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Valentina Carlile Osteopata
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  • Writer's pictureValentina Carlile DO

Why and when to consult an osteopath for a voice disorder?


Why and when to consult an osteopath for a voice disorder?

Maintaining an optimal posture requires continuous adjustment of the body with respect to gravity in order to balance it, and any consolidated musculoskeletal imbalance affects the larynx, potentially creating a vocal disorder (Kuchera, 1997; Hillman, 2019).

Larynx, vocal tract and articulators are connected to the sternum, cervical spine and skull.

Furthermore, the respiratory system is also connected to the spine, as well as the ribs and pelvis.

Spinal misalignments, as occurs for example in the case of scoliosis and cervical whiplash, contribute to determining a muscular imbalance, disfavoring the various axes of movement (Stokes et al., 1989; Koumbourlis, 2006). In the first case what can be altered is the respiratory function since the thoracic diameters are altered, and consequently this can modify the laryngeal position due to its connection with various neck muscles, for example the sternothyroid.

In the second case, a situation occurring on the neck which also alters the mobility of a vertebra, especially at the cervical level, can contribute to increasing the tension of the pharyngeal muscles, or even compromising the neurological function of the larynx and consequently negatively influencing the voice.

Surely there could be dozens and dozens of other examples.

But isn't it about the famous somatic dysfunctions (AACOM, 2017), or rather what the Osteopath deals with?

While on the one hand it is important to pay attention to misalignments, on the other it is also important to correct excess muscle tension even within an "aligned" system. If the body is not free to move, the patient will be vocally penalized (Hillman, 2019).

Specific techniques of laryngeal osteopathic evaluation and manipulation (Lieberman and Rubin, 1998, 2000) have been included by Phoniatricians for years at both a diagnostic and therapeutic level (Rubin, 2000; Sataloff, 2005), techniques which, for example in the case of a vocal alteration with arytenoid misalignment, allow us to differentiate whether we are in the presence of a primacy at the level of the cricothyroid m. or a posterior cricoarytenoid m. (Sundberg, 1998; Harris, 1998), then allowing the osteopath professional to make the choice specific technique most suitable and effective for resolving the dysfunctional situation. Obviously not all dysfunctional conditions can be completely reduced, as happens in cases of damage from intubation, results of partial laryngectomy, post-surgical glossectomy, laryngeal fractures, but after careful clinical evaluation and consideration of the limits and benefits of osteopathic treatment, the The Osteopath intervenes alongside the Speech Therapist for the maximum possible recovery of the function by working on the structure available at that moment because, if it is true that the structure governs the function (A.T.Still), it is also true that each patient has his own potency which must be preserved, conserved and developed.

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