Injury Prevention for a Touring Professional Singer with Phonotrauma
Professional singers who incur vocal injury on tour have a complex set of risk factors and injury mechanisms, making them unique in their voice rehabilitation needs. Guided by an injury-prevention framework, this case describes the role of the speech-language pathologsit (SLP; and laryngology, obliquely) in managing a touring female singer with mild-to-moderate dysphonia secondary to vocal fold nodules.
JD was a 23-year-old female seen for an 8-week history of worsening hoarseness while performing on tour as a professional second soprano in a 3-hour musical. As lead actress, her performance demands included “belt-style” singing frequently paired with intense choreography and loud, animated character speaking. At initial evaluation, JD reported increased difficulty with singing despite completing daily vocal warm-ups. Specific singing complaints included poor vocal endurance, raspy and strained voice quality, reduced vocal power, pitch breaks, and difficulty with register transitions. She also perceived increased vocal effort in singing certain pitches in her upper range after five weekend performances. These vocal issues improved somewhat with voice rest. She denied a history of voice problems with previous roles or performance opportunities, and had no prior history of voice therapy.