Laryngitis: Dealing with a lost voice as a singer, actor or speaker.

One of the most common questions asked of me is “how do I deal with singing when I have laryngitis?” More often than not, the laryngitis is being experienced at “the worst possible time.” Normally there is an audition coming up, or a show. Maybe the laryngitis has passed, but the notes still are not there. It is most possibly one of the most frightening and demoralizing experiences for any singer. While this article is focused on the singer, I would strongly suggest that actors and speakers learn simple techniques to getting their voice back, like diaphragmatic breathing, humming and using some of the suggestions below.

The first thing I would like to say is you are not alone. Everyone has this experience at some point in their life. Maria Callas was known to fully cancel performances when her voice was bad. There are recordings online of Pavarotti singing while clearly very sick – he seemed to be sick more than anyone! Sam Smith toured New Zealand a couple of years ago and he encountered laryngitis while down here. He struggled through some shows and needed complete vocal rest afterwards.

What happens when you have laryngitis?

Firstly, let’s just briefly go over what you’re likely to feel if you have laryngitis.

1. You will probably notice it during the morning one day. You will go to speak and the voice will ‘fry’ (like a croak or drone).
2. When you hydrate and attempt to phonate, the voice will feel noticeably lower. For some girls, the voice may in fact sit higher than usual (like a croaky whisper), but will have no power.
3. You may have soreness in the throat. This tends to be leftover soreness from having a virus higher in the pharynx as sometimes it’s hard to ‘feel’ pain in the larynx.
4. At the later stage of laryngitis, you will notice vocal function return, but the upper passagio is near impossible to sing on (you will feel like you’re pushing) and low notes may be particularly easy to sing, while not necessarily feeling comfortable.

The causes:

1. Excessive yelling or talking over loud music.
2. Being near the end of a flu or cold virus or bacterial infection.
3. Nodules, polyps or an edema(intense area of swelling).
4. Excessive throat (uncovered) singing.
5. Singing or talking too much while the voice is already fatigued.
6. Not taking enough vocal rest after a bout of laryngitis.
7. Acid reflux (GERD), particularly after night-time reflux.
8. Singing without hydrating or warming up.

An explanation:

Firstly, look at the picture of the normal vocal cords below.

From www.voicedoctor.net

The top of the image is the front of your neck, while the bottom is towards your spine.

Now let’s look at a picture of vocal cords with laryngitis.

From nethealtbook.com

In this picture, the front of your neck is at the bottom.

When the body causes inflammation (through hypervascularity, expanding of the arteries), it is doing so to bring more nutrients, repair cells and immune system cells to a site that has been damaged. This is why you get inflammation with itchy bites, or if you have a large gash or pimple.

Now I want you to imagine a guitar; the strings that are the thinnest play the highest tune, while the thickest play the lowest. When you have laryngitis, your cords are puffy and larger, they will therefore generally give you a slightly lower timbre.

You will also notice that the structures around the cords are also inflamed. These ligaments, tissues and muscles are responsible for holding the cords together healthily during normal phonation. While swollen, it is very difficult for the cords to come together properly. This is why you get ‘crackling’, ‘popping’ or ‘frying’ sounds (as if there is buzzing in the cords). This sensation can easily occur days and weeks after the main hoarseness has healed because they are larger structures that take longer to heal. This is why some people find that their voice takes a long time to return to normal function.

This is actually rather good news. Why? Let’s discuss.

When is it ok to sing again?

It is ok to sing again when you can phonate and speak healthily with no pain at all. Also, when you are sick, do a scale  to find the lowest note you can sing while sick. You will notice that you may have a few added on the bottom. Vocal cord swelling has stopped when you can no longer hit these notes. Sing an easy scale on an ‘ooh’ (Italian u) a few times through your lower to middle range. Gradually add notes to the top of this. If you can safely move through your range within 20-30 minutes AND you no longer have overly low notes, your vocal cords have probably stopped swelling. This will normally be the case about 3-4 days after the initial laryngitis occurs.

But then we try to sing after 3-4 days and the voice just doesn’t ‘feel right.’ We are pushing a bit too much, there are still crackles, particularly in the passagio, and the voice feels like it takes forever to warm up. This is because the structures around the cords are possibly still recovering.

How do I restore vocal function?

For about a week after you have recovered, your body will be fatigued (if you have had a virus) and the structures around your larynx will be still and may still be a little swollen. Therefore, the optimal singing function will not return immediately. Consider this a time to go back to basics and work on healthy cord closure and body connection.

I would strongly recommend the Caruso scale if you have not read about this already. This is a scale on an “ah” to “awh” to “uh” (or “ooh” as a female), in the lower, middle and upper part of the range respectively. You can also restore vocal closure by doing staccato vocalizes on 1, 3, 5, 8, 5, 3, 1. Sing note 1 three times on a short “eh”. Then on 3 and 8 use an “oh” vowel (as in “Oh my!”) and on 1 and 5 sing the “eh” vowel. Only take this as far as is comfortable.

Pretend to hug a large tree in front of you as you do this. This is very typical of the Italian/Swedish school of training. This will ensure that you are re-uniting your body with your vocal function as well. Spend about 30 minutes, twice a day on these vocalizes for the first two days after recovering. On the third day, do an hour of vocalizes followed by an extremely simple art-song. Do not sing a song that requires a lot of range, stay within your lower-middle registers. Slowly add a song to your repertoire a day until you have about 4-5 simple songs that you use for re-building strength.

I would also recommend using a number of the suggestions I have outlined below  in the emergency “I have to sing tonight with laryngitis” list. I refer to every bullet point (including inhaling steam, drinking healthy smoothies and teas and using vocalzones).

What if I have an audition or show coming up in a few days?

Photo credit: Justin Tallis (yahoo.com)

Firstly, you may need to make a choice here. If you have an understudy, or you are doing an audition or an exam, you need to seriously consider not performing. Singing while your vocal cords are swollen can and will cause further damage. Think of what happens when you keep scratching an itch or picking at a scab. Here are some approaches you can take:

1. If you have an understudy, you need to speak to the stage manager and production manager to inform them of your issue. This will mean that your understudy is on stand-by for if you cannot go on. This means that right up until you go on, you can pull out. More often than not, singers find their voices coming back right on time, so DO NOT hold back on having your understudy at the ready.
2. If you are doing an audition, notify the producer/audition manager/production manager, NOT the director, that you have laryngitis. Call them and politely inform them of your issue and that, if possible, you could audition a bit later. Give them your apologies of course and keep them in the loop so that they are not left waiting for a suggested date. Do not contact the director or the musical director as they may not appreciate this.
3. If you are doing an exam, you can very easily get doctor certificates to postpone them.
4. Always have a few colleagues in mind who you can call on if you need someone to cover for you in an emergency. It’s not always the case that they are available, but it’s wise to have them around for the worst case scenario.

Unfortunately, a lot of the times, there is no understudy, or the performance is more of a one-off, corporate event and it’s hard to find another singer to replace you. In this situation, there are ways to make this process easier.

Here are some more immediate solutions. The final solutions should only be done AS A LAST RESORT. Please note that if you do not have to sing for a day or two and your laryngitis has only just started, you need to remain SILENT until the day that you are going to sing. You could potentially do steps 1-3 the day before, but ideally you want as must rest as possible. Refrain from socializing and withdraw from any social events that you have planned.

The emergency “I have to sing tonight with laryngitis” list:

• Take one vocalzone every few hours. I also know a lot of professional singers who use Thayer’s throat spray to keep their mouth and throat consistently lubricated and fresh.
• Eat a lot of fruit for vitamin C, make smoothies out of healthy ingredients like kale, spinach, avocado, chia seeds, quinoa and linseed. Use frozen berries and honey for flavour
• Leave a pot of water on the stove. Every 30 minutes, re boil this pot. Take it off the element, put a towel over your head and inhale the steam. Be careful not to burn your face while doing this. I find it is best to go under the towel only when you are going to breathe in, then go out periodically.
• Drink lemon, honey, ginger green tea throughout the day. The ingredients will assist the immune system and give you some mental strength. If you have any residual swelling in the pharynx, this will ease that swelling. It will also calm your nerves. I feel as if tea can be more of a psychological remedy as the feeling of ‘warmth’ and ‘hydration’ in the pharynx can make for less strain and more ease.

From www.diabeticpick.com

• Every hour, spend 10-15 minutes humming, lip trilling and phonating on an “ng” in a VERY comfortable part of your range. As the day goes by, start to increase the outer extent of where you hum.
• Everyone 1-2 hours, spend 10-20 minutes doing breathing exercizes. Lying on the ground, legs bent, feet to the floor works the best for me. Simply inhale and go for as long as possible on a ‘ssssss’. If your breath is working optimally, this does make life much easier.
• After about two hours, do some very easy scales on an “ooh” (Italian u) or “ih” (Italian i) in the lower to middle part of your range. I find that 1,2,3,2,1…. 1,2,3,4,3,2,1… 1,2,3,4,5,4,3,2,1… 1,2,3,4,5,6,5,4,3,2,1 is about as far as you want to go. For the first few sets only go as far as your middle. Nearer the end of the day, do these scales again but more towards the upper part of your range.
• Practice singing some of your lines in pure head voice (‘re-enforced falsetto’ for men, or the higher, lighter mechanism for women). This ensures that you have a back up if your voice does not feel like it can handle certain notes.
• LAST RESORT: Have a pack of ibuprophen or other anti-inflammatory drugs around. This will cause the swelling in your cords to reduce.
• LAST RESORT: Go to a doctor and get them to prescribe a steroid drug for your inflammation. This is guaranteed to reduce the majority of your swelling. However, please do not use these for any more than 1-2 nights. When you reduce the inflammation, you delay healing and may also sing too confidently or with too much push on your cords. Remember that they are still injured and will require excellent technique to keep them protected even with anti-inflammatory drugs.

Laryngitis is something that plagues us all, and sometimes it is impossible to avoid it. As a general rule, I would always recommend avoiding social situations where loud music is involved. I also suggest that you take a multi-vitamin supplement on a regular basis if you know you have a performance coming up within the next 4-6 months.

You should also make sure that the vocal technique you are learning involves ‘protecting’ the voice and keeping the vocal cords in a state of rest, rather than strain. This means that laryngeal tilt, body co-ordination and correct vowel modification in the passagio is required. Feel free to contact me if you have any questions about these things or have a good look around the website, we may answer your question for you!

Have a wonderful week!

Michael