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Vocal Nodules (Vocal Health Issues)

Updated: Jul 31, 2019


As I mentioned in yesterday’s post, the mucosal tissue of the vocal folds is delicate and can be quite easily damaged. The vocal folds vibrate at extremely high speeds which means that they can be easily stressed. Using the voice too much, too loud and incorrectly for long periods of time can cause the lining of the vocal folds to swell and become irritated.

In order to produce sound, we need 3 main elements:

1. A power source (breath pressure and flow)

2. A source of vibration (formed at the vocal folds)

3. A resonator (the vocal tract)

When air travels through the vocal folds they close and then oscillate to create vibration. The vibrations that originate from the vocal folds are then amplified in the different spaces within the vocal tract. When the vocal folds swell and become irritated, it makes it harder for them to come together to produce sound. This causes the singer to generally work harder and when the vocal folds are brought together forcefully over a period of time, this can lead to nodules.

Nodules are a problem of friction on the vocal folds at the point of maximum contact in the middle 3rd. This results in the vocal folds thickening (similar to callous’ on the foot). The thickening of the vocal folds is the bodies defence mechanism to protect itself from irritation. Nodules are paired, so you will never have ‘a’ nodule.

Signs to listen out for:

- Hoarseness of speaking and singing voice

- Decreased vocal range

- Rapid vocal fatigue

- Inability to sing quietly

- Inability to hold a steady pitch


When it come to treatment of nodules, voice therapy & voice hygiene interventions are usually firstly recommended. This involves voice production work, learning how to use the muscles involved in voice to create the best possible sound. As well as learning, how to take care of the vocal folds and keep them free from irritants. In some case’s surgery may be required on long-neglected vocal nodules but surgery is usually the last course of action and is rarely required.

Nodules will generally go away with voice rest but as soon as the voice is used again with the same technique, they will come back. This is why voice therapy, voice hygiene and voice training sessions are important in helping to recover from nodules. Adjusting vocal technique and taking care of the voice can prevent the nodules from returning.


If you have any concerns about your voice, get checked out, don’t wait. It is also important that you see a laryngologist which is an ENT surgeon that specialises in voice. Voice disorders can often be misdiagnosed by ENT’s that don’t have specialised expertise in voice.

If you need the details of any good ENT’s here in London or LA, DM and I’ll send them over.

I hope this helps!

See ya tomorrow! I’ll be back with more! Have a blessed evening!!


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