World Voice Day

The aim of this awareness day is to promote the importance of us all having a healthy voice!

Here are some of our top tips for looking after your voice.

Voice problems - vocal nodules & strain


 Causes of nodules & strain

Voice strain and vocal nodules are caused by stress/abuse to the vocal cords. This can be caused by overusing the vocal cords, which may arise through excessive talking, shouting, cheering, singing, throat clearing and over using the voice in a professional capacity (e.g.. actors, teachers).
Other causes of vocal strain can include stress, over tiredness, anxiety, dehydration, incorrect pitch and poor breath support for speech.

Symptoms of nodules & strain

Hoarseness of the voice
Breathy or a scratchy quality
Reduced range of pitch
Reduced volume
Neck and/or ear pain
‘Lump in the throat’ feeling/ sensation


Treatment of nodules & strain

If you have been diagnosed with vocal strain or nodules, you will than need to consult a speech & language therapist, who will help you identify abusive vocal behaviours and will suggest ways to avoid further damage.
More rarely vocal nodules may be treated medically or surgically, but this is generally considered as a last resort.

Good Vocal Behaviour

Don’t talk if you don’t have to - resting the voice is always beneficial

Drink lots of water - especially if you know that you have to speak more

Swallow or sip water rather that throat clearing / coughing

Avoid smoky / dusty / dry environments

If in environments where you need to raise your voice over background noise, use good breath support ( ask your SLT)

Avoid shouting/ cheering/ screaming

Use appropriate loudness

Use humidifiers at home ( particularly in bed )


Good Breath Support for Speech

The ‘Ssssss’ Test

Take a deep breath and exhale making a Ssssss sound for as long as you can. Do this 3 times and take your best score.

Male adults should be able to sustain for at least 20 secs

Female adults should be able to sustain for at least 15 secs


The Counting Test

Inhale and then count to the highest number you can. Do this 3 times and take your best score.

Male adults should be able to count to at least 15

Female adults should be able to count to at least 10


If you can’t reach these targets - then you need to practice good breath control.

Abdominal breathing

1. Breathe all of your air out - right down - even all the residual air. Hold your breath for as long as you possibly can. When you have to take the ‘in’ breath, concentrate on the movement of you abdominal muscles. They will move upwards and outwards. This is abdominal breathing.

2. Lie on your back and place something of a slight weight over your abdominal muscles. Breathe naturally and you should see the rise and fall of the object. This is a natural position for you to use your abdominal breathing.

3. Now sit on a chair and with a relaxed posture, try to replicate this breathing. Place your hand on your abdomen and you should feel the upward and outward movement.

Using abdominal breathing

Take an abdominal breath when your conversational partner is formulating a question or taking a turn to speak. Plan in advance! Try to breath where a punctuation mark would occur. Practice this with script!

Take reflective pauses. Use your speaking time. Maintain eye contact and use pause effectively. Not only will this help you plan your breathing, it will help with delivery of speech.


Lisa Houghton BSc(Hons) MRCSLT HPC  & Tracey Park BSc(Hons) MRCSLT HPC
Speech & Language Therapists

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