When Should a Singer Go to an ENT?

THIS BLOG HAS BEEN MOVED TO OUR NEW WEBSITE. GO READ IT HERE.

First, a little back story...

For two weeks in 2018, I lost the use of my right arm and was in the most acute pain I’d ever experienced. Two herniated discs in my neck severely impinged my nerves. 

I'll spare you all the details, but ultimately, I had double-disc replacement surgery on my cervical spine to avoid any permanent nerve damage.

The surgery was successful, but if I don't stay on top of my stress and exercise, I get a tight neck, shoulders, and tension headaches.

During a particularly stressful time, as in... my dad died, COVID numbers were super high, and I had a weeklong online vocal conference I was performing at in front of all my peers, I started experiencing some persistent vocal tension and fatigue. 

It scared me.  My voice felt really tight.  It was uncomfortable to sing or speak.  It was cracking, and it wasn't seeming to improve very quickly.

It occurred to me that it was coming from extrinsic muscle tension in my neck and shoulders.

Or, was it? 

I wondered if I possibly had an issue with my vocal folds that could be causing it.

So, I visited my own ENT for a vocal scope and examination.⁠

I wanted to know for certain the cause so that I could choose the best treatment plan and get feeling better again.

Vocal health is not something to be taken lightly. But when should a singer see an ENT?

ENT vs Otolaryngologist vs Laryngologist

First, let’s clarify what an ENT is.

An ENT, or an Ear, Nose, and Throat doctor, is also called an otolaryngologist. They are one and the same.

A laryngologist is an ENT doctor who subspecializes in laryngology. They deal with the voice.

So if you are a singer, or generally a voice user, you would want to see a board-certified laryngologist.

Reasons to See an ENT

If you’re having any of these symptoms, be PROACTIVE and go see an ENT as soon as you can:

1. Changes in the voice or hoarseness that persist more than 2 weeks.

2. Sudden loss of voice or other change, especially during a performance or voice use

3. Pain with voice use

4. Something just doesn’t feel right.

But don’t just wait for the injury to happen!

In a perfect world, singers would get an annual exam from a laryngologist, even when they feel totally healthy. Visit your ENT for PREVENTIVE reasons so that you can:

1. Establish a relationship with an ENT before the problems happen (You don’t want to have to scramble to find an ENT when you are in a vocal crisis!)

2. Identify issues that may put you more at risk for vocal injury

3. Discuss mild symptoms that you might be overlooking, but could be signs of early injury

4. Learn more about your own instrument so you can be better at identifying your own problems

As for my own recent experience, I was happy to learn that my vocal folds looked healthy. No sign of injury.

My doctor recommended trying body work to help release some of the tension.

I took her advice. Even after one session of structural alignment work, I feel a difference.

I was better equipped to make a decision about what treatment to follow after seeing my ENT. Otherwise, I’d still be worrying about it, and I wouldn’t be getting anywhere but worse.

Going to an ENT to get a vocal exam might seem a little scary, especially if you’ve never done it.

But, it’s important to conquer that fear.

I hope you found this helpful. Please share your questions or comments below!

5 Minute Straw in Water Vocal Warm-Up 🗣 ⁠

THIS BLOG HAS BEEN UPDATED AND MOVED TO OUR NEW WEBSITE. GO READ IT HERE.

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If you know me at all, you know I love vocal straw exercises inside and out (of water, that is)⁠. 😜

⁠In this 5 minute video, I'll share with you a really simple and effective "Straw in Water" vocal exercise.

I learned this exercise several years ago from an SLP (Speech and Language Pathologist) at Cedar Sinai in Los Angeles. I still use it for myself and my students today.

When to Use the Straw in Water Exercise

The straw in water exercise is great for warming up/cooling down or soothing a tired voice.

Singing with the straw in water is also a great introduction to straw singing, if you've never tried it.

When I tried straw singing for the first time, it was without water, and I will tell you, I personally found it really awkward. I didn’t understand the “feel” I was aiming for, so I didn’t find it very effective.

After getting the hang of vocalizing with the straw in the water, I was able to then transition to using the straw without water as well. Straw singing in and out of the water are both highly beneficial.

Why sing with a straw?

There is so much science behind why straw exercises are such an effective tool in every voice user’s toolbox.

Straw singing exercises help tone and coordinate the muscles used for singing.

Using the straw trains the posturing of the vocal folds (cords) by lengthening and partially closing off the vocal tract, which is the space from your vocal folds to the tip of your lips.

A back-pressure occurs when the vocal tract is partially closed off and energy feeds back to the vocal folds. The back-pressure trains a more effective position of the vocal folds when they close, helping them to square-up better.

This benefit occurs to some degree with all semi-occluded vocal tract exercises (SOVTs), for example lip trills, tongue trills, humming, singing on a “V”, “J”, or “Z” etc.

Using the straw is basically making the vocal tract longer because the straw is extending the space where the sound is resonating. The elongation of the vocal tract allows the larynx to lower to a neutral position.  When the larynx is neutral, you can't over-squeeze. 

Straw Size Matters

Using the correct size of straw in length and diameter is very important when doing straw exercises.

The size matters because we want pressure equalization.

When you use the straw in water, you can increase the resistance just by how deep you put the straw into the water.

What straws to use

If you are using a regular drinking straw, try putting it into the water about 2 inches.

If you are using really small cocktail-like straws, you may need to use 3-6, so that you don’t have TOO much resistance. It shouldn’t feel like you can barely get any sound or air out.

If you use a large smoothie type straw you might need to put it deeper into the water to get the right amount of resistance. If the straw is flexible, you can also try squeezing it slightly to adjust the resistance.

It's like a mini gym workout for your voice!

Have fun and let me know how it goes in the comments.

⁠