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Florence Welch, lead singer of the Grammy-nominated seven-piece band, Florence and the Machine, has just announced the cancellation of two European concerts. According to her, “I cannot sing for a week… seriously I felt something snap, it was very frightening.”
What could’ve happened to pull this talented singer off the stage?
Almost every time singers complain of “something snapping,” it means a vocal hemorrhage. While this was not explicitly stated, there are a few things that suggest this is what happened. First, her report of feeling “something snap” is very consistent with a vocal hemorrhage. Second, the recommended treatment, a week of voice rest, is the most common treatment for an acute injury like a hemorrhage. Usually, if there is a severe injury that would require surgery (such as the presence of a polyp or other vocal mass), the anticipated period of vocal rest would be on the order of months.
What is a vocal hemorrhage?
A vocal hemorrhage is a bruise of the vocal cord.
It most commonly happens due to voice misuse or overuse. However, it can also happen with relatively minimal trauma, such as a cough or sneeze. Women are thought to be more susceptible because of the hormonal variations that occur throughout a month. At certain periods in the month (usually during the time of pre-menstruation), blood vessels are dilated throughout the body. The vocal cords are no exception. Dilated blood vessels here are more prone to rupture. This is why some voice doctors recommend against scheduling heavy touring while pre-menstrual in women with large blood vessels. These at-risk blood vessels would be identified during a regular voice screening exam, that includes stroboscopy.
The topic of vocal hemorrhage was discussed extensively when Adele suffered from one.
Why did this happen to her?
Without knowing all the details, it is difficult to say. Some hemorrhages are predictable; others are not. Having a qualified laryngologist (voice doctor) on your team is the best way to know if you are at risk. IT is also the best way to know when you have suffered from a hemorrhage. Videostroboscopy is the best way to diagnose a vocal hemorrhage.
There is no way for us to know why this happened in Florence Welch’s case. Any number of risk factors make performers more likely to hemorrhage, many of which are not commonly known by the singing community. For example, certain multivitamins and herbal supplements increase the risk of bleeding, thereby increasing the risk of hemorrhage.
It seems clear that poor technique is not her problem but for many singers, strained voice production is a set-up for a hemorrhage. From the video below, it appears that her singing style is quite relaxed, with good breath support. There isn’t significant tension in her neck while she sings during this live performance; all these factors suggest she is focused on good technique.
Will she be okay?
The great news is that when it is diagnosed correctly and early, a vocal hemorrhage can leave little to no residual vocal damage. The stellar vocals we are used to hearing from Welch should be back in short order. However, one hemorrhage is often a risk for future ones and she should obviously be carefully watched. Further, she may eventually need a simple laser procedure to prevent future hemorrhages.
Prevention was discussed with the Los Angeles Young Men’s Ensemble here.
Read patient stories about Dr. Reena Gupta from The Division of Voice at the Osborne Head and Neck Institute.
To learn more about Dr. Reena Gupta, click here.