When Memphis teacher Katelyn Woodard first noticed her voice was hoarse in 2013, she assumed the condition was temporary.

After all, it was only weeks into her school year at Cornerstone Preparatory School, and the second-grade teacher knew that the early weeks usually are the most vocally challenging.

“I did not go to a doctor for a while because I was trying to convince myself that it would go away,” she recalled.

But by December, when a friend threw her a karaoke birthday party and she could not participate, Woodard realized her vocal condition was serious. “That’s when it really hit me that this is real,” she said.

Woodard is not alone among educators.

“When we think of professional voice users, people always think of singers, actors or entertainers. But teachers are high on that list,” said Kimberly Vinson, an assistant professor of otolaryngology at Vanderbilt University Medical Center’s Bill Wilkerson Center in Nashville.

Teachers spend hours each day talking, often using a loud, projected voice. As with singers, actors or professional speakers, the voice is a critical tool for teachers. The difference, however, is that most teachers have received little to no training about how to use or care for their voices. In fact, many teachers assume that a hoarse or tired voice is normal—and certainly not something to complain about.

“When you look at all the most common voice disorders, teachers have more voice problems than any other profession,” said Amanda Gillespie, an assistant professor of otolaryngology at the University of Pittsburgh. “A lot of teachers think hoarseness is part of their job. But hoarseness is never normal.”

Occupational hazard

Research indicates that teachers are at high risk for voice disorders.

How teachers can care for their voices
• Before the school day starts, do a vocal warm-up, such as buzzing your lips. See video below
• Hydrate! Drink lots of water and, if your classroom or house is dry, use a humidifier.
• Don’t talk over students who are not listening.
• Remember that hoarseness is not normal. If you are regularly hoarse by the end of the day or week, see a doctor, ideally a laryngologist or voice specialist.
• Listen to your voice. If your voice is tired, try to take a break. Don’t try to power through.
• Get adequate sleep.
• Avoid germs that can cause viruses. Wash your hands frequently.
• Notice sudden changes in your voice. A sudden change can signal a serious vocal health issue.

A teacher’s intense day-to-day schedule can be taxing on the voice. Speech therapists recommend vocal breaks—stretches of quiet—throughout the day. But even when they’re not providing classroom instruction, teachers often are using their voices—for instance, for bus or lunch duty.

Especially in winter, schools can be a haven for dry air, which can dry out vocal folds and put strain on the voice. And the demands of daily instructional schedules can make it challenging for teachers to stay hydrated by drinking enough water.

One study showed that teachers were more likely to miss work due to voice problems than were other professionals.

Female teachers are more likely to develop problems than their male counterparts, due partly to human physiology. Their vocal cords hit each other twice as many times per second, which means they’re more likely to develop calluses or other problems.

Some educational specialty areas or environments also can tax the voice—for instance, physical education, music, drama or chemistry, where loud equipment or large rooms may make it harder for teachers to be heard.

Student behavior is another factor. “A lot of vocal health has to do with classroom management,” said Juliana Litts, an instructor and vocal therapist at the University of Colorado School of Medicine. “I understand that you teach a bunch of first-graders and they’re rowdy, but you can’t talk over them.”

But students also suffer when a teacher’s voice is injured. When lessons are presented with a hoarse or raspy voice, students may find it harder to process the information, according to a yet-unpublished study from researchers at Towson University.

“You’d hope it’d make teachers and administrators sit up and say, ‘Hey, we should really pay attention,’” said Gillespie.

How schools can help
• Arrange a teacher workshop or training session on vocal health.
• Provide amplification equipment for teachers, especially in classrooms that have significant ambient noise such as music and physical education.
• Create schedules that allow breaks for teachers to rest their voices, ideally spread throughout the day.

Despite the risks, teachers receive little training on vocal health.

“Nobody tells teachers, ‘OK, so this is a really good way to use your voice in your classroom.’ So teachers go by how they’ve always talked. And a lot of times that gets them into trouble,” Litts said.

By the time Litts sees a teacher for vocal therapy, that teacher often has reached the point where he or she is basically unable to teach. Some teachers wait so long to seek help that they need surgery, she said, while others enter administration or leave the profession altogether.

Equipping teachers

After realizing that her vocal issues weren’t going away, Woodard was at first disheartened. The strain was affecting her both professionally and personally. “My voice is incredibly important to me in many ways,” she said. “I sing at my church, I sing a lot in my life. And I teach, and my voice is my most valuable tool as a teacher.”

At her elementary school, Woodard had used her voice to instruct her students but also to captivate them with humorous voices or songs. On some days, though, it had become physically painful just to talk. “What I remember as a teacher is going through stages of fear, down to stages of what almost felt like grief,” she said.

Her vocation at risk, Woodard saw several doctors. One diagnosed partial vocal paralysis; another identified vocal nodules, which is a more temporary condition caused by growths on both vocal cords. “It’s incredibly difficult to find anyone who knows anything about serious voice issues,” she said. “And it’s hard to get your insurance to help you find the right people and help you get the things you need to get better.”

A rest from teaching the following summer helped. This school year, Woodard is using a microphone and amplifier system, which she said has allowed her voice to stay stronger over the course of the week. A local vocal therapist is working with her, too.

Juliana Litts, a vocal therapist, demonstrates morning exercises teachers can do to warm up their voices. If you’re self-conscious, she says, do them in your car or a private area.

“It’s clear that it’s strain-related, so they believe that therapy will be really helpful,” Woodard said. “But it’s going to take a lot of effort. I’m going to have to work consistently to train how I use [my voice] in my day-to-day life.”

As for other educators struggling with vocal health, a little knowledge and preparation can go a long way toward identifying symptoms and addressing the condition.

“If you start having trouble with your voice, we always recommend a vocal evaluation,” Vinson said. “A lot of time it’s nothing serious; it’s simply getting them into healthy practices.”

Teachers, have you experienced vocal strain? Tell us about your remedies/best practices in the comments below.