– Many of us take our singing for granted. We open our mouths, and for the most part, enjoy the physical sensations
we receive from our singing. Sadly, though, this is
not always the case. For some singers, the process of singing has become a nightmare of
tension and vocal strangulation. So today, we’re going to talk about Muscle Tension Dysphonia. – [Woman] Sound check,
check one, check two. (upbeat music) – Hello everyone, Dr. Dan here with another video designed to develop your voice
and improve your sound. And today’s topic comes to us
care of Ayan Saha, who writes, “Doctor, do u have any
lessons for muscle tension?” “May be a little dysphonic but
there is an extreme tension” “Most of the time in the vocal
box and around the neck.” “Voice tremors a lot and
have to apply effort” “For proper cord closure
during singing and talking.” “Bad singing singing habits developed it” “And by the way there
is no physical damage.” now Ayan left this comment on my video How to Avoid Vocal Fold Constriction. And when I queried Ayan
further about his question, it became apparent that
he may be suffering from a condition known as
Muscle Tension Dysphonia, or MTD for short. MTD is an extreme case of constriction both inside and outside the larynx. It differs from garden variety
vocal fold constriction, because the muscles are
generally constricting in an involuntary manner, even though the voice
user is doing all they can not to activate any
extreme muscle response. And this condition may be
very frustrating and upsetting because it leads to high
levels of vocal fatigue, along with a high sense
of vocal discomfort. MTD will often leave the voice sounding hoarse and feeling dry. The reason for this is the
imbalance in the muscle activity in relation to the sound-making task. When a person is suffering from MTD, their vocal folds
over-exert and tire quickly. The tired voice then
calls upon other muscles, either intrinsic or extrinsic, to lend a hand in the sound-making. And the snowball effect, everything just gets tighter
and tighter and tighter until, in the severe cases, the voice user can feel like like they’re being strangled each and every time they speak or sing. – [Woman] Soundcheck. (cheering) – Now before we go any further,
I want to state very clearly that I cannot and I will not diagnose your vocal condition here on YouTube. In the case of Ayan, who’s question we’re bouncing off today, I queried him at length after he’d been to an Ear, Nose and Throat
Doctor for a consultation. Ayan did everything in the right order. MTD can only be diagnosed by an ENT and is typically then treated
by a Speech Therapist. Now it’s important to see the ENT first because sometimes Muscle Tension Dysphonia can be masking a more significant concern such as acid reflux or a vocal pathology, like a Vocal Fold Cyst. The only way to rule
these possible issues out is to look inside the larynx, and the only professional who can do that is your friendly Ears,
Nose and Throat Doctor. So without seeking to diagnose
your current vocal condition, allow me to provide a list of helpful tips that might help to alleviate
extreme Vocal Fold Constriction along with a vocal exercise that should help to relieve
Intrinsic Laryngeal Tension. – [Woman] Soundcheck. (cheering) – Well, quite clearly, given
that Muscle Tension Dysphonia and its weaker sibling,
Vocal Fold Constriction, are both triggered by heavy, extreme activation
of the laryngeal muscles, the first thing we’re
going to avoid at all costs is yelling and screaming. Loud phonation is a big no-no for people who struggle with MTD. I’m not just talking about parents ranting in an irate manner at their kids. Loud talking can also
occur in loud environments, like clubs and pubs where the
general audio level is high. So the first tip is to
reduce your vocal loads by always talking and singing
in a comfortable volume range. Interestingly, people who
suffer from severe constriction should also avoid whispering. Whispering teaches the muscles
to activate in a poor manner. And when you whisper, the
vocal folds don’t quite adduct or come together in a balanced way. Not good for a voice that needs to learn good muscular balance. And the third tip is to eliminate any
habitual throat clearing. That conscious little
cough that many of us have at the end of our sentences is really very abrasive
to the vocal folds, and again, brings the folds together in an abrupt, aggressive manner. The fourth tip, before
I give you an exercise to help alleviate Vocal Fold Constriction, is to always supply the larynx with an even, consistent breath stream. Sometimes we can find ourselves
finishing spoken sentences or sung phrases on the final vapor of air. This causes the larynx to
ration the remaining air supply by, you guessed it, constricting. So make sure you have a solid breath management
strategy in place. Now, to the fun stuff. The exercise. – [Woman] Soundcheck. (cheering) – The exercise we’re gonna do today is based on the work of both
Joah Still and Janis Chapman. It combines Chapman’s pre-yawn exercise with a Still suppressed laugh. Now be sure to do this
activity standing up, and pay attention to your alignment. We don’t want any toy soldiers, but equally we don’t want
any slouching, either. Now, place your thumb
and your index finger either side of your thyroid cartilage and take an even, comfortable breath. Now as you go to exhale, pretend you’ve just
heard the funniest joke but you’re in a library with strict rules about any loud noise. Now, using an E shape, commence your exhale
over a suppressed laugh. When this exercise is done well, your larynx should drop a little, and your throat should
feel quite open and free. Be sure to repeat this two
to three times each day. The exercise is teaching
the laryngeal muscles to remain free from tension. As always, I’ll be keen to hear how you go with the exercise. Perhaps you’ve struggled with
Muscle Tension Dysphonia. We’d all love to hear your
story, and how you’ve worked or you’re continuing to work through it. Perhaps you’ve got a great exercise and you can share it with all of us. I know Ayan and I will both
be keen to read your comments. Before we close, I do
want to stress once again that if you think that your voice is struggling with constriction
or Muscle Tension Dysphonia both when you talk and when you sing, or when you do either of those things, you should seek the advice of an ENT, who will be able to diagnose
your condition properly. I hope you’ve enjoyed today’s video. Please be sure to leave me a thumbs up and remember to subscribe to the channel if learning to sing is your thing. Every week I upload a new video that is designed to develop your voice and improve your sound, and I’d love for you to join
our Voice Essentials Community right here on YouTube. But until next time, I’m Dr. Dan. Sing well. (cheering)