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Bodily Injuries and Their Effects on the Voice
Robert Thayer Sataloff
The ill effects of laryngitis, respiratory infections, direct trauma to the larynx, and other abnormalities in the head and neck are recognized routinely. However, the relevance of injuries elsewhere in the body is not always so obvious. Such maladies may affect the voice by altering abdominal support, introducing excess tension, distracting the singer through pain, or by other means that throw the vocal mechanism out of balance. Recognizing the potential hazard of injuries throughout the body often allows a singer or actor to compensate for them safely, preventing vocal stress and injury.
The anatomy of the singing voice involves the entire body. The larynx is inseparably interdependent with virtually all other body systems. The functions of the vocal folds (oscillator), supraglottic vocal tract (resonator), and abdomen and thorax (power source) were discussed in Chapter 1. The lower extremities and pelvis maintain a stable, balanced skeleton to optimize contraction of the abdominal and back musculature. Although the arms are less intimately involved with voice production under normal, relaxed circumstances, their direct association with neck and shoulder muscles and their location adjacent to the chest allow them, in abnormal use, to introduce undesirable neck tension or constriction of respiration. The brain is responsible for fine motor control, expression of emotion and stress, control of secretions (including those on the vocal folds), and coordination of all bodily functions. Injury to any part of the body may impair optimal vocal function.
Anterior Neck Trauma
Injury to the front of the neck or to the larynx itself can be devastating. Usually, such injuries result from motor vehicle accidents in which the neck strikes the steering wheel or during altercations or playing sports. Direct trauma to the larynx can produce hemorrhage into the vocal folds, dislocation of the arytenoid cartilages, and fracture of the other laryngeal cartilages. Depending on the severity of the injury and other factors, the outlook ranges from complete recovery to permanent ruination of the voice.1 Such injuries also have the life-threatening potential of airway obstruction. They can be avoided in many cases by proper use of seat belts with shoulder restraints. However, when anterior neck trauma occurs, immediate visualization of the larynx by a skilled laryngologist is essential. Laryngeal injuries are frequently worse than they appear to be at first.
Posterior Neck Trauma
The most common form of posterior neck trauma is “whiplash,” although a direct blow to the back of the neck may produce similar effects. Whiplash frequently is much more troublesome for singers and actors than it is for nonprofessional voice users. This injury can result in neck muscle spasms, hyperfunctional vocal technique, and abnormal neck posturing secondary to pain. The injury is especially problematic in singers who have already had to overcome a tendency
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