What are Nodes?

Vocal fold nodules, commonly called nodes or singer’s nodes, are basically small blisters or calluses on the vocal cords.  They can be caused by vocal abuse, such as excessive screaming, or by singing or speaking with poor technique.

To better understand vocal fold nodules, it’s important to have basic knowledge of how the voice works.  The vocal folds (commonly called vocal cords) are a small pair of muscles inside the larynx, which are covered by a delicate membrane.  As air passes through the larynx, the vocal folds vibrate together, which produces sound.  To make a higher pitch, the vocal folds stretch to become thinner and longer.  For more information on this process, see my previous post, “How the Voice Works: An Overview.”

Nodules are generally caused by prolonged unhealthy use or overuse of the voice.  Vocal abuse can cause hemorrhaging (bleeding) in the vocal folds.  Over time, the vocal folds can develop callus-like lesions, which we call nodules.  Nodules come in many shapes and sizes, and their effect on the voice varies accordingly.

The singing voice of someone with nodules often sounds breathy or raspy.  It may be hard to hit higher pitches or feel like extra effort is needed to make sound.  In severe cases, the voice can be extremely raspy and rough sounding.  Nodules are usually not painful, since there are no nerve endings on the vocal folds.

Nodules are usually treated with speech therapy, which corrects the behavior that caused the nodes and develops healthy vocal habits.  In some cases, surgery may be necessary.  Rehabilitating the voice must be done carefully and under the guidance of a speech therapist and laryngologist.  Singers suffering from nodules should be sure to carefully follow their doctors’ instructions to ensure a full recovery.

The best way to prevent nodules is to sing and speak in a healthy way.  Many people don’t realize that speaking is just as tiring for the vocal cords as singing.  Vocal fry (speaking at the lowest part of your range, with a creaking or rattling quality) is a particularly unhealthy speaking trend, which leads to tension and fatigue in the vocal folds.  Hoarseness or a scratchy-feeling throat can indicate that your vocal folds are fatigued and maybe even slightly swollen.  When this happens it’s important to let your voice rest.

Another important (and easy!) way to keep your vocal folds healthy is to drink plenty of water.  Staying hydrated protects your vocal folds by keeping the mucous membranes moist.  Dry vocal folds are more prone to damage and fatigue.

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