3/8/16
Oh No, Nodules!
Vocal fold nodules are a singer’s worst nightmare. In the past, when
nodules were discovered on the vocal folds, the primary solution was to remove
them. However, it was soon discovered that once removed, they often recurred in
very little time. Nodules are formed due to excess stress on a particular area
of the vocal folds, commonly called a form of vocal abuse. Removing the nodule
does not cure the problem. Most people continue in the same vocal habits,
leading to more nodules. Even well-trained singers can develop nodules if they use
their voices excessively, sing too loudly or at the outer limits of their comfortable
range too frequently. Singers are not the only ones who develop nodules. They
can form as a result of errant speech patterns as well. A singer is taught to
sing, but one rarely receives “speaking” lessons. Speaking patterns and mannerisms
are typically learned from our major caregiver as a child, and carried through
life, for better or worse. Many people are surprised to learn the importance of
adequate breath support, forward focus, ease of phonation, release of tension
and easy onset in maintaining a healthy speaking voice. In today’s society, a
low-pitched, gravelly voice is frequently the norm for many, including adolescents.
Most are not even aware of the fact that they are harming their voices by the
way they speak. Awareness is the first step. Fortunately, for someone diagnosed
with nodules, surgery is rarely the only option, nor is it the first one
considered. Vocal rest is usually recommended along with a course of voice
therapy from a skilled speech-language pathologist who specializes in voice.
The voice therapist will provide compensatory strategies, gentle exercises and
instruction in ways to allow the breath to support the sound and produce “easy”
speaking, to reduce the load on the voice. This course is usually a radical
change in self-concept for the participant. Many argue that the new speaking
method just “isn’t me,” expressing concerns that it will change their
personality if they switch to a gentler mode of speaking. While it is true that
the voice will hopefully change to something healthier, the personality need
not necessarily follow suit. One can maintain personality traits without using
vocally damaging speech patterns to get points across during conversation. You
only have one chance at a healthy voice. Treat it gently. Avoid excessive or loud
speaking, yelling, vocal fry, grunting, singing outside of your range and in
general, anything that tires your voice excessively. It is much easier to
prevent nodules than to treat them once they form. Take preventative action and
develop healthy speaking patterns to reduce the possibility of nodules in your
future.
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