A Manual Therapy in Need of a Manual: Conceptualizing and Comparing Existing Vocal Massage Protocols and Their Use in the Treatment of Voice Problems

ABSTRACTVocal manual therapy (VMT) is a heterogenous term used to describe a variety of touch-based approaches to voice rehabilitation and maintenance. VMT aims to use manipulation, massage, and reposturing to change how the voice sounds and feels. Since first described in 1990, there has been a proliferation in the use of VMT in the treatment of voice problems, with increasing interest in its usefulness within clinical and non-clinical voice settings. This forum article presents a narrative review of 42 studies investigating the use of VMT in a vocal health context. The aim was to identify the theoretical orientations of VMT protocols, draw links between the techniques employed in their administration, and highlight similarities and differences in use of language across VMT protocols. Relevant articles for review were identified via informal literature search using forward and backward citation screening and then described using narrative synthesis. Theoretical orientations were broad and influenced by speech pathology research as well as Finnish massage, naprapathy and yoga. 26 ostensibly different protocols were identified across the 42 studies, with considerable variation in protocol length and frequency. Language was highly varied across protocols. The forum article therefore advocates for greater shared understanding in VMT research and practice.KEYWORDS: Voice therapydysphoniamassagelaryngealvoice disorder Disclosure statementNo potential conflict of interest was reported by the author(s).Supplementary materialSupplemental data for this article can be accessed online at https://doi.org/10.1080/23268263.2023.2262181Notes1. Text describing the protocols was extracted from each of the reviewed articles, collated, and then inputted to the wordcloud package in the statistical software, R. This package is available via CRAN, a network of statistical computations and graphics https://CRAN.R-project.org/package=wordcloud.Additional informationNotes on contributorsLydia FlockLydia Flock is a vocal coach, manual therapist, and published researcher. Lydia was endorsed for the prestigious Global Talent Visa (Exceptional Promise Criteria) by Arts Council England. After training in musical theatre at Ithaca College, the University of Virginia (BA drama, with honors) and the Royal Central School of Speech and Drama (MA music theatre), Lydia established a private voice studio, Flockstars Coaching (www.flockstars.com). Passionate about holistic approaches to voicework, Lydia has completed qualifications in advanced clinical massage (Jing Advanced Massage) and vocal manual therapy. Lydia founded Oxford Vocal Massage (www.oxfordvocalmassage.co.uk), the region’s only specialist vocal massage practice.Stephen R. KingStephen King owns the multidisciplinary Voice Care Centre (www.voicecarecentre.co.uk) in London’s West End. A published researcher and passionate about professional development, Stephen has acquired a breadth of knowledge from his qualifications in advanced clinical massage, medical acupuncture, manual maxillofacial therapy, spinal manipulation, anatomy (including human dissection) and voice pedagogy and is now continuing his studies into counseling and psychotherapy. As an educator, Stephen co-founded Vocal Health Education (www.vocalhealth.co.uk), seeking to educate every single voice user around the world on the subject of vocal health with the pioneering; Vocal Health First Aid (www.vocalhealth.co.uk/vocal-health-first-aid).