Do Your Job – And Lose Your Voice?

Voice strain in people who talk for a living

Many people think immediately of singers and performing artists when they hear about voice problems. But teachers, lawyers, and other public speakers also have incredibly high vocal demands that can lead to difficulties. For example, teachers are required to talk for many hours a day, to bigger and bigger classes, sometimes in very poor acoustical settings. Most do not have access to microphones or other amplification devices, and have to keep speaking over noisy classrooms. All of this can lead to increased vocal strain, hoarseness, and difficulty communicating.

As a result, teachers are at great risk for occupational-related voice disorders. A 2016 study conducted at the University of Miami found that voice-related absenteeism among public school teachers costs Miami-Dade County $1 million per year. To make matters worse, it’s not just the teachers themselves who are significantly impacted by vocal disorders. A 2004 study suggests that students don’t learn as well when their teacher has a raspy voice.

Dr. David Rosow, director of the Laryngology and Voice at the University of Miami Health System, says: “Our physicians and voice therapists work with teachers and other professionals to uncover the root of your voice problems so that we can develop a personalized treatment plan. Did you have a cold and kept teaching? Have you developed allergies? Has your teaching environment changed or have your vocal demands increased? Has our diet changed and caused acid reflux? Or do you have a polyp, nodule, or other growth on the vocal folds?”

Everyday Care for the Voice

Whether you are a teacher, a public speaker, a performer, or just someone who likes to talk, your voice is one of your most important assets, so take care of it!

  • Dryness is hard on vocal folds. Stay hydrated by drinking at least six to eight glasses of water a day; and try to limit intake of dehydrating beverages like caffeine and alcohol to prevent irritation of the throat.
  • Rest the voice when it’s not necessary to use it. Just like other muscular systems in the body, your vocal folds need time to recover from activity. Interspersing talking time with quiet periods allows periodic rest for the vocal folds and helps prevent strain.
  • In a public speaking situation, non-vocal cues to gain the attention of students or an audience can be even more effective than raising the voice, and they cause less strain on the voice.
  • Pay attention to voice changes, and when you’re getting hoarse, curtail the use of your voice as much as possible. Unless you have a cold or laryngitis, it’s not normal to have a hoarse voice. Hoarseness that lasts longer than two weeks is never normal and should prompt a visit to a voice specialist before a more serious problem develops.
  • Most herbal and nontraditional remedies may give some temporary relief but not long term. Steer clear of apple cider vinegar or other acidic treatments, which are actually damaging to the voice.
  • Use a personal microphone and speaker when possible to prevent vocal strain.
  • Have heartburn or acid reflux? It’s important to get these treated, as they can greatly affect the voice.
  • If you have hearing loss, this can make it difficult to tell how loud you are speaking, which can lead to voice strain.
  • Do not clear your throat: It acts as a slapping of the vocal folds over and over and traumatizes them, eventually causing vocal nodules.
  • Avoid yelling: Trying to talk or raise the voice over noisy environments can cause us to talk louder than we realize and can cause voice loss over time.

Besides everyday care for the voice, there are two other components to voice therapy:

  • Education: After diagnostic tests, therapists explain the nature of their problem and how your voice habits contribute to it.
  • Directed Vocal exercises: This aspect of therapy deals with individualized exercise programs developed for each patient that are continually monitored during sessions and modified as needed.

Specialized Voice Therapy

Dr. Rosow says that professional voice users, also known as “vocal athletes”, should give their voices the same care that athletes give their bodies by following good vocal practices and preventive measures. If those don’t work, a thorough evaluation at a voice center can diagnose the problem and provide targeted treatments.

It’s important to get a medical diagnosis before seeking out the assistance from a speech language pathologist, both to identify the problem and to make sure your insurance covers treatment.

Voice therapy is a common means of treatment for individuals with hoarseness that may be related to improper vocal usage or over-use, and is typically curative for a wide range of benign voice disorders. Therapy is also critical in people undergoing surgery to help prevent recurrence due to improper vocal usage.

Similar to physical therapy, voice therapy uses techniques to retrain muscle groups to produce the voice with less effort, strain, and in better alignment. Therapy frequently includes exercises that must be practiced to create a new automatic pattern of speaking.


Mary Jo Blackwood, RN, MPH, is a contributing writer for the UMiami Health News Blog. Based in St. Louis, MO, and Colorado.