Abby Barnes, M.S., CCC-SLP
If your voice sounds hoarse, feels strained, or gets tired easily, you might be dealing with vocal cord damage or vocal cord dysfunction. Common symptoms include throat discomfort, a breathy or weak voice, and trouble projecting. The good news is that many vocal cord problems can heal. You can restore healthy, comfortable voice use through specialized voice therapy.
Your voice does a lot of work every day, often without you thinking about it. But when something feels off, it can be hard to ignore. Vocal cord damage and vocal cord dysfunction can affect how your voice sounds, feels, and holds up throughout the day. You might notice hoarseness, strain, or vocal fatigue and wonder: What’s causing this…and how do I fix it?
Your vocal cords are small muscles located inside your larynx (voice box). They vibrate to create sound, help you speak and sing, and protect your airway when you swallow. Just like any other muscle, they can become irritated, overworked, or uncoordinated. When that happens, you may experience voice changes or breathing symptoms that interfere with daily life.
Some vocal cord problems are outside of your control, such as those caused by illness or neurological conditions. Others are related to how the voice is used and can often be improved with the right care. This article explains the causes of common voice problems, how to tell if vocal cords are damaged, and how speech therapy can help your voice heal.
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Get startedHow can you tell if your vocal cords are damaged?
When you breathe in, your vocal cords stay open to let air move in and out of your lungs. When you speak, they gently close and vibrate as air passes through them. These vibrations are what create sound and allow you to produce your voice.
For a strong, clear voice, your breath, vocal cord muscles, and throat all need to work together smoothly. Because the vocal cords are small and delicate, even minor irritation, swelling, or strain can lead to noticeable changes in your voice.
Some common symptoms of vocal cord damage include:
Pain, soreness, or tightness in the throat
Running out of air while speaking
A strained, hoarse, breathy, or tired-sounding voice
Difficulty projecting your voice
Reduced vocal range (for example, trouble hitting higher or lower notes)
Periods of vocal aphonia (times when you can’t speak at all)
It’s normal for your voice to feel off after yelling, being sick, or using it heavily for a short time. Speech-language pathologist Laura Thorburn, M.A., CCC-SLP, explains that these short-term voice changes are common and often improve with rest and hydration.
However, if you notice ongoing changes in the sound or feeling of your voice, it may be a sign of a vocal cord injury. If these symptoms last longer than two weeks, it’s important to seek care from an otolaryngologist (also known as an ear, nose, and throat doctor, or ENT). An ENT can look at your vocal cords and help determine what’s causing the problem.
Getting answers early can make it easier to treat vocal cord problems and prevent further damage.
What is vocal cord dysfunction (VCD)?
Vocal cord dysfunction [VCD; also called inducible laryngeal obstruction (ILO) or paradoxical vocal cord movement] is a condition where the vocal cords don’t open the way they should during breathing.
Normally, your vocal cords stay open when you breathe in. With VCD, the vocal cords close or partially close during inhalation. This can make it feel hard to get air in, even though your lungs are healthy.
“VCD is a functional breathing and voice disorder, not a structural injury,” explains Thorburn. “That means the vocal cords themselves aren’t damaged, but they aren’t moving or coordinating properly.” This is one key way VCD differs from vocal cord damage, which involves irritation, swelling, or injury to the vocal cords.
Common vocal cord dysfunction symptoms
People with vocal cord dysfunction may experience:
Difficulty breathing in
A tight or closed feeling in the throat
Noisy breathing during inhalation (called stridor)
A sensation of choking or suffocating
Feeling like there’s a lump in the throat
Frequent throat clearing
Lightheadedness or dizziness
Tingling in the hands or feet during severe episodes
Some people have mild or occasional symptoms. Others have frequent or intense episodes that feel scary or overwhelming.
What causes vocal cord dysfunction?
Experts don’t know one single cause of VCD. Instead, episodes are usually triggered by one or more factors, including:
Exercise-induced laryngeal obstruction (EILO): Symptoms triggered by physical activity, especially in teens and young athletes
Medical conditions: Asthma, acid reflux (GERD), or upper respiratory infections
Stress and mental health factors: Anxiety, depression, PTSD, or high stress
Inhaled irritants: Cold dry air, smoke, strong smells, cleaning chemicals, or fumes
Why vocal cord dysfunction is often misdiagnosed
VCD is commonly mistaken for asthma or croup because the symptoms can look very similar. However, asthma affects the lungs, while VCD involves how the vocal cords move during breathing.
Because of this, VCD can be challenging to diagnose. A healthcare provider may use tools such as a medical history review, laryngoscopy, pulmonary function tests, or spirometry to better understand what’s happening.
With the right diagnosis and treatment, many people learn how to manage symptoms and breathe more comfortably.
What causes vocal cord damage?
Vocal cord damage happens when something interferes with how the vocal folds move, vibrate, or heal. Some causes are related to a person's environment or how they use their voice, while others are medical and outside of a person’s control.
It’s important to know that voice problems are not a personal failure. Voice disorders, especially among singers, teachers, coaches, and other professional voice users, often carry stigma. That stigma can prevent people from getting help when they need it.
If you’re feeling pain, strain, or tension when you use your voice, your symptoms are real and valid. Getting care early can protect your voice and prevent long-term damage.
Below are some of the most common causes of vocal cord damage.
Vocal misuse and overuse
Vocal misuse refers to behaviors that place repeated strain on the vocal cords. This can include:
Yelling, shouting, or cheering loudly
Talking for long periods without vocal rest
Singing with poor technique or pushing your voice
Frequent coughing or throat clearing
Smoking or inhaling irritants
You may not realize these behaviors can cause vocal injury over time, but as you learn more about taking care of your voice, you’ll be better equipped to prevent vocal cord damage!
Abnormal vocal cord growths
Some people develop extra tissue on their vocal cords that interferes with normal vibration. These growths may include nodules, polyps, cysts, lesions, papillomas, or, in rare cases, cancer.
Growths can form due to vocal overuse, injury, inflammation, or illness. A medical exam is needed to identify the type and best treatment approach.
Acid reflux and inflammation
Stomach acid that reaches the throat (often called acid reflux or GERD) can irritate and inflame the vocal cords. Chronic inflammation makes the vocal folds more vulnerable to injury and can cause hoarseness, throat discomfort, or voice fatigue.
Respiratory illnesses, allergies, smoking, and substance use can also lead to swelling and irritation of the vocal cords.
Nerve and neurological conditions
Your nervous system controls the muscles used for voice and swallowing. Conditions such as Parkinson’s disease, multiple sclerosis, Huntington’s disease, and ALS can affect vocal cord movement and coordination, leading to voice changes.
Hormonal changes
Hormone imbalances, such as thyroid disorders, can also affect the voice. Changes in hormone levels may impact vocal cord thickness, flexibility, and endurance.
Stress and muscle tension
High stress and tension can cause the muscles around the voice box to tighten. This can strain the voice and contribute to conditions like muscle tension dysphonia. While this is different from vocal cord dysfunction (VCD), stress can worsen both voice symptoms and breathing patterns.
How do you fix vocal cord problems?
Fixing vocal cord problems depends on the cause and severity of the damage. In some cases, short-term voice rest may help reduce irritation or swelling. However, rest alone is not always enough, especially if the problem is related to how the voice is being used.
After seeing an otolaryngologist (ENT) to examine your vocal cords, the next step is often to work with a certified speech therapist. It’s important to find a speech therapist who specializes in voice treatment.
Your speech therapist will begin with a voice evaluation. They will review the results from your laryngoscopic exam and measure how your voice and airflow are working together. These findings help guide the right treatment plan for your vocal recovery. In many cases, the therapist will teach you simple exercises right away to help reduce strain and provide early relief.
Voice therapy focuses on teaching healthy voice habits and improving how the vocal cords work during speaking or singing. Therapy may include exercises to improve breath support, reduce muscle tension, and help the vocal cords vibrate more efficiently. Your speech therapist may also offer guidance on posture, breathing, and ways to protect your voice throughout the day.
Most importantly, voice therapy teaches skills you can use in everyday life. These techniques help your voice heal, work more comfortably, and reduce the risk of future vocal cord injury.
Get matched with a speech therapist who's right for you
Get started nowHow to heal vocal cords safely and effectively
Healing your vocal cords takes more than just staying quiet. While short periods of voice rest can help calm irritation, complete silence for long periods is not usually the best solution. True healing happens when the vocal cords learn to work efficiently and with less strain.
One of the most important steps in healing is guided voice use. A speech therapist trained in voice therapy can help you learn how to use your voice in a way that supports healing. Therapy focuses on helping the vocal cords vibrate more easily, with better breath support and less tension.
During the healing process, your therapist may recommend:
Gentle voice exercises to reduce strain
Strategies to improve breath support
Techniques to decrease tension in the neck, throat, and shoulders
These tools allow the vocal cords to heal while still being used safely in everyday speaking or singing.
It’s also important to know what to avoid while healing. Pushing through hoarseness, throat clearing, yelling, whispering, or speaking for long periods without breaks can slow recovery and make symptoms worse.
Healing means learning how to use your voice with less effort, better support, and greater comfort.
Healing timelines can vary. Some people notice improvement within a few weeks, while others may need several months, depending on the type and severity of the vocal cord problem. Following a guided treatment plan and using your voice in a healthy way can help speed recovery and reduce the risk of long-term damage.
In short, healing doesn’t mean avoiding your voice altogether. Healing means learning how to use your voice with less effort, better support, and greater comfort.
10 ways to protect your voice and prevent damage
Practicing good vocal hygiene can help maintain healthy vocal cords and support a strong, reliable voice over time. According to Thorburn, these 10 everyday habits are key not only after healing, but also for preventing voice problems before they begin.
1 Stay hydrated
Hydration is essential for healthy vocal cord movement. Drinking water throughout the day helps keep the vocal cords lubricated and protected.
2 Manage dry mouth or throat
Use a humidifier or steamer if the air is dry. Drink more water and limit drying substances like antihistamines and mint when possible. If dryness is severe or ongoing, talk with a medical professional.
3 Use your breath wisely
Breath support is what powers the voice. Take regular breaths while speaking and try not to talk on “empty air.” Breathing through your nose helps warm and moisten the air before it reaches your vocal cords.
4 Reduce background noise
Speaking in loud environments often leads to shouting or straining. When possible, use gestures, move closer to your listener, or use amplification like a microphone.
5 Build in voice breaks
Giving your voice short breaks helps prevent fatigue. A helpful guideline is about 10 minutes of vocal rest for every hour of heavy voice use.
6 Address allergies or reflux
Frequent throat clearing or coughing may be signs of allergies or acid reflux. Treating the underlying cause can protect your vocal cords from ongoing irritation.
7 Speak with less effort
Avoid pushing your voice. Speaking at a comfortable volume and pitch can reduce strain and help your voice last longer. Your speech therapist can teach you how to do this.
8 Be aware of your environment
Smoke, pollution, and other irritants can damage vocal cord tissue. What you breathe in matters.
9 Care for your whole body
Stress, poor sleep, and fatigue can all affect your voice. Supporting your overall health helps support vocal health, too.
10 Warm up and cool down when needed
Before long periods of speaking or singing, gentle vocal warm-ups can help prepare the voice. Exercises like lip trills, humming, or straw phonation can also reduce vocal fatigue.
Get expert help for vocal cord damage
It’s frustrating when your voice doesn’t sound or feel like it used to. The good news is that with proper care and guidance, your voice can become stronger, more comfortable, and more reliable over time.
If you’re experiencing ongoing hoarseness, vocal fatigue, throat discomfort, or voice loss, working with a speech therapist who specializes in voice can make a meaningful difference. Voice therapy focuses on helping your vocal cords heal and teaching you how to use your voice in a healthier, more efficient way.
At Expressable, our licensed speech therapists are trained in evidence-based voice therapy and work with adults and children on a wide range of vocal concerns. We offer convenient online evaluations and personalized treatment plans designed to fit into your daily life.
If you’re not sure whether voice therapy is right for you, starting with our free online screener or setting up an evaluation can help point you in the right direction. Getting expert input early can prevent small voice issues from becoming bigger problems.
Your voice matters—and help is available.
Frequently asked questions (FAQs)
Can damaged vocal cords heal?
Yes, damaged vocal cords can heal in many cases. Healing depends on the cause and severity of the damage. Mild irritation or strain may improve with rest and hydration, while ongoing or more serious vocal cord problems often need guided voice therapy. A speech therapist can help you use your voice in a way that supports healing and reduces strain.
How long does it take for vocal cords to heal?
How long it takes for vocal cords to heal varies from person to person. Some people notice improvement within a few weeks, while others may need several months. Factors like vocal overuse, reflux, stress, or structural changes can affect recovery time. Following a treatment plan and practicing healthy voice use can help speed healing.
Can screaming damage your vocal cords?
Yes, damaged vocal cords from screaming are common. Screaming places intense strain on the vocal cords and can cause swelling, irritation, or even vocal cord lesions over time. If hoarseness or throat pain lasts longer than two weeks after heavy voice use, it’s important to seek evaluation from an ENT or speech therapist.
What’s the difference between vocal cord damage and vocal cord dysfunction?
Vocal cord damage involves irritation, swelling, or injury to the vocal cords themselves. Vocal cord dysfunction (VCD) is a coordination problem where the vocal cords don’t open properly during breathing. Both conditions can cause voice or breathing symptoms, but they’re treated differently. A proper diagnosis helps guide the right treatment approach.
How do you fix vocal cord problems?
Fixing vocal cord problems starts with identifying the cause. An ENT can examine your vocal cords, and a speech therapist can help address how you’re using your voice. Voice therapy focuses on improving breath support, reducing tension, and helping the vocal cords vibrate more efficiently. If you’re not sure where to start, you can take our free online screener or schedule a voice evaluation to get personalized guidance.
Key takeaways
Vocal cord damage and vocal cord dysfunction can cause hoarseness, strain, breathing difficulty, and vocal fatigue.
Ongoing voice changes lasting longer than two weeks should be evaluated by a medical professional to prevent further injury.
Healing your vocal cords doesn’t mean complete silence. Learning how to use your voice efficiently and with less strain is key to recovery.
Speech therapy plays an important role in treating vocal cord problems by improving coordination, breath support, and vocal health.
Early support and healthy voice habits can protect your voice and reduce the risk of long-term damage.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech therapy practice serving children and adults. We treat all major areas of communication and feeding, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 3,000 5-star reviews from our clients (4.9/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech therapy with personalized education and home practice activities for faster progress.
Communication is more than words. It’s how we share how we feel and show who we are. We’re here to help you or your child do just that.
