Voice Strain: A Side Effect of Pandemic Work Life

By Kate Eberle Walker, CEO of PresenceLearning, with Sydney Kumin, M.A., CCC-SLP

I was scanning through the chat feed of our community of Speech-Language Pathologists at PresenceLearning, and a post caught my eye:

Does anyone else struggle with voice fatigue by the end of the day?  I lose my voice by the end of the day every single day.  This is my first year working online, and I've never had this problem with in-person services. I'm working with students in their home environment, and as much as I ask them to move to a quieter place, I'm competing with siblings, TV, etc, and I think that's why I'm having to talk so much louder.  Any tips or ideas would be amazing!

Something clicked for me - I had voice fatigue too! I just didn’t know there was a name for it. With long days of Zoom meetings, webinar recordings and online demos, I wasn’t just talking constantly, I was talking louder. And my voice was showing it. Despite the fact that I had established a new habit of keeping a large Swell bottle of lemon water at my desk and refilling it throughout the day, by late afternoon my voice was sounding raspier than Marlon Brando in The Godfather. 

There has been a lot of coverage of “screen fatigue” and its heightened impact during the pandemic. Even before COVID-19, Americans were experiencing the side effects of spending too much time in front of screens, including eye strain, headaches, insomnia and back pain. Post-COVID, the Lerner Center at Syracuse University designated screen-time related eye fatigue to be a “public health side effect of the coronavirus pandemic”, citing that nearly 2 out of every 3 Americans report symptoms of digital eye strain from time spent on computers.

But what about voice fatigue, or, as teacher Susan Stroud called it, “zoom laryngitis”?  Long days spent talking into the computer can lead to voice strain, due to many factors:

1. You might be talking louder than you would if everybody was in the same room.  If you don’t use headphones with a microphone, you most likely are increasing the volume of your voice to ensure it comes through clearly in your meetings.  Even Zoom itself recommends in an FAQ about running effective online meetings: “If the other person can't hear you, talk louder.”
2. You might be compensating for background noise.  These days, it’s rare that anyone is working in isolation in a quiet room.  There’s a lot going on - kids in school, dogs barking at the delivery person approaching the front door, spouses talking on the other side of the wall.  Whether the background noise is on your end or your listener’s, we all have a tendency to speak louder when there are competing noises, to draw in focus.

3. You might be trying to get a word in edgewise.  In large group meetings, there is more cross-talk, and it is often the louder voice that wins the attention of the group. When you’re all meeting in the same place, you might gesture that you have something to say, or turn to the person next to you for a side conversation, but those solutions don’t translate perfectly in zoom (a quick google search confirmed that I am not the only one who finds "hand-raising" in Zoom a bit awkward!) So if you participate in a lot of online group meetings, you might find yourself shouting just to be heard.

4. Your meetings might be getting reduced to the lowest common denominator, or in this case, the loudest common denominator.  If one person talks loudly, people react and turn their computer volumes down, thus making it more difficult to properly hear the individuals who were speaking at a normal voice volume.  People then ask them to speak up, and suddenly you have a group of yellers.

So what to do about it? Here’s where I realized I had the experts I needed right inside my own company.  PresenceLearning provides teletherapy for special education students, and we have over 1,000 speech-language pathologists (SLPs) in our community.  You can find someone with a specialty in just about any area of speech.  So surely, I figured, someone could help all of us who are working in our home offices and striving to get our voices back.  Enter Sydney Kumin, an SLP at PresenceLearning with background working with adults, as well as children, with speech challenges.

“Vocal hygiene is key,” shares Sydney.  “Taking care of your voice and maintaining healthy habits is essential, especially on those long days of consecutive meetings. Step one is understanding what activities are leading to your voice challenges.”

There are two primary categories of behaviors that lead to voice challenges:  

1. Vocal misuse. While my 9 year old daughter might accuse me of “vocal misuse” when I sing along to her Taylor Swift songs, the technical definition is using the voice in a way that causes it to be injured (as opposed to using the voice in a way that injures the ears of others…).  Examples include yelling, throat clearing, talking in large crowds, and whispering.  Yes, whispering is unhealthy for your voice! 
2. Vocal overuse, on the other hand,  is when you talk so much that your voice gets tired. This can happen to anyone whose job requires near-constant talking.  Again, I will reference the harsh judgment of my daughter: after observing me working from home one day, she narrowed her eyes and posed a question.  “So Mom, do you actually do anything for your job, or do you just talk all day?” Fair question.

Sydney recommends checking out The Duke Center for Voice Health, which has a wealth of resources for anyone and everyone struggling with voice strain.  There are a lot of great recommendations for the everyday office worker, as well as other groups particularly prone to voice risk, including actors, singers and teachers.  Yes, teachers! According to Duke, half of all teachers have a voice problem at some point during their careers. In a year where we are all recognizing the immense gratitude we owe our teachers for the strain they undergo every day to be a source of strength for our children, here is yet another health risk they encounter on the job.

The working world has embraced the simplicity of the 20/20/20 rule and blue light-blocking glasses for eye strain, so we wanted to give you a short list of your best tactics to manage vocal strain.  Here are Sydney’s Top 4 tips for taking care of your voice:

1. Mic up.  Use a headset with a microphone to help moderate the volume of your voice and avoid over-exertion.  A quality headset can make a big difference in audio quality, and there are options at all price ranges.  
2. Hydrate. Drink lots of water, herbal tea, or lozenges.  Be wary of caffeine - it will dehydrate you.  If you’re strong, cut it out altogether, or if you’re like me, you’ll keep drinking coffee and therefore will need to add more water intake to the recommended two liters per day.

3. Reserve your voice. Embrace the words of Burr and, “Talk less, smile more.”  Avoid shouting, and be selective when you speak.  The chat function in Zoom makes it possible to contribute meaningfully to a discussion without actually talking at all, and can be a really valuable tool for ensuring that every voice is heard, and no single person dominates a conversation.

4. Take naps.  Voice naps, that is.  If your job requires near-constant talking, be conscious of scheduling in voice breaks.  Since talking with Sydney, I’ve started building in a 15 minute voice nap mid-day, and it makes a world of difference. I also gained some self-awareness; it does in fact require conscious effort to truly not speak a word for 15 minutes!

It’s additionally helpful to check in and see how your throat muscles feel. If the muscles surrounding your larynx are tight, then your voice could in fact be strained. A simple stretch or massage could help relax the muscles surrounding your vocal folds and improve your vocal quality. Vocal coach Chris Johnson has a list of helpful stretches for your jaw, throat, and neck.

And finally, make sure to know the difference between problems you can self-manage at home, and when you need to see a professional.  If you have experienced vocal hoarseness for over a week, it’s time to check in with an Ear Nose and Throat specialist. The more you try to speak with a hoarse voice, the more damage you can cause to your vocal folds, including acute laryngitis, nodules, or vocal fold swelling. (If, like me, your primary reference point for nodes is Pitch Perfect, then you know this is serious!)

Those of us who work in online education know that moving work online that used to happen in-person requires changing and re-examining practices to optimize for the new online environment. The same is true for office work, so as you think about what has changed in your own work environment, awareness of the online meeting dynamics and the way it changes your use of your voice is key. Take care of your voice, and use it wisely!