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Voice & Swallowing Therapy for Hypermobility Spectrum Disorders
Individuals with hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS) often experience overlooked but significant challenges with voice production and swallowing. These difficulties stem from the same connective tissue differences that affect joints throughout the body—including the delicate structures of the larynx, pharynx, and esophagus. It can be frustrating, to say the least, finding a provider who understands how hypermobility impacts function.
Clare Henderson, MA, CCC-SLP offers specialized therapy for individuals with HSD/hEDS to address difficulties with speech, voice, and swallowing. To learn more, contact Clare here.
Common Features of HSD/hEDS
- Fluctuating symptoms and disability. - May experience flares related to “overdoing it,” injuries, or for unknown reasons - Inconsistent or unreliable body performance - Chronic pain and fatigue. May have high pain tolerance. Incoordination - Differences in sensory processing, interoception, and proprioception - Often neurodivergent and/or gender expansive, may have trauma history - Long history of being misunderstood or dismissed by providers - Joint subluxations / instability throughout the body (occurs rarely within the larynx) - Various patterns of muscle tightness and weakness, compensations for instability (some muscles activate very little, some are activated constantly) - Often intuitive, creative, and extremely knowledgeable about their diagnoses - May be skilled athletes, dancers, and singers
Common Co-Occurring Conditions
- Autism, ADHD, Dyspraxia - Dysautonomia - Postural orthostatic tachycardia syndrome (POTS) - Mast Cell Activation Syndrome (MCAS) - Long COVID, Myalgic encephalomyelitis (ME), Chronic fatigue syndrome (CFS) - Fibromyalgia and other chronic pain syndromes - Autoimmune conditions - Craniocervical instability - Chiari malformation - Avoidant/restrictive food intake disorder (ARFID)
Clare's Approach to Therapy
- Highly individualized, centered around the patient as expert on their body and mind - Affirming and accommodating of disability and neurodivergence in the learning process - Breathing pattern retraining - Breathing muscle strengthening exercises - Cautious muscle tension management, including gentle stretching, self-massage, and pain management approaches - Proprioception and interoception building exercises - Tools for kinesthetic feedback (resistance bands, acoustic data, pitch tuners, straws) - Vocal balancing, coordination, and strengthening exercises - Coordination with other care providers, including physicians, PT, OT, trainers, vocal coaches, singing teachers
Hypermobility & Voice Symptoms
- Vocal fatigue - Throat, jaw, tongue, or facial tension with speaking or singing - Pain, soreness, irritation with voice use - Limited pitch range - Hoarseness, raspiness, roughness, breathiness, throaty or croaky voice - Excess/uncontrolled vocal fry - Voice cuts out or breaks - Inconsistent or unreliable voice quality - Difficulty with projection or being heard
Hypermobility & Swallowing Symptoms
- Feeling of food getting “stuck” in the throat - Fatigue with chewing and swallowing (throat, tongue, jaw) - Effortful chewing and swallowing - Coughing or choking with eating, drinking, or on saliva - Excess throat mucus or throat clearing during or after meals - Avoidance of certain types of foods and drinks - Sensation of tightness in the throat with swallowing - Clicking in throat with swallowing or “lopsided” movement