Throat clearing is essentially slamming your vocal folds together. This is potentially damaging to the very fragile tissues of the vocal folds and the “slam” causes them to respond by “swelling up” or becoming inflamed in order to “protect” themselves for the next “slam”. It also causes the necessary thin mucus on the vocal folds to be “blown off”, which dries them out, and triggers production of more mucus. Follow this with your immediate and constant need to use the voice for talking/teaching/singing/etc., and then you are trying to vibrate (make a sound with) swollen and possibly dried out vocal folds. The vocal folds will not vibrate effectively or efficiently if they are irritated, swollen, dehydrated, or inflamed. In addition, your vocal quality may be negatively affected (more “hoarse” or effortful/strained than normal) because of reduced mucosal wave, impaired vibratory patterns, or possibly even the use of muscle tension as your brain has likely noticed the inflammation of the vocal fold tissues and possibly “told” your body to overcompensate. Not to mention the fact that your body will try and heal itself by producing more mucus, so here starts a vicious cycle because now you sense mucus and need to throat clear again.
To Clear or Not to Clear? That is the Question...
February 18, 2019
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And the answer is…Don’t do it.
Unless you cut into this self-destructive repetitive cycle, it will only get worse and possibly develop into a constant habitual response and cause significant vocal fold swelling or even create thickenings on the vocal folds at the point where they are hitting together (these “thickenings” can develop into vocal nodules). Who knew that throat clearing started such a snowball effect?
So how do you cut into this cycle? The first step is awareness. Notice the fact that you just cleared your throat. SO MANY people have no idea because it has become a habit. Possibly use a pen and paper (or the notepad function of your smartphone) to tally your throat clears in a day to improve your awareness of the habit. You may surprise yourself by the final number but this alarming total could be just the fire you need to break the habit, especially when you count every tally mark as a “slam” of your very fragile vocal fold tissues (a.k.a. your instrument). And then the next time you want to clear your throat, notice the feeling of what is making you want to slam those vocal folds together. Is it a tickle, soreness, tightness, or “lump” feeling? Or all of these? Identify the “why” of this pattern. And quickly substitute something else in its place. The best options are a hard swallow (like you are swallowing a golf ball or grapefruit), multiple swallows, a sip of water, multiple sips, and/or a silent “h” throat clear (produced like a soft but purposeful airy “huh” sound) followed by a swallow. Continue to suppress the throat clear with these substitutions until you master your ability to cut right into that behavior. Sucking on throat lozenges (without menthol) or hard candies can also stimulate swallowing and reduce throat clearing.
Common reasons for “a need to throat clear” may include:
*Dehydration (offset this by ensuring you are drinking at least half your body weight in ounces daily, reducing any dehydrators, and possibly using a humidifier, steam, or an ultrasonic nebulizer to supplement hydration)
*Globus sensation (a feeling like there is a lump “stuck” in your throat) commonly caused by reflux, a vocal fold pathology (granuloma, polyp, etc.), or abnormal esophageal (food tube) function (offset these possibilities by seeing a laryngologist, GI doctor, or ENT doctor and managing the issues once/if diagnosed per their recommendations)
*Muscle tension dysphonia—the use of hyperfunction/overcompensation for voice use which can also cause a globus sensation or a feeling of tightness/soreness in the throat in addition to an impaired vocal quality (offset this by being diagnosed by a laryngologist and then per their recommendation go to a few sessions of voice therapy provided by a voice-specialized speech pathologist possibly focused on flow phonation, semi-occluded vocal tract exercises, resonance, and/or circumlaryngeal massage)
*An actual increase of mucus in throat area/on vocal folds (offset this by increasing hydration as this will thin the mucus, and also by managing any causative factors like allergy, sinus, or other contributing medical issues per the recommendation of a doctor; allergies can irritate the mucous membranes and cause them to produce more mucus as a response)
A throat clear is not a solution as you might feel it would be, but a quick action that creates immediate and possibly lasting trauma to your vocal instrument and initiates a self-destructing repetitive cycle. It’s not a “piece of cake” to overcome, but the more you are able to resist that next throat clear, the closer you will be to no longer feeling the need to do so. Increase your awareness and kick the habit—your vocal folds will thank you.
Author
Sara Davis, M.A. CCC-SLP
Author
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