Swallowing Exercises

Swallowing Exercises

This leaflet has been provided as part of your swallow therapy, as recommended by your Speech and Language Therapist (SLT). These exercises may help improve or maintain your swallow function. Please do not use without seeking guidance and agreement from your SLT first. The exercises will be tailored to your needs and you will be shown the most appropriate exercises and how to do them.

Effortful Swallow

Why?

• This exercise helps strengthen the muscles at the base of your tongue and in the wall of your throat.
• It helps to clear food, drink and saliva from the ‘well’ at the base of your tongue.

How?

• Gather some saliva in your mouth.
• Imagine you need to swallow a golf ball.
• Swallow ‘hard’, squeezing all the muscles in your mouth and throat.

Exercise Library | Medbridge | Medbridge (Speech Language Pathology – Dysphagia – Effortful Swallow)

• 5-10 swallows.
• 3 times a day.
• Stop if you are getting tired or finding it difficult.

Masako

Why?

• This exercise helps strengthen the muscles at the base of your tongue and in the wall of your throat.
• It helps to clear food, drink and saliva from the ‘well’ at the base of your tongue.

How?

• Stick out your tongue. Hold your tongue between your lips/teeth.
• Swallow your saliva whilst holding this position.

Tip: If you don’t have enough saliva, moisten your mouth in between repetitions.

• If this is too difficult to begin with, you can keep your tongue against the inside of your teeth.

• 5-10 swallows.
• 3 times a day.
• Stop if you are getting tired or finding it difficult.

Mendelsohn

Why?

• This exercise helps your voice box move up when you swallow.
• It helps to open the entrance to your food pipe (oesophagus) so that food, fluid and saliva can clear from your throat.
• It can help to protect your airway when eating and drinking.

How?

• Place your middle 3 fingers gently on your Adam’s apple (voice box). Swallow and feel your voice box move up and down as you swallow.
• Hold your breath and swallow again – when your voice box moves up, hold it up by squeezing your throat muscles for 3-5 seconds. Relax and breath out.

• 5-10 swallows.
• 3 times a day.
• Stop if you are getting tired or finding it difficult.

Pitch Glides

Why?

• This exercise helps your voice box move up and strengthens the muscles in your throat when you swallow.
• It can help protect your airway when eating and drinking.

How?

• Say “eee” starting with a low pitch and glide up your voice range to your highest comfortable pitch. Hold pitch for 3-5 seconds as strongly as possible.

• 5-10 repetitions.
• 3 times per day.
• Stop if you are getting tired or finding it difficult.

Shaker

Why?

• This exercise improves the flexibility and strength of the muscles in your neck (strap muscles) which move the voice box up and out of the way when you swallow.
• It helps to open the entrance to your food pipe (oesophagus) so that food, fluid and saliva can clear from your throat.
• It can help protect your airway when eating and drinking.  

How?

Shaker (static) part 1

• Lie on your back on the bed or floor. Do not use a pillow.
• Keep your shoulders flat against the bed or floor.
• Lift your head up, bring your chin down to your chest to look at your toes.
• Keep your head lifted for 60 seconds.
• Lower your head and rest for 60 seconds.
• Repeat 3 times.

Shaker (dynamic) part 2

• Lie on your back on the bed or floor. Do not use a pillow.
• Keep your shoulders flat against the bed or floor.
• Lift your head up, bring your chin down to your chest to look at your toes.
• Hold for 1 second then lower your head.
• Repeat this 30 times.

• Practice parts 1 and 2, 3 times per day.
• Stop if you are getting tired or finding it difficult.

Chin tuck against resistance (Modified Shaker)

Why?

• This exercise improves the flexibility and strength of the muscles in your neck (strap muscles) which move the voice box up and out of the way when you swallow.
• It helps to open the entrance to your food pipe (oesophagus) so that food, fluid and saliva can clear from your throat.
• It can help protect your airway when eating and drinking.  
• This exercise is an alternative where the Shaker exercise is not suitable.

How?

• Sit upright in a chair
• Place a rolled up towel under your chin.
• Tuck your chin towards the chest, pressing firmly on the towel.

Video: https://www.youtube.com/watch?v=h0ZrjeUX1jA

Static (part 1)

• Hold for 60 seconds, then rest for 60 seconds.
• Repeat 3 times.

Dynamic (part 2)

• Hold for 1 second, then relax.
• Repeat this 30 times.

• Practice parts 1 and 2, 3 times per day.
• Stop if you are getting tired or finding it difficult.

Helpful tips (adapted from Queensland Health, Clinical Task Instruction sheet):

Effortful Swallow:

Q. Do you find you have an inability to swallow due to a dry mouth sensation?

A. If your SLT advises, take a sip of fluid between attempts. If it is not recommended to do this, consider steam inhalation or using dry mouth spray or wetting your lips with a mouth care sponge.

Masako Manoeuvre:

Q. I am unable to keep my tongue between my teeth during swallowing?

A. Consider holding your tongue between two fingers using a piece of gauze, or gently bite down to maintain tongue protrusion.

Q. Do you find you have an inability to swallow due to a dry mouth sensation?

A. If your SLT advises, take a sip of fluid between attempts. If it is not recommended to do this, consider steam inhalation or using dry mouth spray or wetting your lips with a mouth care sponge.

Shaker:

Q. I keep moving my chin forward instead of lifting my head off the bed. How do I remedy this?

A. Focus on lifting up your head and try to look at your toes.

Q. I’m struggling to move my head forward with my chin down. How do I achieve this?

A. Lift up your head and try and look at your toes. Keep your chin in whilst you try and lengthen the back of your neck.

Modified Shaker/ Chin tuck against resistance:

Q. I don’t feel I am positioning the towel/ ball correctly and keeps dropping.

A. If possible, try and ask a friend to hold the ball/ towel in place whilst you get used to the correct position. If unsure, ask your SLT to re-demonstrate the exercise and re-review the video link

Mendelsohn Manoeuvre:

Q. I can’t maintain holding my voice box in a high position

A: Ask your SLT to re-demonstrate, so you can aim to hold your voice box for a couple of extra seconds in the exercise.

Pitch glides:

Q. It hurts when I voice and my voice breaks

A: stop the exercise and do not push through pain. Make sure you have good vocal hygiene (ask your SLT if you need advice), and only complete at a pitch that is comfortable for you. If you have a known problem with how your vocal cords are moving, this exercise need to be adapted for you.

If you have any queries do not hesitate to contact your speech and language therapist on the details below.

Speech and Language Therapist:  ___________________________________ Contact Number: 01905 760475 or extension 33296

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

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We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

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Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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