What is Muscle Tension Dysphonia, and Can it be Treated? A Crib Sheet.
Updated: Dec 22, 2019
Muscle Tension Dysphonia, or MTD, is fairly common; in the vocal pathology sense of the word. A couple of new students told me they’ve been diagnosed with it, so I decided to spend some time reading up on the pathology.
Luckily, now you don’t have to, because what follows is a 500-word crib sheet. I also included a few helpful links at the end.
MTD can happen to anyone.
It can happen as a result of another pathology, or it can be a free-standing pathology.
It’s almost impossible to tell where it came from once someone has it.
It can be either MT – muscle tension – in which the muscles are over-contracting, or
It can be D – dysphonia – in which the muscles lack coordination, leading to a mis-timing of vocal fold vibrations
Once a singer is warmed up, MTD seems to go away.
That makes it easy to ignore, and that may be ok.
Sometimes it doesn’t get any worse.
But sometimes it does.
There haven’t been any studies that show how people acquire MTD, but there are suspicions.
For instance, teachers are the biggest group of people who get it. That makes voice people think that it’s either from overuse, because teachers talk a lot and often loudly, or from misuse, because teachers talk even when they shouldn’t (laryngitis, overuse, fatigue) or both.
Here’s a list that will narrow it down for you. But not much.
You can acquire MTD as a response to external stimulus, like excessive talking, second-hand smoke, or excessively dry conditions.
You can acquire MTD as a response to internal situations, like acid reflux, stress, lack of sleep, or upper respiratory infections.
MTD can be a response to an underlying vocal fold problem.
Here’s a list of symptoms. This list makes me think that the reason MTD doesn’t get diagnosed early is that these symptoms could apply to many other things as well.
A fluttery sound in your singing when you start to warm up or sing “cold.”
Hoarse or raspy voice
Whispery or breathy voice
“Holes” in your sound, where your voice cuts out for a second
Feeling you have to speak higher or lower than normal
Feeling dry or scratchy
Feeling your voice is tired or aching after you’ve been speaking or singing
A feeling that you’re having to work hard to make sound
MTD is especially bad for singers. We’ll only notice it when our voices are “cold.” Once we’re warmed up it seems to go away. That makes it easy to ignore, of course, and that may be ok. Sometimes it doesn’t get any worse. But sometimes it does. Better to get scoped by an ENT who specializes in singers if you even suspect anything.
One thing health professionals in the World of Voice agree on; the sooner you can start treating MTD, the easier it will be to fix. Once it’s set in, it’s more difficult to change the behavior. They also agree that any other voice problem will very often result in a greater or lesser degree of MTD.
Treatment for MTD, it seems, is the same for treatment of any other type of condition that cannot be fixed in the typical Western medicine way - with a pill or surgery - you have to try stuff until you find something that works.