Everything You Need To Know About Your Voice

Speech Pathologist and Vocal Specialist, Karen Drake M.A., C.C.C., joined us today to tell us everything we need to know about our voices.  Here are the answers to some of the questions Karen gets asked the most:

20 Questions and Answers about the voice:

 1.       I really don’t like the way I sound?  Can I change my voice if I don’t like it? 

 We sound the way we do for a number of reasons.  The size and shape of our vocal tract affects the way we sound.   Accents and dialects also influence our voice and resonance.  The way we use our voice also affects how it sounds.  We can modify accents and dialects and we can learn to use our voices as efficiently as possible giving us a better sound.   A speech pathologist who specializes in treating voice (voice therapy) can help you by giving you exercises that help you to use your voice as efficiently as possible. 

 2.       I think I sound too nasal.  Can I change that? 

 Yes, in general you can as long as there is not an anatomical reason for the excessive nasality (for example a cleft palate).  There are also exercises that you can do to focus your resonance more in the front of the mouth rather than in the nose. 

 3.       People say that I sound hoarse and are always asking me if I have a cold, but I think I sound “normal”.  It is how I have always sounded.  Do I have a voice problem? 

 Often, a voice can sound hoarse simply because it is being used inefficiently with inadequate breath support and too much muscle tension at the level of the vocal cords.  However, if the voice sounds hoarse, it is possible that there is vocal pathology (something wrong with the voice).  Most vocal pathology is completely benign like vocal nodules and can be cured with voice therapy (like physical therapy for the voice).  Occasionally there is a problem requiring surgery to fix like a vocal cyst.  Chronic hoarseness should not be ignored because in rare cases it can be a sign of something more serious like laryngeal cancer.

4.       I have noticed that some celebrities like Demi Moore, Rachael Ray or Joan Rivers sound hoarse all the time.  Do they have a problem? 

 I have never treated any of these people, but from the sound of their voices, they most likely have vocal nodules.  In these cases the lower pitch and breathy hoarseness adds uniqueness to their voice.  However, they most likely have to be careful not to overuse or abuse their voices or they risk having the nodules get bigger and therefore, their voices getting increasingly hoarse and effortful.  Most people with nodules would benefit from getting rid of them as they don’t like the way that their voice sounds hoarse or “cracks” with nodules.  It is also much more effortful to talk with nodules and the voice tends to fatigue fairly quickly.   Again, vocal nodules can be treated with voice therapy.  It is usually not necessary or advisable to have them surgically removed unless they have been there for a long time as there is a risk of scarring the vocal folds.

 5.       What are vocal nodules? 

 They are like calluses that can form on the vocal folds.  They are typically caused by misusing or abusing the voice (yelling, screaming, habitually talking over noise, or habitually throat clearing).  For example, it is not unusual for a cheer leader to get vocal nodules. 

 6.       What do you mean by misusing the voice? 

 Just as an athlete is less likely to get injured if they use efficient form when doing their sport, a person’s voice is less likely to get injured if they use efficient vocal technique when speaking and singing.  To use the voice efficiently, one needs to use adequate breath support, needs to coordinate their breath with sound without pushing and needs to allow their voice to resonate out the front of their mouths.  Most of us do this naturally and our voices sound clear and strong.  However, for some people this balance gets thrown off and they misuse their voice often by not using adequate breath support and then compensating by pushing the voice out with excess muscle effort.  The increased force at the level of the vocal cords can cause nodules to form. 

 7.       What about singers like Louis Armstrong or Tom Waits.   Do they have a problem with their vocal cords? 

 Again, I have not treated these singers, but they most likely have swelling or edema of their vocal cords.  Often edema of the vocal cords is caused by smoking and worsened by drinking alcohol and abusing the voice.  Most people are familiar with what has become known as “smoker’s voice”.  The voice is very low pitched and rough sounding.  This happens because of diffuse swelling of the vocal cords or folds.  If the swelling is minor it will get better when a person quits smoking.  If the swelling is severe, it may require surgery to debulk the vocal cords as well as smoking cessation.  Singers like Louis and Tom used their vocal pathology to build successful careers as singers with a unique, rough sound.  However, most singers would not be happy with swelling on the vocal cords as it causes restricted vocal range and reduced vocal control. 

 8.       My voice has been hoarse of a month after I had a cold.  Should I be concerned?

 Generally speaking, it is worth seeing a doctor any time hoarseness becomes chronic or has lasted over 3 weeks.   An otolaryngologist (formerly known as ear, nose and throat doctors) or a laryngologist (a physician that specializes in voice care) can look at the vocal folds and see if there is any remaining infection there.  Most commonly, the voice remains hoarse after a cold or laryngitis because the speaker continued using their voice when the vocal cords were red and swollen.  Therefore they needed increased effort to “push” their voice out.  That pattern of “pushing” then becomes a habit even after the cold is long gone.  When the voice is pushed out with extra muscle effort, it can sound quite hoarse. 

 9.       So, if I get laryngitis, should I just whisper? 

 Actually, if you have laryngitis, you should completely rest your voice with no talking or whispering.  You should drink plenty of water to keep the voice from getting too dry.  Whispering is not recommended because it is often done with excess muscle tension which can become a pattern even after the infection has healed. 

 10.   I notice that whenever I get stressed out or am feeling emotional, I tend to lose my voice.  Why is that? 

 Our voices are often a unique window to our soul.  They reflect how we are feeling.  Most people have experienced calling a friend who did not mention that they were upset, but you could tell that they were by the sound of their voice.  Our vernacular includes terms like, “I am feeling choked up”.  Meaning, I feel tight in my throat because I am trying to hold back my emotion.  Our voices and our breathing which powers our voice are both very sensitive to stress and emotions.  If the vocal muscles get very tight, we can temporarily “lose” our voices as the vocal cords are held too tight to vibrate. 

 11.   My teenager’s voice is driving me crazy.  I can barely hear him and he always sounds bored and uninterested. 

 Believe it or not, the way your teenager is talking has a name.  He is using an excessive amount of “glottal fry” with speaking.  Glottal fry is the low, rough sound that the voice has when it is used with a minimal amount of air behind it.  The volume of the voice is decreased and there is little inflection to the voice.  It can be “cured” immediately by simply taking a breath prior to speaking.  The voice then returns to normal clarity, resonance and volume.  Using glottal fry is not a very efficient way to speak.  If teens continue to speak like this as they get older and if they go into jobs requiring a lot of voice use, they will likely end up with voice problems. 

 12.   I am a singer and I have been noticing changes in my singing voice.  It gets tired and my range is reduced.  I have had singing training and I think that I use my singing voice efficiently so why is this happening? 

 Many singers actually use excellent vocal technique when singing, but use poor vocal technique when speaking.  They tend to not get enough air when using their speaking voice causing the vocal muscles to tighten in order to compensate.  These muscles then get fatigued and do not perform as well when singing even if the singing technique is good.  Also, singers, just like athletes, need to warm up their voices with vocal exercises prior to singing and optimally should do a warm down as well. 

 13.   I use my voice a lot as a teacher.  Are there things that are good for my voice that I should be doing?  Are there things that are bad for my voice that I should be avoiding? 

The following is a list of things to do or not to do for optimal voicing:

  • Do drink lots of water to keep the vocal folds moist. 
  • Do use adequate breath support for voicing.
  • Don’t smoke.
  • Don’t drink excessive amounts of caffeine or alcohol as both can be drying.
  • Don’t routinely talk over noise, yell or scream.
  • If you teach in a large classroom, gym or theatre or if you teach aerobics or fitness classes, do use a microphone.
  • Don’t habitually cough or throat clear.  Drink water instead.
  • Don’t continue talking if you have laryngitis.  Rest your voice instead. 

 14.   I know that breathing is important for voicing, but how am I supposed to breathe? 

 The most efficient way to breathe is abdominally.  The lower ribs expand and the abdomen moves outward on an inhale.  The abdominal muscles then naturally contract as the air is released on the exhale.   Many people have inefficient breathing patterns like breathing shallowly, with their chest muscles or frequently and unconsciously holding their breath for short periods throughout the day. 

 15.   I have a friend who is 32 years old and she sounds like a little girl.  Is that normal? 

 No, it is not normal.  When a voice does not lower during puberty and a childlike voice is maintained into adulthood, it is called puberphonia.  Males or females can have puberphonia, but it is most dramatic in males.  It can be successfully treated with voice therapy aimed at helping the client relax their laryngeal muscles and use their voice more naturally. 

 16.   Are there people who are prone to voice problems? 

 Generally speaking, people who use their voices a lot are more likely to get voice problems.  This includes teachers, lawyers, doctors, salespeople, coaches, singers, reporters, entertainers, moms, etc.   Of course other people can develop voice problems due to injury, disease, etc.

 17.   My voice is too soft and I always have to repeat myself.  Is there a way that I can get louder? 

 Yes.  Typically you can learn to get louder by using better breath support (your power source) for voicing, by relaxing your vocal tract and by making sure that you are projecting your voice from the front of your mouth.  A speech pathologist that specializes in voice can give you exercises to help you improve your loudness. 

 18.   My daughter in 4 years old and has a raspy, deep voice.  People think it is funny, but should I be worried? 

 There are a number of things that can cause hoarseness in a young child.  Most of them are not cause for major concern, but if she also has shortness of breath or makes noise when she is breathing then she should be seen by an ENT as soon as possible.  Children can get a virus on their vocal cords called Papilloma which can affect the voice and can partially block the airway causing noisy breathing.  More common causes of hoarseness in children include nodules, polyps or cysts.  A polyp or cyst may eventually need to be surgically removed.  Nodules can usually be successfully treated with voice therapy once the child is old enough to participate. 

 19.   I have smoked for many years and have become hoarse over the last month or two.  Should I see a doctor? 

 Yes.  You should see an otolaryngologist and have your vocal cords looked at.  Smoking is a risk factor for laryngeal cancer.  Laryngeal cancer is very treatable if diagnosed early.  Your hoarseness is more likely due to swelling of the vocal cords called polypoid corditis, but you want to be sure to rule out cancer as soon as possible. 

 20.   I love to sing.  I am almost 60 years old.  Can I still sing as I get older? 

 Yes.  You can enjoy singing well into old age.  The voice does undergo some changes as we age causing the voice to sound somewhat different.   The vocal cords tend to be drier and there is some loss of vocal range.  However, like any muscle in our body, we will maintain optimal function by using it.  It may require more vocal warm up and you may not be able to hit the high notes, but keep singing.  Enjoy your voice. 


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