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VitaVoice: Voice Care Feature

Carrie Garrett - Voice Specialist Speech and Language Therapist. Registered voice practitioner with the British Association of Performing Arts Medicine (BAPAM).


Music Teachers are at greater risk of developing voice problems

Teachers often consider voice problems such as throat discomfort, vocal fatigue, and hoarseness an occupational hazard. With demanding work schedules, lack of

support from management and a culture which continues to embrace the mantra

‘keep calm and carry on’, many disregard their voice problems and struggle on,

never considering seeking specialist medical advice until the issue becomes severe.

According to a 2011 study published in the Journal of Voice, teachers are eight times

more likely to suffer from voice-related health conditions than the general public, with the prevalence of voice problems amongst music teachers being up to four times that of classroom teachers.


Voice overuse, misuse and ‘new use’ are the greatest risk factors for developing a

voice problem. Speaking too loudly or for long periods without adequate rest can

strain the vocal cords, leading to inflammation and injury. Ineffective speaking or

singing technique can exacerbate problems further.


When we consider the working environment, vocal demands can be significantly

higher for music teachers than their classroom teacher counterparts with long

periods of high intensity voice-use, often singing and speaking against high levels of

background noise, with poor room acoustics requiring increased vocal effort to be

heard by the students. Add to the mix other common risk factors for developing voice problems, such as being female, having allergies, respiratory infection, acid reflux, chronic cough or throat clearing, dehydration, stress, anxiety, having hearing

problems, or smoking and the odds of developing a problem become even greater.


Voice problems can affect both work and social life, impacting mental health

alongside interfering with job satisfaction, performance, and attendance. According

to a 2014 study in the International Archives of Occupational and Environmental

health, approximately one-third of teachers miss work at least once during their

careers due to voice problems,


The impact of voice problems among teachers creates substantial financial costs to schools with the cost to schools calculated at around £15m a year (Source: NEU

Voice Care guidance 2018). Other studies have shown voice problems may even be

detrimental to students’ learning and achievement.


How Teachers can help themselves

Teachers need to be able to sustain their voice, energy, and concentration for

extended periods of time, which is both physically and mentally taxing. Stress and

tiredness often contribute to increased susceptibility to illness, and this can lead to

further fatigue, decreased vocal endurance, vocal power, and worsening voice

quality. It’s common for teachers to become trapped in a downward health spiral

leaving them more susceptible to voice misuse and overuse as the term continues

and they struggle to be heard.

Consider how common it is for music teachers to experience voice problems in

winter term with the multitude of rehearsals and performances running up to

Christmas, winter coughs, colds and vomiting bugs, and the additional cover

required on top of already busy personal schedules. It's no wonder voices begin to suffer.


Making small changes to daily habits can have a huge positive impact on how well

your voice may fare during term time. We are not machines, and our bodies need

opportunity to recover and reset. Implementing strategies to reduce volume,

frequency and duration of voice-use can have immediate clinical benefits in vocal

health.

So how does this look in practice?

You could begin by reflecting on how you use your voice-use each day, prioritising

which lessons or tasks will likely require more from your voice and dialling down the

vocal effort and volume used on less important tasks. Plan for proximally closer

interactions in smaller groups, and frequent opportunities for voice rest by

considering teaching methods used, delegating tasks, or seeking small periods of

solitude throughout the day. Also consider alternative non-verbal strategies for

gaining attention and requesting routine actions from your students as these can

literally ’save your voice’.


Daily Habits for a Healthy Voice

Alongside quitting smoking, tackling acid reflux, checking whether any medications

cause dryness, and seeking support to manage stress and anxiety, the following 6

daily habits can help you to be proactive in maintaining a healthy voice:

Stay Hydrated – Keeping your vocal cords hydrated is essential for vocal health.

Drinking 8 glasses of water/ herbal teas is recommended throughout the day. Use

daily warm steam inhalations to lubricate and soothe your vocal tract and to thin

secretions (so they’re easier to clear), before and after heavy voice use. Limit drinks

that contain caffeine or alcohol as these can be dehydrating, cause irritation, and

prevent you from achieving quality sleep.


Eat well - Fuelling your body with the essential vitamins and minerals it needs to meet the demands you put on it is key to staying healthy. If your immune system is working optimally, you will be more likely to avoid the coughs and colds which will keep you and your voice out of action. If you do become ill, a healthy body will likely

recover faster.


If you don’t manage to eat your 5-a-day regularly, a daily vitamin supplement

such as VitaVoice Optimise, formulated with professional voice users in mind,

may be a good investment to correct any nutritional deficiencies, to support

specific physiological functions related to vocal performance, and maximise

your general wellness alongside maintaining energy, cognitive sharpness, and

focus.


Take Breaks - Many voice problems are caused by inflammation and tension building up from misuse and overuse of the voice. Take regular ‘absolute voice rest’ breaks from speaking or singing to give your vocal cords time to rest. This could be 10 minutes TOTAL SILENCE through lunch-break, scheduling in time to sit quietly, going for a walk on your own, or quietly practising some meditation, gentle breathing exercises, or stretches during your day. Setting vocal boundaries for yourself, such as ‘I will only speak during class time and will rest my voice and hydrate during breaks’ can be key to maintaining healthy voice.


Avoid Excessive Talking - It’s important in the classroom to frequently check in with yourself as to whether you have tension in your neck, face, or jaw, whether you are raising your volume or pushing your voice unnecessarily. Try to limit excessive talking and shouting, as this can strain your vocal cords, putting you at greater risk of vocal injury. 


Be Mindful of your Environment - If the acoustics are not ideal, using a portable voice amplification system has been shown to reduce voice overuse as it reduces the intensity and effort required of the voice to be heard. To reduce atmospheric dryness, try having a bowl of water in the room to improve humidity, or open the windows, and keep sipping water to stay hydrated.


Smile! - Smiling, laughing, and spending time relaxing really is the best medicine when it comes to the voice. Feel good hormones dopamine and serotonin are released when you smile, helping you stay calm and perform tasks better.


Myths vs Facts:

Teachers who use singing or deliver singing as part of the curriculum can be well-

placed to offer vocal health advice to colleagues across other school or college

departments, as a personal interest in voice and some knowledge about vocal health is likely to have already been established. However, it’s important to stay up to date with what is fact, and what is anecdotal.

Colleagues within the staffroom have been known to share well-meaning advice and discuss various remedies as a means of improving voice issues. Drinking honey,

lemon and ginger or herbal teas tastes nice and can provide comfort and a hydration boost, but what you swallow doesn’t go anywhere near your vocal cords and so will not affect your voice directly.


Gargling salt water or apple cider vinegar may provide relief for your throat but it isn’t ‘washing off your vocal cords’. Anything which numbs sensation such as antiseptic throat sprays or throat lozenges may do more harm than good as you may feel you’re able to carry on talking or singing, exacerbating inflammation, and causing further damage.


Avoiding dairy or coffee is generally a myth and individuals should judge whether to

reduce these based on how they personally affect their own digestive system,

energy levels and mucus secretions. Everybody needs adequate rest however, so

considering the switch to decaffeinated drinks beyond midday may improve your

ability to switch off come bedtime. Boosting your water intake should allow the body

to release energy more effectively if you need an afternoon pep-up. Combine this

with a healthy snack and some movement and stretching and you should be feeling good to go!


Prevent voice problems with these simple daily voice exercises:

Warm Up Stretches - Before you start singing or speaking, take some time to warm up your body with some movement and gentle stretches, particularly of the neck and shoulders. Gentle chewing, tongue stretches, and yawning are great for relaxing your jaw, tongue, and throat.


Abdominal Breathing – Using appropriate breath support for speaking or singing

tasks will help prevent straining your vocal cords and keep your voice healthy. Try 2-

5 minutes of some breathing exercises at the start of your day. For example: inhale

for 4 counts through your nose and exhale on an ‘ss’ or ‘zz’ for 8 or more counts.

Gradually increase the length of the outbreath each time, making sure no tension

creeps into your face, throat, neck, or shoulders.


Warm up your Voice – Vocal exercises can be used throughout the day to energise your voice production and ‘reset’ your voice. Examples include humming a few glides or a simple tune, or using some straw phonation, lip trills, or tongue rolls. Tongue twisters can improve articulation. Reciting a poem or story using exaggerated intonation can improve the ‘musicality’ of your voice. Improved ‘musicality’ will help keep the voice healthy and flexible along with engaging your listeners more effectively.


Cool Down your Voice - End each working day with a few cool down exercises for

body and voice, for example, gentle stretches and using descending pitch glides, lip

trills or straw phonation.


When and how to seek specialist medical help

You are not alone, and help is out there! Prolonged and recurring hoarseness in the

absence of a cold or throat infection and a persistent change in pitch or quality of

voice should be investigated.


If any of the symptoms listed in this article persist for longer than 2 weeks, it is

recommended you seek expert medical advice. Speak with your GP and ask for

them to refer you to ENT.


The British Voice Association (BVA) has a list of Voice Clinic across the UK, and the

British Association of Performing Arts Medicine (BAPAM) has recommendations for

professional health practitioners who work with performing artists regularly.


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