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muscle tension dysphonia/laryngeal massage

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Hi there. I am a 39 year old teacher and (former?) singer. I'm hoping to find some encouragement from anyone who has had any success with treatment for muscle tension dysphonia.

I have been having voice issues since October of 2010. I have seen three doctors and received three different diagnosis...but MTD is the one that makes sense to me. I'm seeing my fourth doctor next Friday. I've worked with two different speech therapists without much success.

Recently, I've read some good things about laryngeal massage. I've also read about topical lidocaine and botox. Everything else seems to be speech therapy. Does that check out with other people's experiences/expertise?

I'm very frustrated and discouraged. My voice has been bothering me a lot lately. I'm an elementary school teacher, so I'm speaking all day long. I've been using a microphone and that does help, but it is still a strain.

I miss singing. I've sung since I was a little girl. Singing is just...well, I'm not going to try to explain the experience of singing to a bunch of vocalists ;) Anyway, it's been my greatest joy. Right now, it usually hurts when I sing. When it doesn't hurt, it still feels strained and one dimensional.

Any encouragement/information would be greatly appreciated.



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Hi, motojj.

For persons who use their voice professionally, its quite often the case that problems arise. There are exercises you can do to help your voice rest and return to better function.

Here is a link to a discussion and video about such an exercise, from Dr. Ingo Titze of the National Center for Voice and Speech.


This exercise is based on the physical principle that phonating with air resistance at the lips changes the muscular action of the phonation. All the semi-occluded voiced consonants (V, Z, french Je, lip buzzes, etc) will have the same effect.

I do them every day, in sirens, as warm-ups for the day's speaking and singing.

Let us know how things progress.

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Most speech therapists (like me) who get referrals from good laryngologists are experienced with singing and singers' concerns, so you need not be afraid that all we do are tongue-twisters.

Speech (voice) therapy for MTD typically includes laryngeal massage, and numerous other exercises designed to relax and re-balance throat muscles. Singing-derived exercises, breath work, stress management counseling, and other aspects of whole-person-rehab get mixed in as needed.

I hope this helps -- no need to despair!

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