Why Is Muscle Tension Dysphonia Happening To Me?

Have you been asking yourself: Why me? Why do I have MTD? How did that happen? 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.

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.

What is Muscle Tension Dysphonia?

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.

Symptoms of MTD

There are many different symptoms of MTD and no two people are the same in how they sound or experience the symptoms:

a voice that sounds rough or hoarse,
a weak or even breathy voice,
a feeling of squeezing inside the throat when speaking,
pain when speaking,
a loss of voice completely after 5 minutes of voice use,
a clear voice that cuts out or fades away from time to time,
a tired voice after a long day of talking,
no vocal power,
a feeling of a lump in the throat,
and many more ...

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.

What causes MTD?

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:

irritants,
upper respiratory infection such as common cold or flu,
smoking,
acid reflux,
excessive demand placed on your voice,
chronic illnesses,
allergies,
anxiety,
stress,
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.

How Does MTD develop?

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.

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. Click here to schedule a chat with me.

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.

Link to the video: https://youtu.be/FtHREHsCeeo

ERIN

"Katarina, this is an excellent unit on becoming aware of habits that might prevent efficient use of one's voice. For years I probably engaged in all of these harmful behaviours and it really took a toll on my ability to sing. It has taken me about 10 years to learn to fix a lot of these problems."

FEDERICA

"Katarina, if you didn't exist, one would have to invent you! You have helped me overcome and solve problems that I struggled with for the last eight years, and in such a sound, graceful way. Your lessons make complete sense and they are really helping me improve so quickly."