Sports coaches are vocally reliant, with recognized occupational risk factors affecting their voice use and vocal health. Limited prior research has cooperatively explored coaches’ experiences of vocal ergonomic factors during coaching participation. Further, no research has explored coaches vocal or broader presenteeism experiences. As part of a broader action inquiry, coaches (n = 28) in nine professional basketball teams were asked about their vocal and broader health experiences relative to coaching participation. In seven teams, inquiry dialogue with coaches explored coaches’ experiences of presenteeism, including the contributions of vocal ergonomic factors. These factors were present at various levels of coaches’ work systems, including personal factors, work activity demands, team culture, club-based factors, and sport-related factors. These discussions also revealed how gender and adverse vocal health were associated with coaches’ beliefs regarding presenteeism behaviors. Findings from this inquiry provide innovative contributions to the broader academic narrative regarding presenteeism.