👐 Laryngeal Massage: When, Why & Who Should Be Doing It?

So, your voice is feeling tight, your larynx is so high it feels like it's left the building, and someone suggests laryngeal massage as the magic fix. Or maybe you’re a voice clinician wondering if this hands-on approach is something you should add to your practice.

Either way, before anyone starts digging their thumbs into delicate neck real estate, let’s talk about what laryngeal massage actually is, who should (and shouldn’t) be doing it, and why proper training is non-negotiable.

TL;DR: Laryngeal massage can be a game-changer for reducing tension and improving vocal function - but it’s not risk-free and should only be performed on others by someone with the right training. If that’s not you? Stick to manipulating your own larynx and refer clients out.

Now let’s dig in! 🔍

🔎 What is Laryngeal Massage?

Laryngeal massage (or circumlaryngeal manual therapy, if you’re feeling fancy) is a hands-on technique aimed at reducing tension, improving mobility, and freeing up the voice. It’s often used in cases of:

✅ Muscle tension dysphonia (MTD)
✅ Post-illness compensatory tension (lingering voice strain after a cold or upper respiratory infection)
✅ Hyperfunction & laryngeal elevation (hello, high-stress speakers & singers!)
✅ Pre/post-surgery vocal recovery (under proper clinical guidance)

More than just a relaxing throat rub, a good laryngeal massage requires real-time assessment, anatomical knowledge, and the ability to adjust techniques on the fly. And that’s why not everyone should be doing it to others.

🛑 Who Should (and Shouldn’t) Be Performing Laryngeal Massage?

✅ SLPs Can Perform Laryngeal Massage… If They’re Trained!

Can speech-language pathologists perform laryngeal massage? Yes—if they have the proper training and hands-on experience.

🔹 In Ontario, CASLPO does not require an official certification, but it does require SLPs to practice within their competency. That means:

• You must have formal training. Laryngeal massage isn’t typically taught in grad school, so this requires post-graduate training, mentorship, and hands-on practice.
• You must be able to assess, adjust, and modify in real-time.
• You must have a clear clinical rationale for using manual therapy techniques.

Bottom line: If an SLP is properly trained, they can incorporate laryngeal massage into their treatment plan. If they’re not? They should refer out to someone who is.

🚫 CDAs (Communication Disorders Assistants) Cannot Perform Laryngeal Massage

Unlike some other tasks that can be delegated under supervision, laryngeal massage isn’t one of them. Here’s why:

🔹 It requires real-time clinical decision-making. If a client experiences pain, discomfort, or unexpected symptoms, an SLP needs to immediately assess and adjust. This level of moment-to-moment decision-making can’t be delegated.

🔹 SLPs must be able to fully document and explain what was done. If a CDA performs hands-on therapy and something goes wrong, the SLP is left making an educated guess about what happened—and that’s not good enough.

That said, CDAs may be able to assist in teaching clients self-massage techniques. But that should always be under careful training and supervision by the SLP.

⚠️ Massage Isn’t Neutral: It Can Help, But It Can Also Harm

Laryngeal massage isn’t risk-free. When done incorrectly, it can:
🚨 Aggravate existing conditions (or mask an underlying problem that needs different treatment)
🚨 Cause discomfort, pain, or emotional distress (especially in clients with trauma histories)
🚨 Potentially damage delicate structures (the larynx, carotid arteries, vagus nerve—so many vital things live in the neck!)
🚨 Delay proper treatment if the true cause of the voice issue isn’t being addressed

Even registered massage therapists (RMTs)—who receive extensive manual therapy training—often refuse to work on the anterior neck because of the risks. If they’re hesitant, SLPs should be too—unless they are properly trained.

🗣️ What About Self-Massage?

Now here’s where things get interesting - voice user, clients and patients CAN do self-massage.

🔹 Bodies are self-limiting, meaning it’s much harder to hurt yourself when you’re guiding your own touch.
🔹 Self-massage can extend the benefits of therapy between sessions.
🔹 Clients can explore what feels good and adjust based on real-time sensation.
🔹 It promotes autonomy and control—especially important for clients with trauma or sensitivity to touch.

An SLP with proper training should teach clients self-massage techniques when appropriate. And laryngeal massage should always include an element of teaching someone how to take the reins themselves. But when it comes to therapeutic interventions, having a client massage themselves is NOT the same as performing hands-on therapy on them.

⚖️ Liability & Professional Responsibility

If you’re an SLP thinking about incorporating laryngeal massage, here’s the deal:

🔹 If you aren’t trained, doing it is outside your professional scope. And that’s both an ethical and legal issue.
🔹 If a client experiences harm and you weren’t trained, you’re liable. That could mean professional, legal, and reputational consequences.
🔹 Even if you are trained, ongoing consent & assessment are mandatory. Clients need ample opportunities to off-road if they change their mind or feel like they've hit a wall. And if a client reports pain or new symptoms, you must know what to do.

💡 Final Thoughts: Should You Do Laryngeal Massage?

If you’re an SLP, voice therapist, or vocal coach wondering whether you should be using laryngeal massage in your practice, ask yourself:

✔️ Am I properly trained?
✔️ Can I assess and modify techniques in real-time?
✔️ Do I have a clear clinical rationale for using it?
✔️ Would my client be better served by an RMT, PT, or osteopath?

And if you’re a voice user looking for laryngeal massage, remember:

✔️ Only seek treatment from someone trained in manual therapy.
✔️ Be proactive in asking about their credentials.
✔️ Consider learning self-massage techniques.
✔️ Know that you have full autonomy over your own body—if something doesn’t feel right, speak up.

At the end of the day, this isn’t just about whether we can do laryngeal massage—it’s about whether we should.

🚀 If you’re interested in incorporating laryngeal massage into your practice, invest in high-quality training and mentorship.
🚀 If you’re not the best person for the job, refer out.
🚀 And for CDAs? That’s still a solid nope.

💬 What Do You Think?

Have you had laryngeal massage? Are you considering training in it? Drop a comment below—I’d love to keep the conversation going! 🎤💡