Transcription
In my last video, I was talking about muscle tension dysphonia, causes, common symptoms, and the diagnostic process. In this video, I am going to talk about muscle tension dysphonia treatment options. Stick around, and we’ll start right after this.
Hi! I am Katarina, a speech-language pathologist from How 2 Improve Singing. And here on this channel, I share practical tips about using your voice in a healthy way. So, if this is a topic that interests you, consider subscribing to this channel and hitting that bell notification icon so that you don’t miss any of my videos.
So how do you treat muscle tension dysphonia, or MTD for short? The good news is that primary MTD responds really well to voice therapy, which should be the gold standard for treating this condition. The length of therapy depends on several factors and can last from a few weeks to several months or longer. The goal of therapy is to decrease or eliminate tension so that the laryngeal muscles can work efficiently again.
It is important to know that this video offers just an overview of possible treatment options and should not be replaced for an individualized and personal treatment plan developed by an experienced speech-language pathologist. As I said in my previous video, people with muscle tension dysphonia have very different manifestations of this disorder, and their treatment needs have to be developed based on their individual needs. It may be necessary to treat underlying or contributing factors, as well as the voice itself. For example, if MTD developed secondary to vocal fold lesions, the ENT specialist may suggest other treatment options, such as medication or surgery. Or if acid reflux or emotional stress is a contributing factor to MTD, then these conditions should be treated appropriately.
The role of a speech-language pathologist is important in the therapy process. I personally like to use the ALERT framework. Each letter of this word stands for an area addressed in voice therapy. Let’s go through the letters together:
A STANDS FOR ANATOMY. During the diagnostic process of MTD, the voice specialist should get a very clear picture about the anatomy and function of the vocal instrument. This is done through a videostroboscopic examination. Based on the findings, it may be necessary to consider medication or surgery in some cases.
L STANDS FOR LIFESTYLE. In this area, you need to identify behaviors and lifestyle factors that contribute or are responsible for MTD. This may include adjusting your daily schedule to decrease vocal use, get enough sleep, eat a healthy diet including sufficient hydration, improve overall vocal health, or identify and eliminate harmful vocal behaviors. The most dangerous vocal behaviors are those that we don’t know we are using in our every day lives. And, you can discover some of these behaviors by clicking this link and downloading a checklist of vocal abusive behaviors.
E STANDS FOR EMOTIONS. Emotional stress and anxiety are well-recognized causes of MTD in many people. The speech-language pathologist may help you identify these factors. She or he may offer some relaxation, breathing, and mindfulness techniques to deal with some of them. Sometimes, it may be necessary to work with other professionals to treat them.
R STANDS FOR REFLUX. Reflux can be a triggering factor of MTD. LPR, or laryngo-pharyngeal reflux, is very common in people with voice disorders, and therefore it has its own special letter in this voice treatment framework. So, in order to eliminate tension, you need to start managing acid reflux with the help of your doctor.
AND FINALLY T STANDS FOR TECHNIQUE. This is the core of voice therapy. The speech-language pathologist may use different approaches and techniques to eliminate tension from the vocal mechanism and establish and promote more efficient ways of sound production. Here are three examples:
#1 Establishing optimal body and head and neck alignment. Body and neck misalignment can lead to MTD because the muscles have to work from a mechanical disadvantage. Simply, muscles have to work harder if your posture is not optimal.
#2 Improving breathing patterns and coordination of breathing with the phonatory system. People with MTD are known to have altered breathing patterns and inefficient breath control. Therefore, a huge part in voice rehabilitation is working on developing good breathing habits. My channel has many videos on this topic, so make sure to watch them.
#3 Vocal exercises to establish and strengthen healthy voice use. Some examples of very specific techniques are Vocal Function Exercises, first developed by Dr. Stemple; Stretch and Flow Phonation exercises, first introduced by Dr. Stone; Resonant Voice Therapy; or semi-occluded vocal tract exercises, and more specifically, straw exercises or tube phonation exercises. If you know me a little bit, you know that I am a big fan of straw exercises, and you will find more videos with these type of exercises on my channel. So, don’t forget to check them out.
Bonus tip: Muscle tension dysphonia massage is a very popular and common approach to therapy of MTD. The goal is to reduce tension from the superficial laryngeal muscles, which in turn reduces tension from the muscles inside your larynx. This technique has many names, such as laryngeal massage, manual therapy, circumlaryngeal massage, and many other names. I made a whole video on this topic, so feel free to watch it. I will link to it at the end of this video.
Even though these techniques are very different, they have many things in common. The goal is to take away pressure from the vocal folds and redistribute vocal effort to all participating structures. These techniques use vocal exercises like humming, buzzing, phonating on the vowels /i/ or /o/, on fricatives Z or V, or phonating on NG like in the word sing. And they start in the most comfortable range and slowly progress to include a wider vocal range through stretching vocal exercises such as slides or glides. Many of these techniques work directly with breath management in coordination with laryngeal muscle use.
And that is all for this video. Check out my other videos right here below, and don’t forget to subscribe for more videos about healthy voice use. I will see you soon.