What To Do If You Are Suffering With Your Voice

Advanced clinical vocal specialist Stephen King discusses exactly what to do if your voice doesn't feel right and you think you might have a vocal issue.

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What To Do If You Are Suffering With Your Voice

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    Are you are suffering with your vocal health?

    Losing your voice too easily, struggling with your range, think you might need a camera down your throat or things just don’t “feel right”?

    Here are the steps you should take to get the treatment you need and see yourself back to your belt in no time.


    First Step – See Your GP

    If you have a vocal issue that hasn’t gotten better or things just don’t “feel right” for more than two weeks; the first thing you need to do is go and see your GP.

    Whilst a GP is not a vocal specialist and likely doesn’t have experience with performers, you have to see them first so they can rule out any general ill health and get referred to a specialist if needed.

    They may say silly things to you such as “just give up singing for a while” or “rest your voice for six months” but in any case you need to push for a referral to a specialist voice clinic.

    Get Referred To A Specialist Vocal Clinic

    A specialist vocal clinic is an NHS facility where the doctors have a narrow focus on treating issues specifically with the voice. These clinics can sometimes be within a hospital where usually an ENT (Ear, Nose & Throat) or Laryngoligist (specialising in the vocal mechanism) can further assess you and your situation.

    It’s important that you push your GP to refer you to a specialist clinic for further examination as this is a free service.

    A list of NHS vocal clinics in every major city in the UK can be found here:

    https://www.britishvoiceassociation.org.uk/free_voice-clinics.htm

    While you’re waiting on that golden referral there are a few things you should do.

    Is Your Diet & Lifestyle Supporting Your Voice?

    Consider your diet and lifestyle; are there any obvious issues you could be addressing there?

    Interestingly there’s no hard and fast rule about diet in regards to singing

    Research shows that over half the population of the western world have some degree of intolerance to lactose and gluten (this is probably where the myth about eating chocolate or milk before singing comes from!)

    This could cause undesirable effects in the vocal tract due to imbalances in the digestive system. It is worth cutting out these ingredients to see if it helps your vocal production.

    If you are experiencing vocal fatigue, a good place to start is to ask yourself are you doing too much of the following:

    1. Not too long – This varies from person to person, only you know what’s too long for you.

    2. Not too loud – Can you allow your mic to do more work for you? Do you need coaching help with your speech support or projection?

    3. Not too high – Are you constantly singing right at the boundary of your range or speaking at an unnaturally high pitch?

    4. Not too often – Are you using your voice a lot, every single day, for extended periods?

    5. Not warmed up – Are you gently warming up for an appropriate length of time for you?

    6. Not cooled down – Are you gently relaxing your vocal muscles every time, afterwards.

    7. Not hydrated – are you drinking a litre of water at least 4 hours before you need to sing?

    8. Not rested – Are you sleeping 7+ hours a night and taking the equivolent of two days vocal rest a week?

    This above list is intentionally a little non-prescriptive as each voice is different. Some people don’t need to warm up for 15 minutes, in fact new research from the ballistics and manual therapy world suggest we may only need 3 to 4 minutes, otherwise over the course of an 8 show week you could have added 2 extra hours of vocal load just in warmups!

    The same is true for how long in total you should be singing for, how often, how much hydration you need and how much rest you require. The main point here is that addressing how each of these 8 things apply to you and your individual voice should be first on your list of ways to improve your vocal health.

    Book A Manual Therapy Treatment

    Sometimes all you are experiencing is a lot of muscular tension which can be alleviated by a few manual therapy (or vocal massage) sessions.

    There are various forms of manual therapy, the most popular being “Vocal Osteopathy”, “Vocal Physiotherapy” and my own painless method of “Myofascial Release” each has their own techniques and characteristics.

    You can check out PhysioED, Fabi and the team at West End Osteopathy as well as my own practice King – Manual Therapy based in Covent Garden. Each type of treatment is different but ultimately the end goals are the same.

    Book A Session With A “Vocal Rehabilitation Coach”

    Whilst all vocal coaches and singing teachers should have a working knowledge of the vocal cords and surrounding areas most singing teachers and vocal coaches are not equipped to deal with voice problems.


    Most singing teachers and vocal coaches are not equipped to deal with voice problems. - says @skingvocal Click to Tweet

    A vocal rehabilitation coach has specific training in identifying and diagnosing voice disorders and their root causes for example; muscular problems or lesions (cysts, polyps, nodules).

    They can help you with things like stretch and release of vocal tract tension, physical alignment of your body and vocal instrument, improving performance breathing habits and vocal fold function while using your voice.

    There are only a few in the UK but they are a good place to start assessing any technical faults and starting you off thinking differently about your voice.

    If you value your voice, please seek help from a kickass specialist.

    Consider Psychotherapy Or Mindset Coaching

    We start to sing from the brain, not the larynx, so it’s important that your thoughts are in order before your muscles can coordinate your artistry.

    You can book some psychotherapy or mindset coaching sessions to help you deal with thoughts and beliefs about yourself, your voice, your work and life that all contribute to injury prevention, rehabilitation and better performance overall because singing made in the brain and manifested in the larynx.

    If you’re not sure which would be a good fit for you, you can contact Applause For Thought who are a non-profit that provides free and low cost mental health support, talks and workshops to those working in the entertainment industry.

    Also, listen to the podcasts put out by Industry Minds, ‘coz why wouldn’t you? They offer break-through podcasts discussing mental health in the creative arts.

    After A Scoping – Keep Your Results

    When the referral date for your ENT finally comes through they might suggest that you have a Laryngoscopy (camera down your throat). This will help them see if there are any physical signs of vocal abnormalities like tears, bleeds, lesions, nodules etc.

    Make sure you keep the images or video of the scoping process. This is so that other professionals can help you in the future.

    It’s important to remember that if they do spot something wrong, a diagnosis is not always permanent and in fact injury happens to 80% of professional voice users!

    We wouldn’t feel as ‘dirty’ about having an ACL injury as we do about getting nodules right? This needs to change; the level of anxiety surrounding voice use is high enough already!

    Put A Maintenance Plan Together

    These days I am seeing an increasing number of worried singers with no action plan.

    To recover from a vocal issue no matter how small or severe and to maintain a healthy instrument you need to put together a plan out of everything listed above;

    Consider your lifestyle, diet and how you’re using and supporting your voice. Book some manual therapy sessions, vocal rehabilitation coaching and consider your mental wellness too.

    Follow the directions of your doctors and get their help in developing a vocal rehabilitation and maintenance plan that suits you and your needs.

    Obviously this can cost hundreds of pounds a year so if you need financial help you should start by contacting one of the following organisations for financial and other help.

    Help Musicians UK

    Help Musicians UK who are an independent UK charity for professional musicians of all genres and career stages. HMUK help at times of crisis, but also at times of opportunity, giving you the extra support you need at any crucial stage that could make or break your career. They can help with things like paying for therapy or medical treatment as well as making payments towards household bills and other living costs to help cope if a crisis means you’re not working.

    BAPAM

    Another great place to look is BAPAM – the British Association for Performing Arts Medicine. BAPAM is a healthcare charity giving medical advice to people working and studying in the performing arts. BAPAM help you overcome (and preferably avoid) work-related physical and mental health problems.

    Their clinicians are experienced at dealing with the problems performing arts workers frequently face, and can help with an accurate diagnosis and advice including identifying efficient care pathways, both in the NHS and from other specialist individuals and services.

    The BAPAM team can also advise about the availability of financial support for people experiencing health problems affecting their ability to work or study.

    If you make a proportion of your living from, or study in the performing arts, they can help you.

    Want Some Help With Your Voice?

    I’ve put this together as I’m seeing an increasing number of worried singers with no idea how to help themselves or seek help from others. I hope this helps you out.

    If you are worried about your vocal health or want to chat about anything you can DM me on twitter and I’ll be happy to help in any way I can.

    You can reach me at: https://twitter.com/skingvocal/

    And please share this because someone on your timeline may just need to see this!


    I originally trained as a ballet dancer at Central Ballet before retraining at ArtsEd in Musical Theatre. After recovering from a knee injury I left performing and am now an advanced clinical massage therapist with an Advanced Certificate in Myofascial release and a unique Level 7 Post Graduate Certification in Vocal Pedagogy, which has seen me develop my own painless form of vocal massage. I am an international lecturer and educator teaching vocal massage, vocal health and anatomy for Modern Vocal Training, as well as training singing teachers in my technique from my clinic in Covent Garden. Follow @SKingVocal on Twitter

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