Resonant Voice Exercise is Better than Vocal Rest?

Doctors and SLP’s alike used to recommend voice rest for healing vocal fold tissue after trauma. Cheering at a football game, coaching a little league soccer tournament, parenting, or even teaching a class can qualify as overuse or phonotrauma. But, what if all this time we had it wrong? Well, not necessarily wrong, but just not totally correct. What if voice rest did good things to our vocal fold tissue, but resonant voice did something even better?

What Kittie Verdolini Abbott likes to call the “Scream Study” shows just that. She and her cohorts (including Ryan Branski and Clark Rosen) took a group of 9 folks and subjected them all to the same task to “tax” their vocal fold tissue (talking loudly for 1 hour, with a few small breaks in between). Then, they separated them into 3 groups.

1) This group would go on total voice rest for 24 hours.

2) This group would talk in “normal conversational speech” voice

3) This group would produce resonant voice sounds (forward focused resonance with easy feeling to promote low impact vibrations with the vocal folds barely touching) in phonemes /m/, /n/, /ng/ and /j/ and comfortable pitch glides and scales. (They did this in addition to resting (4 minutes of resonant voice for every 30 minutes of silence.)

Vocal fold secretions were then suctioned from each participant and analyzed to determine presence of certain enzymes associated with inflammation or swelling. The results showed that inflammation was increased in the talking group, it improved in the rest group, but it improved more in the resonant voice group!

Crazy, right?! You would think that phonation after trauma would be damaging, but this study suggests that low impact, barely adducted/abducted phonation may improve swelling.

The sample size was small and the study could not control for voice modality (pressed voice versus lower impact during the loading task.) It was also hard to say what was “loading” to one person and not vocally challenging to another, but the data collected is very intriguing.

There is definitely more information to be gathered in future studies, but this study shows some very exciting results.

Resources: Abbott KV, Li NYK, Branski RC, et al. Vocal exercise may attenuate acute vocal fold inflammation. Journal of voice : official journal of the Voice Foundation. 2012;26(6):814.e1-814.e13. doi:10.1016/j.jvoice.2012.03.008.

Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. She rehabilitates voice and swallowing at her private practice, a tempo Voice Center, and lectures on vocal health to area choirs and students. She also owns and runs a mobile videostroboscopy and FEES company, Voice Diagnostix. She is an affiliate of ASHA Special Interest Group 3, Voice and Voice Disorders, and a member of the National Association of Teachers of Singing and the Pan-American Vocology Association. Knickerbocker blogs on her website at She has developed a line of kid and adult-friendly therapy materials specifically for voice on TPT or her website. Follow her on Pinterest, on Twitter and Instagram or like her on Facebook.


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