Preventive measures to recover from hoarse voice

It's that time of year again, sports fans. We've marched through March Madness, when NCAA basketball playoff brackets bloomed and died and Cinderella stories rose from the shadows to revel in momentary glory.

Another fixture in the excitement of the season's waning moments is the colorful TV commentary of Sir Charles Barkley, former 11-time NBA All Star and current superstar of searing insight.

As playoff coverage intensifies, though, Chuck has had a tendency to become less outspoken - not in his wit, but in his delivery. His voice cracks and grows hoarse. The bullhorn becomes a bullfrog and weakens to a whisper. Viewers have to lean in to hear classis phrases like "They're gonna beat them like they stole something." And with close games and epic upsets, surely he's not the only one playing hoarse.

With the Final Four this weekend, we asked Richard McHugh, M.D., a voice specialist and assistant professor of Otolaryngology at the University of Alabama at Birmingham's School of Medicine to break down film of Sir Charles, a Birmingham-area native.

When Barkley's voice goes quiet it's a common condition not limited to TV stars called phonotrauma that causes vocal cord hemorrhage, McHugh says. In other words, the voice is a product of delicate muscles and tissue; straining those muscles shuts down the voice like a full-court press.

"Voice abuse, or phonotrauma, happens when there's a certain amount of yelling, especially at a sports event when you're trying to be heard over a high volume of noise," McHugh says.

To produce our voice the lungs power breath through v-shaped folds to create vibration. "At a normal voice the folds move aside at some point. We don't know why, but the brain tries to recruit muscles typically used for swallowing to try and keep those folds together, which squeezes and tightens your voice," McHugh says.

The swallowing muscles aren't effective at producing a good-quality voice, McHugh says. Their vibration creates the raspy sound.

Other factors that can strain a voice include dehydration, which is increased by having a drink of alcohol (or two, or a few) or caffeinated beverages. Dry winter air is also a culprit. Staying out too late, not getting enough rest and working too hard can create general fatigue, which also contributes to a froggy voice. Add allergies, acid reflux and a chronic cough or clearing of the throat to the list, too, McHugh says.

Professional speakers and vocalists know how to produce a louder voice without straining, but it takes years of training, McHugh says.

For the vocalized majority, McHugh recommends preventive measures:
•Stay hydrated; drink two- to four-times as much water as alcohol or caffeine, and use a humidifier in your bedroom at night
•Avoid yelling and straining your voice as much as possible
•Get plenty of rest
•Practice functional voice rest - don't talk unnecessarily, and keep your voice to a normal tone

If you find yourself barking like Barkley, there are a few things you can do to recover quickly, McHugh says:
•Avoid menthol cough drops or throat lozenges - the "cooling" feeling in your throat is the evaporation of alcohol, leading to more dryness and irritation
•Use fruit-based or glycerin-based non-mentholated cough drops or candies, such as Halls Breezers and Grether's Pastilles
•If you feel a tickle in your throat use an expectorant product such as plain Mucinex - but avoid products with added ingredients such as dextromethorphan
•Warm tea with honey soothes without drying your throat; a warm compress helps some people
•Stay hydrated

Aside from being (more) difficult to understand, a hoarse voice like that of Sir Charles doesn't create serious medical problems. "It usually resolves in two to four weeks," McHugh says. "If you've just had a cold it's reasonable to wait a little longer before going to your doctor."

For Barkley, that leaves plenty of time to rest and recover for the NBA playoffs.