Think Outside the Voice Box: Protect Your Voice During March Madness

As fans gear up for the start of the NCAA men's college basketball tournament, it's easy to get caught up in bracket excitement without realizing the strain that March Madness may have on your vocal cords.

"We use our voice to express ourselves, whether it's enthusiasm at our team scoring a buzzer-beater, or extreme disappointment when they miss the shot," said Anca Barbu, MD, laryngeal surgeon and associate professor in the Jim and Eleanor Randall Department of Surgery, Division of Otolaryngology-Head and Neck Surgery at Cedars-Sinai. "And those expressions are fine, but the volume at which we're doing so can put the vocal cords at risk of trauma."

Barbu, who specializes in professional voice and voice disorders, recently spoke with the Cedars-Sinai Newsroom about tips for enjoying the upcoming NCAA Tournament, and other major sporting events, while maintaining vocal health.

What are the risks of screaming too much during sporting events? What short- and long-term damage can you do?

Vocal cord trauma, also known as phonotrauma, can occur when we overuse our voice, potentially causing damage to the cords. In the short term, this can present as a change or loss of voice. Typically, this type of injury should resolve itself in 24 to 48 hours.

In the long term, vocal cord damage can become chronic laryngitis if the voice doesn't get a chance to rest and heal.

If you lose your voice all of a sudden, such as in the middle of talking or yelling, we worry about more of an acute event such as a vocal fold hemorrhage. If that happens, seek medical care.

What tips do you recommend for preventing vocal strain while cheering on your favorite team?

In already loud environments, such as a packed arena or even an in-home watch party with friends, people tend to get louder to project over the ambient noise, creating a greater risk of vocal cord strain. I always tell patients that during these times, you can still be animated by cheering with your hands and facial expressions or clapping and using other external noisemakers rather than projecting your voice. Signs and banners are a great option, too. Just think outside of the voice box, if you will.

Are there certain foods and drinks you should avoid to protect your voice?

When you think about the types of foods consumed at these kinds of sporting events or watch parties, they tend to be very reflux-inducing foods. Foods that are greasy, fatty or spicy, alongside alcohol and carbonated beverages, will tend to create more acid in your stomach, leading to heartburn and silent reflux, also known as laryngopharyngeal reflux [LPR]. This creates an environment in your throat where tissues may be swollen, which makes them more prone to trauma and can present as a sore throat the next day. If you're planning to enjoy these foods that may trigger silent reflux, do so in moderation or consider taking an antacid to help avoid the issue.

Additionally, it is important to avoid other carcinogenic products like tobacco or vaping, as those can irritate your vocal cords and throat as well.

If you do overdo it, how can you recover?

If you lose your voice instantaneously or experience hoarseness following overuse, the best thing to do is to simply be quiet. Vocal rest, avoiding all talking, is recommended for at least 24 and up to 72 hours, depending on the severity of the laryngitis. Do not try to push through with your voice or even whisper, because that is when greater injuries may occur.

At what point should you consult a doctor for vocal issues?

If vocal rest has not resolved the issue in 72 hours, you should contact your primary care doctor.

However, if it's been three or more weeks of laryngitis from yelling and your voice has not returned to baseline, it's important at that point to see an ENT [ear, nose and throat specialist] for an exam of your vocal cords. If you are someone, such as a singer or actor, who relies on their voice professionally, it would be recommended to specifically see a laryngologist-an ENT with specialized training for voice-related issues, including vocal cord swelling and trauma.

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