By Duke Medicine News and Communications

With the ACC tourney gearing up and March Madness getting in full swing, basketball fans are topping decibel charts with their verbal support for their favorite college team.

Unfortunately, all that screaming won't help any player score a goal. It could, however, do temporary or even permanent damage to your vocal cords.

"Too much screaming can change the quality of your voice, your ability to use it how you want to, and even put you at risk for losing your voice's natural sound," says David L. Witsell, MD, Director of Duke University Medical Center's Voice Care Center.

Enthusiastic sports fans aren't the only ones who should be concerned. Millions of professionals including lawyers, teachers, clergy, singers, actors and other professionals rely on their voices daily for their occupation.

And, misuse or abuse may partly explain why nearly eight million people have vocal problems, according to the National Institutes of Health.

Your voice is the sound that's produced when air passes through the vibrating smooth muscle of the vocal cords, explains Witsell.

"Problems are often due to overuse or straining the vocal cords excessively," like excessive talking, throat clearing, coughing, inhaling irritants, smoking, screaming or yelling. Individually or collectively, they can cause the vocal cords, which are housed in the larynx, to become irritated and inflamed.

Once strained, a normal voice can quickly turn into the breathy, raspy sounds associated with laryngitis. In some cases, vocal nodules or calluses form on the cords, making a person sound hoarse, low-pitched and slightly breathy. Witsell says a similar-sounding voice can result from vocal growths, or polyps which are more like soft blisters.

In some cases, people who project too hard or use too much force when speaking may end up with painful ulcers or sores that result when the tissue on or near the larynx that helps the cords move, wears away.

While eliminating bad vocal behavior is a good first step, it may be too little, too late. Sometimes therapy is required to help individuals adapt good vocal techniques.

In other cases, medication and possibly even surgery may be required.

But none of this means you have to root for your team in silence. "You can be loud, cheer joyfully and clearly when you support it all with good breathing techniques and good hydration," Witsell says.

Below, more tips on how to prevent vocal problems before they start:

• Drink at least two liters of water per day, minimize caffeine and alcohol consumption (no more than two servings each per day). "Dry vocal cords don't vibrate well and are more likely to become injured," says Witsell. Decongestants and antihistamines can also dry out your vocal cords so avoid them too. Ask your doctor about nasal treatments for allergies.
• Don't strain your voice to be heard in noisy situations.
• Don't smoke. "It bathes your vocal cords in a harmful irritant," Witsell says.
• If you have acid reflux, consult your doctor for medication, avoid acid-producing foods (citrus, spicy foods, fried and fatty foods, caffeine, carbonated beverages, etc.) and wait three to four hours before lying down after a meal.
• Take 15 minute "voice breaks" three to four times per day if you have to use your voice a lot for work, singing, family interactions, etc.
• Avoid talking, singing or screaming your team support if you have a cold or laryngitis.
• Pace your voice use: Rest your voice before and after a big talking day (or a night at the game) -- don't push your voice beyond your limits of range, loudness or endurance.
• Learn to use your speaking voice in a healthy way by consulting a voice trainer or voice therapist.
• If you are a "professional talker," warm-up your voice before using it and consider taking voice lessons to learn how to maximize the efficiency of your vocal technique.