By now most of us know that repeated forceful throat-clearing is not a good idea, as far as your vocal folds are concerned. In fact, my friend and colleague, laryngologist Dr. Joel Portnoy, says “Throat-clearing is like injuring your vocal cords just before you want to use them”… to sing, to teach, or even to parent effectively. So why are so many guilty of that vocal infraction?
Habit, that’s why. Throat clearing, for most of us, is a long-standing ingrained habit. You feel mucus, and you immediately want to hock that up! But a few moments later, there’s that pesky glop again. So what really happens when we clear our throats, and how does throat-clearing set up a vicious cycle?
Let’s back up for a minute, and talk about what causes throat clearing to begin with. It isn’t just one simple answer.
First of all, let’s debunk that all-too-common statement, “I have SO MUCH mucus”. You personally haven’t cornered the market on the stuff, you know. Our bodies make 1 to 1-1/2 liters of mucus every day! It’s there for a very important reason: it lubricates and protects your body’s tissues, filtering out irritants that enter your respiratory system. Without it, we’d be pretty miserable. Mucus is necessary to create proper functioning of the voice and swallowing mechanism.
All that mucus has two ways to leave your nose: the front, or the back. Either it’s dripping out the front of your nose, or down the back, what we call post-nasal drip. And usually, this post-nasal drip happens rather innocuously. Many people don’t even notice it, until that mucus becomes excessive or thick. It can even feel like a lump in your throat, or what we call a globus sensation. When we feel all that mucus and globus sensation, our natural reaction is to throat-clear – FORCEFULLY.
Things that might cause this thick or excessive mucus include:
- insufficient hydration
- food sensitivities
- a cold or sinus infection
- irritants like smoking or a dry, dusty, or fumy environment
- alcohol and caffeine consumption, both of which can dehydrate your mucous membranes
- silent reflux or laryngopharyngeal reflux, where the acid backs up all the way to your throat
- side effects from some blood pressure medications known as ACE inhibitors
- laryngeal sensory neuropathy. (According to allergy expert Dr. Brian Rotskoff of the Clarity Allergy Center in Chicago, with laryngeal sensory neuropathy, the nerves leading to the voice box and larynx become hypersensitive and the cough or clearing are more frequently triggered. When this happens patients may need medication to calm the nerves and allow healing in order to break the cycle).
So here’s the problem: when we clear out throats with that typical forceful “hocking” sound, we slam our poor vocal folds (“cords”) together in a rather violent manner. This causes inflammation and actually reinforces the urge to clear, and a vicious cycle is established. The more you clear your throat, the more you’ll feel like you need to clear it, and the cycle continues. It feels like that gluey glop on our cords never leaves!
But how do we break this cycle of mucus, throat-clearing, and vocal cord irritation? First, make sure to visit an otolaryngologist, (an ear, nose, and throat doctor), preferably a fellowship-trained laryngologist, who has specialized expertise in care of the voice. This way, you can rule out, or get appropriate treatment for, any underlying medical condition. Next, increase your hydration to approximately ½ your body weight in ounces of water, unless you have a medical condition that precludes this much hydration. Remember, sometimes it isn’t that we have a lot of mucus; it’s that it’s too thick from dehydration. The increased hydration will thin the mucus. (See our blog and video on Hydration here.)
Steam inhalation is another way to “breathe” water directly onto the surface of your vocal folds to moisturize them and thin the mucus. Since this is direct and instant, actually much faster than drinking water, it’s helpful to steam shortly before a performance or presentation. (I’ve even done this again during a show, at intermission). You should drink water also, of course, but water takes longer to reach your vocal folds since water has to pass through your digestive system first. So, sip water all day before, during and after professional voice use, or even a noisy social event, and don’t forget to steam 1-2 times a day for a few minutes, more if you’re not feeling well or having vocal problems. (See our blog and video on Steaming here.)
If you do suffer from silent reflux, avoid the foods that trigger your reflux, including tomato sauce, greasy food, mints, vinegar, chocolate, caffeine, alcohol, and smoking (you surely want to avoid smoking altogether if you want to have a healthy voice! ?). Avoid eating right before singing. This might stir up quite a bit of mucus. You certainly don’t want your increased abdominal muscle pressure (singer’s breath support) to press against a full stomach, especially if you’re prone to reflux!
So, can you clear your throat safely and effectively? YES!! Let me demonstrate a few simple methods to safely clear your throat, that you can try immediately, including my favorite, which I call “Air Hocking” or the “Forceful /H/”. You can do these as much as you want, and you won’t hurt your vocal cords. And here’s a word of advice: in case you feel like these methods don’t work, please be patient. They will work as you develop a knack for using them consistently, and your vocal cords will be happier. See our video below for a demonstration of these techniques.
Now you know several ways to avoid thick mucus, to begin with, and a few neat techniques to clear your throat without damaging your vocal cords. Wishing you a Choice Voice….and Happy Hocking!