Finding Your Voice Again after COVID

 My Story

When we think about the lasting effects of COVID, we often focus on fatigue, breathlessness, or brain fog. But for many people, one of the most distressing and least talked about symptoms is losing their voice.

As a specialist fatigue physiotherapist who experienced this myself, I want to share what I've learned both personally and professionally. You are not alone, and there is plenty you can do.

A bit about what happened to me

During the pandemic, like many people, I had a recurrent cough that would not stop. The more I coughed, the more irritated my throat and cough reflex became. Over a number of weeks, it got worse and worse until one day, when I projected my voice on a scary ride at a fairground, there was a sudden, sharp stabbing feeling in the side of my neck, and I couldn’t talk. It felt like I had a sharp fish bone stuck in my throat. 

Eventually, after a number of pandemic-related delays, I had an endoscopy, and the Speech and Language Therapists concluded that I had a vocal haemorrhage. My larynx has become twisted and asymmetrical, and one side wasn’t working properly. 

It took many months to recover the power in my voice. 

You can hear the whole story in this interview via the button below or at the bottom of the blog.

The voice is not just the larynx

Your voice isn't just your larynx.  It's a complex, multi-system process involving:

• Your lungs and diaphragm: which must produce and control airflow

• Your larynx (voice box): where sound is created

• Your tongue and mouth: which shape your words

• Your jaw and muscles in your face: which allows for free movement 

• Your nervous system and stress response: which affects muscle tension in the face and tongue 

When COVID disrupts all or any part of this system through repetitive coughing, inflammation, diaphragm dysfunction, or reflux the entire mechanism can be thrown off balance. There may be many aspects to consider before the voice can function fully. 

Losing speech threatens us deeply as social creatures

Losing your voice isn't just inconvenient. It is deeply isolating if you can’t talk. Talking is our world. 

Perhaps you can't work. Basic communications with family may have become hugely frustrating. Your world may have become very quiet, and for many people, that quiet is accompanied by real fear. Will this get better? Is this permanent?

I know that fear first-hand. At my worst, I could only speak for five minutes at a time. I couldn't do my usual work if I couldn’t talk: I need at least an hour of vocal endurance for a therapy session.  Picking up the phone, chatting to a neighbour on a dog walk, and even having a conversation over dinner became impossible. 

Being unable to talk is extraordinarily frustrating, but it’s also a huge threat to our identity. 

A few ideas that might help:  

1. Don't panic 

If your voice has been affected for less than six to eight weeks following a cough or illness, give it time. Rest, hydrate well, and avoid straining. Try not to whisper, but also pace yourself. Many voice problems will settle. 

2. Hydrate, hydrate, hydrate

Your vocal cords need moisture. Drink plenty of water throughout the day. Avoid alcohol and caffeine: not only will they not help stress, sleep and muscle tension, but they can also dehydrate the larynx, which will irritate things further. 

3. Pace your talking

Just as you would pace physical activity in fatigue recovery, you need to pace your voice. Find a baseline, how much talking feels manageable, and work up gradually. Avoid back-to-back conversations or meetings without vocal rest in between.

4. Deal with muscle tension

Muscle tension around the neck, shoulders, jaw and tongue makes voice problems significantly worse. Practices like yoga, gentle stretching, walking outdoors and mindfulness all help to soften these structures and take the strain off your voice.

5. Create a project 

When we lose our work or daily routines, we need to think creatively about how to give our day and life purpose. Think about creating a project that feels important to you, that gives you the space to heal and get better, whilst creating a focus. 

6. Watch out for reflux

Reflux, where stomach acid travels up and irritates the larynx, is common after COVID. Reduce citrus, spicy and fatty foods, avoid eating close to bedtime, and speak to your GP or pharmacist about whether an antacid might help.

7. Think about background noise 

Background noise makes it much harder, as you may need to project your voice. If you’re talking to someone, ask to turn off the radio or TV, or try to meet somewhere quiet. Ask for a quiet table if you’re going out. 

8. Humidify

Steam inhalation, simply draping a towel over your head above a bowl of hot water, can provide real relief. Avoid adding anything to the water as this can irritate. Handheld nebulisers with saline solution might also help. 

9. Avoid irritants in the air 

Smoking will irritate the larynx significantly, but so will smoke from a campfire or firepit. Perfumes or fumes might also be hard to be around. 

10. Get help 

If your voice problem has persisted beyond eight weeks, have a chat with your GP and consider a referral to a Speech and Language Therapist. A physiotherapist can also help release tension in the diaphragm, tongue and surrounding structures. 

An important mindshift

Acceptance was the hardest and most important thing I had to learn.

The more I fought my voice problem, the worse it became. The tension, worry,  the frustration: all of it compounded the muscle tightness that was already making things worse.

Getting to a place of "this is what is happening right now, and I can work with it" was important. This involved tolerating the uncertainty rather than battling with it. I don’t mean a ‘passive acceptance’, but an active, compassionate approach to working with your body, how it is right now, rather than fighting against it.

Hope matters. It’s important to recognise the enormous healing power of our body: that you can adapt, find ways forward, and live a full life even while managing an ongoing challenge.

I'm now enjoying a full and active life. I’m back at work, and back to socialising and exercise. I do still need to consider and  manage my voice but now it’s in the background, not the centre of my world and worry like it once was. 

How Vitality360 can help: 

At Vitality360, our team of specialist therapists works with people navigating the complex, multi-system challenges of long COVID, including voice problems, fatigue, breathlessness and pain.

If you'd like to find out more about how we might be able to help, please get in touch.

To watch a full interview with Jessica Sands on this topic,see below:

Jessica Sands is a Specialist Fatigue Physiotherapist and Director of Vitality360. She has over 25 years of experience in fatigue rehabilitation and has been at the forefront of long COVID care since the earliest days of the pandemic.