In The Vocal Injury 101 Series, Megan Gloss shows how you can avoid vocal injuries that affect popular singers.
Case: Keith Urban
Diagnosis: Vocal polyp
If you want to find inspiration in facing vocal hindrances, look no further than Country crooner Keith Urban.
Urban has battled vocal issues throughout much of his career.
But he didn’t consider it serious enough for surgical intervention until a polyp developed on his vocal cord, forcing him to push for the higher notes that once felt effortless in his register.
He lost his falsetto altogether – the golden ingredient of many songs that drove the fans wild.
Thanks to the advancements of surgery and working to strengthen his voice with a vocal coach, Urban emerged better than ever.
“I think if a footballer in their 40s was given their knees back like they were in their early 20s, that’s kind of how I feel right now,” Urban said recently.
“It’s an extraordinary feeling of freedom. I don’t have to push the pedal down to 70 mph to reach those notes anymore.”
Vocal polyps, like the ones that effected Urban, and vocal nodules have key similarities and differences.
What are vocal polyps and nodules?
The American Speech-Language-Hearing Association describes nodules as benign growths that form on the vocal cords as soft, swollen spots, most often resulting from vocal abuse, such as repeated vocal strain.
These spots can develop into harder, callus-like growths that have the potential to become larger and stiffer the longer the vocal abuse continues.
While similar to nodules, polyps can take on a number of forms. They can appear on one or both vocal cords as a swelling or bump, a stalk-like growth, or a blister-like lesion.
Most are larger than nodules and can be compared to blisters, while nodules are more similar to calluses.
What are the symptoms?
According to Dr. Henry Hoffman, ENT from the University of Iowa, nodules and polyps can cause similar symptoms, including hoarseness, breathiness, rough or scratchy sounds present in the voice, harshness, a shooting pain from ear to ear, a lump-in-the-throat sensation, neck pain, a decreased pitch-range and vocal fatigue.
Singers whose voices demonstrate these symptoms for more than 2 weeks should consult an ENT, Hoffman said.
An evaluation of vocal quality, pitch, loudness and the ability to sustain the voice will determine if either polyps or nodules could be a factor.
How do you treat and recover from them?
Both polyps and nodules can be treated medically, surgically and/or behaviorally.
Surgical intervention usually involves removing the nodule or polyp from the vocal cord; however, this approach is most suitable when the nodule or polyp is large or has existed for a lengthy period of time.
Today’s medical advancements have made it so these growths can be treated and surgically removed via laser, causing less scaring of the vocal tissues and strong recovery prognosis.
However, Hoffmann warns that laser surgery could yield some risk and advises singers to avoid it.
“Although we taught a course on lasers in laryngology for about 18 years – and still use them – we haven’t used lasers for nodules or polyps for many years due to concerns about thermal damage (scarring) and the availability of better instrumentation,” he said.
It’s more common for singers to receive and benefit from behavioral intervention, or voice therapy in response to polyps or nodules, even after a surgical procedure.
Voice therapy can involve teaching and implementing better vocal technique to decrease the risk of vocal nodules or polyps due to vocal strain or abuse and using voice treatments to alter pitch, loudness and/or breathe support for healthier singing.
Stress-reduction techniques and relaxation exercises also can be incorporated and beneficial for singers.
How can you avoid them?
Most vocal coaches advocate a healthy and organic singing technique, allowing the voice to grow through good breath support and vocal placement and not pushing or forcing the voice excessively beyond its natural capabilities, especially when nursing the voice back to health during the recovery process.
Teachers often can train singers in healthy ways to create dramatic sounds or vocal effects.
If you suspect your voice might be suffering from polyps or nodules, see an ENT, and resist the urge to force the voice to avoid further damage.
Also, implement healthy vocal rest practices and work regularly with a reputable vocal coach.
Urban’s New Found Freedom
Urban’s success in surgery, combined with a healthier approach to technique has even inspired his songwriting.
“I think getting my voice back has sort of been a metaphor for finding my voice more so as well as an artist, broadening it, really, to the things that I want to write about and I feel ready to write about that I guess I haven’t in recent years,” he said.
Check out Anthony Jahn’s blog: Polyps, Nodules – the Same Thing?
Megan Gloss is a classically trained vocalist and writer based in the United States.