Adele said she felt a “pop” in her throat. Then it sounded like someone covered her voice with a curtain.
Any singer who has suffered a vocal hemorrhage will know what she’s talking about. Despite being a common, usually pain-free vocal injury, it brought Adele’s career to a halt—not once but twice. And she’s in good company. Sam Smith, Keith Urban, and John Mayer, for example, have had various injuries that resulted in surgeries and treatments, and were fortunate to resume their rigorous schedules. Vocal injuries are not exclusive to pop singers—they’re also realities for musical theatre actors grinding out eight shows a week.
Career paths in musical theatre, opera, and film/TV have an organized process, a system that performers can easily follow: casting notices, auditions, and job offers over simplifies it, but a clear system exists. Training for these career paths are also structured. But for pop singers, not so much. (I use “pop singer” as an umbrella term for all genres in the commercial music industry.) These singers are one-person bands. Until they can afford to pay someone else to work for them, pop singers have to do everything: organize travel, set up and break down gear, speak loudly in noisy venues, manage press, design their wardrobe, and of course, get the money.
These self-starters often honed their skills in garage bands, school functions, and then local clubs. Many began playing an instrument and started singing out of necessity—learning how to sing may not have been at the top of their hit parade. Karen Carpenter, for example, was a drummer. Some voices are naturally set up in a healthy way, but others require guidance. In either scenario, a young voice can often sustain questionable technique—until something happens. Often, it’s a combination of unsustainable singing habits, poor physical health, and rigorous tour schedules sandwiched by recording sessions. It’s never one thing. I meet these singers when they’ve hit a wall—perhaps unknowingly injuring themselves—or developed compensatory singing habits just to “get through it”.
Once they find me, implementing vocal technique is often the answer. More often, I hear something that needs to be scoped by one of a few trusted otolaryngologists I work with. Sometimes singers find the otolaryngologist first, get diagnosed and treated (likely without surgery), and work with the office’s speech-language pathologist (SLP).
The SLP will teach the singer how to speak in a healthy way with semi-occluded vocal tract exercises such as straw phonation and lip trills, as well as manual work like laryngeal massage and base of tongue stretches. They may even introduce the singer to a healthy vocal technique. But when it’s time to move forward with more in-depth vocal technique—the artistic and organic application of that technique—the SLP refers the singer to me. Often, I work in tandem with the SLP.
Some years ago, I was diagnosed with a vocal paresis myself. My left vocal fold wouldn’t fire quite like it should. The saint of a voice teacher that I was referred to, Joan Lader, listened to me speak over the phone and said with comfort and certainty that I was going to be just fine—and through our work, I was. If she hadn’t made me feel hopeful and at ease, I wouldn’t have gotten anywhere. How your voice teacher makes you feel is paramount.
The path of least resistance… works! Take the easy way in.

Here’s what a first session might look like:
Function:
- Singing and speaking come from the same place, so a neutral ah with a b in front of it (bah) on a five-note scale in speaking range is often comfortable.
- Moving this exercise up and down by half steps gradually tells me a lot about how a voice functions, specifically where the comfy range begins and ends and how it negotiates registration (chest, mix, head, falsetto for men).
Finding a progression:
- When a voice is too open (breathy or woofy), I work with vowels that are more closed like A’s and E’s. If I find that a voice is tight, I may start with open vowel sounds like ah and oh and introduce consonants to loosen things up. Any vowel can be modified in any way to support the exercise.
- I try to mention breath as little as possible. Asking for “calm, low breath” and using the right vocal exercise eventually leads to coordination in the body, and breath begins to support the voice. Individual tweaking is always necessary. Unless there is a real issue, too much chatter about breath can be confusing and gets clients stuck in their heads.
- Like working a muscle group the same way for too long at the gym, it’s dangerous to linger on one type of exercise. I mix things up and change direction often. Short tongue twisters work well—they can energize the voice or may free up some musculature that’s stuck in the vocal tract (the area between the esophagus and the lips and including some of the nasal cavity).
- This process requires patience. I gently educate clients in registration so that we both have the same reference for where they are in their voice. I listen to the exercise I’ve created to see if it effects change in the voice. If it doesn’t feel good, it’s not working. The exercises keep changing and morphing based on what I’m hearing. And voila! There begins to be a progression toward easier singing.
- Different otolaryngologists call different injuries different things. It doesn’t matter. Instinct, ongoing training, and experience as a teacher and as a singer tell me what to listen for and where to go next with a client. I’ve been injured and I know what it feels and sounds like. My job is to see how an injury behaves and what combination of exercises change that behavior, strengthen new behavior, and if possilbe eliminate the problem. I’m not looking to change a client’s sound.
A few things to ask yourself: how does your singing feel to you? Do you tire easily? Does your recovery time from a gig seem too long? Are you concerned that your voice won’t meet your schedule demands? If so, it might be time to find a voice trainer.
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