The unwell voice

Vocal problems are common — about 10-20% of all children and 7% of all adults have voice disorders at any given time. (The incidence for teachers alone is higher — about 15%.) The causes of these problems, however, are quite varied. Voice disorders can be caused by disease, injury, over-use or environmental exposure.

Symptoms for most voice disorders are remarkably similar:

  • hoarseness;
  • difficulty making high pitches;
  • voice breaks;
  • aching and tiredness in the throat;
  • difficulty making soft sounds;
  • a feeling of "effortfulness" when using the voice; and
  •  low volume or complete loss of voice.

The key to correcting most voice disorders is to get medical help if the problem doesn't resolve promptly. Sometimes what you thought was just a hoarse voice due to an ordinary virus or an episode of over-use could be a symptom of something bigger.

Signal of disease: Because teachers are prone to voice problems, it's easy to imagine that fatigue or overuse are always its cause. However, a teacher's problematic voice could be the symptom of another, and possibly, serious illness. When it comes to disease, teachers face the same risks as the general population. Many medical circumstances can impact how the voice sounds. Consider that your larynx is located on the "super highway" of important body parts: your heart, lung, nervous system.

Diseases that show up in the voice (as hoarseness, tremors or other voice changes) include:

  • gastroesophageal reflux disease (GERD);
  • larynx cancer;
  • endocrine dysfunction, such as hypothyroidism; and
  • nervous and musculoskeletal system disorders, such as Parkinson disease.

Unsure? See your doctor.


A few healthy and unwell larynges

How the voice gets hurt: Voice trauma doesn't necessarily mean a blow to the neck. More often, vocal disorders due to trauma stem from the lengthy and winding configuration of the laryngeal nerves.
The right and left recurrent laryngeal nerves power most of the vocal fold muscles. They travel from the base of the skull into the neck, down through the upper chest, and back up to the vocal fold muscles in the neck. This long path makes the laryngeal nerve vulnerable to a serious traumatic injury: vocal fold paralysis. If there is nerve injury, your physician must understand the circumstances of the injury and any resulting difficulties. A thorough medical examination, usually along with imaging studies, is essential.

Can your voice hold up? Face it: our bodies are uniquely composed with differing strengths, weaknesses, tolerances and fragilities. Teaching places a high demand on even the most resilient vocal system. Besides over-use (in politically correct terms, a "vocal overdoer"), damage can arise from excessive throat clearing, coughing, inhaling irritants (a problem especially for art, industrial education or chemistry teachers), smoking, screaming, yelling, or speaking too loudly or at an abnormally high or low pitch. If a teacher's larynx is inherently fragile, s/he needs to be a diligent manager of vocal health to meet the intensity of teaching. You are your vocal system's chief executive officer. With the right information and motivation, about 75% of teachers' voice problems can be prevented or self-managed. Don't undermine your important role in vocal health.