What Causes Singing Strain or Pain?

A sore throat from singing will strike fear in most singers, and for a good reason. Feeling irritation, strain, or pain during or after singing can be the signs of a wide range of issues and some vocal imbalances. However, if not taken care of early on, these symptoms can develop into more serious issues that can sideline the career of a professional singer and prevent amateur singers from progressing with their singing goals. Here we will discuss what can cause various vocal health issues and imbalances, and ways to avoid them.

Think of vocal balance as that place where your voice sits in the "sweet spot" of having ease in reaching all of your vocal range, having beautiful resonance, and good projection and tone, all without strain or forcing the sound. 

Several parts of the voice must be in balance to make the magic happen.

Simply put, we need proper breath support to the vocal folds, and we need the resonators in our mouth and throat to resonate and project the sound out to our listeners. (AIR - CORD - VOWEL.) But within this simple breakdown, there are so many nuances within each step of the pathway of singing that vocal imbalances can and often do occur during one's singing career.

What can start as an imbalance can quickly turn into irritation or a scratchy throat. If this imbalance is not adjusted, over time it can then turn into damage such as vocal nodules, vocal polyps, a vocal hemorrhage, and even vocal cord paralysis.

But the good news is if caught early, vocal damage can usually be reversed by resting the voice for a period of time along with voice therapy with vocal professionals. So it is imperative to listen to your body, and if you feel pain during or after singing or have persistent hoarseness, you seek out a professional opinion.  

But here are some common imbalances that can lead to vocal issues:

Breathy Singing

Although a popular stylistic choice in the pop world, breathy singing can lead to the vocal folds being dried out by the excess air being pushed through them. Also, when singing in a breathy tone, the vocal cords are not coming together as much, and if you are conditioned to sing this way, when you go to try to sing with more intensity with the vocal cords engaged more, your voice will likely tire easily and feel strained.

Tension 

Tension is one of those things that can be hard to nail down, as tension in one part of your body can have a domino effect and cause other areas to be tense as well. For example, tense extrinsic muscles in the larynx can lead to tense intrinsic muscles. Also, if your jaw is tight, your neck may become stiff and vice versa. Tension in any of these areas can lead to squeezing the throat muscles and forcing notes, which can fatigue and injure the vocal folds. 

Belting with Poor Technique

When belt singing incorrectly, singers tend to bring up too much weight or a "pulled chest" voice to create the sound. This pulled chest can lead to increased tension and squeezing, again putting the vocal cords under stress and at risk of damage. 

Healthy belt singing is when a singer is able to balance the resonances and registers to have a powerful sound without having to strain or push to get the notes. An additional effect of creating balanced acoustic energy is that this energy feeds back to the vocal cords, creating an extra resistance or backpressure at the vocal folds that create even more ease in singing these belted notes.

If you have a sore throat and difficulty swallowing, it could be an upper respiratory infection, such as a viral infection or a bacterial infection. Throat infections cause inflammation that can lead to a sore throat. You may also notice a fever and chills. Other symptoms include coughing, sneezing, runny nose, headache, body aches, fatigue, and loss of appetite. If your throat is infected with strep throat, antibiotics are usually prescribed by your doctor.

When experiencing throat pain from illness, you will want to get plenty of sleep and drink plenty of fluids, like temperate water and warm (not hot) herbal tea. Gargling with salt water can also soothe a sore throat. We all have our favorite home remedies, but essentially, you want to rest the voice, take care of yourself and give enough healing time until acute laryngitis resolves before singing or exercising your voice.

Medical conditions and prescriptions can also affect the voice as many medicines can be dehydrating. For example, antihistamines, decongestants, cough suppressants, muscle relaxers, diuretics, and antidepressants can dry out the mucous membranes of the mouth and throat. 

If a singer continues to use poor vocal technique, an irritated throat over time could turn into chronic hoarseness or even permanent damage. The voice box can only take so much vocal abuse, so prevention and knowing the warning signs of possible damage is imperative as a singer. As well, public speakers who use their voice a lot should also be aware of damage from overuse.

Here are some vocal injuries and conditions explained:

Vocal Nodules - These are small callous-like nodules on the vocal cord. They are often caused by excessive vibration of the cords from overuse, straining, or poor technique. Similar to the way you get callouses on your hands from hard work, vocal fold tissues build a thickened layer triggered by overuse or irritation. Quite often these nodules grow in pairs on the vocal folds in the area where the folds meet with the most pressure. Symptoms are breathiness, hoarse voice, a rough or scratchy throat, or a change in the voice.

Vocal Polyps - These are benign growths similar to a blood blister on the vocal cords. They are most often seen in people who sing for long periods of time but can also occur from one-time vocal abuse like yelling at a concert or overusing the voice over a short period of time. Symptoms are similar to vocal nodules.

Vocal Hemorrhage - Blood vessels rupture within the vocal fold causing bleeding. Symptoms are hearing two pitches at once or a fluttery voice—hoarseness, a reduced natural range, or less ability to hold a pitch steady or sing quietly.

Chronic Straining - Overuse of the voice can result in chronic straining of the vocal cords. Chronic straining causes scar tissue to form, which results in the thickening of the cords. Symptoms are chronic hoarseness, throat irritation, throat clearing, pain or feeling of a lump in the throat when speaking or singing, and changes in pitch. 

Vocal Fold Scarring - Scarring of the tissues on and surrounding the vocal cords causes them to stiffen and become less flexible. This makes it harder for the vocal cords to vibrate properly during singing. Symptoms are difficulty singing or speaking, breathiness or hoarseness, and a voice that tires easily.

The bottom line is that when a singer experiences vocal strain, throat pain, or chronic laryngitis symptoms, it is imperative to take a vocal rest and seek out advice from a medical professional if the symptoms do not resolve within a reasonable amount of time or if symptoms continue to reoccur after resuming singing practice or performance.

Acid Reflux is when stomach acid backs up into the esophagus, causing heartburn and a burning sensation in the chest. It can also cause damage to the vocal cords, which can result in hoarseness. The best way to treat acid reflux is through diet changes and timing when you eat (eat several hours before going to bed.)

Try to avoid foods that trigger acid reflux like fatty meats, fried foods, spicy foods, coffee, alcohol, chocolate, citrus fruits, tomatoes, garlic, onions, beans, dairy products, and carbonated beverages. Try eating smaller meals more frequently throughout the day instead of three large meals. Also, drinking lots of water and avoiding caffeine and smoking will help the mucous membrane stay hydrated.

Gastroesophageal Reflux Disease is a more severe level of Acid Reflux where the stomach acids come back down into the esophagus and burn the lining of the esophagus. In order for the vocal cords to heal properly, they need to be moistened regularly, and a doctor may prescribe medication.

Dehydration of the vocal folds will make them stiffer and less flexible, making it harder to sing with a tendency for a singer to force the notes; in addition, dry vocal folds are more prone to irritation or strain.

To prevent dehydration, drink enough water and other non-caffeinated drinks throughout the day. Avoid sugary drinks and juices because they tend to increase the amount of saliva produced and will dilute the moisture content of the vocal folds.

Also, avoid dehydrating foods and beverages such as coffee, alcohol, and salty foods or snacks. 

Another thing to take into consideration is humidity and your singing voice. Where you live or depending on what kind of heating and cooling systems are in your house or in venues can significantly affect the voice. If you live or work in a very dry area, and no matter how much you drink or try to stay hydrated, you feel you still have a dry throat, you may want to invest in a humidifier or a nebulizer to help keep your vocal folds hydrated. 

A hot shower can help steam and hydrate the voice, but the effects are short-lived, and in a situation like singing at a music venue, you won't have this option, so a portable option like a nebulizer can help immensely. 

The best way to prevent vocal strain, irritation, or damage is to practice proper singing techniques and to practice regularly to keep the voice in shape. Even 15 - 20 minutes of vocal practice a day that includes a good vocal warmup can help keep the voice flexible, build stamina, and extend vocal range. 

Also, seeking a qualified voice teacher to help you develop good singing techniques is well worth the investment. With so many online singing lesson options these days, it is easier than ever to find a singing teacher to help you develop your voice safely.

If you would like to learn more about vocal techniques for the beginner singer, my latest book, "Beginning Singing" is available in digital, audio, and paperback versions, and it also comes with free bonus video lessons. If you are interested in online vocal lessons, please reach out to our front desk at [email protected].