Vocal Health for Performers

This is a video demonstrating normal vocal cords in a professional singer as seen during a laryngeal videostroboscopy exam. Below are some tips to keep your vocal cords looking this healthy.

Protect your voice

  • Have an Ear Nose and Throat doctor specializing in voice (laryngologist) perform a baseline videostroboscopy of your vocal cords.
  • This test is more specific than endoscopy, as it allows the clinician to observe vocal fold oscillation, which is critical for assessing potential voice pathology.
  • Provide candid feedback to singing teacher, coach or director regarding throat comfort. It may sound great but not be comfortable for you to produce the voice quality. Ask for alternatives if you are experiencing fatigue, pain or discomfort with the voice production they are encouraging.
  • Sing within your range. If you accept a role that is not characteristic of your voice classification, you run the risk of damaging your voice.
  • Belting is not bad for your voice, just make certain you can achieve the powerful sound without excessive breath force, volume or throat tension. Always seek singing teachers with particular expertise in the type of music you want to sing. Classical music training is an excellent foundation and common among singing teachers; however, this does not always address how to sing efficiently in your selected music genre.
  • Speaking technique is very important to preserve singing ability. Another angle to consider is that you are selling your voice and it is far more marketable to do so with strong, resonant tone clarity. Avoid use of abrupt speaking onsets, vocal fry and throat focused resonance. For more details, consider our Voice Health for Singers course.
  • Always warm-up. Start in speaking range, slowly progress to mid and upper/falsetto ranges. Incorporate semi-occluded exercises (example: lip buzz, rolled R).
  • Stay healthy. Keep physically fit; singing is a sport.
  • Consider social choices the night before a performance. If you don’t, you may lose your voice. Avoid excessive talking and especially do not converse amid competing noise. Think of every situation in which you may be taxing your voice (example: waitress/waiter at loud restaurant).
  • If you feel fatigued, STOP. Otherwise, you may develop long-term vocal cord damange.
  • Don’t cough or clear your throat. It can callus your vocal cords or create other pathologies that may require surgeries. This will also impede the vibratory integrity that gives your voice the unique, marketable quality.
  • Vocal hygiene: drink a lot of water. The best way to know you are drinking enough is if you urinate clear. Avoid caffeine and alcohol. They can further dehydrate you and may exacerbate a potential condition of reflux. An excellent reflux textbook guiding lifestyle changes is Dr. Jamie Koufman’s Dropping Acid.
  • Your medications could be causing voice side effects. The following is a link to the National Voice & Speech website, where they have developed an excellent resource to check if there are adverse effects on your voice: www.ncvs.org

Signs of voice pathology

  • Vocal fatigue
  • Pain speaking or singing
  • Change in voice quality throughout the day
  • Running out of air
  • Pitch range restriction
  • Delayed onset of voicing, especially in upper range


  • Don’t whisper: Not necessarily. If performed correctly and without excessive strain, this might be just the opportunity you needed to rest your voice. It is more of a articulation mime versus sound. Minimize the amount of air you use. It is the strain of whispering loudly (you might as well be talking) that gets the bad rap.
  • Vocal cord surgery will cause permanent damage: You might hear horror stories of vocal cord stripping for nodules, polyps or other pathologies. Could this damange your vocal cords? Yes, absolutely. One shouldn’t allow the experiences of other people to dictate surgical choices. Avoidance of surgery may ruin your voice may hold you back professionally. The profession of laryngology has come a long way. Seek out a fellowship-trained laryngologist with particular interest and expertise in singers. Understanding there are risks involved in all decisions you make, do your research. Ask them about the surgery, how many they have done, what the success rate is and the amount of vocal therapy you can anticipate. Removal of vocal cord cysts and polyps, which traditionally do not go away with voice therapy or vocal rest, can be extremely straightforward procedures with short recovery times. If all goes well, you may be singing again within 4-6 weeks.
  • Intubation for surgery will damage my voice: This is possible, but unlikely. The incidence of intubation related vocal cord damage for routine outpatient surgeries is pretty low. Spend time discussing with the anesthesiologist your concerns. They will often elect to use a smaller breathing tube and take extra caution to protect your voice.
  • Throat sprays, tea, lozenges help your voice to sound better: Consider this….when you swallow, there is a structure that covers your vocal cords so that you do not choke. That means fancy teas are not even touching your vocal cords. Sometimes the introduction of herbs will simply irritate your throat, whereas your goal was to heal. If you swear by your vocal remedy of a specific drink, keep drinking it. Placebo effects are strong and it is possible that you find significant benefit to the surrounding laryngeal musculature. Final verdict: Drink water. Only water. It is found naturally in the body and needs to be replenished steadily as you sing.

The Voice Diet

—Want to lose weight? Eat 1200 calories/day.
—Want to lose vocal cord swelling? Shhhhhhh.
—You get 20 points per day. Here’s how it works:
—2 = 30min total talking at quiet volume/humming nearing speaking pitch.
—4 = 30min total talking at moderate volume/singing in comfortable range.
—6 = 30min total singing/talking at loud volume/singing at register extremes.
—8 = violent coughing or throat clearing >10x/24hr
—Add 3 points if you did not consume a net of 64oz water
—Add 3 points if you did not take your reflux medicine (if appropriate)