The Voice Care Center

Chances are, if you do any of the following things you are slamming your vocal folds together and hurting them.

	Yell
	Speak often or in a loud voice
	Cough or clear your throat often and hard
	Use an unusual or tense voice during play or anger
	Use a pitch that is too high or low

Also, if you are a very tense, nervous person who is under a lot of pressure, the tension may focus in your neck, shoulders, or laryngeal area, resulting in vocal fold injury.

When you first begin to abuse your vocal folds with these behaviors, they thicken and become red. If the vocal abuse continues, the thickening near the middle fold can develop into a blister or nodule.