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Phase 1: Vocal Hygiene (The Foundation)
Phase 1: Vocal Hygiene (The Foundation)
Hydration: Drink at least 3-4 liters of water daily. The mucus on your vocal cords needs to be thin and lubricated to vibrate without friction.
Acid Reflux Management (GERD/LPR): Many of my patients in Mumbai suffer from silent reflux due to late dinners or spicy food. This burns the back of the vocal cords. Avoid eating 2-3 hours before sleep.
Total Voice Rest (Strategic): We rarely prescribe "total silence" anymore unless there is acute hemorrhage. Instead, we use "Voice Conservation"—speaking only when necessary.
Phase 2: Direct Voice Therapy Exercises
Phase 2: Direct Voice Therapy Exercises
1. Semi-Occluded Vocal Tract (SOVT) Exercises
1. Semi-Occluded Vocal Tract (SOVT) Exercises
A. Straw Phonation
A. Straw Phonation
What you need: A small stirrer straw (like a coffee stirrer) is best, but a regular frooti/juice straw works if the small one is too hard.
The Action: Put the straw in your mouth and seal your lips around it.
Step 1: Blow air through it (no sound) to feel the flow.
Step 2: Sustain a steady sound /u/ (like "who") through the straw. You should feel a buzz on your lips, not in your throat.
Step 3: Perform "Sirens" (glide from low pitch to high pitch and back down) through the straw.
Duration: 2-3 minutes, 5 times a day.
B. Lip Trills (The "Brrr" Sound)
B. Lip Trills (The "Brrr" Sound)
Blow air through your lips to make them vibrate like a horse or a motorboat.
Add voice to it.
Glide up and down in pitch.
Why this helps: You cannot do a lip trill if you are squeezing your throat. It forces your larynx to relax.
2. Resonant Voice Therapy (Frontal Focus)
2. Resonant Voice Therapy (Frontal Focus)
The "Mmm" Exercise
The "Mmm" Exercise
Gently close your lips and teeth slightly apart.
Make a "Mmmm" sound.
The Goal: You must feel a strong buzzing/tickling sensation on the bridge of your nose and lips. If you feel it in your throat, you are pushing too hard.
Progression:
"Mmmm"
"Mmmm-ah"
"Mmmm-one", "Mmmm-moon", "Mmmm-man" (Words starting with M).
3. Diaphragmatic Breathing (Abdominal Breathing)
3. Diaphragmatic Breathing (Abdominal Breathing)
The Exercise: Lie down on your back. Place one hand on your chest, one on your stomach.
Inhale: Only the hand on the stomach should rise. The chest remains still.
Exhale: Hiss out an "Ssssss" sound while keeping the chest still and letting the stomach fall.
Application: Practice this while sitting and eventually while speaking.
Phase 3: The "Confidential Voice"
Phase 3: The "Confidential Voice"
Imagine you are telling someone a secret in a small room.
This is not a whisper (whispering is actually bad for the voice as it tightens the cords).
It is a breathy, soft, low-volume voice.
This prevents the vocal cords from slamming shut, giving the nodules/polyps time to heal
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