From Nodules and Granulomas, to Haemorrhages, and Surgery Complications
This week I thought it would be interesting to look at the kind of issues that can befall singers who neglect their vocal health, nodules and otherwise. Now some of the following are due to particularly hazardous vocal technique (or lack thereof). However, even with half-decent or great technique, if you over-use your voice and give yourself inadequate rest you can encounter similar issues.
John Mayer – Granuloma
A few years ago John Mayer had to cancel an extensive tour to undergo surgery for a granuloma.
John Mayer is a self-taught singer, and if you watch interviews with him at Berklee College of Music he talks about the search to find a great ‘base’ tone for his voice. Sadly, this tone (as cool as it is) is not a healthy form of phonation full stop, let alone for extended periods. Granuloma is a swelling/inflammation of the cartilage at the back of the vocal cords, whereas nodules occur on the cords themselves (see below). However the growth of this inflamed tissue can interfere with vocal function and cause a great deal of pain and dysphonia (i.e. can’t pitch correctly).
In my opinion, from a technical perspective John Mayer has always been way too light with his chest voice. I’m talking purely technically and NOT stylistically. This results in a LOT of excess air passing over the vocal cords (which you can hear in almost every song). Functionally speaking, this results in insufficient stability throughout his voice, which then leads to strain at the top of his (chest) voice when he tries to gun it on the higher notes.
He also constantly flips between a light insufficiently stable (but regularly strained) chest co-ordination and his artistic use of falsetto. This kind of vocal habit can really wreak havoc on a voice. This is because the cords are constantly being strained and excessively taut one second, then being suddenly let go of like letting go of an elastic band the next. Such a constant flip-flopping can create a lot of wear on the voice and the connective tissues. Add into that an intensive gigging schedule and you’ve got a recipe for vocal disaster.
Adele & Sam Smith – vocal cord haemorrhage
A haemorrhage is a particularly unpleasant issue. It’s where the tissue of the vocal cords themselves rupture and bleed all over themselves. This also creates swelling, much like any other cut in the human body.
In Adele’s case, you can hear the amount of sheer pressure she uses when she sings. In fact, if you listen to her recorded version of ‘Rolling in the Deep’ you can hear her voice trembling to try and hold onto that very first high note in the chorus. This is indicative of a singer using significantly excessive amounts of air pressure to generate their sound and trying to retain that chest-like sound as high as possible. Sam Smith has vocal habits/behaviour a little closer to that of John Mayer.
Singing in a kind of ‘crafted yelling’ co-ordination or repeatedly cranking up the volume without adequate technique or rest periods in between is remarkably bad for the voice. I can’t even begin to describe how damaging it is, even for short periods of time, let alone entire concerts night after night. Continued misuse and OVER-use of the voice in this way is what resulted in this damage to her voice.
Michael Buble – nodules
A year or so ago, Michael Buble announced he had to cancel at least part of his tour to have vocal cord surgery to remove nodules. Nodules are like blisters/callouses on your vocal cords. These generally occur as a soft localised swelling on one cord initially, then hardening to a hard nodule (like a blister), and often result in a matching nodule on the opposite cord as the initiating nodule rubs against the other vocal cord during phonation. Soft nodules can occur quite regularly with even loud shouting at events, football matches, concerts etc, and so are not uncommon per se (though we should try to avoid even these). However, prolonged singing on nodules or adema (swelling) is what tends to lead to hard nodules.
Now while Michael Buble is not perfect technically, he doesn’t sing in ridiculous keys. He also doesn’t sing with dramatically excessive volume, nor does he experiment with vocal distortion. He is relatively clean when he sings and doesn’t jam his voice as hard as it will go as often as he can. In short, he’s not perfect, but he is a great example of what can happen when even as a singer with half-decent technique. Over-singing (gigs night after night!) can just create that level of wear in the voice. Gigging every night with inadequate rest can still lead to serious vocal issues.
Julie Andrews – Nodules, then surgery complications
Julie Andrews is an unusual case. She went in to have nodules removed, but the surgeon allegedly botched the operation. This resulted in a piece of her vocal cords no longer being there or being available in the way it once was. My recollection from conversations with other coaches was that the surgeon slipped during the operation, but I cannot find a reliable source to corroborate this. In any case, surgery is a serious route to go down, and the consequences never leave the voice the same again. Once nodules reach the hardened stage, they must be removed surgically, whereas soft nodules (the ones that are “merely” a localised swelling) can reduce with rest and corrective exercises.
The Upshot is…
You only get one voice – be smart about how you use it and look after it.
If you’re straining, stop doing it. If you’re repeatedly straining, DEFINITELY stop doing it. Whether you’re being too heavy and aggressive (like Adele previously), or light and flipping to falsetto (like John Mayer), or even whether your technique is reasonably together but you’re singing without adequate rest (like Michael Buble), you have GOT to respect the inherent requirements of how the voice is meant to work and how it’s meant to recover.
Learn More: Related Articles
If you want to learn more about vocal health and voice issues, you may enjoy the following articles:
Shouting masquerading as singing: Why so many singers are just yelling
Why vocal problems so regularly derail careers, permanently
Vocal Health Issues
My Singing Voice Hurts: 5 Habits for Vocal Health
Vocal Longevity: The Icarus Effect
Why do I keep losing my voice: Overuse, Misuse and Abuse
The Seriousness of Vocal Fold Nodules