If you had told me 10 years ago that I would have my first feature in Opera Now talking about vocal health I would probably have laughed in your face. Back then my trajectory was clear, and my sights were firmly set on an international career as an opera singer.

In 2015, in the midst of a successful career as a young artist, I sustained an injury to my vocal cords which would change the course of my career dramatically. After suffering months of erratic vocal changes and diminishing self-confidence, I finally discovered why things had been so difficult – years of extreme hormonal changes as a result of early menopause had left the tissue of my vocal folds vulnerable to injury.

Those physiological changes had led to unhelpful compensatory behaviours which, combined with the trauma and stress of coming to terms with the implications of my diagnosis while still performing at a high level, had led to a vocal injury in the form of a large haemorrhagic vocal fold polyp. By the time I discovered what was actually at the root of my problems I had pushed myself so far beyond breaking point that it took me years to put myself together again, vocally, and psychologically.

Kate Valentine as Fiordiligi in English National Opera’s production of Così fan tutte [Bettina Strenske]

It’s hard to convey the madness which sets in when one experiences vocal injury. As singers, our identities are so closely entwined with our instruments that it is hard to tell where one starts and the other ends. The sudden loss of this identity can be incredibly traumatic and brings with it an unwelcome cocktail of fear, shame, disappointment, paranoia and isolation.

We would never dream of blaming an athlete for injury and yet when a singer is injured, it always goes hand in hand with the belief that they must have had bad technique, or somehow did something to bring it upon themselves. This culture of blame and the stigma surrounding vocal issues is unfair, unrealistic, and incredibly harmful. To expect these delicate pieces of tissue to cope with the demands we place them under as professional voice users without occasionally becoming injured or needing time out for rest and recovery is delusional.

A light bulb went off in my head during my own muddled experience of injury and rehabilitation, and I made a promise to myself then to be part of the change – to do everything in my power to prevent others from going through similar adversity. I developed a passionate interest in vocal health and have dedicated my time since then in continued professional development, expanding my knowledge in this field so that I may educate, support and improve working environments for fellow singers.

Over the past six years I have undertaken extensive training in anatomy and as a massage therapist, in voice release massage with Luise Breyer-Aiton in Switzerland, vocal massage, manual therapy and laryngeal manipulation with Stephen King at the Voice Care Centre, as well as manual therapy for speech and swallowing disorders with Walt Fritz.

As a manual therapist, certified vocal health first aid and voice care practitioner, I now run two multidisciplinary centres, dedicated to the care and support of professional voice users. Valentine Voice Care reflects my mission to help remove the mystery and stigma surrounding vocal wellbeing and injury by creating a safe space to help all professional voice users with their journey – whichever part of the journey they are on.

The voice can be influenced by a myriad of complex factors, and vocal difficulties are rarely the result of one straightforward physical diagnosis. When looking after your voice it’s important to view symptoms through a biopsychosocial lens, considering the complex interplay between the biological, psychological, and social factors which make you human. Allergies, psychological stress, viruses, neurological conditions, muscle tension, and environmental factors can all affect the way our voices feel and function. The longer you ‘soldier on’ with compromised vocal cords the higher the chance that you will adopt compensatory behaviours and risk injury in the long term.

Alongside my work as a therapist I spend a lot of my time now engaging with the next generation of singers to educate about vocal health, sustainability and injury prevention, helping them to find autonomy, and giving them the language to advocate for themselves as artists.

The pressures of staying well as a performer are substantial and our industry is getting tougher all the time: a shrinking work pool, greater physical demands being placed on artists in the rehearsal room and on stage, complex travel and visa issues, and decreasing financial reward during a cost of living crisis make this is an incredibly vulnerable time for artists.

Although I am currently not performing, I am, and always will be, a singer. It’s in my bones. When I first discovered I had an injury I was overwhelmed with grief for what I might be losing, but over time those feelings evolved and the question became not can I still do it, but do I still want to? The way I was treated by the industry left a mark that, if I’m honest, I have never fully recovered from. Giving myself permission to stop was an interesting challenge, but the pandemic gave me the final nudge I needed. Having spent my whole life up until that point training to be a singer it felt impossible to imagine that I could ever be competent at anything else, let alone enjoy it.

Once I got over the initial impostor syndrome around retraining I surprised myself at how thirsty I was for knowledge. I discovered that I am a natural therapist, educator and thought leader. My extensive experience as a singer affords me the level of understanding and empathy that my clients so desperately need. When I was a wee girl I wanted to be an opera singer or a nurse when I grew up. There is an enormous sense of comfort and fulfilment in knowing that I have somehow ended up exactly where I was always meant to be.

The Valentine Voice Care Centre launches on 14 February in Lewes, East Sussex: valentinevoicecare.com

This article originally appeared in the Spring 2024 issue of Opera Now. Join our community of opera lovers – subscribe to Opera Now today