Muscle Tension Dysphonia
Disclaimer: I am a speech pathologist and singing voice specialist; however, I am not your speech pathologist or singing voice specialist. Please seek evaluation by a laryngologist if you believe you have a vocal issue requiring treatment. If so, the laryngologist may refer you to a speech pathologist for voice therapy.
Want to learn more about how to care for your voice and keep it healthy? Consider taking my course on vocal wellness!
What Is Muscle Tension Dysphonia?
Muscle tension dysphonia (MTD) is one of the most common things I treat as a voice specialist. In a nutshell, MTD is when extra muscles are recruited to make your voice happen. It causes the voice to sound rough and/or strained and reduces vocal stamina.
MTD can be primary (meaning it’s the only thing that is making your voice decline) or secondary (meaning there’s something additionally wrong with your vocal anatomy). Either way, the extraneous muscle tension that is being used is your brain’s way of trying to fix the problem, and force the vocal folds together.
What Causes Muscle Tension Dysphonia?
When your brain recognizes something is wrong with your voice, the brain subconsciously tries to “fix” your voice by using extra muscles. The problem is the brain chooses to use muscles that aren’t meant to be used for voicing – they’re usually swallow muscles. So, even if the cause of the initial voice change is temporary – perhaps you had a cold and did a lot of coughing, causing the vocal folds to swell and not vibrate as well – the brain sometimes continues to hold on to that muscle pattern. This causes your voice to remain strained despite the return to normal vocal fold vibrations.
What Is the Treatment for Muscle Tension Dysphonia?
This condition frequently requires voice therapy to re-align the subsystems of voicing. Our voices require the coordination of 3 different subsystems. The first is respiration – breathing and being able to meter exhalation. This is the power we use to cause the vocal folds to vibrate. Our next subsystem is phonation, which is caused by the vibration of the vocal folds. This is dependent on our vocal folds being healthy and pliable to be able to produce a smooth vocal tone. Finally, resonation, which is use of our mouth, nose, and throat to project our voices. These structures act like the organ pipes of our voices and allow us to change the way our voices sound.
If I took vocal folds out of the human body, and put them on a bench to blow air through them, they would buzz. What makes our voices sound like our voices, is the unique structure and use pattern of our mouth, throat, and nasal cavities. I can make my voice sound as if I have a cold if I close off my soft palate so that no air is getting through my nose. I can also make my voice sound really hyper nasal if I let extra air through my nose. And finally, I can make it sound normal by balancing how much air and voice is going into my nasal passages as opposed to my mouth and throat without constriction. If you constrict the throat, the voice sounds “strained.” This strained sound is a classic sign of muscle tension dysphonia.
See a Laryngologist for Diagnosis First
Before seeing a speech pathologist (hopefully one who specializes in voice), it is important to have a laryngologist evaluate your vocal folds to determine if your voice problem is primary muscle tension dysphonia or secondary to some other type of vocal fold pathology. If voice therapy is warranted, the laryngologist will send you to a speech pathologist- they may even have a voice specialist speech pathologist working closely with them as a voice team.
Was this explanation helpful? Let me know your thoughts in the comments! For more information about hoarseness diagnosis and treatment, I’d recommend checking out this site.
Want to learn more about how to care for your voice and keep it healthy? Consider taking my course on vocal wellness!