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Sounds of Summer: Note-worthy Protection for Your Hearing and Voice

Summer is always full of outdoor activities here in New England – baseball games, concerts, festivals and more. While it's always good to remember the sunblock and shades when heading to an outdoor event, you may not think about protecting the two things that can be injured by the crowd noise that generally comes with these types of gatherings: your voice and your ears.

Cheering and yelling for your favorite ballplayer or group is always fun and part of what it means to be a fan, but it's important not to overdo it – you can cause damage to your vocal cords and lose your voice for several days (which is never fun). Likewise, your hearing can be permanently damaged by long hours of loud music or repeatedly spending time in a loud, crowded atmosphere.

Keeping Your Voice Strong

person yelling

Whether you are in the bleachers at Fenway, hundreds of feet in the air at Six Flags, or just expressing yourself in a loud manner, it's important to protect your vocal cords to avoid excessive wear and tear.

Laryngitis is a common swelling of the larynx, or voice box. This swelling usually involves the vocal cords, and leads to hoarseness or even complete loss of voice. There are a number of simple ways to mitigate the occasional laryngitis or voice loss, but if you have a problem that persists for more than a week, be sure to see a doctor.

"When cheering at Fenway Park, rest your voice by using 'thunder sticks' or doing the Wave, but try not to yell loudly over noise in order to protect your vocal folds," says Cynthia Wagner, a speech language pathologist and Manager of the Voice, Speech and Swallowing Clinic at Beth Israel Deaconess Medical Center. "There are other ways to cheer the Red Sox without risking vocal fold damage, which can make it hard to work due to throat pain the next day."

The same goes if you're at a concert – it is okay to chat with others in the crowd, cheer and sing, but don't go overboard. Clapping along to the music or just waving your hands in the air can be fun too.

"Even if you go to a nightclub or any kind of party and the music is really loud, and you try to scream or shout over the noise, most people come back with vocal cord swelling, a hoarse voice and sore throat afterwards," explains Wagner.

Initial swelling will go down after a day or two of resting your voice and drinking plenty of water, Wagner says, but using your voice at top volume in a loud atmosphere frequently can inflict permanent damage – calluses, or nodules, can form on your vocal folds from overuse. She likens the calluses to a blister a construction worker might get while hammering; more and more hammering will cause the blister to get tougher over time and more difficult to get rid of.

"Small, soft vocal fold lesions known as nodules are easily reversible with voice therapy when found early," Wagner says. "However, larger or harder nodules can be harder to reverse with voice therapy alone."

So when you're in a loud place and trying to talk with your pals, it's best not to push your larynx to its limit.

"Use sign language, gestures, even texting," Wagner suggests as ways to get your words across in a noisy crowd. "Your message will be heard and understood if you send a text instead of screaming. Or, speak at a normal level directly into the person's ear."

Drinking plenty of fluids when a lot of vocal use is required will help your throat from becoming too irritated. Water is the best choice for hydrating your vocal cords. In general, avoiding smoking is one of the best ways to protect your voice and vocal cords – it can cause the cords to swell and is particularly linked to throat-related cancers.

Causes of Voice Loss

man with sore throat

Lots of yelling and screaming aren't the only things that can cause laryngitis, hoarseness, or loss of voice. Other contributors include:

  • Upper respiratory tract infections, usually caused by a virus (like a cold).
  • Airborne irritants, such as cigarette smoke, pollen, dust and mold allergens.
  • Vocal nodules or vocal polyps.
  • Gastroesophageal reflux disease (GERD), in which the vocal folds can be irritated by stomach acid that rises up in the esophagus.

People who use their voice a lot in their daily career, such as teachers, priests or rabbis, and singers, can also find themselves having voice troubles due to overuse or misuse of their speaking or singing voice.

"A lot of people as they age tend to lose muscle tone and muscle bulk in their larynx, just as they do in other parts of their bodies," notes Dr. Pavan Mallur in the Division of Otolaryngology at BIDMC. "If they're trying to make up for that, they'll compensate by using other muscles in their neck and this can lead to vocal fatigue."

Help for Hoarseness

When your voice becomes hoarse or your vocal cords irritated, rest your voice. It's the best thing you can do to help, as excessive talking only makes it worse, according to Wagner. Use a quiet, easy voice when talking; write long or complicated explanations down if necessary.

Steam inhalation can also help a hoarse or overused voice. Most drugstores carry personal steam inhalers, which you can use just about anywhere; just fill with water and allow the steam to be released.

"Using steam inhalation and drinking lots of water can help to put moisture back into your vocal folds," says Wagner. "It does make a difference."

Again, if a voice problem lasts for more than five to seven days, see your doctor. If it is a vocal cord-related issue, an otolaryngologist (ear, nose and throat doctor) may recommend speaking voice therapy with a speech language pathologist.

Preventing Hearing Loss

Too much noise

All that cheering, screaming and singing at big events are what help create the loudness that can affect your ears. Noise exposure is a major cause of preventable hearing loss; lengthy and repeated exposure to loud sounds will eventually lead to some degree of hearing loss. Noise-induced hearing loss is typically gradual and painless but, unfortunately, permanent.

"Hear the world but turn down the sound," advises Donica Porter, AuD, Director of Audiology at BIDMC.

Dr. Porter suggests everyone use hearing protection, such as earmuffs or earplugs, when in a noisy environment (like a loud concert), or when around loud sounds that can injure the sensitive parts of the ear. Lawnmowers, weed whackers, chainsaws, motorcycles, and snowmobiles all produce potentially harmful levels of noise.

It's also important to note that children are particularly vulnerable to high noise levels, Dr. Porter adds. If children are accompanying adults to loud summer activities, they too should be provided with earplugs. Small heads and ears need smaller devices to protect hearing, and these can generally be obtained through online retailers.

"While we are thinking about protection, remember your pets," Dr. Porter says. "Dogs have super sensitive hearing. Fireworks, in particular, can be very painful and frightening to a dog strolling through a park with you. Keep them safe and away from firecrackers, fireworks and firearms. They will love you for it."

Turn Down the Volume and Tune Up Your Health

girl listening to headphones

When you're the one controlling the sounds around you, lower the volume. Keep your headphone- or ear bud-connected device set at no more than half volume. According to a study in the Journal of the American Medical Association, listening to loud music through ear buds appears to be the main reason why one in five adolescents have some degree of hearing loss.

Generally keeping yourself in good health can also help keep your hearing sharp, according to Dr. Porter. Including plenty of vitamins and other nutritious foods in your diet is important. Leaving issues like high blood pressure, hypertension and diabetes untreated can adversely affect your hearing.

So how do you know when "loud" is "too loud?" Noise levels are potentially dangerous if:

  • You must raise your voice to be heard.
  • You can't hear someone three feet away from you.
  • Speech around you sounds muffled or dull after you leave the noisy area.
  • You have pain or ringing in your ears following exposure to noise.

Evaluating and Treating Hearing Loss

If you think you may be having trouble with your hearing, an evaluation by an audiologist is a good place to start.

The human ear (click to enlarge)

"Like optometrists who evaluate vision, audiologists are prepared to diagnose the auditory system, determining where in the system hearing loss may exist," explains Dr. Porter. "Because the organ of balance, the vestibular system, is a part of the auditory system, audiologists are responsible for evaluating dizziness and balance problems as well."

And if an exam does reveal hearing loss, there are many options for treatment that have been made possible by technology advances over the last several years.

"New digital hearing instruments offer spatial analysis of sound, identification of speech in noise, digital feedback control and integration of Bluetooth technology, to name just a few of the features available," says Dr. Porter. "Packaged to be nearly invisible, these digital chips work automatically to provide exquisite listening comfort."

We're always reminded in the hot weather to protect our skin and eyes from the sun, and be careful of bugs and ticks too. But where ever your summer activities take you, be aware of your ears and throat as well – taking good care of your hearing and your voice are just a few more steps you can take towards living a healthy life.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted July 2012

Contact Information

Otolaryngology/Head and Neck Surgery 
Beth Israel Deaconess Medical Center
110 Francis Street, 6-E
Boston, MA 02215
Phone: 617-632-7500
Fax: 617-632-7501

Contact Information

Voice, Speech and Swallowing Clinic
Beth Israel Deaconess Medical Center
West Campus, Farr Lobby Entrance;
Span Building, Room # 106
185 Pilgrim Road
Boston, MA 02215
Phone: 617-632-7400
Fax: 617-632-7401