Have you been asking yourself: why me? Why do I have muscle tension dysphonia?
How did that happen? Well, in this video,
let me answer some of these questions so that you understand not only how you got it but
most importantly, what you need to do to start your journey to a free voice without tension.
Hi! I am Katarina, speech language pathologist 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 future videos. I have been helping people with vocal issues for
a very long time. A big portion of those people have the diagnosis of Muscle Tension Dysphonia.
And many of them have the same questions: Why me? How did this happen to me?
They are such common questions that very recently I made a whole workshop on the same
topic. And I want to share some information from that workshop right here with you.
My goal is that by understanding how Muscle Tension Dysphonia is created,
you will understand what your next step should be in finding your solution for this vocal issue.
So, first of all, what is Muscle Tension Dysphonia or MTD for short and why is it
so challenging to deal with this condition? Muscle tension dysphonia is a very common voice
disorder, more common than you would think. It is characterized by excessive muscle recruitment,
which leads to altered vibratory patterns of vocal folds and a change in voice production.
The word dysphonia means a change in voice or abnormal voicing. So, MTD is a change in the sound
or in the feel of your voice due to excessive muscle tension in
and around the voice box. MTD can sound and feel differently for different
people so therefore it seems to be so challenging to diagnose it and deal with it.
There are many different symptoms of MTD and no two people are the same in how they
sound or experience the symptoms. They can have a voice that sounds rough or hoarse, or they can
have a weak or even breathy voice. Some people may feel squeezing inside their throat when speaking,
others feel pain or lose their voice completely after 5 minutes of voice use. Yet, others may have
a clear voice that cuts out or fades away from time to time. And some people just feel tired
after a long day of talking. For others, MTD means no vocal power, for others, it’s a feeling of a
lump in the throat. As you can see, there is a huge spectrum of what MTD can look and feel like.
However, what all of these people have in common is that the vocal function
is somewhat altered. Muscle tension dysphonia is a so called
“functional dysphonia,” which means that there are usually no structural changes readily observable
on the vocal folds. Therefore, your ENT may say to you after an endoscopic exam: “Your
vocal folds look beautiful! There is nothing wrong with your vocal folds.” And that is very confusing
to many people because they can still feel that there is something going on with their voice.
But of course, things are more complicated than this because we can have a primary MTD
with pristine vocal folds and a secondary MTD with some structural changes on the vocal folds.
Confusing, right? In any case, if you are dealing with the secondary type,
you need to address both the primary reason for your vocal issue as well
as the excessive muscle tension that has developed as a compensatory mechanism.
Ok, let’s move on and let me answer this question. What causes MTD and why me?
To be absolutely honest, science does not have all the answers. We know that there are usually
several factors coming together in creating MTD. But we really don’t fully understand
why some people develop MTD and others don’t.
There are many possible triggering causes, such as irritants, upper respiratory infection such as
common cold or flu, smoking, acid reflux, excessive demand placed on your voice,
chronic illnesses, allergies, anxiety, stress or even emotional trauma and many more …
It’s never one thing. And very often, you may not even remember all of the circumstances that
led to MTD. During this initial phase, when one or more of these factors exist,
you exert more vocal effort in order to keep producing a clear voice. You may push your voice,
you may continue talking through sickness or discomfort, you may use vocal technique that
puts strain on the tissue of the vocal folds, you may use more breath pressure to speak clearly.
And over time, you develop inefficient muscle patterns when using your voice. And this new
way of using your voice becomes a habit, becomes the new normal for you. This is a gradual process.
MTD does not happen overnight even though it may seem like that. And while the initial cause
may not be present any more, the inefficient patterns remain. And you only notice it after some
time when it becomes a problem. If you can relate to this, just write ME in the comments below.
Now, let’s talk about tension. How is tension created? There is either too
much muscle action present or there are too many muscles working for a given vocal task,
including the muscles that are not required to work.
This is important to know because you want to address this when dealing with MTD. When I work
with clients, we often work with effort scales. I often ask them when doing a simple vocal task:
on a scale from 1 to 10, how much muscle effort are you using? Can you use
more or less? How would it feel? Human beings are very able at controlling how much muscle
effort they are exerting. So it is important to always check
muscle work when doing vocal exercises. Developing this awareness can be life changing.
Secondly, when I work with clients with MTD, we often work on separating the function of
different vocal structures. I told you that tension is created when too many muscles work
at the same time. By learning how to control them independently of
each other, you also decrease the tension. If you are ready to work towards a free,
strong and confident voice, you can apply to our Vocal Freedom System coaching program. Check out
the links in the description below this video. Now, let’s talk about the treatment of MTD.
The first line of treatment for muscle tension dysphonia is voice therapy. It's not
vocal rest. It’s not drinking more water. And it’s not steaming. These are some very basic things
that may be beneficial but if you are not doing some kind of voice therapy or rehabilitation,
you are not dealing with MTD. You may also be asked to pursue other treatments
that aid in tension release, such as massage therapy, acupuncture,
psychotherapy or physical therapy, at the same time you are receiving voice therapy.
There are two main goals of voice therapy: reduction of tension and improvement of vocal
efficiency. How do you do that? Well, there are several approaches. But these are three
big areas that I work on with my clients, who are very successful at finding more vocal freedom.
#1 Tension Releasing Techniques
Techniques that release muscle tension. Very logical. You have too much
tension so you work on reducing it. This can be a manual approach,
vocal exercises or mindfulness exercises. Yes, mindfulness exercises. I have to
make another video just on the topic of the amazing benefits of mindfulness exercises.
#2 Techniques to Develop Efficient Motor Patterns
As I said before, it is not enough to rest your voice and hope for the best,
or hydrate or steam and hope that the pain when speaking will go away. The
only way to really deal with MTD is to re-learn or develop vocal patterns
without tension. This is a process and it takes time. It’s not a quick fix.
#3 Vocal Endurance and Strength Building Exercises
Finally, techniques to build some stamina and strength so that you
can use your voice for as long as you need it as well as in high demand vocal tasks such as
talking in a group of people, presenting in front of an audience or yelling across the room.
As you can see, there is no one quick exercise or answer because
complex issues require complex solutions. However, I made a video, in which I walk
you through 7 steps that lead to a strong voice without tension.
If you want to know what voice, body and mind considerations you need to take
to truly free your voice, click the link in the description below this video.
If you found this video helpful, click the like button and share it with your friends.
Check out my other videos on the topic of MTD. I hope to see you soon. Bye.