Vocal Injury and Recovery

In January of 2009, I was diagnosed with recurrent nerve paresis of the right vocal fold. I am an opera singer with a master’s degree in vocal performance from a major university. I am a lyric coloratura. This diagnosis was both cathartic and devastating. Cathartic because it explained so many of my vocal troubles which had plagued me for years, and devastating because, well, what exactly is an opera singer without a voice? My voice has healed completely and my singing still needs some work; but this process of recovery led me into a new passion. I am currently training to become a speech-language pathologist who specializes in voice disorders and injury. I am in my first year of college study towards this new goal, and I decided to write this blog to tell my story of recovery, to give hope to those who are dealing with vocal injury, and to educate those who work with professional voices…with some of the knowledge I am gaining right now.

The effects of vocal injuries are wide-reaching. Through my own experience, I have begun to understand just how wide-reaching they are. Vocal injuries carry with them a wide array of emotional upset for anyone experiencing difficulty with vocal function, but this is especially true for the professional voice user. There is not only the trauma of having a dysfunctional voice, but also the burden of dealing with assumptions made by others that the performer has done something to cause it. This can carry a great deal of guilt. If a performer takes their craft seriously, they either did not cause their injury, as in the case of a nerve disorder, or they simply lacked the education to know that their behaviors could damage their voice.

Even though I did not carry the guilt of harming my own voice, I still had far-reaching issues to deal with in this realm. I wasn’t sure my voice would ever just be “normal.” After therapy, I had to re-train my voice to sing from scratch. And although I made progress, I have made the most progress in recent months due to my recognition that I must start at the beginning to have my voice work properly. I must re-learn how to breathe with an open and relaxed throat, how to coordinate a clean on-set, and how to form my vowels without creating tension. Instead of being an advance singer who was just tweaking her technique here and there, I was really starting from the beginning.

Before I get into my story too deeply, I would like to go ahead and put in some pragmatic suggestions up front for those singers out there currently recovering and for their voice teachers (which will all be expanded upon as the blog goes on!):


For the injured singer: 

• If you suspect you have an injury, please see an otolaryngologist (ENT) in your area to get a stroboscope done of your voice. (It’s even better if they specialize in professional voices!) 
• If you have had a diagnosis of an injury already, find an SLP who specializes in voice. (The SLP field is a very wide one with many different specialties to go around, so this is particularly important.)
• Follow the SLPs instructions and do the necessary work, or practice, outside of therapy to yield the best results. (They are not magicians who can fix your voice with just one hour of work every week. You’ve got to put in your time outside as well…just as with voice lessons!)
• Do not be surprised if the SLPs measurements show a healed voice, but your singing is not automatically better. Muscle memory dies very, very hard.

For the voice teacher of an injured voice:

• Reserve extra patience for your student as they recover. As I said, old muscle memory dies hard, and singing on an injured voice inherently trains in more than the usual amount of “bad habits.” It will take some time to recover from that.
• If this student seems to “lack confidence,” please realize it is most likely not a confidence issue, it is a trust issue. Singing on an injured voice is like playing Russian-Roulette, you just never know when you’re going to sound great or awful. Whatever comes out that day seems to be out of your control, and no matter how much you focus on “technique” it just never gets better. Even after healing, this trust issue of the “unpredictable voice” will still linger. Instead of saying “work on your confidence,” say instead “you can trust your voice now, so let’s just sing.”
• We don’t “listen” to ourselves as much as we “feel” in our throats. The process of recovery made me highly tactile in terms of what healthy laryngeal sensations are vs. unhealthy ones. I really don’t mind not hearing myself, but, as a master-manipulator (see below), I sometimes don’t know what I’m really supposed to be feeling, since sensation is very deceiving for someone suffering this compensatory muscle action for an injury that is not even there anymore.
• You’ve probably got a master-manipulator on your hands. Those of us who sang on an injured voice for years prior to a diagnosis got very, very good at all sorts of laryngeal and pharyngeal manipulation to accomplish some sort of passable sound. We need the most help with finding where relaxed “neutral” actually is! Relaxed doesn’t feel like “space” to us, it feels like we’re not doing anything. And not doing anything will freak us out. All we’ve ever done is over-do just to sound decent. If your student seems to get frustrated or seems to get more manipulative as a lesson goes on, just remind them that they should be sensing a very miniscule amount of muscular effort rather than really “working at it.” 

As I begin my story of vocal injury, diagnosis, and recovery, I hope this information is helpful to those dealing with this in some way, through personal experience or teaching.  Thanks for reading so far, and I hope you come back again soon!