Do you ever get hoarse? Have you ever completely lost your voice?  Do you tend to lose your voice when you get a cold? Are you ever hoarse after singing or speaking? Have you ever wondered what to do if your voice is hoarse?  What if there is a way to quickly heal vocal hoarseness or avoid getting hoarse in the first place?

Well, as a matter of fact, there is.

If you were to search for help regarding hoarseness or lost voice on the internet, or ask your ENT (Ear, Nose and Throat doctor) or laryngologist, you would learn that acute hoarseness and loss of voice could be due to factors such as bacterial or viral infection, allergies, acid reflux, smoking and vocal abuse.

You may be diagnosed with terms such as laryngitis, pharyngitis, tonsillitis, strep throat etc. Know that every “–itis” simply means that there is an inflammation. So Laryngitis means that there is an inflammation of the larynx. Inflammation can be due to viral infection, bacterial infection, acid reflux, vocal abuse etc.

An ENT would treat a bacterial infection with antibiotics and would also prescribe rest and silence. From other sources you may be advised to drink lemon tea, herbal tea, tea with honey, chicken soup, cough drops, throat lozenges, etc.

But what if you found out that the allergies, infection, acid reflux, illness or other difficulties didn't cause hoarseness?

Let’s ask ourselves this question:

What really happens when your voice becomes  hoarse?

Let's first look at how sound is produced.

Your voice is produced when your vocal cords (or vocal folds) come together and vibrate. If they can't do that, there will be no sound.  So let’s imagine a day when you talk or sing a lot and you start getting more and more hoarse. What is it that is happening?

Well, if you need to be heard, you probably experience more and more effort to produce sound.  This effort brings with it that you use muscles that would normally not be used on a good day.

As soon as there is weakness or dysfunction somewhere in our body, the body will always compensate. For example, when you get an infection, the body produces the heat of a fever to fight it. If you hurt your foot, but still need to move forward, muscles will compensate and you will walk differently.

When your voice becomes irritated or fatigued, compensatory muscles kick into action. Desperate to produce sound, you use more and more effort, which results in more muscle tension and worsening of any potential inflammation.  If the tension becomes so severe that the vocal cords are unable to vibrate together, you have lost your voice. Swelling could be involved, which may have gotten worse because of the extra effort to speak or sing, but often swelling is not the primary problem.

A lost voice is often not due to inflammation, but is rather a tension/cramping condition that can be eased rapidly. And almost like magic, the voice can produce sound again.

Go here to see a free video on how to heal hoarseness 

For many this compensatory tension is habitual and the voice is therefore susceptible to any kind of irritant.  Many have a tendency to get hoarse simply because of weakness. Naturally, any irritant will then create havoc to an already weak voice.

You should know that people with strong functional voices are not all that affected by a cold.

Also keep in mind that if you engage in voice training you develop such an awareness of your instrument that when you start to feel “under the weather” you will know the best way to warm up and keep the voice performing. You will know what to do before your voice becomes hoarse!

You then know how to produce sound without having to add extra effort. that increases tension and adds swelling of sensitive tissues. You also know when it is time to employ effective vocal exercises to create free vibration and when it's best to be silent!

A well-trained speaker or singer knows how to protect the body from irritants and infections, and how to recover quickly when the voice has had too much.  Basically, a trained speaker/singer learns to recognize the signs before the voice "goes out," and therefore is able to prevent hoarseness in the first place.

On a good day we can get away with anything. On a a bad day we need skills. It is certainly more difficult to function at our peak when we're attacked by irritants. But if you keep your body healthy, it won't succumb quite as easily to bacteria and viruses.

(There many other issues that need to be addressed when it comes to chronic hoarseness, which might be classified as voice disorders.)

In summary:  If you develop a greater awareness of your voice and rebalance the muscles that are involved in creating sound you do not need to become hoarse again.

How does a dehydrated vs. hydrated body affect your singing and speaking voice? What effect does dehydration have on performance?

So you want to perform at your peak? You want to be mentally and physically sharp throughout the day? You want to be creative and productive and energized? Many people say they want this, yet they deplete their bodies of the very "fuel" that makes this possible. Many rather have sodas, coffee, etc., rather than a glass of water.

As a vocal and performance coach, I have found that just about everyone who seeks my help for voice problems drink frighteningly small amounts of water. (Many drink a lot of other, not so healthy, fluids.) This is hardly a coincidence. Although there is more to healing and peak performance than drinking water, hydrating the body is a very important and ever so easy step. Studies have suggested that the average American is dehydrated. As much as 75% of the population may be chronically dehydrated.

While scientists argue whether these statistics are true or not, and how much water a person really needs, what we can agree on is that the thirst signal weakens as we age. We also know that the more dehydrated we become, the more our thirst signals weakens. When you start drinking more, you start feeling thirstier more often – you are awakening the thirst signal.

If you are thirsty you are already dehydrated. Thirst is never a measure of adequate hydration.

Water is the medium through which all of our cells communicate with each other. It is how the immune system monitors the body for invaders or imbalances and how it knows where to send its "troops" when the body is under threat; all done without our conscious awareness of what is happening.

Water makes it possible for the autonomic nervous system, and its two branches, to maintain equilibrium in the body. Every cell in our body becomes aware when there is even the slightest water shortage. In response, the cells change from a state of optimal function to a state of conservation. Our tendency to substitute water for sodas, coffee, juices, etc. adds to the problem. Sodas create a bigger problem than merely the dehydration factor. They are also highly acidic and water is needed simply to restore pH balance, or the body will take from its calcium reserves (the bones) to maintain equilibrium.

The dehydrating effect of caffeine is still being debated, but people who drink coffee tend to do so instead of drinking water (even instead of eating food sometimes), rather than in addition to it. Most health practitioners, nutritionist, sports-trainers, athletes, singers, peak performers, etc., agree that drinking more than our thirst tells us is of absolute necessity for optimal performance.

• Water carries nutrients to our cells, aids digestion by forming stomach secretions, flushes our bodies of wastes, and keeps our kidneys healthy.
• The kidneys control the concentration levels of bodily fluids and the balance of electrolytes. They are responsible for removing excess hormones, vitamins, minerals, and foreign toxins such as drugs, chemicals, and food additives. They get rid of the waste products from protein metabolism - uric acid, urea, and lactic acid - but they need lots of water to accomplish this.
• Research has suggested that women who stay adequately hydrated reduce their risk of breast cancer by 79 percent.
• Gastrointestinal problems have been shown to be connected with water shortage. Hydration can help prevent chronic joint diseases, such as rheumatoid arthritis because water reduces inflammation and promotes cartilage health.

As singers and speakers, we depend on the flexibility and elasticity of the tissues, membranes, muscles and cartilages in our throat. We need water and lots of it. No liquid ever touches the vocal cords directly on its way down. You are not lubricating the vocal cords with the sip that you just took, although the swallowing itself does have a lubricating effect. To truly lubricate the vocal cords and the larynx, the water must go through your entire system.

On stage, we expel enormous amounts of energy whether it is a physical performance or not. Touring musicians live in air-conditioned vehicles and air-conditioned hotel rooms. AC and heating dries the air. The traveling voice professional would benefit by bringing a portable humidifier (clean it often to avoid bacterial growth). Airplanes are probably the most dehydrating forms of transportation. Athletes and singers drink copious amounts of water when flying (as should everyone). Jet lag worsens with dehydration. Conversely, keeping the body hydrated when flying is one way to diminish the effect of jet lag.

So how much is enough? The answer is that it depends. The measuring stick is always to have clear and odorless urine throughout the day (except for early morning). Can you drink too much water? Yes, the condition is called hyponatremia, and is a condition in which excess water intake dilutes the normal amount of sodium in the blood. However, realize that we are here talking about massive intake of water, such as the marathon runner who drank 3 liters in one hour the night before a race. The bottom line is this:

• If you want to heal illness, you need to hydrate.
• If you want to prevent illness, you need to hydrate.
• If you want optimal performance, you need to hydrate.

Some examples of disorders of the voice are nodules, polyps, calluses, hemorrhaging folds, vocal fold paralysis, vocal fold paresis, vocal fold bowing, granulomas, polypoid degeneration, and Spasmodic Dysphonia. There are a multitude of factors that may start the decline of a voice, such as bacterial/viral infections, allergies, acid reflux, neck injuries, substance abuse, psychological stress, etc.

Voice problems may also result from a person's physical use of the voice, whether we call it overuse, underuse, misuse, or abuse. However, what most disorders have in common is some form of muscle imbalance. Even though, for example, paralysis and paresis may be caused by a virus, granulomas may originate from acid reflux, and polypoid degeneration originates from smoking, these irritants set the stage for muscle imbalance in and of themselves

The key to treating voice disorders is to address both the 
muscle imbalance as well as reducing the impact of irritants.

Treating muscle imbalance Our body is brilliant at compensating in order to survive and in order to continue functioning. If you get too hot, you sweat to cool down. If you get dehydrated, a host of bodily functions begin to save energy for survival. If the larynx is hit by acid, the body creates mucus to try to protect it. If your foot is in pain, your whole body compensates in order to be able to move forward.

Likewise, if there is discomfort when singing or speaking (for whatever reason), the muscles of the vocal apparatus begin to compensate in order to produce sound. In fancy language we call this "maladaptive compensatory behaviors", and they become habits over time. Athletes know that it is often this secondary tension - the misalignment of the body - that can become a bigger problem than the original injury.

The athletes who have gotten to know their bodies well know that the initial treatment of an injury is of the essence for effective and expedient recovery. They also learn to train their muscles for maximum output. Although training methods evolve constantly, the key is always balance and "good form" in performing exercises to propagate a habitually effective use of the body. They also learn to recover from fatigue and how to treat their injuries.

The voice user would benefit by revering their instrument 
and body in the way of an athlete.

Like the athlete, the vocalist wants to be able to optimize his instrument to his maximum physiological capacity. The daily voice user (most people) benefit greatly when the voice is operating functionally, and everyone who has been hit with a voice disorder knows what a debilitating effect it has on one's psyche. A voice disorder can hardly be healed without voice training.

The term "Muscle Tension Dysphonia" has been created to describe a severe muscle imbalance. We could argue that every vocal disorder has a grade of Muscle Tension Dysphonia. A good example of this condition has been noticed when a person has surgery to remove vocal fold nodules without any voice therapy. Often this person experiences the same kind of hoarseness after the surgery as she had before. The reason for this is that the muscles have adapted to the nodules being there, and even though the nodules now are gone, the muscles still function as if the nodules were present. This is a good example of how brilliantly our bodies (not always to our benefit) hold on to muscle memory.

Nodules (mostly women) and polyps (mostly men) are easy to blame for hoarseness and lack of range. However, the hoarseness and range reduction are more likely a result of the muscle tension/imbalance that led to the nodules, and have worsened with the presence of the nodules.

The good news is that with voice training, we are able to rebalance
the functioning of these muscles. We can implant new habitual ways 
of using the muscles. We can strengthen and free the voice just as 
we can develop any other muscle in our body.

However, depending on the severity of the condition and depending on the individual's desire for optimal condition, there may be more than voice training that needs to be addressed. I personally work closely with some of the top health providers in their respective fields. Solving a person's vocal problems, as well as helping the performing singer/speaker to optimal performance, becomes a team effort.

Removing/treating irritants Substance abuse - In this day and age no further comments should need to be made regarding the effects on the body and the voice from smoking and the abuse of alcohol and other substances.

Acid Reflux - Laryngeal reflux, where acid backs up and irritates the larynx, has been shown to be a major factor in many disorders. There are many ways to combat this and my view on the common treatment method is addressed in The Truth About Acid Reflux.

Sinus infections/allergies – Sinus dripping, a.k.a. postnasal drip, has a major effect on the health of the vocal cords (vocal folds) and the elasticity of the larynx. There are numerous methods to treat your sinuses in which pharmaceutical drugs are probably the least effective and the most destructive.

Remove irritants from your indoor environment. Mold, dust mites, dust, pollen from outdoors etc., are notorious for creating sinus problems (and other health problems). A high quality HEPA air filter should be a must for any serious voice user. In addition to trying to remove allergens, the task would be to boost the body's immune system to lessen the impact of irritants.

Chinese herbs (custom formulated by a specialist) have shown to be exceptionally effective without the side effects of pharmaceutical drugs. Osteopathy treatments and Acupuncture treatments are also very effective in treating sinus problems.

Recurring Laryngitis - Here is a condition where far too many rely on corticosteroids or cortisone (such as prednisone), often unaware of the accompanying lowered immune function, which sets the individual up for the next laryngitis. The suffix "–itis", whether gingivitis, gastritis or laryngitis refers to an inflammation. The most powerful anti-inflammatory substance is cortisone, which is produced naturally by the adrenal glands.

The trap of pharmaceutical drugs When you take manufactured cortisone, the adrenal glands see no need to continue their natural production, which is why there are numerous side effects. Many people already have weakened adrenal glands to begin with due to stress, substance abuse, irregular blood sugar levels, chronic illness, chronic pain, chronic inflammation, etc.

For someone with a recurring inflammatory condition such as laryngitis, the strategy to strengthen the adrenal glands (and learning to use the voice with less stress) would probably be more helpful rather than weakening them further by taking synthetic cortisone. Acid reflux might also be a precursor to laryngitis as the acid irritates the vocal apparatus. Consider then, the quite common tendency to administer cortisone together with acid-suppressing pharmaceuticals. One might want to think twice before taking out both the adrenal glands and the stomach acid production – two of the most vital functions for one's immune defense.

Add an antibiotic to this concoction, which not only kills the unfriendly bacteria (perhaps), but also kills the friendly bacteria necessary to fight any invader. One can imagine what the body must go through as it tries to compensate for this severely depressed immune system. In light of the quick reduction of the acute inflammation, this treatment option seems understandable.

If this is the big moment of your career and you are to sing at the Olympic opening ceremony, it might be necessary. However, in most cases such a shortsighted approach is hardly in the best interest of the individual.

There are numerous ways to treat an inflammation. Hydration - Constant hydration may be the simplest, yet most overlooked treatment for all voice disorders and should always be part of the plan. Read Hydration And The Singing Voice.

Fatigue - Few things wear down the voice as much as lack of sleep. Few things are as powerful for healing the body and the voice as sleep.

Humidity - The tissues of the larynx do not do very well in dry environments (the body in general does not do well in dry conditions). Indoor heating and air-conditioning dries the air. A voice professional is well served by using a humidifier in dry conditions. Note that cleaning the humidifier is a necessity (depending on the manufacturer) or it can create a breeding ground for bacteria and mold.

Nerve energy to laryngeal muscles - For many people, the condition of their spinal column has a direct effect on their voice (and health in general). If the 4th and especially 5th cervical vertebra is compressed (which is quite common), it directly affects the nerve energy to the larynx. In such cases, a Chiropractor trained in Applied Kinesiology, an Osteopath, an Acupuncturist, and/or a structural training program, such as The Egoscue Method, helps tremendously. Someone skilled in laryngeal massage can also make a difference.

What about Surgery? If surgery is chosen it would be considered a more desirable option if it was in addition to, rather than instead of, other strategies. It is advisable to research extensively and get many expert opinions both from surgeons and non-surgeons before an irreversible surgery is performed.

Conclusion. Realize that everything is connected. There is no need to separate the voice from the rest of the body. There is no need to separate body from mind. An affected voice affects your mental state and your mental state affects your voice. When you learn to rebalance the muscles involved in voice production, dramatic results can occur. These are skills that the average voice user is seldom exposed to.

When you also rebalance and strengthen the body and mind as a whole, you not only empower your voice and body, but your life in general. How you sound is of less interest than that you are able to experience the free functionality of your voice. Your voice is you.