Why is my voice hoarse?
- Nimra
- 3 days ago
- 2 min read
It's very common to hear that the clients I work with will experience some level of hoarseness. Surprisingy, this can apply to adults and children. As an SLP, hearing hoarseness (without any other underlying medical issues) tells me that the voice has been pushed to its limits with overuse and requires some extra support now in order to heal, recover, and return to normal use.
How does the voice work when it's not hoarse?
When we speak, we need strong airflow, vocal fold vibration, and to shape the sound effectively with our mouth (and for some sounds, our nose). Think of the lungs as the powerhouse -- without airflow out, we cannot speak at all. Next, the vocal folds (tucked away inside our larynx), vibrate against eachother to create a sound that we can shape. They also control pitch; stretching longer makes the pitch higher and compressing makes the pitch lower. How forcefully they slam together can also add to the volume we hear. Finally, our mouth (tongue, teeth, palate, nasal passageway) all help to shape that vibration and airflow into the sounds we hear.
This is an interesting diagram showing the differences between a child vs. adult airway. You can see how much smaller the child's airway is compared to the adult.
For children that I have worked with, the difficulty lies in difficulty for parents to explain that they may be hurting their voice, as well as how much "easier" it is to quickly lead to voice over-use when they are very chatty and speak very loudly at a young age. I have even worked with a lovely 4-year-old who loved to talk but unfortunately had a lot of hoarseness because of this!
As adults, we can last a bit longer but voice change can happen slowly until we can't ignore it anymore. Take a look at how the vocal folds vibrate in this video.
What is happening when I hear hoarseness?
The vocal folds are feeling strained, and this can often lead to irritation and swelling on the vocal folds themselves. This leads to the vibration not being smooth anymore - distorting the sound we hear. Sometimes, an area near the vocal folds called the "false vocal folds" can try to contribute since the voice is having difficulty. Unfortunately, this only adds to the strain as they normally do not need to be involved in voice production. All of these issues can add up over time and require support to break the habit.
This post considers voice change without other medical concerns. However, if you do have underlying issues such as reflux, this can also be targetted. We can also consider other conditions that require further support from an ENT.
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