By Siobhan Groves, CF-SLP
Singers are often told to avoid coughing and throat clearing in order to keep from damaging their vocal cords. But how do these behaviors actually impact the voice?
Your voice and your cough both happen at the level of your vocal cords, which are situated right above your airway. The fact that we can speak and sing is secondary to the primary purpose of our vocal cords, which is to close and protect our airway from anything that could “threaten” the lungs, such as food and liquid, smoke in the air, or allergens and irritants. Our cough is designed to propel any of these “threats” away from our lungs. So, coughing is necessary as a protective mechanism for respiratory health. However, it is also traumatic to the vocal cords.
How coughing affects the vocal cords
When a person speaks or sings, their vocal cords come together with a force similar to a golf clap – the action is soft, gentle, and when it’s over there’s little to no feeling left behind. When a person coughs or clears their throat the force is more like clapping for a standing ovation – the rate and force of the action is increased significantly, and when it’s over your hands are red and irritated. Now imagine that happening over and over at the level of your vocal cords. Prolonged periods of coughing and throat clearing can lead to swelling, irritation, and even lesions on the vocal cords. It can also lead to heightened sensitivity in your airway, making it more likely that you’ll cough again in reaction to minor irritation.
Sometimes a period of necessary coughing – during an illness, for instance – can evolve into coughing and throat clearing out of habit. Your body may have healed from the illness, but the irritation and sensitivity in your throat may linger. Your brain may then interpret that irritation as a threat, and in response will send a signal to cough or clear your throat when it is unnecessary. This creates even more irritation and can become a cycle.
Should I be coughing?
To determine if your cough is necessary, consider the circumstances. When you cough, are you producing mucous? Did something go down “the wrong pipe” when you swallowed? Is there smoke, dust, or allergens in the air? These are all examples of times when your cough is necessary to protect your lungs.
On the other hand, do you feel like something is in your throat but your cough is consistently dry? Do you frequently clear your throat in order to clear your voice? Does the cough feel like scratching an itch where it feels good in the moment but doesn’t really resolve anything? This is more likely a habit cough.
How can I stop coughing?
In order to begin resolving a habit cough, first think about why the cough exists. First, work with your doctor to treat any medical conditions that could be triggering the cough, like acid reflux or allergies. Once those symptoms are under control, the next step is to reduce the level of irritation in your throat. Sometimes reminding yourself that the cough is unnecessary is enough, but when a cough becomes a habit, the brain may need to replace the habit with something else.
Try replacing your cough with a swallow of saliva (known as a dry swallow) or with a sip of water. When you feel the urge to cough, inhale gently through your nose, take a small sip of water or swallow your saliva, and then exhale through rounded lips. Continue this cycle until the urge to cough resolves. This action will help to clear any mucous that may be in your throat and reduce the level of irritation in your larynx.
If this does not resolve the urge to cough, try gargling a small amount of plain water while make a sound with your voice. A gargle is effectively the same as a cough in this circumstance but it’s a much gentler way of bringing your vocal cords together to move mucous away from your airway.
Be mindful of coughing. Your cough is designed to keep you healthy, so develop an awareness of when it is necessary and when it is not. Singers and other professional voice users must treat their voice with care at all times. Develop healthy habits around coughing and throat clearing and gain one more tool for use in preserving the health of your instrument.
Siobhan Groves is a voice & swallowing specialist who sees patients in our SouthPark office. Are you looking for voice & swallowing care? Call 704-295-3000 to make an appointment. You can also request an appointment online or through myCEENTAchart.