Clearing the throat can be traumatic to the vocal folds (vocal cords). It’s rather like smacking them together with too much force. Doing this excessively, and over a prolonged period of time (known as chronic throat clearing), can injure the vocal folds and this will in all likelihood impair the quality of the voice – perhaps resulting in a hoarse and/or breathy voice. The vocal folds may become inflamed and there may be some localized irritation.

In sum, repetitively rapping the vocal folds together is potentially damaging and this alone can be sufficient to cause a voice difficulty. For example, throat clearing is a commonly associated with of functional dysphonia.

Repetitive cycle

Frequent throat clearing is a self-destructive, repetitive cycle. Mucus (throat secretion) builds up on your vocal folds. You feel this as a tingle / soreness / tightness / lump, and you feel forced to cough. So…you cough! This blows the mucus off your vocal folds and your voice recovers for a few seconds. But blowing off the mucus makes the vocal folds dry and this triggers the production of more mucus…which you feel as a tingle / soreness / tightness / lump…and you cough…which…

We need to break this cycle.

Breaking the cycle

Perhaps the hardest thing to do here is to commit to not coughing or clearing your throat when you feel that tingle / soreness / tightness / lump in your throat. Remember, you’ve built up a habit and it’s going to take will power to overcome it. But the benefits are well worth it. So, when you feel that desire to cough or clear your throat, try each of the THREE STEPS first.

The first step is to simply take a normal sip of water. Just take a sip. But don’t cough afterwards! And see if that has helped to remove the desire to cough or clear your throat.

If this doesn’t work, move onto the second step – using a firm swallow. For this, take a small sip of water and hold it in your mouth. Now place the palm of one hand at the top of your chest, resting on your sternum (breast bone). Lower your chin slightly. Now, when you are ready, imagine that you are trying to swallow a pea or a small candy all in one go, and swallow the water firmly – imagining you are gently pushing down a pea/candy. At the same time, gently push down on the top of your chest. That’s it…but don’t cough or clear your throat afterwards. For most people, a firm swallow should help and it’s well worth practicing this technique.

If you’ve tried the firm swallow and you still feel that you have to cough/clear your throat then try the third step – a so-called ‘dry cough’. For this, take in a relatively deep breath and, again, place the palm of one hand against the upper chest on the top part of the sternum. Now, when you are ready, blow out the breath reasonably forcefully using the sound /h/ (like in the word how) – it’s like panting and you should hear a lot of air friction as you exhale forcefully. But remember, you must not cough at the same time. The trick is to keep the vocal folds relaxed and as open as possible (which is what happens when we say the sound /h/) whilst we exhale. This has the effect of blowing any gathered mucus off the vocal folds. Now, as this is quite a drying technique, you will then need to take a small sip of water immediately afterwards to lubricate your vocal tract. But do not cough or clear your throat!

Further ideas

Whilst these steps are not overly difficult to perform, breaking the habit of throat clearing can take quite some time. It can be helpful to ask someone you trust to gently alert you if they hear you clearing your throat. This can act as a gentle reminder that you need to practice these steps for ridding yourself of this potentially harmful habit.

A final few ideas for eliminating throat clearing are:

• laugh gently and then swallow
• pant softly in and out a few times before swallowing
• hum softly and then swallow

NB: It’s generally not possible to swallow more than three times in a row without using any drink or food. In other words, if you perform a swallow maneuver without anything in your mouth (no liquid or food), you can only do this a maximum of three times in succession, Try it and see! So, if you are attempting any of the above ideas (e.g. laughing, panting, humming before swallowing), it’s best to actually swallow a small amount of water. This way, you will avoid any unnecessary strain.

Drinking plenty of water (for a healthy adult, up to about 8 glasses each day) can help to thin the mucus. Also, eating too many dairy products may thicken the mucus. You may wish to experiment with cutting back on the amount and/or type of dairy products you eat.