VOICE, RESONANCE & TONGUE TIE

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Voice and resonance disorders can result from psychological, physical, or physiological factors. Common conditions addressed by Speech-Language Pathologists (SLPs) include:

• Vocal nodules, polyps, or granulomas
   
• Voice changes post-thyroidectomy
   
• Vocal overuse or abuse
   
• Neurological disorders (e.g., Parkinson’s disease, spasmodic dysphonia)
   
• Paradoxical Vocal Fold Motion (PVFM)
   
• Head and neck cancers
   
• Post-surgical voice rehabilitation
   

Functional oral restrictions—commonly referred to as tongue-tie, lip-tie, or buccal frena restrictions—can affect far more than feeding, swallowing, breathing, speech, and airway development. They can also impact voice quality, resonance, range, and endurance.

A restricted tongue doesn’t just affect articulation—it is biomechanically connected to the larynx via the hyoid bone and extrinsic lingual muscles (genioglossus, hyoglossus, styloglossus, and palatoglossus). 

This means that any restriction in tongue movement can:

• Increase tension in the laryngeal area
   
• Reduce vocal range and endurance
   
• Alter resonance and tonal quality
   
• Contribute to vocal fatigue and strain
   

Even partial restrictions—sometimes as little as 20% limitation—can produce measurable changes in vocal performance, both in speaking and singing.

For professional voice users—opera singers, theater performers, touring musicians—a restricted tongue can mean the difference between a reliable performance and one plagued by fatigue, limited range, or tonal instability.

Common pre-release complaints among singers with undiagnosed oral restrictions include:

• Limited or unstable vocal range
   
• Frequent vocal fatigue during rehearsal or performance
   
• Strained or pressed vocal quality
   
• Reduced resonance or “ring” in the voice
   

Post-frenectomy (tongue or lip tie release) combined with myofunctional therapy, singers often report:

• Greater ease of phonation
   
• Expanded range and resonance
   
• Improved breath management
   
• Increased endurance and vocal stamina
   

Myofunctional therapy focuses on restoring proper oral rest posture, breathing patterns, and swallowing mechanics. While it does not target the larynx directly, it strengthens and balances the orofacial and pharyngeal musculature that supports the vocal mechanism.

Benefits for voice users include:

• Reduced laryngeal tension
   
• Optimized tongue posture for resonance
   
• Improved breathing efficiency
   
• Greater stability and endurance during performance
   

Voice Lessons

• Purpose: To develop singing technique and musical artistry.
   
• Provider: Vocal instructor.
   
• Focus: Breath control, pitch, tone, performance skills.
   

Vocal Coaching

• Purpose: To refine skills for specific performances or projects.
   
• Provider: Vocal coach.
   
• Focus: Interpretation, style, stage presence.
   

Voice Therapy

• Purpose: To rehabilitate voice after injury or treat voice disorders.
   
• Provider: Licensed SLP/Voice Therapist.
   
• Focus: Vocal health, recovery from trauma, prevention of re-injury.
   

Important: Voice therapy is a medical, rehabilitative service and can only be provided by a licensed Speech-Language Pathologist.

Whether recovering from vocal fold surgery (e.g., nodule removal) or oral surgery (e.g., frenectomy), the vocal mechanism requires structured, therapeutic rehabilitation before returning to full performance.

Without proper rehabilitation, risks include:

• Re-injury to the vocal folds
   
• Permanent changes in vocal quality
   
• Reduced range, power, or control
   

Voice therapy with an SLP ensures:

1. Safe recovery and gradual reintroduction of vocal exercises.
    
2. Strengthening of laryngeal and surrounding musculature.
    
3. Restoration of optimal technique before resuming lessons or coaching.
    

Recovery typically spans 3–6 months before safe return to unrestricted singing.

For clients—especially professional singers—impacted by tongue-tie, our integrated Pre- and Post-Frenectomy Vocal/Myo Program ensures:

• Comprehensive pre-release preparation to optimize healing and function.
   
• Coordination with your ENT, release provider, and vocal coach.
   
• Guided recovery that addresses both functional muscle patterns and vocal technique.
   
• Long-term stability in voice, resonance, and performance quality.
   

Most myofunctional therapists do not specialize in working with professional singers, and most SLPs do not have advanced training in myofunctional therapy. This is a niche within a niche.

Our practice specializes in:

• Professional singers and performers.
   
• Clients recovering from oral restrictions.
   
• Integrated myofunctional + voice therapy rehabilitation.
   
• Collaboration with elite release providers and vocal coaches.
   

We also treat non-singing clients with vocal pathology such as hoarseness, nodules, and PVFM.

We will provide a thorough assessment and customized plan. If an oral restriction is found to be impacting function, we will refer you to a specialized release provider and prepare you for the frenectomy procedure. We collaborate closely with your release provider, ENT, and vocal coach throughout the process. As with any myofunctional client, voice clients receive pre-frenectomy therapy for several weeks before any release or surgery.

When it comes to voice, it is essential to work with a therapist who can determine readiness for release and guide you through the post-frenectomy vocal/myofunctional program to achieve optimal, long-term results. Most SLPs do not have this additional focused training. Seek an SLP who specializes in both myofunctional therapy and voice therapy for the best outcomes.

Key Takeaway: If you are a professional voice user or recovering from a frenectomy or vocal surgery, seek care from an SLP with advanced training in both voice therapy and myofunctional therapy. This dual-focus approach ensures safe recovery, optimal function, and the best possible long-term vocal outcome.

If you are a singer or interested in improving your voice, contact me to set up a consultation.