Preventing Vocal Injuries Among Instructors

ADVANCE for Speech-Language Pathologists & Audiologists,
Dec. 23, 1991
By Alida Engel

Over the years, I have become more aware of my body through weekly aerobics classes. My instructors have taught me how to prevent injuries, eliminate excessive strain and respond appropriately to the warning signs my body sends.

But while they are aware of many physical problems that might arise, they may not be tuned in to potential vocal injuries. Teachers who persistently strain their voice while shouting directions in class can damage their vocal cords and may eventually develop vocal nodules or polyps. They need to become more aware of the vocal chords as a muscle and apply their knowledge of proper body maintenance to the use of their voice.

If appropriate attention is given to early warning signs, damage to the vocal folds can be prevented and even reversed.

One warning sign is a voice that hurts or is tired after talking a lot. Others include losing one's voice after excessive use, from a cold or when tired; feeling tension in the throat and neck when talking; frequently running out of breath; and straining to talk.

Maintaining voice quality requires having the proper environmental setting, breathing, word attack and muscle tension. The instructor who ignores a sore throat and pushes to be heard is beginning a cycle of muscle abuse.

If used in a forceful, tense manner, the muscles of the larynx will fatigue. Long-term abuse will result in changes in normal muscle tone and function and the vocal musculature will have to work even hard to produce appropriate phonation. In order to be heard, the speaker will have to exert grater pressure, which will cause more damage to the larynx.

Harmful behavior includes shouting in an extremely dry, cold or dusty room; yelling instructions over loud music; shouting with a sore throat and cold, yelling excessively with a throat dry from antihistamines; maintaining poor eating, breathing and sleeping habits; shouting with excessive tension in the neck and upper body; and instructing with an improper breath supply.

The long-term effect of this type of disregard can be dramatic. Preventive measures implemented prior to heavy use will result in a healthier voice mechanism that can handle the demands of long hours of teaching.

These measures fall into five categories.

• Environment: Turn down the music and use alternative means of giving directions, such as counting only movement changes, creating a habitual counting pattern (8, 4, 2, etc) or using hand signals, finger snapping, a microphone or whistle. Explain the necessity for these modifications to class members and seek their cooperation.

• Health: Drink plenty of fluids and limit spicy foods. If you suffer from frequent gastric influx, seek the advice of a dietician. Maintain good posture. When ill, limit your voice production, throat clearing and the use of throat drying medications. Cough or clear your throat gently when necessary. Do not force voice production before and during menstruation.

• Susceptibility: If you have a history of voice disturbances or allergies, take extra precautions. Use healthy vocal techniques and condition the voice by easing into demanding verbal situations.

• Stress: To ameliorate stress, which may damage the small muscles of the larynx, take time before class to warm up your voice and visualize proper use of voice during instruction. If stress cannot be self-limited, consider participating in stress-reduction programs, meditation, or yoga.

• Phonary factors: Proper breathing and vocal use can be modified most readily. Inhale and exhale by contracting your abdominal muscles, not by raising your shoulders. Increase loudness by acquiring more air from the abdomen, not the throat, and opening your mouth wide. Renew your breath frequently, shouting before all the air is exhaled, and use an easy attack on words (starting words with an "h" sound).

Instructors should also rest their voice by talking less, although whispering is discouraged because it strains the vocal chords. They can also seek out a speech-language pathologist to help reshape poor vocal habits.

Not all voice problems can be eliminated. If a problem persists for more than 10 days, the instructor should see an otolaryngologist.

Maintaining a health voice that sounds good takes knowledge. Aerobics teachers who apply what they know about proper body and muscle care to their voice usage will enjoy a better functioning vocal mechanism that can endure long hours of use.

• This article drew upon the writings and expertise of Dr. Thomas S. Johnson, Dee R. Child, Virginia L. Aaron, and Dr. L. Madison.