A rare case of LDP only when inhaling

I treated a Man who had the issue of a firm larynx that goes into a deep position when he inhaled.
The Man expressed to me how he was bothered by this issue with every breath he took.
He went to see a Doctor of respiratory medicine because he thought he had an apnea syndrome. That doctor told him that there was no problem with his throat. He then sought a second opinion, and came to my Voice Care Clinic.
I measured the stiffness of the musculus extrinsic laryngis using a hardness tester.
I got the following results:
Without voice:29tone
With voice:38tone
When exhaling:33tone
When inhaling:61tone!

I was so surprised at the numbers this Man displayed. The level of stiffness was so high, and strangely only when he inhaled.
When I listened carefully when he inhaled, I could hear an inward air sound in the form of a ‘Hyu’ from him.
He seemed to be inhaling with the utmost strength!
He stated that it has been hard for him to breath for as long as he could remember. In other words a really long time, this was not a new issue.
Digging deeper into his history was not easy, but after going through a lengthy checklist of probable causes, we discovered that the root of the problem started when he was kid. He avidly attended swim class and his personal swim coach always told him to, ‘Inhale air as strong and deep as you can when taking a breath before going under the water.’
Taking his swim training very seriously and to prove dedication, the Man began inhaling air in this extreme nature with all the strength he had, every breath … even when he was not swimming.
Due to his intense swim training, this Man unknowingly created a habit of inhaling air too strong in his daily life. He could exhale properly at a normal rate, in which air would still exit his lungs automatically without any strain.

It was a long road of over several months of recovery training, but I eventually was able to rehabilitate this Man.
After I cured him, the final result of the level of stiffness of his musculus extrinsic laryngis went to down to 30tone.
He used to feel a sensation of choking when he was sleeping, which would wake him up suddenly. Now, not only can he can sleep well after fixing his stiff muscles, but most importantly he can take a breath normally when inhaling without making a ‘Hyu’ air sound anymore.

Note:This rare case of Inhalation LDP was an learned/acquired habit of the musculus extrinsic laryngis, not a disease.

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Flexion reflex of the muscles relating to vocalization

A handful of my patients at the clinic over time have said to me, “I feel like my throat is more stiff than normal and have a feeling of choking/coughing. This problem started soon after an ultrasonic treatment was applied to my throat at another clinic/medical office.”
In most of the cases I have encountered, the irradiation intensity of the ultrasonic treatment previously used did not fit the individual’s muscle needs. Such as being too strong. When the degree is not accurate, I believe ‘flexion reflex’ of the muscles relating to the vocalization occurred, causing those issues.

‘Flexion reflex’ is triggered by stretching and massaging the larynx intensely, and must be taken into consideration during massage and ultrasonic treatments. The flexion reflex is a sudden automatic withdrawal movement occurring in response to a stimuli, and effected by the contraction of the flexor muscles of all the joints on the same side.

The muscles relating to vocalization are really small. If those muscles take too much of a powerful force suddenly, they tend to shrink reflexively.

Our experienced clinic uses special ultrasonic methods for treating the throat. These treatments are for available for vocalists looking to improve their voice or individuals who wish to target an area of a pre-existing condition or issue of the throat. The results sought as well as what we have seen are positive, showing increased flexibility of the muscles (impacting vocal range and muscle strength) and improved blood circulation.
The process of massaging the larynx is very detailed and precise! This is because you have to stretch each muscle fiber one by one gently and carefully. A process, both myself and colleagues at my Tokyo based Voice Care Clinic take pride in.

Of course, to have successful results from such treatments the Clinic and Professionals must have the vast knowledge of the neck and throat muscles as well as a subtle sense of touch. If you move the vocal muscles too forcibly, the larynx will shrink toward the cervical spine and cause (Larynx Deep Position) LDP.

Note:The flexion reflex is often caused by those who massage their larynx by themselves, making the muscles stiff and obstructing letting their voice out.
Amateur self massage of the muscles relating to vocalization almost always causes some muscle damage, more often to the myofascitis and the subluxation of the arytenoid cartilage. So, please be careful, and aware of the muscle mechanics involved as well as the risks.

Laryngeal stress, what would cause a choking feeling?

If you feel a choking in your throat, please go to the otological hospital or to a certified respiratory medicine specialist. If either of those Doctor says that there is no problem, I believe you have the condition, LDP.
LDP stands for “Larynx” “Deep” “Position.” It is a habit of rigid muscles. It is ‘not’ a disease.
The larynx, hyoid bone, thyroid cartilage and the cricoid cartilage get into a deeper or lower than normal position. That action causes an uncontrollable choking reaction, because the musculus of the extrinsic laryngis shrink towards the cervical spine.
Muscles will also become immobile, shrinking and stiff often in the wrong position.

LDP is caused by muscle hypertonia, stress, wrong vocalization, self massage, laryngeal trauma, and asthma or respiratory disease.
Stress is an especially serious problem. In recent studies, LDP has been found in individuals who suffered stress from bullying or harassment at school or an office. In these studies’ followups, after the individual’s throat has healed from whatever injury or stress it has been exposed to, they mostly always still have LDP.
If an individual has had LDP for a long time, the stiff muscles cannot go back into their normal position quickly.
At our clinic, Aida Voice Care Clinic, I have cured a lot of people who have LDP, using my proven treatment solutions for individuals with LDP.
Our treatment methods find the muscle fibers of stiffened throat muscles, and stretch and massage those muscle fibers one by one to acquire flexibility.
After the muscles seem flexible from manual massage or our massage equipment, we adjust the larynx by slightly pulling to put it back into its normal position.

There are of course variations to every individual’s treatment of LDP. Some are becoming better and recovering after only 2 or 3 treatments, whereas some never get better even after taking treatment for 2 to 3 years.
These cases outcomes are so different because the musculus extrinsic laryngis cannot be repaired easily and has a known habit of going back to being stiff.

Note1: When eating or drinking with LDP, the pharyngeal constrictors (the middle constrictor and inferior constrictor only) muscles stiffen, obstructing the throat, which affects swallowing.

Note2:LDP puts an individual’s hyoid bone into a deepened position, obstructing the epiglottis making it stand up. This specific condition has been known to affect many Opera Singers, making them unable to sing the bel canto.
A famous case comes to mind of the late influential Opera Singer, Maria Callas. When she was at her peak, after examination her whole larynx looked forward. In contrast to when she had a slump in singing, her larynx showed having a stuck tension in a deeper than normal position. Please see ”Maria Callas:Investigating changing her voice” for more details of this renowned Opera singer.

Stretching the vocal cord muscles

A fact about the vocal cord muscles us that they contract but cannot extend by themselves. These muscles also
do not relate to opening and closing the glottis.
If your vocal cord muscles become stiff, your voice will have the following issues:
1. Difficulty controlling pitch
2. A narrow voice range
3. Difficulty letting out the falsetto (the upper register of the human voice, the opposite of a chest voice)
4. High register producing a metallic sound
5. Easy to leak breath out (common hoarse voice)

Remedy: You need to stretch the vocal cord muscles to acquire flexible movement.
I recommend this method of taking hold of the thyroid cartilage, move it up and down to contract and elongate the vocal folds.
At my voice care clinic we usually do this stretch without making any sounds or using the voice, but if you do it with letting out the voice, it’s really easy to let out the high register voice.

Note1:Please be responsibile if you stretch by yourself. Take stretching slow and gently.

Note2:A singer once told me, “I can let out my voice and only move the left vocal cord.” We checked his vocal cord by using an optical fiber scope when vocalizing, and confirmed that both of the vocal cords were completely moving! The singer’s claim had been proved wrong. After all, we cannot move the vocal cord at will.

Note3:Many vocal Coach’s often say “You can stretch your vocal cord, when you let out your voice.” But, this is not true! It is impossible to contract and elongate the vocal folds when vocalizing.
However, you can train the muscles related to move the vocal folds if you vocalize a lot. Although, this action is not stretching, it is the same action as when you are running or swimming.

Doing something while listening to music: The influence of multitasking

It’s common for people to multitask during their day to day routines. More often relating to adding music or sound to an activity … it’s doing two things at the same time such as walking while listening to music, watching TV and eating a meal or studying with music.
There are pros and cons to doing something else while at the same time listening music.
\Pros:
1.You can relax or become more motivated do something when listening to one of your favorite songs.
2.You can memorize the song quickly.
Cons:
1.You get distracted and possibly unable to focus on doing your work.
2.You might not the memorize lyrics or melody correctly because you cannot focus solely on listening to the song.
I think everyone has experienced this before, learning the wrong melody or rhythm because you heard a song for the first time when you were busy doing something else.
It’s common with learned lyrical errors, that after they’re learned for the first time, the individual always sings incorrectly at the same part even if they practice singing the song over and over again.
This issue is specifically caused by what is known as ‘the mirror effect.’
The mirror effect is when an individual memorizes music naturally from only listening to it. This is done subconsciously, and the listener can reproduce the sound.
However, this does not mean or guarantee the listener can memorize the sound correctly! If the lyrics or rhythm is learned or heard wrong it will be repeated back wrong. This is the biggest con of learning music when multitasking.
Multitasking definitely influences your learning and singing! If you listen to a song while doing something, please be aware of that.
Focusing on listening to a song over and over again many times is the best way to learn a song, if you really want to sing it well.

Note1:I generally use the term, “listen,” when I refer to focusing. This means to capture every sound carefully as well as hear it.

Note2:There are individual variations about the mirroring effect. Some amazing people can memorize a song perfectly even if they listen the song while doing something else at the same time. And, some people cannot memorize the song at all even if they listen to the song over and over again.

Urban legends of Vocalization

There are a lot of rumors and urban legends which we don’t know for sure are true or not about vocalization. I’ve picked out some of the most common rumors and urban legends about vocalization, and will review them below:

1.Lifting up the soft plate is good when singing
Even if you lift up the soft palate, the resonance chamber won`t increase significantly because the soft palate is very small.
Many people worry when they are lifting the soft palate. They start and then second guess themselves and worry they could be controlling the hard palate.
The truth of the matter is, that it is impossible to lift the hard palate up because it is composed of hard bone.
Most people press the tongue down when expanding the oral cavity to make more space in the oral cavity when they are trying to lift the soft palate. I believe this is referred to to lifting the soft palate down.

2.Showing your teeth is good when singing
I sometimes hear that the voice sounds better if you let out your voice while still showing your teeth.
In a study I ran, I asked one group to show their teeth all the time and another group not to show their teeth at all when singing.
As a result, I concluded that if you show your teeth all the time when singing, you do in fact contract the cheek muscles as well as the corners of mouth go upward which do make the voice sound better.
If you do not show your teeth at all when singing, the orbicularis oris muscle becomes stiff and you cannot move your lips easily, which makes the voice sounds boxy or worse. Therefor, showing your teeth is better than not when singing.

3.Pulling your throat down is good when singing
The purpose of this method is to expand your pharyngeal cavity vertically to improve your voice. Although there are some problems and risks to consider when doing this.
The larynx is suspended by each the right side and left side of the stylopharyngeus muscle and the stylohyoid muscle(stylohyoid ligament).
If you pull the throat down too much, these muscles or ligaments are really extended and could deteriorate your vocalization.
Furthermore, if you use/perform this method too much, it is possible to rupture the stylopharyngeus muscle.
The actions in this method also obstruct the cricothyroid articulation from moving freely, because you have to contract the sternohyoid muscle or the thyrohyoid muscle forcefully when pulling your throat down.
These actions make it hard to control your tone’s pitch or the high register.
I would like to recommend you to expand the pharyngeal cavity forward but not downward, and then the move the hyoid bone forward while at the same time keeping the epiglottis standing up to increase the flow of exhalation.

4.Singing and warming of the throat
I hear often people want to heat up their larynx deeply because it is commonly known that the performance of vocalization is deteriorated if the muscles get too cold.
However, if you heat up too much, the movement of muscles become sluggish. It is because of this reason that I do not recommend to heat up your muscles too much or use extremely hot/burning tempertaures.

5.Dance is not good for the voice
The shock vibrations from the ground and movement is suspected to burden the vocal chords when dancing and singing at the same time.
I have confirmed through studies that even if you bring pressure or vibrations to the throat, by way of dancing movements it does ‘not’ negatively influence the performance of the vocal folds.
However, if you sing a song when you are landing from a jump or high place, you cannot exhale your breath well which will effect vibrating singing techniques and could briefly obstruct vocalizing.
This does not mean that dance is bad for the vocal chords. Dancing while singing only affects breathing, which would just alter a person’s ability when singing.

There are still so many rumors about vocalization, and most individuals will believe what they want without researching, thinking there is no right or wrong way. As a ‘Voice Care Specialist’ I advise a person to always follow this golden rule: if you cannot believe and trust in a method, then you should be careful about trying it.

Training of the pharyngeal constrictors and cricothyroid muscle

I have talked about my theory that… ‘The cricothyroid muscle might be the same muscle as the pharyngeal constrictors,’
You can stretch the pharyngeal constrictors by sliding and turning over the thyroid cartilage or by stretching the muscle fibers gently.
In my voice care salon I usually use a small vibrating tool, the brand name is “Gold Vibration,” to massage or finely move the muscles of the throat relating to vocalization.
In order to train the pharyngeal constrictors, for more specific training, relieving firmness, and increasing the flexibility of the cricothyroid muscle, I focus on the instrinsic muscle area.
I think this is the most effective and reliable training available for the pharyngeal constrictors and cricothyroid muscle. This is because, using this method, it is possible to contract the muscle fibers of the cricopharyngeal part of the pharyngeal constrictors and cricopharyngeal muscle.

Note:A professional such a myself, a trained technician or vocal coach can easily know and recognize that the muscle fibers of the middle constrictor go towards to the greater cornu of the hyoid bone when touching the middle constrictor.
Mind you, there are individual variances in size and shape for every person.