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Liner Notes
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Body
& Soul
Voice Care with David M. Alessi, M.D
STEROID SHOTS AND THE VOCAL CORDS
MBADC: Some singers who have voice problems on the road get steroid shots
to get them through the tour. Are those given in the neck, and what do they do, in
laymen’s terms?
DA: Steroid shots are typically given in the butt, because it’s the
biggest muscle in the body. What steroids do is, they basically take away the swelling.
Steroids can be very, very helpful if they’re used in the right way, and they can be
very, very harmful if they’re used in the wrong way. A classic person to use a
steroid shot would be someone who has an acute viral laryngitis,
where they have swelling of their vocal chords and they have
hoarseness, and they’re exceptionally well-trained, like an opera singer. Obviously
that’s not your audience, but that would be the perfect person for it. The worst
person for it is somebody who’s in the middle of a two-year tour where they‘re
singing eight shows a week, and they basically have screaming technique. And you take them
in and they have redness and swelling of their vocal cords, and the shot will help them
for a few days, and then all of a sudden they’ll wind up being even worse off than
they were before.
The steroid shots will take away swelling, but they will not erase the underlying
pathology--the underlying problem. So if somebody has some vocal over-use, and then they
take a steroid shot, and their voice sounds a little better for a couple days, then all of
a sudden they’re banging their vocal cords together and they’re already injured,
the steroid’s only masking [the problem].
So if they have an acute problem, like a really bad allergy attack, if they have just one
really big show coming up, like a huge audition or if they have a gig in front of some
record company executives that they really want to sound good for and all of a sudden
they’ve got some problems, that’s the perfect time
for steroids--as long as they’re going to have a couple days’ of rest
afterwards. But in the middle of a long tour, where some of these performers have to go
site to site to be able to get their steroid shot to sing, is really not what you want to
do.
MBADC: So how long could a singer safely do the steroid shots?
DA: Everybody would be different, and many times people can get away with
it, but when you do it often, then you have a bleed in the vocal cords because you’re
already singing on already injured vocal cords, and it will cause permanent damage to your
vocal cords. And that’s what you’re risking, and that’s what you don’t
want to have happen…There’s not any clear answer to how many times you can do
that. But basically whoever’s giving that shot needs to get into the head of that
singer. They need to change something fundamentally if the only way they can get out there
to sing is with steroid shots.
Side Effects of Steroids
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