Massage techniques for the muscles and fascia of the throat (pharynx and larynx)－中醫師王星凱

This is a set of massage techniques for treating chronic inflammation of the pharyngeal and laryngeal muscles, tendons, and fascia.

Individuals with chronic pharyngitis may experience symptoms such as pain during voice use, difficulty speaking, and a reduced vocal range.

Generally, three types of people are more prone to chronic pharyngeal muscle inflammation:

Those who overuse their throat, such as teachers, vocalists, actors, campaigners, tour guides, market vendors, etc., who often need to speak loudly or shout.
People with a weak constitution and cold extremities, as they are more prone to injuries due to their physical frailty.
Chronic disease patients and the elderly.

I developed this method primarily because I once suffered from severe chronic throat pain. Every morning upon waking and while speaking or singing, I would experience intense pain. Despite consulting many doctors, both traditional and Western, I could not find a cure or determine the cause. Later, I studied traditional Chinese medicine, acupuncture, Chinese meridian theory, myofascial trigger points,, and combined these with Western anatomy of the throat. After years of exploration, I finally understood the underlying causes and developed a treatment method. Massage is just one component of the treatment; another component is Chinese herbal therapy.

This massage method can be roughly divided into three parts based on anatomical locations:

Upper Part: Includes the hyoid bone and the muscles, tendons, and ligaments above it, such as those in the pharynx, palate, and root of the tongue.
Middle Part: Involves the muscles, tendons, and ligaments around the thyroid cartilage.
Lower Part: Encompasses the muscles, tendons, and ligaments around the cricoid cartilage.

The principle for selecting massage points follows the concept from the Yellow Emperor's Inner Classic (Huangdi Neijing) of "using pain as the location for acupoints" and the concept of "Ah Shi points" from Sun Simiao.

For the Upper Part, the massage locations include:

Pterygoid Raphe: This area is the junction of the buccinator muscle and the superior constrictor muscle, where stress tends to concentrate and is prone to injury.
Above the Tonsils: The junction of the palatoglossus and the levator veli palatini muscles.
Behind the Tonsils: You can palpate the styloid process and move towards the hyoid bone’s lesser horn to reach the styloglossus, stylopharyngeus, and the posterior belly of the digastric muscle.
Palatopharyngeal Arch: This area targets the palatopharyngeus muscle.
Around the Eustachian Tube: By moving your finger over the palatopharyngeal arch, you can touch protruding Eustachian tube and massage the levator veli palatini muscle.

For the Middle Part, you can massage:

The muscle belly of the thyrohyoid muscle and the attachment of the inferior constrictor muscle. Some pain points may be difficult to reach with fingers and may be better treated with acupuncture, such as the thyrohyoid membrane and the cricothyroid muscle’s attachment.

For the Lower Part, massage locations include:

The cricothyroid muscle’s attachment to the cricoid cartilage, the tendon arch of the inferior constrictor muscle, and the attachment of the cricopharyngeus muscle. These areas are relatively easy to reach. Additionally, you can massage the posterior cricoarytenoid muscle and the transverse arytenoid muscle behind the cricoid cartilage, but this requires special techniques.

For example:

To massage the left posterior cricoarytenoid muscle, gently push the cricoid cartilage to the left with your finger to create space. Then use another finger to press in the left posterior area of the cricoid cartilage. (Alternatively, you can push the cricoid cartilage backward and massage through the posterior esophageal wall, which is simpler.)
To massage the left transverse arytenoid muscle, use several fingers to gently push the thyroid cartilage to the left and create space. After moving one finger around the posterior left side of the thyroid cartilage, press towards the right and forward to target the transverse arytenoid muscle.

Pain points in the thyroarytenoid muscle, lateral cricoarytenoid muscle, and vocalis muscle cannot be directly massaged but can be indirectly massaged with special techniques.

For understanding the throat structure, in addition to the Netter anatomy atlas, the 3D anatomy videos produced by the University of Lyon in France are highly recommended.