You are on page 1of 15

The Role of Voice Protection in the Treatment of

Vocal Diseases


Voice disease refers to the abnormal voice problems caused by the diseases of the
human throat and related organs. When the voice volume, tone, tone quality,
duration of sound and resonance are abnormal, it becomes becomes a voice disease.
Voice disorders are common among vocal students. For vocal workers, the vocal
cords are the most valuable musical instruments, because since singing is the most
natural ‘human voice’ as a special ‘musical instrument’. However, according to the
relevant data, voice students have a high proportion of voice disease.diseases.
Surveys have suggested indicated that as much as 87% of classical singing students
suffer from at least one symptom of vocal attrition. (Achey, M.A., & He, M.Z., & Akst,
L.M., 2016, p.193) 22% of Contemporary Music singing students began their
education in the high school, with vocal nodules. (Sielska-Badurek, E. M., & Sobol,
M., & Olszowska, K., & Niemczyk, K., 1995, p.1) Some students with a good voice
talent, after a period of campus life and study, will tends to have a voice functional
disorder. Some students will have a disease that lasts longer, even will have the
result of invalid treatment.leading to more serious problems. Of course, the reasons
are many, but the unscientific use of voice is one of the most important reasons. As
a result, the relevant studies point out that many voice students lack correct voice
training common sense. ‘Together, these findings suggest that singers view singing
teachers as the primary source of vocal health information and seek out medical
professionals only when a severe vocal health pathology has developed.’ (Latham, K.,
& Messing, B., & Bidlack, M., & Merritt, S., & Zhou, X., & Akst, L. M., 2017, p.251. e4)
Voice students tend to use the incorrect way to practice for a long time, causing
vocal cord congestion, pharynx, throat congestion, chronic pharyngitis and other
diseases appearto develop. ‘Singers are considered elite vocal performers among all
the professional voice users. A disruption in voice quality brings a negative impact on
to the performers' careers as well as on business' profits.’ (Pestana, P.M., & Vaz-
Freitas, S., & Manso, M. C., 2017, p.723) For a vocal worker, voice is vital and voice
disease should be treated realistically.
Some adverse factors affecting voice in singing will not only affect the quality of
vocal music teaching or performing, but also bring a very negative impact on the
voice, and the serious one will cause voice disease. Unscientific vocalization is one of
the important common causes of voice disease. The scientific way of vocalization is
to use the least amount of vocal energy to exert the maximum acoustic effect of
vocal organs so as to achieve the best artistic effect. If the scientific vocalization
method could be grasped, it could save the sound energy, reduce the load of vocal
cord, and get the ‘immune function’ that can prevent many vocal cord diseases. Even
some of the original diseases of the vocal cord can be self-healing and eradicated.
This study explored the significance of voice protection in singing for the
treatment of voice disease. The study is divided into four sections. The first section is
the acoustic analysis of voice and the function of voice, including some common
vocal diseases. The second section is the analysis of the causes of voice diseases,
from the two angles of physiology and psychology. The third section analyzes the
unhealthy factors that affect voice in singing, including the incorrect vocalization and
the excessively using theuse of the voice, as well as the bad habits. The forth section
points out the importance of voice protection in singing.

The Voice and Several Common Vocal Diseases

To analyze voice diseases, it is necessary to have a holistic understanding of the
voice. Voice is a function of a person. From birth, it marks the beginning of the voice
function, later developed develops into a language and then used to sing and
communicate. Voice is closely related to our life. It is an indispensable tool for
communicating ideas and expressing emotions, especially for people who have use
voice as a career, . hHaving a good voice is more important for different people than
other people. The voice can be interpreted simply as ‘the sound made by the vocal
organ of a human being’. The English voice ‘voice’ originates from the Latin ‘vocare’,
the original meaning is ‘shout, call’.

The Voice Mechanism
‘In speech and singing, the quality of the produced sound can be influenced by
neuronallyneuronal controlled muscular adjustments in both vocal tract and larynx.’
(Herbst, C. T., & Hess, M., & Müller, F., & Švec, J. G., & Sundberg, J., 2015, p.91) The
voice is produced by the larynx. The sound movement of the human being is under
the control of the cerebral cortex, the signal through the laryngeal motor nerve
reaches the sound organs of the various parts and leads to the sound. As a vibrating
object, vocal cords can be articulation articulated under the impetus of air, but this
kind of voice's voice range, volume and timbre are very limited, let alone the artistic
voice. It is only under the control of the brain that a wonderful song can be sung.
The voice produced mainly by the glottis closed to complete, and the closure of
the glottis is mainly realized by the following three factors: (1) elastic back vocal
cords; (2) subglottic air escapes leading to lower pressure; (3) the negative pressure
formed in the exhaled air at the glottis. Of course, the voice is produced not only by
the closure of the glottis. At present, there are three theories about the mechanism
of voice, including aerodynanicaerodynamic-myoelastic theory, neurochroaxic
theory and comprehensive theory. aerodynanicaerodynamic-myoelastic theory is
also known as ‘aerodynamic theory’, the idea is that when the sound is produced by
the vibration of the vocal cords of their vocal cord tension and elasticity in expiratory
pressures; the neural theory that the vibration of the vocal cords is controlled by the
brain, the brain through the laryngeal nerve issued issues rhythmic impulse, In order
to control the vocal cord and make it vibrate, the comprehensive theory holds that
the above two theories should be combined. This study supports the comprehensive

Several Common Vocal Diseases
Voice disease refers to the abnormal voice caused by the diseases of the human
throat and related organs. When the voice volume, tone, tone quality, duration of
sound and resonance are abnormal, it becomes voice disease.
Common voice disease basically has the following kinds:
 Laryngitis;
 Vocal cord edema;
 Poor glottal closure;
 Vocal nodules;
 Inflammation of the vocal cords;
 Hysterical vocal dysfunction.

The Analysis of the Causes of Voice Disease-Physiological and

Psychological Causes

There are many several causes of voice diseases, which are generally classified into
two categories: voice diseases caused by incorrect vocalization; voice disease caused
by the failure to comply with the voice health system. Unscientific vocalization is the
main cause of voice disease.

The Physiological Causes of Voice Disease
The vocal organs are composed of four parts:
 The power part. The dynamic part includes the respiratory muscle group related
to lung, trachea, bronchus, thoracic and diaphragmatic, abdominal muscles.
 The source part. Mainly including the vocal cords of the larynx, is the birthplace
of the voice. The sound is produced by the vibration of the object, and the voice
is produced by the vibration of the vocal cord.
 The resonance part. The resonance part is the resonance organ, the human
body has the natural resonance organ. From the point of the physiological,
directly on the voice of resonance effect is the sinus, vocal cord at the top of the
laryngeal cavity, pharynx, nose and mouth, in addition, the chest, forehead, two
zygomatic parts also have resonance effect. The vocal performer cannot control
the posterior chamber, but can control the resonant cavity in front.
 The language structure part. This part is the articulatory organ, including the
lips, teeth, tongue, cheek, palate, mandible, etc. It is mainly composed of vowels
and consonants by changing the position and position of the above organs. In
singing, in order to make the language more beautiful and clear, the parts of the
speech organs are more active than usual.
The above is the physiological causes of the voice. From a physiological point of
view, the abnormality of these organs can be a sign or a cause of a voice disease. If
these organs cannot be reasonably protected, or these organs cannot be used
correctly, there is a possibility of developing vocal diseases.

The Psychological Causes of Voice Disease
Vocal music is a product of the combination of skills and vocal arts, with a certain
amount of individual differences and personality traits. Singing is a complex process
involving many movements, such as breathing, resonance, speech and hearing.
These movements are controlled by the human mind. Most people's activities are
carried out under psychological adjustment, which is more obvious in singing. To
some extent, psychological factors sometimes play a decisive role in vocal
performance. Therefore, it is very necessary to analyze the psychological causes of
voice diseases.
Psychological factors can have a great influence on the voice. The changes of
voice caused by mood swings and mental factors are very common in real life. Mood
swings cause of voice disorders are as follows: singing voice control under the
cerebral cortex is a coordinated movement, only good mood can present the
content of the works, plot, artistic conception and emotion; some undesirable
stimulation can cause the deterioration of the mood, the cerebral cortex function
disorders, the declination of the control ability of the vocal organ, thus has a great
influence on the voice.
The Negative Factors that Affect the Voice

There are many bad factors that affect the voice in the teaching and performing of
vocal music, mainly in the following aspects.

The Incorrect Vocalization
Incorrect vocalization, mainly refers to the vocal organs in certain aspects of voice to
appear unbalanced, uncoordinated movement, incomplete or new sounds, thus
affecting the health of the voice. It is mainly manifested in the following aspects:
 Inability to use breathing properly
‘Respiratory changes are one of the most obvious and perceptible changes
associated with singing. The air that is exhaled from the lungs is the source of power
for articulation and singing. Continuously stable air pressure vibrates the vocal cords,
while resonance apparatuses and articulators adjust the structures to produce
different timbres.’ (Kang, J., & Scholp, A., & Jiang, J. J., 1995, p.1) Breathing is very
important when singing, the correctthe balanced breathing method cannot be
ignored. However, many people adopt the pure chest breathing method when
practicing. This breathing method cannot coordinate the activities of the muscles of
the chest and abdomen and the muscles of the larynx, resulting in excessive tension
in the larynx, thus resulting in ato compression of the glottis. It can also cause the
vocal cord to be impacted, increase the burden of the vocal cords, and cause fatigue
or injury to the vocal cords. The upper chest is also easy to stiffen, making the neck
muscles tense and blood vessels dilate. All of this these affects other
organs to perform their best.
 Uncoordinated vocal cords
The vocal movement of human vocal cord has two states: heavy function and light
function. The former is really sound, the latter namely refers to the hair is false,
correct vocal movement should be a combination of true voice, with the increase of
tones, vocal cord by the overall vibration into edge, by the thick and thin, tension
also gradually rise. This is a very complex form of motion that takes a long time to
master. However, in practice, many people do not grasp well. For example, too much
use of the real sound, not only the high pitch cannot sing, but also easy to cause the
vocal cord congestion edema, hiss; excessive use of falsetto, so that the bass will not
come down, easy to produce vocal nodules. If the two kinds of functions are not well
coordinated, there will be a change of in sound in the singing and the discoloration
of the sound area.
 The incorrect application of the resonance
The sound of the vocal chords is very small and thin. Only by relying on the
resonance to expand and beautify the sound can it become singing. Good resonance
can add color to words, sound and emotional expression, which is very important for
singing. Only by using resonant resonators scientifically and rationally can singers
beautify sound. If the resonance is not properly applied, the singing would lose its
charm, and the vibration of the vocal cord could be over-exercised due to the lack of
the protective mechanism of the resonant cavity, resulting in laryngeal disease.

Overly UsingOver-Using the Voice
Excessive use of voice is also a common bad factor in vocal music teaching. This is
one of the most common causes of voice disease. Excessive use of the voice, more
than the load of the vocal cords, even if the singing method is correct, will also cause
the vocal cord to get out of control and cause disorder, causing the vocal cord motor
injury. In severe several cases, the vocal cords can be hyperemic, edema, and
bleeding, and the chronic ones will thicken the vocal cords and produce a small knot
or polyp. In addition, if the singer does not pay attention to choose the appropriate
singing situation, too much singing in the open air or singing in a place with poor
acoustics may cause the singer to excessively use his/her voice thus cause a voice
disease. Coughing, sneezing, and a habit of habitually clearing the throat can also
cause vocal cord injuries if the singer does not stop these habits.

Bad Habits
Bad habits can also have an adverse effect on the voice. For example, it is difficult to
ensure the health of vocal performers without a scientific diet. Some vocal learners
often eat foods that stimulate their throats like chili and mustard, which can have a
very bad effectnegative effects on noise, which can affect the singing career; Some
vocal music learners are addicted to drinking and smoking, and the nicotine and
other harmful substances found in tobacco can directly stimulate the respiratory
tract, causing the singer's throat to dry, itchy, sputum and cough, and can cause the
vocal cord to show chronic inflammatory reaction, which causes the vocal cord to
become polymorphic, which in turn causes the voice to become dark and lose the
A singer's vocal health is complex and the way in which a singer cares for
and uses her voice and body on a daily basis encompasses many subjective
aspects of good vocal health. This includes proper hydration, avoiding
sources of irritation such as smoking or drugs, avoiding misuse or overuse
of the voice, and avoiding excessive struggle to produce a clear sound.
(Castelblanco, L., & Habib, M., & Stein, D. J., & de Quadros, A., & Cohen, S.
M., & Noordzij, J. P., 2014, p.612)

Voice Protection in the Treatment of Voice Diseases

As mentioned above, according to the relevant research, unscientific singing and the
lack of voice health common sense are the main reasons of voice diseases.
Therefore, improvement in the vocal method should be adapted to treat voice

The Relationship between Psychological Activities and Physiological
Functions in Singing
Psychological activity is the reflection of the objective things in the real world and
the relationship between them in the brain. Any activity of a person is carried out
under the control of psychological activities, and the psychological activity is directly
related to the person's practical ability.
 Psychological movements and physiological functions in singing develop each
The psychological factor of singing is a branch of psychological factors, which is
mainly related to the psychological factors in singing and teaching, which provides
theoretical basis and scientific basis for vocal teaching. The learning and singing
process of the voice is a comprehensive development and improvement process
integrating vocal skills, psychological quality, cultural and artistic accomplishment as
well as life experience. The composition of psychological factors is the spiritual
means composed by the basic elements, which is the indirect behavior; the singing
skill is the specific method and technique designed by consciously manipulating and
controlling the singing, which is the direct action. The singing psychological factors
are not directly involved in the activity, but they are dynamic and moderating in the
activity, which is the psychological tendency of cognition activities. In addition, the
singing skill is to undertake the task directly in the activity and play the role.
Therefore, the learning of vocal skills should always be closely combined with the
cultivation and training of psychological quality.
The learning of voice is different from that of other subjects. It is a combination
of skills and vocal art, with certain individual differences and creative expression of
individual characteristics. Singing is a complex process involving multiple movements
of breathing, resonance, speaking and hearing, and of course all these movements
are governed and controlled by the mind. The singing psychology is very
complicated, and it is affected by the emotion, personality, consciousness,
temperament and other aspects of each individual's psychological factors. Singing is
a unified movement, vocalization and other aspects of movement are coordinated
through the control of the nervous system. It is impossible to sing the right sound if
the performer is depressed, distracted, and devoid of proper singing passion.
The psychological activity runs through the whole process of vocal teaching and
vocal performance. Singing is to use music and language arts to express thoughts
and feelings of people. If an individual wants to express the artistic image, use song
to express feelings, the individual must master singing skills, also needs the
assistance of intelligence. Vocal performance is not only the process of human body
operation, but also the artistic activity process of psychological control and
regulation. The two are interdependent and interact with each other.
 Conduct singing with psychological activities
Singing art is the spiritual product of human beings. The singing psychology is the
reflection process of the human mind to the objective reality of singing. It is the
precondition for the normal development of singing activities. It is the mental
restraint and control of the mind consciousness of the brain to the physical
movement of the body. In vocal performance, whether in the performance of singing
skills or in the performance of singing art, there are complex psychological activities
Vocal art has a unique, and unspeakable nature. In vocal learning, it is not just
the movement of the human muscles, ligaments and bones, but the performance of
the human mind. It is the process of neural dominance, thought guidance, and
emotional catharsis. From this perspective, singing is influenced by psychological
factors such as emotion, emotion, interest and personality, which plays a very
important role in vocal performance. One cannot rely on vision to achieve the
purpose of learning directly, because one cannot see one'sone’s own singing state
while singing. But one's intuition or feeling to control the muscular activity related to
singing. In this case, the mental activity directs the physiological muscle energy. The
mastery of singing skills is achieved to a certain extent by feeling, while the control
of vocal skills is achieved by abstract feeling. Only under the control of good
psychological state, the physiological function can be exerted to the greatest
extent. , otherwiseOtherwise, the singing is just mechanical voice, which is not
Vocal art is a performing art, which requires the singer to complete his/her
works at the stage of the performance. The success or failure will be directly
presented to the audience at present, there is no room for modification. Because of
the high risk of this type of art, it demands a higher level of psychological quality for
artists. Some vocal performers have certain singing skills and have strong singing
skills, but they have not been able to work normally in practice, which is in close
relationship with the psychological activities of that time. Some vocal performers
with high singing ability tend to have good psychological quality, and the initiative of
psychological activities is very strong, and they do not spread their energy on
meaningless things.
The psychological activities have a guiding role in singing practice, not only in
the understanding of singing art, but also in the stage of singing reality. In the
process of singing, the psychological activity will have a great influence on the right
or wrong of the voice, and the positive mental activity will guide the correct
vocalization, otherwise, it may lead to the wrong vocalization method and cause the
voice disease. The psychological factors in vocal music activities should be attached
great importance.

Voice Protection
Some of the negative factors in vocal teaching and performing not only affect the
quality of vocal teaching and performing, but also have a very negative effect on the
voice. Therefore, to some extent, improvement of improve the methods of singing
has the vital significance for the treatment of voice diseases.
 The role of scientific vocalization in voice protection
Because of the frequent use of voice, vocal workers tend to be more susceptible to
laryngitis, vocal cord edema, hyperplasia of the vocal cords , and nodules of the
vocal cords. These diseases often result in a dull or hoarse voice, which seriously
affects the work efficiency. The unscientific singing method is one of the important
causes of voice disease. When the bad stimulation caused by the wrong singing
method exceeds the adaptive capacity of the vocal organ, it may cause the injury of
local cell tissue. The incorrect method of vocalization will greatly waste the energy of
vocalization and damage the balance regulation of the vocal organs, which will cause
the vocal cords to develop continuously. Even with surgery or drug treatment, it is
difficult to cure and will inevitably relapse frequently. The scientific method of
vocalization is to use the most vocal energy to achieve the maximum acoustic effect
of the vocal organ , and to achieve the sound effect of the best artistic vocalization. If
one can master the scientific method of vocalization, one can save the sound energy
and reduce the load of the vocal cords and obtain the ‘immune function’ of many
vocal cord diseases, even if the original diseases of the vocal cords can be healed and
 Voice Protection in Singing
As mentioned earlier, there are a number of undesirable factors in singing that can
damage the voice. Therefore,, being be careful to protect voice when practicing or
performing is essential. In general, there are several areas in particular that need to
be noted.
First, from a physiological standpoint:
(1) Controlling the time of practice and the intensity of singing. In vocal music, it Is
necessary to train the high notes, but it also takes time. Following the principle of
gradual, to be careful and not push too much when practicing. Vocal performers
should pay attention to the combination of work and rest, follow the rules of
voice training and avoid the acute or chronic damage of the sound. If the rule of
voice training is not followed, there may be serious injuries and obstacles to the
vocal cords, which may result in the generation of vocal disorder.
(2) Using correct vocalization and singing methods. Generally speaking, if the
vocalization method is not scientific, it is difficult to detect at first, but the timbre
will begin to become unrounded and gradually become hoarse, which may cause
voice disease in the long run. Therefore, if the singer feels uncomfortable with
the throat, it may indicate that there may be a problem in the singing method.
He/she should try to adjust the condition and method and then, during a certain
period of time, let the vocal cords to be rested. Singers should always be mindful
of their voice and make appropriate adjustments to their voice.
(3) Maintaining adequate rest time. Singers should maintain adequate sleep time,
because lack of sleep can make people's blood become more acidic, and muscles
tend to feel tired. The throat muscles are very small and sensitive . muscles, and
slightly fatigue can be reflected. In general, people who sleep less and suffer
from insomnia could not last longer in singing.
(4) To develop a good living habit. To form a regular habit, do not overeat, eat more
fruits and vegetables and other nutritional foods. Do not eat too much before
sing. Because when the food is too full, the free contraction of the diaphragm is
restricted, causing the breathing movement to be obstructed, thus affecting the
singing tone. Make it a good habit to exercise regularly. Sports are very
important to the singer. Exercise helps expand lung capacity and enhance muscle
elasticity, which is good for singers. In general, it is more likely that the regular
exerciser is more receptive to the singing method, especially the breathing
method, because it is easier to understand the expansion of the chest frame and
the strength of the muscle contractions in the breathing. Therefore, it is
necessary to develop the good habit of regular exercise, so that people can have
abundant energy and energy to sing and can also enhance immunity and resist
various diseases.
In the second place, from psychological perspective:
Keep a healthy mind. In the teaching and singing of vocal music, psychological
activities play a very important role. Human vocal organs, like other activities of the
human body, are subject to psychological control. When singing, excessive mental
burden and psychological stress can cause the disturbance of vocal organ activity
and affect the performance of the song. Therefore, in order to achieve the desired
effect of vocal music performance, vocal performers should maintain a good
psychological state. When singing performances, try to relax, in order to ease the
state into the vocal music performance, seeking the most suitable method to study.
In the daily accumulation of accumulation and training, gradually develop a sound
emotional, emotional and good psychological state. To be able to withstand the
challenges and the setbacks, to get over all the obstacles. Only when the
psychological regulation is good, can the singing method master better, as well as
obtain the higher singing level.

Voice diseases are common among vocal workers, so that voice protection is vital to
singers. If the throat is uncomfortable, it should be treated at the first time. As long
as taking early diagnosis and treatment, many voice diseases can be resolved or
controlled. The proper voice protection methods are very beneficial to the recovery
of the voice, because when the voice is fatigue and has diseases, the appropriate
methods of voice protection can play a good role in the health of voice.


Achey, M.A., & He, M.Z., & Akst, L.M. (2016). Vocal Hygiene Habits and Vocal
Handicap Among Conservatory Students of Classical Singing. Journal of Voice, 30(2),

Castelblanco, L., & Habib, M., & Stein, D. J., & de Quadros, A., & Cohen, S. M., &
Noordzij, J. P. (2014). Singing Voice Handicap and Videostrobolaryngoscopy in
Healthy Professional Singers. Journal of Voice, 28(5), 608-613.

Herbst, C. T., & Hess, M., & Müller, F., & Švec, J. G., & Sundberg, J. (2015). Glottal
Adduction and Subglottal Pressure in Singing. Journal of Voice, 29(4), 91-402.

Kang, J., & Scholp, A., & Jiang, J. J. (1995). A Review of the Physiological Effects and
Mechanisms of Singing. Journal of Voice, 9(1), 1-6.

Latham, K., & Messing, B., & Bidlack, M., & Merritt, S., & Zhou, X., & Akst, L. M.
(2017). Vocal Health Education and Medical Resources for Graduate-

Level Vocal Performance Students. Journal of Voice, 31(2), 251.e1-251.e7.

Pestana, P.M., & Vaz-Freitas, S., & Manso, M. C. (2017). Prevalence of Voice
Disorders in Singers: Systematic Review and Meta-Analysis. Journal of Voice, 31(6),
Sielska-Badurek, E. M., & Sobol, M., & Olszowska, K., & Niemczyk, K. (1995).
Contemporary Commercial Music Singing Students—Voice Quality and Vocal
Function at the Beginning of Singing Training. Journal of Voice, 9(1), 1-5.