Vocal Hygiene: Key Considerations for Singers, Teachers of Singing, and Professional Voice Users

MU4043 Vocal Pedagogy, Irish World Academy of Music and Dance, University of Limerick

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The subject of vocal hygiene can be a difficult topic to discuss and to assess; there has been excessive research done on vocal hygiene as a way to prevent vocal disorders, where there have been slim findings and results, “Vocal hygiene as a sole strategy for the treatment of voice disorders has shown minimal, but favourable results” (Behlau and Oliveira 2009). There are many things that need to be considered when discussing vocal hygiene in general; What are some of the many different vocal disorders and illnesses that singers and voice users may be faced with? What are some things that can be done to prevent said vocal disorders? What are some preventative measures that singers and voice users can take to maintain a good vocal hygiene routine for themselves and their practice? What are some key points that both singers and teachers of singers need to keep in mind about vocal hygiene? This essay will outline the meaning of vocal hygiene, look into the different voice disorders and preventative measures for them, and discuss key considerations that singing teachers, singers, and professional voice users should take into account in their daily lives and within their artistic practices.

What exactly does vocal hygiene mean? Vocal hygiene can be defined as the general maintenance of the individual voice and the upkeep of healthy vocal routines. As stated previously, conversation around the general topic of vocal hygiene is a relatively difficult one to discuss given that there is not much data to be collected from the results of studies that researchers perform on the topic of vocal hygiene and health. When people talk about vocal hygiene, most likely they would be discussing the different voice disorders and possibly about some of the preventative measures that can be taken by singers and professional voice users to keep their voice in a healthy state for their own artistic practices. With information collected with combined research and findings from a variety of specialists, Drs. Hoffman and and Sapienza, well known clinical professionals throughout the performing arts community and whose work and studies target educators in the field of laryngeal and respiratory physiology, state in their revised novel Voice Disorders (2020) the latest medical developments surrounding the general voice, the vocal tract structures, and their functions,

In the current management of voice disorders, the clinician now needs medical, surgical, and behavioural knowledge of the vocal mechanisms and of the structures and systems that contribute to voice production. Each (research scientist, phycologist, surgeon, singing specialist, vocal coach) has varying roles in the care of patients with voice disorders (Hoffman and Sapienza 2020).

What are some of the more common voice disorders that many singers and professionals struggle with, and what are some measures that can be taken to prevent them? The most common voice disorders that are seen amongst singers who practice poor vocal hygiene are laryngitis, nodules, and vocal cord paralysis (Mayo Clinic 2022), which leads to many singers not able to perform to their fullest potential, and in a lot of cases, can hinder their career as a vocalist. For most voice disorder cases, singers and voice users may be prescribed with lots of rest and plenty of fluids to keep the larynx and the vocal cords hydrated, along with medicine and anti-inflammatory medication to help with any swelling or irritation that may be present. When diagnosed with a voice disorder, doctors may also suggest the option of undergoing speech therapy in more advanced voice disorder cases,

Like every part of the body, the vocal cords need regular rest and fluids. Speech pathology specialists teach how to use the voice better, how to clear the throat and how much liquid to drink (Mayo Clinic 2022).

Moving into conversation specifically on vocal hygiene amongst singing teachers, studies have shown that their has been a limited availability of proper resources and care from singing teachers who may be struggling with their vocal hygiene; consider this stated by Pasa et al. in ‘The Relative Effectiveness of Vocal Hygiene Training and Vocal Function Exercises in Preventing Voice Disorders in Primary School Teachers’,

Voice disorders in teachers have a significant impact on their occupational functioning and well being. Teachers are believed to have a high prevalence of voice problems because of the unfavourable acoustic environments in which they work and the high vocal demands and stress levels associated with teaching (Pasa et al. 2009).

Not only can voice disorders have an effect on singing teachers physically, but they can also have an effect on them mentally, emotionally, psychologically. These voice disorders can make the jobs of singing teachers very difficult, along with presenting negative environments for the students as the teacher may have increased frustrations and trouble with communication due to the voice disorder, “The voice disorders that teachers experience can impact on their teaching by preventing them from conveying information to students clearly and effectively…” (Pasa et al. 2009). Teachers, in general, are required to project their voice, causinging discomfort and strain on the vocal cords, in order to communicate and redirect their students within the classroom setting, so naturally, it is quite common for researchers to see some type of vocal strain and vocal disorders amongst singing teachers.

What are some considerations that singing teachers can take to keep their vocal hygiene healthy? All around for any general voice user, one of the best and most common things that teachers can do to heal and prevent voice disorders and to keep a healthy vocal hygiene is to stay hydrated and to get good quality rest, however, this may not be possible in some cases, in which singing teachers may have to resort to their own preventative methods within the classroom; some examples of this are using non verbal actions and demonstrations to their students to allow for the voice to have proper rest for healing time.

What about considerations that singing teachers can take for the students that they teach? It is important to note the fact that young boys and girls' voices develop at a different rate than one another and including their vocal anatomy, more particularly in the adolescent years where there are the most significant changes to a child voice. Young children are usually unaware of what vocal hygiene is and the damages that can be caused to the voice, where in cases like these, oftentimes the teacher will need to present and educate their students on proper vocal hygiene and preventive measures for vocal damage. Vocal therapy is a common tool used to educate and treat school-age children, specifically,

Behavioural (non-surgical) voice therapy is the first-line management approach for children diagnosed with vocal nodules…Their study showed that a program of vocal hygiene education and voice exercises was effective in reducing vocal nodule size (Ma et al. 2021).

When working with children and adolescents, singing teachers must consider educating their students about the changing in their voice as they age, such as puberty, and how they can maintain a healthy vocal hygiene routine as they grow and as their voice develops; vocal and speech therapy can be immensely effective to children and adolescents who are experiencing a developing voice, consider this statement by Ma et al. in ‘The Effectiveness of Vocal Hygiene Education With Resonant Voice Therapy for School-Aged Children With Vocal Nodules’ after analysing a study about voice disorder treatment in children,

The present results contribute to the literature suggesting that vocal hygiene with resonant voice therapy is effective in improving vocal quality and voice-related quality of life for children with vocal nodules (Ma et al. 2021).

There are many singers who unfortunately suffer from poor vocal hygiene, and not very many singers know what to do when they contract different voice disorders or how to prevent them from occurring. There are many habits that singers may be guilty of and oftentimes unaware of in their vocal hygiene practice. Some examples of this may be throat clearing, “loud speaking, and loud singing for long durations of time” (Boominathan et al. 2013). A study was done in India to assess different vocal hygiene practices amongst professional and training singers and professional voice users of a varying level; this included politicians, teachers, and more. Stated by Boominathan et al., the results of the study read as followed,

The results revealed politicians and vendors had the highest point prevalence and frequency of voice problems…About 84.3% of voice professionals considered that abusive (nonvocal) habits had a negative influence on voice (Boominathan et al. 2013).

There were quite a number of people who were involved in the study who said that they had been resorting to home remedies rather than seeking out professional help from doctors and speech therapists in order to prevent and cure any voice disorders or effects of vocal abuse. It is widely assumed by professional singers that proper singing training, with a focus on using proper techniques, promotes a healthy vocal hygiene (Maria et al. 2021). Because of this assumption, a study was performed on college-aged ‘trained’ and ‘untrained’ singers in order to analyze different vocal hygiene habits. This was particularly important to do on college level singers as many students at that age are more prone to activities such as partying, drinking, smoking, and more habits that are harmful for the voice in general, “...college level singers have been reported as having intermittent adherence to vocal hygiene and significant vocal health concerns” (Maria et al. 2021). The results of the study showed that there were no significant differences between the ‘trained’ and ‘untrained’ singers in terms of warm up routines or keeping their body hydrated, however, the study showed that “11% of our sample reported intermittent less than daily marijuana use, with one singer reporting daily consumption” (Maria et al. 2021).

What does this mean for singers and professional voice users? Singers and professional voice users should always be mindful of their habits when it comes to their vocal hygiene. Some considerations that can be taken for these groups are to document their use of any substance that could possibly have an effect on the voice, whether that be caffeine, alcohol, tobacco, and more. Substance use, particularly shown by the study stated by Maria et al., portrays how it can have a negative effect on a singers’ vocal hygiene; it is important for professional voice users to keep up a good practice for a healthy voice, including plenty of rest and plenty of hydration.

For all voice users – singing teachers, singers, and professional voice users – vocal hygiene is something that can be difficult to take into account within their practices and careers at times, but there are important considerations that can be taken to ensure the upkeep of a healthy vocal hygiene, as well as preventative measures for vocal abuse and any voice disorders that may develop due to a poor vocal hygiene by the individual.

Ultimately, vocal hygiene education amongst professional voice users is something that should be implicated more in professional settings, as well as promoting professional advice, help, and guidance to those who may need it.

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Bibliography

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Behlau, M., Oliveira, G. (2009) ‘Vocal Hygiene for the Voice Professional’, Current Opinion in Otolaryngology & Head and Neck Surgery, 17(3), June 2009, 149-154, available: Vocal hygiene for the voice professional : Current Opinion in Otolaryngology & Head and Neck Surgery (lww.com)

Pasa, G., Oates, J., Dacakis, G., (2009) ‘The Relative Effectiveness of Vocal Hygiene Training and Vocal Function Exercises in Preventing Voice Disorders in Primary School Teachers’, Logopedics Phoniatrics Vocology, 32(3), July 2009, 128-140, available: Full article: The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers (tandfonline.com)

Hoffman, B., Sapienza, C. (2020) Voice Disorders, 4th ed., San Diego: Plural Publishing

Mayo Clinic (2022) ‘Voice Disorders’, Mayo Clinic | Diseases and Conditions, October 2022, available: Voice disorders - Symptoms and causes - Mayo Clinic

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Ma, E., Cheung, Y., Siu, A., Lo, J., (2021) ‘The Effectiveness of Vocal Hygiene Education With Resonant Voice Therapy for School-Aged Children With Vocal Nodules’, Journal of Voice, November 2021, available: The Effectiveness of Vocal Hygiene Education With Resonant Voice Therapy for School-Aged Children With Vocal Nodules - ScienceDirect

Boominathan, P., Rajendran, A., Nagarajan, R., Seethapathy, J., Gnanasekar, M., (2013) ‘Vocal Abuse and Vocal Hygiene Practices Among Different Level Professional Voice Users in India: A Survey’, Asia Pacific Journal of Speech, Language, and Hearing, 11(1), July 2013, 47-53, available: Vocal Abuse and Vocal Hygiene Practices Among Different Level Professional Voice Users in India: A Survey: Asia Pacific Journal of Speech, Language and Hearing: Vol 11, No 1 (tandfonline.com)

Maria, C., Sung, S., Baird, B., DiRenzo, E., (2021) ‘Vocal Hygiene in Collegiate Singers—Does Formal Training Relate to Practices?’, Journal of Voice, 35(6), November 2021, 859-868, available: Vocal Hygiene in Collegiate Singers—Does Formal Training Relate to Practices? - ScienceDirect