Voice is central to how we communicate, express emotion, and connect with others. When voice quality changes—whether gradually with age or suddenly after illness—it can be unsettling, frustrating, and isolating. While voice changes are common, they are not something people have to simply accept.

Speech‑language pathologists (SLPs) play a vital role in identifying the cause of voice changes and helping individuals restore strength, clarity, and confidence in their voice—at any age and stage of health.

The eyes may be the window to the soul, but the voice tells the story. The vocal cords are incredible little muscles that reflect who we are and what we’re feeling. They’re tied to our overall wellbeing. I believe everyone deserves a healthy, clear, strong voice to tell their story and connect with loved ones. – Kristen Davis, CCC-SLP, CBIS, Speech Language Pathologist at Frederick Health Liberty Outpatient Clinic.

Why Do Voice Changes Happen?

Voice changes occur when something affects the complex coordination of the vocal cords, breath support, and surrounding muscles. These changes may develop gradually or appear suddenly, depending on the cause.

Voice Changes Related to Aging

As part of the natural aging process, the voice can change due to:

• Weakening or thinning of vocal cord muscles
• Reduced lung capacity and breath support
• Changes in posture and muscle coordination
• Reduced tissue elasticity and hydration

These changes—often referred to as presbyphonia—may lead to:

• A softer or weaker voice
• Hoarseness or breathiness
• Vocal fatigue
• Difficulty being heard or understood

Voice Changes Related to Illness or Medical Conditions

Voice changes are also common following illness or medical events and can affect adults of any age. These may include:

• Respiratory illnesses (such as pneumonia, COVID‑19, or chronic lung disease)
• Neurological conditions (Parkinson’s disease, stroke, multiple sclerosis)
• Prolonged intubation or hospitalization
• Reflux or gastrointestinal conditions
• Cancer treatments involving the head, neck, or chest
• Viral infections that irritate or inflame the vocal cords

Illness‑related voice changes may result in:

• Sudden hoarseness or voice loss
• Weak vocal projection
• Vocal strain or discomfort
• A shaky, rough, or unstable voice

Regardless of the cause, persistent voice changes should be evaluated—not ignored.

Why Voice Changes Matter

Voice issues affect more than speech—they affect participation in life. When speaking becomes difficult or effortful, people may:

• Avoid phone calls or social gatherings
• Feel frustrated during medical appointments
• Reduce work or volunteer activities
• Experience emotional stress or withdrawal

In some cases, voice changes can indicate underlying medical conditions that benefit from early intervention.

The Role of Speech‑Language Pathology

Speech‑language pathologists are specially trained to evaluate and treat voice disorders caused by aging, illness, or injury. Treatment is non‑invasive, personalized, and function‑focused.

How an SLP Can Help

Comprehensive Voice Evaluation

An SLP assesses voice quality, strength, pitch, endurance, breathing patterns, and vocal habits while considering medical history and recent illnesses or treatments.

Targeted Voice Therapy

Therapy focuses on:

• Improving vocal cord function
• Increasing vocal strength and projection
• Enhancing breath support and efficiency
• Reducing strain, hoarseness, and fatigue

Education and Vocal Care Strategies
SLPs teach practical strategies to protect the voice, manage fatigue, and avoid habits that may worsen symptoms.

Restoring Confidence and Participation
Improving voice quality often leads to renewed confidence in conversation, social interaction, and daily communication.

Voice Therapy Is Effective at Any Age and Any Stage of Recovery

A common misconception is that voice therapy won’t help once changes are established or if someone is older or medically complex. In reality, many people experience meaningful improvement, even months or years after voice changes begin.

Voice therapy adapts to each person’s needs—whether they are recovering from illness, managing a chronic condition, or experiencing age‑related changes.

“Voice therapy can improve not only the speaking voice but also the singing voice—whether you sing for enjoyment or are a trained vocalist,” says Davis. “Often, people first notice a problem when they have difficulty reaching higher pitches while singing.”

She adds that “singing requires complex coordination of breathing and the muscles responsible for raising and lowering pitch. When these muscles aren’t working together properly, ongoing vocal strain can build over time, potentially leading to vocal cord problems such as nodules, polyps, or chronic inflammation—all of which can negatively affect singing quality.”

When to Seek Help

Consider evaluation by a speech‑language pathologist if voice changes:

• Last longer than a few weeks
• Follow illness, hospitalization, or surgery
• Interfere with daily communication
• Cause vocal discomfort or fatigue
• Lead to avoidance of speaking situations

Early intervention leads to better outcomes—but improvement is possible even later.

Supporting Communication at Every Stage of Life

Healthy communication is essential to quality of life. Whether voice changes develop with aging, illness, or recovery, speech‑language pathology provides expert care to help individuals stay heard, stay connected, and stay engaged.

If you or a loved one are experiencing voice changes, a speech‑language pathologist can help restore strength, clarity, and confidence—no matter the cause.

 

During Patient Safety Awareness Week, we recognize the many ways hospitals protect patients every single day. In rehabilitation services—Physical Therapy (PT), Occupational Therapy (OT), and Speech‑Language Pathology (SLP)—patient safety is at the heart of everything we do.

Whether a patient is recovering from surgery, illness, injury, or a neurological condition, therapy plays a key role in helping them regain strength, function, and independence. And none of that is possible without a strong commitment to safety.

How Physical, Occupational, and Speech Therapists Support Patient Safety

Rehabilitation professionals help patients rebuild their abilities—but they also work to prevent complications, injuries, and setbacks. Here’s how each discipline contributes to a safer healing process.

 

🟦 Physical Therapy: Safe Mobility, Strength, and Recovery

Physical therapists help patients move safely throughout their hospital stay. Mobility is essential for recovery—but it has to be done the right way.

PT focuses on safety by:

• Assessing mobility and balance before each session
• Preventing falls through proper technique and assistive devices
• Teaching safe ways to stand, transfer, and walk
• Monitoring vital signs, fatigue, and pain
• Helping restore strength and endurance without overexertion
• Reducing risks of complications like blood clots, pressure injuries, and pneumonia

PT ensures patients push forward without pushing too far—building confidence and preventing fall‑related injuries that can delay recovery.

 

🟩 Occupational Therapy: Safety in Daily Activities

Occupational therapists help patients safely return to meaningful everyday tasks—like bathing, dressing, grooming, toileting, cooking, or using their hands again after injury.

OT supports safety by:

• Teaching safe techniques for daily activities
• Recommending adaptive equipment to reduce strain or fall risk
• Improving cognitive safety—attention, memory, problem‑solving
• Assessing home safety for discharge planning
• Ensuring patients can navigate their environment safely
• Training patients on joint protection, energy conservation, and safe body mechanics

OT helps patients regain independence without risking injury or reinjury.

 

🟧 Speech‑Language Pathology: Safety in Swallowing, Communication & Cognition

Speech‑language pathologists don’t just work on speech—they also play a crucial role in medical safety, especially for patients with swallowing or communication difficulties.

SLP enhances safety by:

• Evaluating swallowing to prevent aspiration and pneumonia
• Recommending safe food and liquid textures
• Teaching strategies to reduce choking risk
• Strengthening cognitive skills like memory, reasoning, and attention
• Improving communication so patients can express needs, pain, or concerns clearly
• Supporting patients with voice or airway challenges

SLP ensures that eating, drinking, and communicating are safe and effective—all essential for healing and quality of life.

Safety Is a Team Effort: Therapists, Patients, and Families

Therapists work closely with nurses, physicians, dietitians, and caregivers to create a coordinated safety plan tailored to each patient.

 

Patients and families can help by:

• Asking questions about mobility, swallowing, or equipment
• Using call lights and assistive devices as instructed
• Following recommendations for exercises, safety strategies, and daily activities
• Notifying staff if something doesn’t feel right
• Sharing concerns about pain, dizziness, or swallowing changes immediately

When patients feel comfortable speaking up, therapy becomes safer and more successful.

Putting Safety First, Every Day

During Patient Safety Awareness Week—and every day—Physical Therapy, Occupational Therapy, and Speech‑Language Pathology work together to ensure patients receive safe, high‑quality care.

From preventing falls to ensuring safe swallowing, from teaching safe movement to supporting cognitive function, rehab services are essential partners in creating a hospital environment where patients can heal with confidence.

Patient safety isn’t just a priority—it’s a shared mission. And in rehab, that mission guides every step, every activity, and every goal.

Bridging exercises—lifting your hips off the ground while lying on your back—are a cornerstone of many rehabilitation and strengthening programs. They’re commonly used to improve glute strength, core stability, and hip control. But what many people don’t realize is that a small detail like foot and ankle position can significantly change which muscles are doing the most work.

 

A recent study by Escamilla et al. (2024) examined how different bridge variations activate muscles when the ankle position is altered. Participants performed bridges with their toes pointed down (plantar flexion) and with their toes pulled up toward the shin (dorsiflexion), including both double-leg and single-leg bridges.

 

Key findings from the study:

• Hamstrings showed greater activation when the toes were pointed down.
  Plantar flexion appears to place the hamstrings in a position where they contribute more force during hip extension, making this variation useful when hamstring strengthening is a goal.
• Hip adductors (inner thigh muscles) were more active when the toes were pulled up, particularly during single-leg bridges.
  Dorsiflexion likely increases the demand for pelvic and femoral control, requiring the inner thigh muscles to work harder to stabilize the leg.
• Core muscles—specifically the internal and external obliques—demonstrated increased activity with toes pulled up, but only in certain bridge variations.
  This suggests that dorsiflexion may enhance trunk stability demands, especially in more challenging or asymmetrical bridge positions.
• Glute muscle activation remained relatively consistent regardless of ankle position.
  This indicates that while foot position influences supporting muscles, the glutes remain a primary driver of the movement in both setups.

 

Practical takeaway:

Small setup changes can lead to meaningful differences in muscle engagement. Simply adjusting ankle position during a bridge can shift emphasis between the hamstrings, inner thighs, and core—without changing the exercise itself.

If you’re using bridges for rehabilitation or performance, this matters. Whether your goal is to:

• Improve hamstring activation
• Enhance core control
• Build hip and pelvic stability
• Progress toward single-leg strength

…these subtle variations can help tailor the exercise to your specific needs.

 

Start by scheduling a consultation with a physical therapist. Get personalized advice and begin your journey strong and safely.  They can help to modify bridge exercises to better match your rehab goals. Sometimes, the smallest adjustments make the biggest difference.

When Spencer first joined Tx:Team as a college intern, he didn’t imagine he’d still be with the company more than a decade later. What began as a short-term opportunity rooted in a shared alma mater and a mutual favorite professor evolved into a fulfilling career defined by continuous growth, evolving responsibilities, and meaningful mentorship.

A Wabash College economics major, Spencer was drawn to the field not just for its math-heavy curriculum but for the way it helped him understand decision-making and opportunity costs. “It’s a way of thinking. Economics isn’t always tied to money, it’s a decision-making tool as well,” he explained. As an intern, Spencer gained early exposure to Tx:Team’s operations. He dove into financial reports, participated in team events, and began to understand the broader mechanics of how the business side of healthcare functions. What initially sold him on the job offer was the promise of autonomy and the freedom to build systems from the ground up while learning how data and financial insight could shape big-picture decisions.

After graduation, Spencer transitioned into a full-time role with Tx:Team, where his initial responsibilities centered on core accounting functions such as bank reconciliation, accounts payable, and billing. But as he became more immersed in the organization, his role began to expand. Today, he works across financial forecasting, data analysis, and tool development, creating practical solutions that empower clinic leaders and directors to understand and manage their performance. “Every team leader analyzes the data differently,” he said. “So a lot of what I do is build management tools because those metrics are what drive their financial results.” Among his proudest accomplishments is developing a unified financial forecasting system that offers daily visibility into performance across all clinical settings. This has been a game-changer for operational insight and strategic decision-making.

But Spencer’s time at Tx:Team has been about more than just numbers. It’s also been about learning how to lead. “You learn to step back and listen to what their needs are and take that in and not come with assumptions or some judgements there,” he shared. His leadership style has been shaped and strengthened by key mentors, including Scott Benedict, Carroll Nelligan, Bob Haan, and Ann Hightower. “They all approach it differently…they’ve all given me different lenses into how they manage and lead.”

When reflecting on why he’s remained at Tx:Team for so many years, Spencer pointed to the constantly evolving nature of his role and the people who make the work worthwhile. “This job has evolved almost every year… which keeps it exciting and keeps me coming through those doors every day.” He added, “I keep coming back to… It’s a good place to work. Good team here that’s always trying to help you.” Looking ahead, Spencer is energized by what’s next. With Tx:Team expanding its footprint in employer-based clinics and forming stronger partnerships with health systems, the future looks bright. “We are learning that we provide that product really well,” he stated.

From intern to leader, Spencer’s journey is one of continuous evolution. He’s building systems, supporting teams, and helping Tx:Team grow, one strategy at a time.

We are pleased to announce the promotion of three associates to new positions at Tx:Team. Please join us in congratulating them on their new roles!

Mitch Parsons has been elevated to the position of Director of Rehabilitation – Employer Based Clinics.  Mitch originally joined Tx:Team in 2004 and worked as a primary Physical Therapist and Outpatient Coordinator.  After leaving to pursue other endeavors, Mitch rejoined Tx:Team in 2017 in the newly created position of Manager – Employer Based Clinics.  Mitch brings over 25 years of clinical and management experience in a variety of settings, including critical-access hospitals, long-term care facilities, continuing-care retirement communities, home health, and employer-based clinics to his new role.  He will continue to work with new and existing employers to offer the best in musculoskeletal Primary Care and Work Injury Management solutions for their employees. Mitch is a graduate of the Indiana University School of Physical Therapy and the MBA Program at University of Tennessee.

Katie Guerdan has been elevated to the position of Director of Human Resources. Katie joined Tx:Team in 2015 and has held the positions of Human Resources Generalist and Manager of Human Resources. Katie has spent the majority of her career working for healthcare-related companies, which has afforded her valuable and applicable experience in the areas of regulatory compliance, employee relations issues, performance management, training, recruiting, and benefits administration.  Katie is a Certified Professional in Human Resources and is a member of Society for Human Resource Management. In her new role of Director of Human Resources, Katie will be responsible for further optimizing Tx:Team’s human resources processes, focusing specifically on growth, efficiency, and maintaining effective internal systems.  Katie is a graduate of Indiana University.

Spencer Sheridan has been elevated to the position of Director of Finance.  In the summer of 2011, Spencer completed an eight-week internship with Tx:Team during which he built or enhanced many of our financial forecasting tools. One week after his graduation the following summer, Spencer rejoined Tx:Team in a fulltime role in Finance department.  He has developed a passion for measuring, analyzing, and connecting operational performance to financial outcomes. Spencer has held previous roles as Financial and Operations Coordinator and Manager of Finance.  Spencer brings a systematic and analytical approach, coupled with a strong desire to help solve problems, to everything he does.  In his new role as Director of Finance, Spencer will be responsible for further standardizing financial processes and systems, leading the development of new forecasting platforms, and overseeing all aspects of accounting and finance for Tx:Team. Spencer is a graduate of Wabash College.

We are proud of Mitch, Katie, and Spencer, and look forward to working with them closely in their new roles. Congratulations, all!