After the Session: Working with Muscle Tension Dysphonia with Dr Claire Thomas

How can singing teachers support singers experiencing muscle tension dysphonia (MTD), particularly when they are returning to singing after voice therapy? In this practical short course, Dr Claire Thomas explored how teachers can help singers rebuild efficient vocal coordination, return to performance demands and reduce the risk of recurring difficulties.

Rather than focusing solely on the clinical aspects of MTD, the session centred on a key question for singing teachers: what can we do to support the singer in front of us?

Understanding our role as singing teachers

A central theme of the session was the importance of recognising professional boundaries. Singing teachers are not responsible for diagnosing or treating voice disorders, but they play a valuable role in noticing changes in vocal function, supporting efficient singing behaviours and recognising when clinical input may be needed.

Dr Thomas emphasised that symptoms such as vocal fatigue, loss of range, unreliable register transitions, discomfort and reduced stamina should not automatically be attributed to MTD. Persistent or worsening difficulties may require further assessment, and collaboration with speech and language therapists and other clinical professionals can help teachers support singers safely and effectively.

From voice therapy back to singing

For singers who have received clinical treatment, returning to performance can involve much more than regaining a comfortable speaking voice. They may still need to rebuild their upper range, registration, sustained phrases, vocal stamina and ability to meet the demands of repertoire, acting and movement.

Dr Thomas introduced a gradual, singer-centred approach: reduce unnecessary effort, establish reliable coordination, rebuild singing tasks and progressively increase performance demands. Rather than applying a universal sequence of exercises, teachers should observe how each singer responds and adapt their approach accordingly.

Practical strategies for the voice studio

Throughout the session, participants explored practical ways to assess vocal effort and encourage more efficient coordination. These included gentle body-awareness activities, breath work, semi-occluded vocal tract exercises (SOVTs), humming and glides, alongside strategies for gradually reintroducing pitch, vowels, lyrics and repertoire.

An important takeaway was the need to assess not only how a voice sounds, but also how much effort it takes to produce that sound. A singer may appear to be performing successfully while experiencing considerable discomfort or fatigue. By checking in with the singer and testing how an exercise transfers into actual singing, teachers can make more informed decisions about what is helping.

Dr Thomas also highlighted the importance of managing vocal load. Rehearsal schedules, repeated full-voice singing, speaking demands, insufficient recovery and the physical demands of performance can all influence vocal function. Strategies such as marking during rehearsals, pacing vocal use and allowing adequate recovery can help singers manage these demands more sustainably.

Building confidence through informed choices

The session reinforced that supporting a singer with MTD is not about finding one perfect exercise or encouraging them to push through difficulty. It is about understanding the individual, recognising when something changes, identifying the point at which a task becomes more demanding and returning to the last comfortable, successful step when necessary.

By combining careful observation, collaboration with clinical professionals and gradual, evidence-informed teaching strategies, singing teachers can play an important role in helping singers rebuild confidence and return to the demands of performance.

Explore upcoming short courses with Voice Study Centre to continue developing your knowledge and practice in voice pedagogy.