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Vocal Fold Swelling Pt. 2: Warning Signs and Risk Factors

Warning Signals

Our bodies are amazing and give us warning signals when something is wrong. That’s what a symptom is- a warning signal. All too often, however, we ignore these warning signals and just keep going.

Vibration is not infinite. It is finite and there is a threshold. Each of us has a different limit and learning to discern what is for you is the key. Knowing what vocal injury and swelling sounds like, feels like, and how to monitor baseline vocal capabilities can help identify acute swelling, making it possible for us to take a step back and avoid chronic problems. While any one particular acute episode of vocal overuse and swelling is usually nothing to be overly concerned about, repeated instances of overuse can lead to more chronic swelling. That eventually leads to what we might call vocal nodules or other benign vocal pathologies. In fact, frequent day-to-day variability in the high, soft range for a singer is a strong warning signal that intermittent swelling is sort of coming and going.

In fact, frequent day-to-day variability in the high, soft range for a singer is a strong warning signal that intermittent swelling is sort of coming and going.

It is entirely possible to develop vocal injury from simply living a very busy vocal lifestyle. Which most of us do. Vocal fold swelling and injury almost always affect the voice “top down.” Meaning the highest notes in one’s vocal range will likely become impaired first. Common signs or symptoms generally include:

  • Changes in voice quality (frequent hoarseness or voice loss

  • Vocal fatigue or reduced endurance

  • Increased effort for speech or singing

  • Onset delays

  • Difficulty with high, soft singing

  • Day-to-day variability

  • Long periods of voice rest to return to baseline

Risk Factors

Understanding the risks associated with vocal overuse is essential to protecting the voice and avoiding injury. We should all consider personal and professional commitments, as well as our tendencies in those circumstances. A busy vocal lifestyle combined with innate talkativeness or loudness for an individual automatically raises their risk level. If you are a highly talkative individual who has two or more of the following life circumstances, then you are considered at “high risk.”

  • Daily speaking and/or singing for 6+ hours

  • Extended, daily voice use with little to no rest

  • Additional weekend commitments

  • Hoarseness or vocal fatigue with 1-2 day recovery

Training, style, genre or experience rarely have much at all to do with developing vocal fold injury. In fact, I see just as many classical singers with injury as I do any other style or genre. I say that because there is a long held thought that classical singing is the healthiest way to sing and that training in that particular style has more technical and foundational benefits for a singer. This is simply a myth. While poor technique for any singer can sometimes be a contributing factor in certain cases of vocal injury, it, too, is rarely the reason someone develops injury. It is more likely that the amount of voice use - innate talkativeness and vocal demand or load combined - that led to the trauma. The performance industry is full of high demands and pressures for singers physically, environmentally, financially, vocally, and emotionally. Those unrealistic expectations are often part of many singer’s stories when they find themselves having been diagnosed with a vocal injury.


  • Learn to pay attention to and interpret warning signals your voice is giving you

    • Such as: losing high and quiet notes, onset delays, day to day variability etc.

  • A busy vocal lifestyle might put you at more risk for vocal fold swelling

  • Each person has different vocal and vibrational limits, respect yours

  • Training, style, genre or experience are not the main factor is developing injuries

Want More?

Sign up for the Vocal Fold Swelling Workshops are up! Sign up here

  • February 23rd at 10AM CST (available for replay for 2 weeks)

This blog is the part of a five part series on vocal fold swelling.

Sign up for the mailing list to be alerted when more parts of the series come out

Can’t wait that long? Go to Lori’s instagram to get more information, infographics and reels!

Vocal Fold Swelling Pt. 2: Warning Signs and Risk Factors

Vocal Fold Swelling Pt. 3: Healing, Rest, and Recovery (Coming Soon)

Vocal Fold Swelling Pt. 4: Detection (Coming Soon)

Vocal Fold Swelling Pt. 5: Prevention (Coming Soon)

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