Voice rest is universally recognized as “something good.” Physicians often recommend it, and even more often singers self-prescribe it. But when the period of rest is over, is your voice instantly back to its full glory? The answer, often, is no. A day or two of voice rest is beneficial and has no ill effect, but longer periods of non-singing can leave the voice changed. Why is this so, and what can you do, after weeks of painfully self-imposed silence, to resume normal singing?
First, a disclaimer. I write this column as a laryngologist. I realize that these issues are the province of voice teachers. My suggestions are based on what we know about laryngeal physiology. As you return to singing after prolonged voice rest, it is best to work through the rough patches with your teacher.
To fully recover the voice after prolonged rest, ask yourself several questions. First, why did you go on voice rest in the first place? While limited voice rest can be beneficial for many kinds of hoarseness, it is most appropriate for singers who have had a discrete injury at a certain point in time. This might be a vocal fold hemorrhage that needs to be monitored over weeks while the tissues reabsorb the blood and the vocal fold returns to its normal color and shape. Another example is a small hemorrhagic polyp, the result of inadvertently singing with a hemorrhaged vocal fold. Yet another injury might be some pain from a pulled muscle or a specific incident of overstrain. These sorts of injuries respond well to voice rest, since they typically result from one vocal mishap, and healing is usually complete within a few weeks.
OK—you have finally completed your two to four weeks with pen and paper, listened silently to your phone messages (and your roommate), and now you (or your teacher or doctor) feel it’s OK to try to sing again. So you start. Your voice sounds strange, strained, lacking resonance and flexibility. The top is fuzzy, the passaggio is uneven. This is not your pre-rest voice! What happened?
First, don’t panic. My first recommendation, if the voice rest was self-imposed, is to have a laryngologist examine your larynx. It is possible that your original problem is not what you thought it was, that is, not one that disappears with voice rest. If you happen to be an “untrained professional singer” (Richard Miller’s term), whether the issue is tension or nodules, no amount of voice rest will correct your problem ultimately. Chronic vocal nodules also occur among trained singers, of course. With rest the nodules may shrink somewhat, but they will not completely disappear. The treatment for chronic injury nodules, rather than rest, is to rework the technique.
What if your injury is one that is normally amenable to vocal rest, such as a hemorrhage? Consider first the possibility that the problem has not yet completely resolved. Keep in mind that even when that hemorrhaged vocal fold looks normal in shape and color there may be a slight and invisible lingering edema that the doctor cannot see (although it might be demonstrable as persistent stiffness on stroboscopy). In this case, a little more rest would be one option.
But what if your larynx looks absolutely normal? Well, you haven’t forgotten how to sing, but your larynx may need some reminding. The most common negative effect of prolonged voice rest is a gradual elevation of the larynx. If you put your thumb and index finger between the upper margin of the thyroid cartilage and the hyoid above, you will find that the thyrohyoid space, painstakingly pried open thanks to years of practice, has become narrowed and tight—the larynx simply resumes its normal (pre-training) high position. A large part of the vocal distress in the post-rested voice comes from this elevation, and includes excess tension, lack of resonance and power (due to decrease in the first formant), and a generally thinner voice. The extrinsic muscles (laryngeal elevators and depressors) are at fault—after weeks of just breathing and swallowing, they have simply reverted to their “default setting.”
It is important to recognize this, and work hard on lowering the larynx again. Do not fall into the trap of trying to muscle the voice. This makes the elevation (and the vocal problem) worse. More voice rest is also a poor choice here. It doesn’t address the elevation. This requires not rest, but re-lowering the larynx by strengthening the laryngeal depressors.
Next, your intrinsic laryngeal muscles also need a refresher course. Compared to singing, the normal breathing, unvoiced whispering, and swallowing movements of the larynx at rest demand a very limited range of contraction and excursion from these muscles, and they need you to put them through their paces again. Your next job, therefore, is to rework the passaggio. Work it gently and not with a lot of volume, re-teaching the muscles how to coordinate the shift from chest to head voice. Obviously your larynx remembers quite a bit (muscle memory, proprioception), but gently remind it. Going down from head into chest (versus going up) is a good way to start.
Finally (and purposely the third item of three), look at your top notes. You recall that in high head voice the vocalis muscle is pulled thin and flat, as the cricothyroid tilts the thyroid cartilage forward. The vocalis doesn’t lose its bulk or power during the rest period (the larynx moves constantly with breathing), but it needs to be gently stretched again, as you would stretch tight muscles before getting on the machines at your gym. If the top is persistently difficult, don’t forget my first point—you may still have a bit of lingering edema from the original injury, so don’t push.
Now that the various parts are working again, you can finally take that baby out for a real drive. Ritorna, Vincitor!
DISCLAIMER: The suggestions Dr. Jahn provides in these columns are for general information only, and not to be construed as specific medical advice or advocating specific treatment, which should be obtained only following a visit and consultation with your own physician.