Voice Rehabilitation

Ruth is particularly qualified and accomplished at assisting individuals to regain and strengthen their voice thanks to more than two decades of performing and teaching classical singing. Not only does she know the science of vocal production, but she has years of experience listening to how people sound and is adept at pinpointing the areas of tension that impede healthy voice production. Ruth refers to and receives referrals from the UCSF Voice and Swallowing Center and Kaiser Permanente.

  • Ruth is particularly qualified and accomplished at assisting individuals to regain and strengthen their voice thanks to more than two decades of performing and teaching classical singing. Not only does she know the science of vocal production, but she has years of experience listening to how people sound and is adept at pinpointing the areas of tension that impede healthy voice production. Ruth refers to and receives referrals from the UCSF Voice and Swallowing Center and Kaiser Permanente.

    Ruth provides a number of different exercises to relieve tension and encourage healthy voice production. These range from relaxation and breath management exercises to a variety of phonation tasks. The latter begin with whichever sounds the person is able to produce without strain. These gradually increase in complexity as the new vocal habits become embedded. Most of Ruth's clients require approximatelysix sessions, but there are exceptions at both ends of the spectrum. Critical to success is both the motivation to change one's speech habits and the daily practice of voice assignments. Certain activities - such as smoking and yelling - should be dispensed with before beginning rehabilitation. If you have not already been seen by a Laryngologist, Ruth will be happy to recommend one.

  • Most people take their voice for granted, unless it becomes hoarse, tires easily, or in some other way ceases to function as before. Usually such dysphonia is of short duration but, in some cases, it may become chronic. If it lasts for more than two weeks and is unrelated to an upper respiratory tract infection it is advisable to visit a Laryngologist or throat specialist. The Laryngologist, using videostroboscopy, will usually be able to diagnose the kind of voice disorder and to determine whether any pathology is present, such as growths on the vocal folds. Growths include nodules, granuloma, cysts, and polyps.

    The first two tend to respond better to voice retraining than the latter two. Nevertheless, Ruth has had success in reducing the size of these as well.

    Treatment of dysphonia will vary, depending on the diagnosis. Some voice disorders tend to be unresponsive to the kind of behavioral retraining inherent in voice rehabilitation, while others are very responsive. In the latter case, much of the success will depend on the motivation of the patient to alter his or her speech or singing habits. If pathology is present whose cause lies in habitual vocal habits, there is no point in undergoing surgery before first learning how to alter this behavior. Otherwise, the pathology will most likely return.

  • Some useful terms:

    • Dysphonia: An abnormal voice quality, such as hoarseness

    • Videostroboscopy: The use of a camera - either by means of a rigid oral scope or a flexible nasal scope - to obtain video images of the laryngeal structure and of the vocal folds in motion. This is a simple, outpatient procedure, involving little or no discomfort, and is far superior to the traditional ENT exam using a mirror.

    • MTD (Muscle Tension Dysphonia): Muscle tension either in the throat and neck area or involving the breathing mechanism that prevents easy phonation. A significant portion of Ruth's voice rehabilitation practice involves MTD, which generally responds well to behavioral retraining.

    • SD (Spasmodic Dysphonia): A neurological voice disorder that involves involuntary "spasms" of the vocal cords causing interruptions of speech and affecting the voice quality. There is a certain amount of controversy regarding the treatment of SD.

    The following links reflect a few of these viewpoints:

Testimonials

  • "A few years ago I developed a serious problem with my voice. We were on tour promoting one of the largest selling records in music history - 'Supernatural'. I got food poisoning about an hour before a show in Europe and couldn't stop vomiting between songs during our three-hour show. This was the first show on a three-week tour, and I had no time to let my voice recover. I could barely talk, can't remember how I managed to sing, and I ended up developing nodules on both vocal cords. I was scared to death that I would never be able to sing again. When I got home I immediately began seeking help from some voice instructors. Their techniques didn't feel right to me so my instincts told me to seek another way. A friend of mine turned me on to a Laryngologist in San Francisco, who has since retired. While treating me, he recommended that I give Ruth Rainero a call because he had heard some great things about her. I am happy to say that Ruth's philosophy and techniques were the only ones that made any sense to me and, after working with her for some time, my voice returned strong and continues to be stronger than ever today. I never needed surgery. Thank you, Dr. Mink, and thank you sincerely, Ruth."

    -Tony Lindsay, lead singer with Carlos Santana

  • "As a professional singer and actress, I was devastated when I suffered a vocal injury. My speaking voice was fine, but I had lost range and control in my singing voice. Ruth helped me retrain my body after the injury, learning how to release tension and change ingrained habits that may have even pre-dated the injury, to come out an even stronger singer on the other end. I cannot express what an incredibly supportive, knowledgeable, nuanced teacher Ruth is! She’s always honest, respectful, and encouraging. She helped me feel like someone really understood what I was going through , even in the darkest hours when I couldn’t sing anything more than simple glides. Now, I’m back out there performing and regaining confidence, thanks in no small part to Ruth! As a Speech-Language Pathologist, I am grateful to have someone I trust to refer my singing patients to after working with me in the clinic. Her excellent knowledge of the mechanics of the voice makes me confident that she is able to continue building my patients' singing skills with healthy habits. Ruth is an essential part of my team approach to treating professional voice users!" - Jennifer Cleary, M.S. CCC-SLP, Speech-Language Pathologist, Voice Coach, ExploreVoice Studios

  • "When they told me two years ago that I had a polyp on my vocal cord, the surgeon recommended that I go to Ruth Rainero for voice therapy. I have had no surgery and I attribute a good deal of the recovery of my voice to her. She explained to me how I had been straining my voice (more by talking than by singing, incidentally) and how I could stop doing so. Her style of teaching "clicks" with the way I learn things. Also, Ruth doesn't treat the voice as only physical - she recognizes the more subtle aspects of singing. Ruth is serious and dedicated but, at the same time, open and not overly orthodox nor stuck in the past. This inspires trust and for me makes lessons with her a way to learn about aspects of singing I hadn't considered much before."

    Jonathan Richman, Singer

  • "I am delighted to recommend Ruth to anyone whose voice is not doing what he or she wants it to do. With patience, warm encouragement and exceptional skill, Ruth guided me to a significantly improved speaking and singing voice after it was determined that I was causing significant harm to my voice through incorrect use. This was a challenging undertaking for me, and I felt supported and guided throughout the process. In an amazing turn-around, my improved voice habits resulted in the disappearance, over time, of the granuloma that had developed near my vocal cords, without resorting to surgery. I was thrilled with this end result and am now pleased to continue my work with Ruth to further enhance my singing abilities."

    -Jonathan Funk, Attorney

  • "I was diagnosed with muscle tension dysphonia, an extremely debilitating condition which affected me both personally and professionally. A Laryngologist at UCSF referred me to Ruth, who enabled me to regain full use of my voice. I highly recommend Ruth's unique and effective approach to anyone requiring voice rehabilitation." - Paul Cuff, CEO, Calex Manufacturing Company

  • "I found Ruth after a traumatic year of vocal pain and consults with multiple speech therapists, otolaryngologists and voice coaches. I wasn’t sure recovery was even possible. However, within the first few sessions with Ruth I could feel my voice regaining strength. I was initially afraid to trust my progress, but Ruth’s compassion, understanding, and grounded optimism carried me until I could believe that my voice was truly healing. Ten sessions later, I am once again singing with joy and ease. I am so very grateful to Ruth. It’s rare to find someone with her combination of skill and compassion. I can’t recommend her highly enough."

    -Wendy Fiering, Singer and Teacher