THE VOICE CLINIC – MEDICAL SERVICES
Clinical Care, Rehabilitation and Optimization of the Professional and Artistic Voice
Our voice clinic was the first clinic in India, dedicated to clinical care, rehabilitation and optimization of the professional and artistic voice. We specialize in the treatment of vocal injuries and problems that occur in singers, actors and other professional vocalists, and provide the highest standards of care to all voice patients. We go beyond medical treatment and rehabilitation, to help them optimize and achieve peak levels in the voice for their professional, performance and artistic requirements.
We were also the first to offer a program in preventative voice care and vocal education to professional & occupational voice users, empowering them to maintain the health of their voice throughout their career. Preventative voice care and vocal health maintenance programs help professional vocalists cultivate a vibrant, healthy and strong voice, and reduce the incidence of vocal nodules and other voice-use related problems that are common among professional & occupational voice users.
We have a conservative, holistic and comprehensive approach to the treatment of voice disorders. Voice disorders are complex and involve multiple factors, as the voice occupies a unique space at the intersection of the body, breath, emotions and thoughts. We address not only the physical and vocal aspects, but also the emotional and psychological component of the voice disorder.
Vocal technique and voice-use related problems seen in professional vocalists respond well to voice therapy and corrective voice training. We design personalized rehabilitation and treatment plans, that help reverse voice problems without surgical intervention, when diagnosed early. Vocal rehabilitation includes specialized voice therapy and corrective training to facilitate healthy and physiological voice production, modify harmful vocal behaviours and habits, learn efficient voice use, and develop effective vocal technique for long- term vocal health. It also includes stress management strategies, lifestyle modification and medical treatment of associated factors that affect the voice.
After successful vocal rehabilitation, we work on enhancing the quality, resonance, range, flexibility, endurance, strength and power of the voice, to help our patients maximize their vocal potential to meet their artistic and professional requirements and goals.
Who should seek advice?
Professional & artistic voice users and others with the following symptoms and limitations:
- Your voice quality, power, flexibility and range do not meet your professional needs
- You have vocal limitations that prevent you from exploring the full potential of your voice
- Hoarse, harsh, raspy, gravelly, rough voice
- Breathy, soft, weak, unenergetic voice
- Nasal or de-nasal voice
- Difficulty singing higher notes
- Difficulty with register transitions
- Inability to sing notes that you could sing effortlessly in the past
- Reduced pitch range
- Prolonged warm-up time
- Problems with breath efficiency for singing and speaking
- Technical difficulties with the singing voice
- Throat pain, soreness & discomfort associated with speaking and singing
- Singing and speaking is effortful
- Need to clear the throat frequently
- Vocal fatigue or tiring of the voice
- Difficulty projecting the voice
- Difficulty speaking loudly or softly
- Change in voice quality
- Instability or breaks in the voice
- Hoarseness or change in voice following a sore throat, cold or flu that lasts for over two weeks
- Sudden loss of voice
- Any change in the voice if you are or have been a smoker
- Recurrent throat pain or persistent cough, that does not respond to routine treatment
Services offered at our voice clinic
- Clinical Assessment of the Voice
- Singing Voice Assessment
- Acting Voice Assessment
- Professional Speaking Voice Assessment
- Scientific Computerized Voice Analysis
- Phonetogram or Voice Range Profile for singers, actors and vocal artistes
- Rigid and Flexible Laryngoscopy
- Laryngeal Videostroboscopy
- Vocal check-ups for professional vocalists before major performances, tours, sports commentary seasons, public speaking events
Voice Therapy, Treatment and Vocal Optimization
- Care of the Professional & Artistic Voice
- Vocal Enhancement Coaching for professional vocalists
- Corrective Voice Training for professional vocalists with vocal limitations
- Specialized Artistic and Performance Voice Therapy for singers, actors, voice-over artistes and vocal performers with voice disorders
- Specialized Speaking Voice Therapy for professional speakers with voice disorders
- Non-surgical Vocal Rehabilitation for vocal injuries and problems
- Vocal Optimization Training for High Vocal Endurance, Power and Stamina to prepare for concerts, tour performances, sports commentary seasons, major speaking assignments
- Breath Therapy and Breath Optimization for the voice, and for health & wellness
- Optimal Pitch Training
- Voice Care and Vocal Enhancement Training for children and teenagers
- Voice Therapy for vocal problems like vocal fry, muscle tension dysphonia, soft or weak voice, nasal voice, instability in the voice, vocal onset problems including a breathy voice and hard glottal attacks
- Vocal Rehabilitation and Medical Treatment of organic [structural] voice disorders
- Vocal Rejuvenation and Restoration for vocal fatigue and the ageing voice [presbyphonia]
- Digital Manipulation and Laryngeal Manual therapy for MTD [muscle tension dysphonia]
- Transgender Voice Therapy
- Lifestyle and Behavioural Modification after a vocal injury
- Psychological Rehabilitation and Counselling for professional vocalists & performers with a vocal problem or injury
- Stress Management Strategies
- Handling Public Speaking and Performance Anxiety
- Peak Performance Coaching through mind- body approaches, hypnotherapy, creative visualization and guided imagery
Preventative Voice Care
Preventative voice care is offered to professional and occupational voice users to promote vocal health before a voice problem occurs, to diagnose changes in the vocal folds at an early stage, and to maintain the health and longevity of the performing voice. It includes
- Singing and Speaking Voice Analysis
- Computerized Voice Analysis
- Laryngeal Evaluation
- Voice Training to develop and maintain vocal quality, stamina, power, flexibility & range
- Vocal Education & Vocal Hygiene for vocal health maintenance
Common Voice Problems and Disorders in Professional & Artistic Voice Users
- Functional Voice Problems
- Organic or Structural Voice Disorders
- Combination of Functional and Organic Voice Orders
Functional Voice Problems
Patients present with vocal symptoms and complaints but their vocal folds are normal. There are minimal or no anatomical or structural changes involving the vocal folds but the vocal mechanism is used inefficiently or incorrectly. Functional voice problems are usually related to voice usage and vocal technique.
Hyperfunctional or voice-use related dysphonia is often seen in professional and occupational voice users. It usually manifests initially as excessive muscle tension and is referred to as Muscle Tension Dysphonia or MTD. Patients develop vocal symptoms and limitations because of strenuous and extensive use, misuse, abuse, unhealthy and inefficient use of the voice, issues with vocal technique, harmful vocal habits, failure to develop a vocal practice & warm-up routine, inadequate training combined with extensive & exacting professional demands.
Other co-existing medical factors often contribute to and worsen the voice problem. These include allergies, laryngopharyngeal reflux [acid reflux], sinusitis with a post nasal drip, throat infections, hormonal problems, smoking, excessive use of alcohol, substance abuse, stress, fatigue, emotional & psychological factors and an unhealthy lifestyle.
In cases of functional voice problems like muscle tension dysphonia, the voice is effectively restored through vocal education and care, corrective voice training, voice therapy combined with vocal optimization, and other adjunctive therapies like manual laryngeal therapy or circumlaryngeal massage. Early diagnosis and behavioural intervention play an important role in restoring the voice and preventing organic or structural changes in the vocal folds.
Hyperfunctional Dysphonia can precede or lead to Organic or Structural Voice Disorders.
Organic or Structural Voice Disorders
These involve a physical change in the vocal folds, which is often a further progression of functional voice problems, combined with other medical factors.
- Vocal fold nodules
- Vocal fold polyps
- Vocal fold cysts
- Vocal fold haemorrhage
- Vocal fold granulomas
- Contact ulcers
- Reflux Laryngitis
- Traumatic Laryngitis
- Pseudocysts of the vocal folds
- Allergic voice problems
- Hormonal voice disorders
Although vocal artistes and performers usually present with the above mentioned vocal problems, they can also present with organic and neurological voice disorders like vocal fold paralysis, vocal fold atrophy due to ageing, laryngeal cancer and spasmodic dysphonia that are seen in the general population.
Although we categorize voice disorders, they often interact and overlap. Individuals with a structural disorder may develop a functional component like muscle tension dysphonia, as they try to compensate for their voice disorder. Individuals with a functional component like inefficient vocal technique, vocal overuse or misuse and excessive muscle tension may present with structural changes like vocal nodules, polyps or haemorrhage. While emotional and psychological factors contribute to the development or worsening of a voice problem, professional vocalists with a voice disorder may also develop a psychological or emotional component, because a change in the voice is usually emotionally devastating.
How are voice problems in professional & artistic voice users different?
Professional and artistic voice users, especially singers, are usually sensitive about any change in the voice, as it affects their professional image, creative expression and livelihood. Subtle changes in the voice are perceived as significant, because it limits vocal range, resonance, projection and flexibility that are required for freedom in emotional and artistic expression.
Just as sportsmen and athletes are more prone to physical injuries, because of the exacting and specialized demands placed on their bodies, similarly professional vocalists are more likely to suffer vocal injuries and problems, because of the extensive and specialized demands placed on their voice. Apart from keeping their voice healthy, they need to maintain their voice at peak or optimal levels. It is therefore, not surprising, that professional voice users are referred to as vocal athletes, and singers are considered the Olympic athletes of the voice world.