Mechanical stress is always encountered in phonation. This includes tensile stress, shear stress, impact stress during collision, maximum active contractile stress in laryngeal muscles, inertial stress, and aerodynamic stress (pressure). Order of magnitude calculations reveal that tensile stress can reach the greatest value (near 1.0 MPa), contractile stress is next in size (near 100 kPa), and aerodynamic stress is relatively small (1-10 kPa). Inertial stress and impact stress are greater than aerodynamic stress, but less than contractile stress. Excessive collision and acceleration may be responsible for the greatest tissue damage, even though they do not account for the greatest stresses. This is because they act perpendicularly to the direction of tissue load-bearing fibers and are applied directly to mucosal tissue.