Healing of vocal fold swelling and injury involves:
-whatever you want to call it.
If someone is experiencing an episode of acute swelling, moderate voice rest typically results in resolution of swelling within 12-24 hours.
Ideal recovery for overuse and swelling is overnight, or no more than a one to two day recovery period.
If it takes longer than a few days to return to baseline this mvay suggest more severe swelling that needs more time to resolve. There are exceptions! Contributing factors present related to medical conditions or viral illness like post-nasal drip, frequent throat clearing, coughing, etc. can further irritate vocal fold tissues and make the recovery period longer. We must consider these factors as we observe and monitor recovery but resist the temptation to always assume that the 'reason my voice is hoarse, tired, or I can't sing my high notes' is strictly related to these factors. This lens may cause us to miss warning signals that are more directly related to vocal overuse. It’s important to give the voice the time it needs to recover. This means silence! When intermittent swelling episodes become more frequent and closer together we begin to suspect more chronic injury. This type of scenario absolutely warrants seeing a professional to verify the health of the vocal fold tissues. Like a laryngologist or voice specialized speech language pathologist.
Early attention and an immediate response is important to avoid more long-term issues. It can be challenging sometimes for singers to figure out how much voice rest is needed in order to maintain their best baseline. An example of working towards this would be taking frequent shorter breaks of voice rest off and on throughout the day.
What Else Can I Do Besides Resting My Voice?
Discovering just the right balance of voice rest vs. voice exercise for normal amounts of voice use is a worthy goal.
While vocal exercises don’t necessarily heal vocal injury and swelling, we do know that certain types of exercise can go a long way towards mitigating swelling and reducing a singer’s risk. I typically recommend daily vocalizing on light, low impact vocal exercises such as SOVTEs paired with Resonant Voice sounds (like humming) for 5 minutes up to 3 times daily for best results. Ideal sounds for this are: lip trills, humming on /m/, buzzing, straw phonation, and /zu/. Descending gliding patterns and scale patterns (going from high to low) are especially useful for healing purposes and cool-down.
The frequent vocal reset with these helps to speed up the healing process in my clinical observation and experience. But don't just take my word for it. A study conducted by Verdolini Abbott et al. (2012) found the same, supporting the use of a specific type of vocal exercise paired with vocal rest.
How Do I Balance Resting My Voice, When I Need it For Daily Life?
Making the decision to sing or not during healing of either acute vocal fold swelling from overuse like we discuss here, or from acute swelling with illness such as an upper respiratory infection can be a tough one. In the acute stage of swelling in either case, the voice and body will likely dictate what is possible and advisable. Pain, soreness, loss of range and high, soft singing are examples of warning signals that warrant resting the voice and not going forward with obligations.
Marci Rosenberg (2022) gives a wonderful overview of the 3 phases of recovery from illness that can be useful in determining these things. She refers to the second and third stages as transitional and reentry. In these stages, the voice is likely to recover to a degree and not as problematic and there are fewer symptoms and limitations, so one could misinterpret that it is okay to return to singing too soon. Rosenberg suggests using history and previous experience with to help make these decisions, as well as establishing one's vocal baseline or ceiling with a swelling test and self-monitoring, which we'll be covering in more detail in the next installment of this blog topic.
Ready to Learn More?
If you want to learn more strategies for mitigating vocal swelling you're in luck! May 5th 11AM CST 2023 Sonnenberg Voice is hosting an online workshop to treat hands on ways to help swelling when it happens. Click here to sign up or learn more
You can also keep your eye out for Part 4 of the blog series on acute swelling: Mitigation and Prevention.
Part One: What it is and Why You Should Care
Part Two: Warning Signs and Risk Factors
Part Three: (This Article)
Part Four: Mitigation and Prevention (Coming Soon) Sign Up Here to Be Notified
Verdonili Abbott et al. 2012 can be accessed online here: https://pubmed.ncbi.nlm.nih.gov/23177745/
Rosenberg, M. (2022). To Sing or Not to Sing? The Performer's Guide to Managing Illness and Performance Demands. Journal of Singing79(2), 207-211. https://www.muse.jhu.edu/article/867855.