The fall, which required Underwood, 35, to get more than 40 stitches, occurred around the same time she was recording her sixth album Cry Pretty.
During a recent interview with Vulture, the “Before He Cheats” singer opened up about how the accident took a toll on her mentally and physically.
“I felt like the differences were more in my head than they were in anybody else’s that would listen to the things I was doing. I had wanted to be in the studio sooner than I was, actually recording these songs, but I had stitches inside my mouth, outside my mouth. It was physically impossible,” Underwood told the outlet.
“Going into the studio for the first time, it was a mind game: ‘Do I sound the same? Is my diction the same? Does my mouth move the same as it did before?” Underwood recounted.
“I would sing something and then look at David [Garcia] and be like, ‘Did that all come out clearly?’ My m’s and b’s and p’s were kind of the issue. And he was like, ‘I thought it sounded great,'” the Grammy award winner said of her producer.
While it was difficult for Underwood to initially accept that her injury had an effect on her vocals, she’s now come to accept it.
“Things change just as you get older; muscles change. I kind of expect I’m not always going to sound like I’m 22 coming off of American Idol. Hopefully, I get better,” Underwood, who recently announced she and her husband Mike Fisher are expecting their second child, added.
In November 2017, just a few days after hosting the CMA Awards, Underwood fell on the steps outside of her home, a rep for the singer told PEOPLE in a statement.
In addition to suffering the abrasions to her face, Underwood also broke her wrist.
For a while after her fall, Underwood kept a relatively low profile telling fans “I may not look the same.”
However, she is now back to her country best. In June, Underwood and Fisher made their first red carpet appearance together since the accident at the CMT Awards where she won her 18th CMT Award.
Underwood was also selected as CMTs Artist of the Year in October and scored an American Music Award for Favorite Country Female Artist also in October— in addition to releasing Cry Pretty in September.
Underwood and Brad Paisley will co-host Wednesday’s CMA Awards, airing at 8 p.m. EST on ABC.