Protect Your Vocal Folds: The Little Muscles That Give you a Voice!
As a Speech Language Pathologist, I have been curious about the impact’s cystic fibrosis, COPD, and other respiratory illnesses have on vocal quality.
Having been around the CF community for a couple of years, I know that CF can impact numerous organ systems that require consistent medical attention. I know that vocal quality could potentially be impacted due to chronic coughing, yet it is not usually detrimental to one’s overall health.
Your voice says a lot about who you are and allows you to express yourself. A reduced vocal quality can impact your ability to work, as some individuals rely on their voice for their career (e.g., teaching, coaching, singers), it can create challenges in feeling comfortable expressing oneself, as well as can be painful and frustrating to experience.
After reaching out to the CF community, I have learned that vocal quality is a concern form some. Examples that came back from the CF community were:
- Feeling like one had a reduced vocal range: sometimes following TOBI and/or after post-transplant
- Reduced volume, specifically at the top end
- Sinuses impacting vocal quality
- Loss of voice when tired and sick, and sometimes waking up without a voice
- Raspy, deep voice: this was seen as both a pro and a con
It is important to note that the following information is only general information and should not be considered a treatment approach, but simply as recommendations to support vocal health.
Why is the voice impacted by CF?
Sound is produced when the air from the lungs is pushed between the vocal folds (two elastic structures in your larynx). Sufficient pressure is needed to cause them to vibrate.
The vibration is what produces voice/sound.
Breathing provides the force to initiate and sustain vocal ford vibration.
Reduced air pressure = reduced volume and ability to speak at longer sentences
Having a chronic respiratory illness, like CF or COPD, can severely impact your lung volume, which reduces the amount of sufficient air needed to build the pressure between the vocal folds to increase the volume of sound.
Voice Quality Symptoms resulting from CF:
- Dysfunctions in vocal fold movement due to the build-up of mucus on the vocal folds and chronic coughing.
- Medications that cause dry mouth/reduced saliva
- For example: TOBI is an inhaled medication. Inhaling medications can cause dryness, swelling, and irritation. Small traces of medication can get left of the vocal folds causing inflammation. This inflammation can result in a hoarse voice, croaking voice, breathy voice, and/or loss of voice.
- Lung Transplants
- Insufficient lung capacity
- Increased risk for gastroesophageal reflux (GER), which can cause inflammation to vocal folds if you have experienced GER for a long period of time
- Intubation during lung transplants causes increased risk for dysphonia (spasms of the vocal folds) and laryngeal stenosis (narrowing of the airway)
Research findings specifically focused on vocal quality and CF: (you are not alone!)
- Reduced vocal intensity (loudness)
- Increased levels of jitter and shimmer (excessive movement of vocal folds during sound production)
- Increased roughness, breathiness and weakness of vocal quality
- Increased dysphonia (dysfunction of vocal fold movements) causing a strained and strangled voice quality, and can cause no voice at times
- Impacts women more than men
- Phonotrauma to vocal folds (vocal fold abuse) due to: medications, reflux, and chronic coughing
Okay, enough about “why” the voice changes, and time to get to Three Tips!
- Hydration is the most important thing you can do for your vocal folds!
- What’s recommended?
- 2 liters of water/day: more than 62 oz a day
- Drink water after coughing to rehydrate vocal folds
- Use Glycerin Lozenges (halls, gummy bears)
- Reduce gum intake / chewing = it hyper stretches the vocal fold muscles
- Monitor caffeine and alcohol intake
- Gould’s gargle routine
- ½ tsp sea salt
- ½ tsp baking soda
- ½ tsp honey or maple syrup
- 1 cup warm water
- Gargle silently for 5 minutes
- 2 liters of water/day: more than 62 oz a day
2) Respiratory training – for your vocal folds!
- Avoid whispering … seems contrary, right? Whispering actually makes your vocal folds work harder
- Relax your throat muscles and shoulders
- Diaphragmatic breathing (belly breathing)
- Breathe from the diaphragm, keep your muscles relaxed.
- Let your volume increase gradually instead of all at once
- Speak as you exhale
- Inhale into abdomen, keep tongue on floor of mouth (relax tongue), lips gently closed
- Exhale from abdomen and gently exhale with “s” or “sh” sounds
- Do 5 breaths per day
- Singing is helpful!
- You expand the lungs more and exhale in a more prolonged way
- Have something to say but feel that your voice just isn’t quite right? Try saying it in a toon.
3) Reach out to a speech language pathologist for more specialized treatment approaches if it is an area of concern and/or symptoms are worsening
Don’t hesitate to reach out if you have any questions.
By: Nicole Ezcurra, CF- SLP, LSVT
More From THE Blog
Human beings are routine and patterned based species. We like things that are predictable and stable. This is because the more routine-based our lives our, the less cognitive activity it takes to complete a task and we preserve more energy as a result. This natural...
The primary function of the respiratory system is to provide gas exchange between the atmosphere and cells within the body. This occurs in four continuous and concurrent processes. The first process is pulmonary respiration (ventilation). Pulmonary...
During the inspiration of air, the thoracic cavity expands and there is a decrease in the intrapleural pressure around the lungs in order to allow the lungs to expand. As the lungs expand, the diaphragm contracts, due to the increased transabdominal pressure and...
There is no mystical aura that engulfs the gym that gives individuals the gift of brute strength, or gives individual’s cardiovascular capacity like Secretariat, the triple crown record-breaking stallion at Belmont Stakes. There are numerous variables that...
Sit-ups and crunches have been the staple-mark core exercises used to build core strength and endurance. They are easy to implement; you don’t need equipment or a lot of space to perform them. But, are they really the most efficient exercises to target core...
Performance testing can take on many different looks depending on what you are wanting to measure. For example, if you are looking to improve cardiorespiratory efficiency, VO2max testing is typically used. If you are looking to measure speed, you may use a...
There are many approaches to exercise.; a buffet of options to pick from these days. You have the option of focusing on mobility and range of motion by participating in yoga classes. You can test your exercise capacity by joining a cycling class or by...
It was about a year ago when I watched an exercise video a colleague had sent me. The fitness enthusiast filmed a HIIT training workout for their followers. The workout consisted of various lower body weight plyometric based exercises. It had only been a...
The primary aim of exercising is to improve quality of life, strength, endurance, and/or movement capabilities. Integrating a resistance and cardiovascular training program into a client’s lifestyle can improve posture, respiration, musculoskeletal strength...
There has been a flood of exercise content these last few weeks. It is great to see trainers, coaches, and experts in the field of science giving back to the community. There are many ways to exercise and we have seen many different approaches to training. We believe...
Let’s be honest. Motivating youth to do workouts after school or on the weekends can be hard enough, and now not only are doing their workouts at home, but they are also taking their classes online at home! With so much times at home, how do you keep your...
Your child has a right to be a kid! Of course, having a child with cystic fibrosis brings on more challenges and worries. It requires being more alert to surroundings, your child, and others. But, your child still deserves to play and you still deserve to watch your...
The clearance of mucus is very important for individuals fighting pulmonary conditions. In cystic fibrosis (CF) and COPD the clearance of mucus is crucial to clearing bacteria pathogens to reduce the decline in lung function. To understand how we can attack the...
Intrinsic motivation is something that develops over time. Kids don’t yet have the cognitive abilities to grasp the concept that, “exercising is good for physical and mental health.” The understanding that by “doing something good for your body now, your future self...
One of the ways people measure their success in the gym each week is by counting how many times they showed up to the gym. For example, 5 days in the gym equals 5 workouts. That is assuming you are only working out once a day. When planning out our weekly schedule,...
Exercising is important for everyone. Exercising has many benefits from improving cardiovascular health, decreasing stress, to even improving lung function in cystic fibrosis and COPD. However, what is good for us doesn’t mean we will always want to partake in...
The body is a remarkable system that takes time to recover. When you have chronic illness, such as CF or COPD, the recovery time the body needs will be a little different than for a healthier individual. This is due to decreased oxygen consumption and...
Strength training can be a powerful tool to daily living. Strength training helps improve respiratory function, muscular strength and endurance and it supports your ability to live with using less effort. The musculoskeletal system moves the body’s joints so that you...