Cold, flu, COVID and RSV have been circulating across Australia this winter. Many of us have caught and recovered from one of these common upper respiratory tract infections.

But for some people their impact is ongoing. Even if your throat isn’t sore anymore, your voice may still be hoarse or croaky.

So what happens to the voice when we get a virus? And what happens after?

Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved.

Why does my voice get croaky during a cold?

A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear.

The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds.

When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse.

Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky.

In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether.

Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (post-nasal drip). But coughing slams the vocal cords together with force.

Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs.

Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality.

How can you care for your voice during infection?

People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are more at risk of forcing their voice before it’s ready.

The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold.

Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest.

Drink plenty of water, avoid alcohol and exposure to cigarette smoke. Inhaling steam by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords.

Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this strains the muscles.

Instead, consider using “confidential voice”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by.

During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally.

What should you do if your voice is still hoarse after recovery?

If your voice hasn’t returned to normal after two to three weeks, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist.

If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be treated with voice therapy and don’t require surgery.

You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold.

In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, lip trills (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.

Yeptain Leung, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

From “breathwork recipes” to breathing techniques, many social media and health websites are recommending breathwork to reduce stress.

But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as Pranayama from India and qigong from China. Such practices have been used for thousands of years to promote a healthy mind and body.

The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer?

So, what’s the difference between the breathing we do to keep us alive and breathwork?

Breathwork is about control

Breathwork is not the same as other mindfulness practices. While the latter focus on observing the breath, breathwork is about controlling inhalation and exhalation.

Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth.

The diaphragm is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs.

Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from fire breathing to the humming bee breath.

Breathwork can calm or excite

Even small bits of breathwork can have physical and mental health benefits and complete the stress cycle to avoid burnout.

Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale.

In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower.

You can also slow the breath by doing:

• box breathing (count to four for each of four steps: breathe in, hold, breathe out, hold), or
• coherent breathing (controlled slow breathing of five or six breaths per minute), or
• alternate nostril breathing (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way).

You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out.

In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, fire breathing (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and Lion’s breath (breathe out through your mouth, stick your tongue out and make a strong “haa” sound).

What is happening in the body?

Deep and slow breathing, especially with a long exhale, is the best way to stimulate the vagus nerves. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system.

Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone cortisol and helps to regulate emotions and responses. It also promotes more coordinated brain activity, improves immune function and reduces inflammation.

Taking deep, diaphragmatic breaths also has physical benefits. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm.

Slow breathing reduces heart rate and blood pressure and increases heart rate variability (normal variation in time between heart beats). These are linked to better heart health.

Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and develops resilience to stress.

Breathing in through the nose

We are designed to inhale through our nose, not our mouth. Inside our nose are lots of blood vessels, mucous glands and tiny hairs called cilia. These warm and humidify the air we breathe and filter out germs and toxins.

We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body.

Nasal breathing increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure.

Consistently breathing through our mouth is not healthy. It can lead to pollutants and infections reaching the lungs, snoring, sleep apnoea, and dental issues including cavities and jaw joint problems.

A free workout

Slow breathing – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in helping post-traumatic stress disorder (PTSD) is also promising.

Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in chronic heart failure, chronic obstructive pulmonary disease and asthma. It can also improve exercise performance and reduce oxidative stress (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise.

A mind-body connection you can access any time

If you feel stressed or anxious, you might subconsciously take shallow, quick breaths, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity.

Just a few minutes a day of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises in the workplace reduce blood pressure and stress, which is important since burnout rates are high.

Bottom line: any conscious control of your breath throughout the day is positive.

So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.

Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong and Judy Pickard, Senior Lecturer, Clinical Psychology, University of Wollongong

This article is republished from The Conversation under a Creative Commons license. Read the original article.