Vocal health is of paramount importance to singers, as the voice is their instrument and needs to be kept in excellent condition for it to perform effectively. When vocal illness is present, it can impact not just the voice, but can lead to other physical and emotional health problems. One of the major issues is who and where to go for help and advice.
Many singers, along with other professionals such as teachers, doctors, and public speakers, suffer from problems arising from issues with their vocal folds: laryngitis, vocal nodules, and polyps, as well as paralysis of the vocal cord. These are two bands of muscle tissue located in the larynx that vibrate, producing sound waves through the nose, mouth, and throat; this produces the tone, volume, and pitch of the voice. An article written by Sataloff looks in detail at the challenges involved with vocal fold scarring, and he stresses that “the best treatment is prevention” (2015: 467). He also suggests that singing teachers have “a basic understanding of vocal fold healing in order to help guide and counsel students” (2015: 467). Of equal importance are the resonators, the throat, mouth, nasopharynx, nose, and sinuses, to add color and depth to the voice; when there is not enough air and sound able to bounce around the vocal tract, singers can encounter many further vocal problems.
For example, a bad cold causes congestion of the vocal tract and the nasal cavity, which means that the vibrations are unable to bounce around the nose, and this changes how the voice sounds. Another common problem for singers is having a deviated septum; this occurs either naturally or after a trauma to the nose and causes the cartilage in the front of the septum or the bone at the back to be crooked. This can make breathing difficult because of increased nasal congestion and be the cause of recurrent sinus infections, headaches, and postnasal drip. Surgery called septoplasty can be carried out to straighten the septum, but it is difficult to ascertain whether the operation will improve the problem.
I have been singing since I was ten, classical since twelve, and opera since sixteen. I started to realize around the age of sixteen (when my voice was stabilizing and I was beginning a more vocally strenuous repertoire), that something was wrong with my voice. I felt constantly blocked up, as though I had a constant cold. My throat would dry up extremely easily, and I would feel uneasy singing above an FG. As a tenor, this was rather daunting. Eventually, an ENT specialist told me that I had a deviated septum, but that an operation might not actually help at all. Now in my third year of university and I have still not received the help that I need. It's become imminently clear to me that there is not enough support for singers and their general welfare. I intend to meet with another leading ENT specialist in London soon to try to get to the bottom of my own health problems, but I would like to discuss the effect that illness can have on the performer mentally.
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I know that singers, and all musicians for that matter, are already anxious enough before a big performance, exam, or gig, without having to worry about external factors. I find myself in a near-constant state of anxiety whenever I perform, fretting about my throat being dry every five seconds, being too blocked up, and whether that means I will not be able to reach the big Bb or C at the end of my piece. It is fair to say that the mental damage that the illness brings forward is equal, if not more, stress-inducing for the singer than the physical factors. To put it simply, there is an enormous lack of both medical and mental health support for singers at all levels of education. For us, our first line of defense is our singing teacher. If we think something is wrong, we go to them, which is not always the answer, as they may not all be vocal experts. It's vitally important that singers get the attention they need early on in their musical education, otherwise, we are subject to the risk of damaging our voices permanently without even knowing anything is wrong.
Trollinger talks about a relatively new area called ‘performing arts medicine’, which is a field “composed not only medical doctors, but also specialists in music performance and mental health” (2016: 3). Trollinger believes this to be of the utmost importance for those involved with performing, as it encompasses performance anxiety, hearing loss and physiological problems relating to singing. Another article written by Latham includes an in-depth survey carried out in 75 postgraduate schools and colleges looking at how much education is provided on vocal health and who provides it. She concluded that although a high number provided “some instruction in vocal health and vocal physiology to their graduate singing students” (2016), under half used any medical professionals, and there was a real need for more collaboration with these professionals and for vocal health to be a compulsory module at university. LaPine discusses the importance of vocal health and awareness for singers and other professionals who rely on their voice and stresses the need for a multidisciplinary approach, including “physicians who are trained to manage laryngeal function, certified voice teachers and coaches who are knowledgeable about voice production and voice use” (2008: 29), along with speech-language pathologists and psychologists.
I attend a performing arts university, but I’ve found very few resources available in the library on vocal health. In conducting my own research, I have discovered that there is much work being carried out around vocal health which will hopefully lead to better understanding and awareness for the performer and the teacher. I have also discovered websites such as The British Voice Association and BAPAM, which provide specialist health support to performing arts students and professionals.
In conclusion, vocal health is vital for singers, and vocal illness can impact not just the voice, but also a person's overall physical health and emotional well-being. There are services and help available, but I believe that this subject should be an integral part of the university department and possibly incorporated within a compulsory module.
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