it that way, and will blame the instructor before realising that we have no control over the type, or amount, of singing that goes on outside of teaching hours.
There are exercises available on this site for singers to practise improving their vocal technique. Here is the link for easy download: http://helencolemansinging.com.au/product-category/exercisefiles/
© Helen Coleman