Voice Massage Therapy

Written by:
Kristal Medina

August 24, 2009

Voice Massage is a treatment that assists all muscle groups related to breathing and voice
production through the use of classical massage strokes. It is designed to relieve tension in the
muscles so that correct posture, flexibility, especially in the area of the rib cage and diaphragm,
and over all relaxation will return. Breathing exercises and stretching may also be used.
This tension release in body and mind is necessary for balanced voice production. The muscles
that are associated with voice production are located in the middle and upper part of the body,
the chest, the neck, the face and the head. Massage strokes are tenderly applied to the area in
pain or question. The respiratory muscles and masticators as well as the tongue are also treated.
Manual pressure on the larynx or postural adjustments to the head and neck might be used
initially to establish a lowered larynx position before and during phonation. A suggestive
approach to therapy for individuals exhibiting specific muscle misuse would be the use of
inhalation/expiration to reduce anteroposterior compression. This paper will discuss various
massage modalities for the voice.
Voice massage is used for voice students to improve their training process. It is also used
for voice patients as a supportive treatment usually given in 5 sessions. Studies prove that voice
massage and voice therapy provide increased relaxation and vocal endurance. Psychological
affects are also positive because most people like to be heard and touched.
Voice Massage therapy is an appropriate therapy for the following:
1. To assist in methods of general relaxation
2. To prevent voice disorders in all persons who use their voices professionally e.g. singers,
teachers, politicians
3. To aid voice production and speech and voice therapy
4. To help wind instrument players breathing and lip positioning troubles

5. To release tension and pain in the muscles of mastication

6. To support reflux treatment by releasing tension in external throat muscles and the
diaphragm
7. To increase the effective of breathing both generally and specifically e.g. asthmatics
8. To facilitate easier breathing, swallowing and speaking for ALS or Parkinsons disease
9. To relax muscle tension e.g. computer users
10. To provide strength and improvement in breathing function in athletes
One session lasts 45 - 75 minutes, however, in some cases of very established voice and
breathing problems or exhaustion, more sessions are needed. Voice Massage is performed only
by licensed and trained Voice Massage -therapists. It is not physiotherapy, speech therapy or an
alternative therapy nor is it invasive. No equipment or heating is used. Voice Massage Therapy
was developed by Ms Leena Koskinen, a massage therapist from Finland in partnership with
medical and voice specialist, and it has been in use since the 1980's.
Another source, Paul Newman wrote a book titled An Introduction to Voice Movement
Therapy. He emphasizes the works behind pyschotherapeutics of singing and vocal expression
along with the process of voice movement therapy, which combines scientific and artistic
techniques that release the voice, body, and mind from constriction and inhibition. He explains a
history on the roots of voice movement therapy from Sigmund Freud to Alfred Wolfson. The
five major factors in holistic voice movement include: ideokinesis, breathing, enhancement,
placement, and movement massage. According to Regina Monti, (a Licensed Clinical
Psychologist) describes the controversy over actual "scientific" or "true" physiological difference
in abdominal or thoracic breathing. Vocal teachers continue to stress the significance of
breathing from different parts of the body. Locating areas of breath expansion is not only useful

to performers, but it is necessary for the balance of mind and body because two different
breathing methods have different psychological and emotional connections. Newman writes
about integrating the use of movement to "reverse unnecessary muscular habits relating to
vocalization by giving the body a new sensory experience. This can include hands on massage
to nurture the muscles, and it can provide kinetic and visual imagery which can help a client's
ability to overcome resistance to fears and restraints on vocal function.
Manual treatment for reduction of musculoskeletal tension associated with vocal
hyperfunction is increasingly becoming more evident in its effectiveness. Laryngeal Massage
Therapy (LMT) is basically a circular massage applied to the hyoid bone along its length. It
consists of rotational massage, kneading and streching of the perilaryngeal muscles. When the
supralaryngeal muscles are less resistant, the larynx is lowered by pressure applied with
both hands to the superior edge of the thyroid cartilage. Massage is then ended when the
perilaryngeal musculature has softened and when the larynx can be moved easily from side to
side by lateral digital pressure.
Laryngeal massage therapy (LMT) is directed mainly at the sternocleidomastoid
muscles at the start of the massage and subsequently at the supralaryngeal area. Clinical
experience suggests that massage of these muscles lateral to the larynx can lower the tension
which also reduces anxiety. Subsequent kneading results in the softening of the supralaryngeal
area allowing the high-held larynx to lower.
Based on technique of laryngeal musculoskeletal reduction described by Aronson,
manual circumlaryngeal therapy (MCT) differs from LMT in the following ways:
1) Clients/patients describe their vocal tract discomfort before therapy
2) Palpatory evaluation is conducted by a clinician before or during the procedure

3) Active tactile therapy is carried out by using both hands or one hand
4) Client/patient is asked to vocalize after or during therapy.
The major distinction between MCT and LMT is the MCT reveals a smaller thyrohyoid space by
circular massage in that area while LMT does not. Clinical experience suggests that after
massage, kneading, and stretching of the perilaryngeal musculature during LMT, the thyrohyoid
space suddenly enlarges as the musculature becomes more relaxed and the larynx lowers.
According to massage-shools.net, other areas of massage therapy that surround the neck
and larynx are five point schemes. These points produce effective benefits for medical
conditions.
1) Ren Ying Point is located at the tip of the Adam's Apple- anterior border of
sternocleidomastoid muscle. The benefits include regulation of blood pressure, control of
asthma, cough, dizziness, goiter, headaches, hypertension, hypotension, speech impaired,
throat constriction, and throat soreness.
2) Lian Quan Point is located at the upper border of the hyoid bone on the neck on the anterior
midline, in depression superior to the hyoid bone. Benefits include help of speech/mouth
disorders, drooling, cough, loss of voice, mouth ulcers, swollen tongue, thirst, and throat
disorders.
3) Qi She Point is located at the root of the neck, superior border of the sternal and clavicle,
between sternal and clavicular heads of sternocleidomastoid muscle; Benefits include the
alleviation of cough, neck stiffness, and throat pain.
4) Shui Tu Point is located on the neck, on anterior border of sternocleidomastoid muscle,
below to the laryngeal prominence; This alleviates treatment for sore throat, hoarse, and
throat soreness/swelling.

5) Tian Ding Point is located at the anterior margin of posterior triangle of the neck on
posterior border of sternocleidomastoid muscle, 1 fingers breadth inferior to the laryngeal
prominence; This alleviates treatment for ache because of swollen tonsils and sore throat.
Overall, voice massage and laryngeal massage therapy are beneficial to singers, teachers,
pastors, politicians, and others who use their voice frequently throughout the day. There are
physical, psychological, and spiritual benefits that can also be associated with voice massage
therapy because our voices are an extension of our emotions and souls. Vocalizing is a way of
communicating our desires to be heard and/or touched by others.

Bibliography
Aronson, A.E. 1990. Laryngeal Manual Therapy: A Preliminary study to examine its treatment
effect in management of muscle tension dysphonia. Clinical Voice Disorders. Third
edition. New York, NY.
Kokinen, Leena. Voice Massage. www.voicemassage.com/index_en.html (accessed 13 August
2009).
Laukkanen, Anne Marie, Leppanen, Kirsti, and Irma Llomaki. 2009. Self-Evaluation of Voice as
a Treatment outcome Measure. http://proceedings.1alp/S07/S07.10FinalPaper.Pdf.
Monti, Regina. Reviewed work: The Singing Cure: An Introduction to Voice Movement Therapy
by Paul Newham. Boston: Shmabhala, 1994. www.jstor/org/stable/898409
Newham, Paul. 1994. The Singing Cure: An Introduction to Voice Movement Therapy. Jstor.
Boston: Shambhala.
Point Schemes for Carotids on the Neck. 2009. http://massagetherapy-schools.net (accessed 12
August 2009).
Rammage, Linda, Morrison, Murray, and Hamish Nichol. 2000. Management of the voice and
its disorders. 2nd edition. Singular.