Speech and Language Therapy - Oldham Community Adult Speech and Language Therapy - Swallowing Exercises

Base of Tongue Exercises

• Hold each exercise for a count of 5 unless stated otherwise
• Repeat each exercise three times
• Carry out all of the exercises three times a day

1. Stick your tongue out as far as possible – try to keep it central. Hold for a count of 3.
2. Stick your tongue out as far as possible – try to keep it central. Hold for a count of 3 then roll tongue back into your mouth.
3. Pretend to gargle – hold tongue in this position for a count of three.
4. Repeat the sounds ‘k – k – k’ ‘g – g – g’
5. Put your tongue behind your lower front teeth and bulge the body of your tongue out of your mouth until you feel a stretch on the base of your tongue.
6. Open your mouth and press down on the back of your tongue with your finger. Whilst pressing down with your finger try and lift your tongue against the force.

Masako Maneuver

This technique is designed to help the back wall of the throat move forward to meet the base of the tongue. This helps reduce the amount of food residue high in the throat.

• Place your tongue between your teeth and hold it in that position
• Keeping it in this position do a swallow. Repeat 5 times

Mendelsohn Maneuver

This is an exercise to increase laryngeal elevation and open up the entrance to the oesophagus to help food go down the right way.

• Swallow your saliva and pay attention to your neck as you swallow. Can you feel your adam’s apple lift and lower?
• Now this time don’t let your adam’s apple drop
• Hold it up with your muscles for several seconds
• This feels like you are ‘holding on’ to the middle of your swallow

Jaw Exercises

• Repeat each exercise three times
• Carry out all of the exercises three times a day

Stretch the jaw down, opening the mouth wide. Raise the eyebrows up as if startled.

Clench your teeth together tightly. Feel how tense your jaw is. Now relax slowly. Open your lips and let your jaw rest in an easy relaxed position.

1. Lower your jaw as far as you can by opening your mouth wide, then close it again.
2. You can gradually increase jaw opening by using a stack of spatulas. Gradually increase the number in the stack. Slide them in on one side of the mouth, through to the other side.
3. Drop your jaw gently and move it slowly to the right and then the left. Repeat moving from left to right.
4. Repeat the exercise above however this time place a hand on the right side of your jaw. Gently resist the jaw movement with your hand as it moves to the right. Repeat on the left side.
5. Drop your jaw and make exaggerated chewing movements with your mouth closed.
6. Repeat the exercise with your mouth open.
7. Place a hand or fist under your jaw/chin and as you try to keep your jaw open push upwards.
8. Place a fist under your jaw/chin firmly as you try to open your mouth.
9. Open your mouth. Place a hand/finger over your chin. Try to close your jaw whilst your finger tries to hold the mouth open.

Chin Tuck Against Resistance

• Carry out all of these exercises 3 times daily for 6 weeks
• Sit upright in a chair and place the ball or tightly rolled up hand towel under your chin
• Open jaw to its maximum position, tucking the chin to compress the ball/towel and maintain this position for 10 – 30 seconds
• Build up the time gradually
• While holding this position, squeeze hard with all of your muscles and swallow hard
• Return to the starting position
• Repeat this exercise 10-20 times per session, until the muscles under the chin are fatigued

Supraglottic swallow

Take a mouthful of food or drink, when you are ready to swallow it:

1. Take a breath in through your nose.
2. Hold your breath in your throat while you swallow.
3. Immediately after you swallow, let out the same air that you have been holding with a throat clear or a small cough.

Tongue Exercises

• Hold each exercise for a count of 5
• Repeat each exercise three times
• Carry out all of the exercises three times a day

1. Stick your tongue out as far as possible – try to keep it central. Hold for a count of 3.
2. As above then roll tongue back into your mouth.
3. Stick your tongue out. Lift your tongue up to your nose and hold for three. Then down to your chin. Try to increase the speed of this exercise gradually.
4. Stick your tongue out. Use a spoon or finger to press down on the tongue as you try to lift it to your nose or to the roof of your mouth.
5. Stick your tongue out. Put your finger under your tongue. Try to push your tongue down as your finger tries to push it up.
6. Stick your tongue out. Put your finger to the side of your tongue. Push your tongue towards your cheek while your finger pushes the opposite way. Repeat on the other side.
7. Stick your tongue out. Move your tongue as far to the right as you can and hold. Repeat on the left side. Try to increase the speed of this exercise gradually.
8. Pretend to gargle – hold tongue in this position for a count of three.
9. Stick your tongue out. Hold the tongue tip firmly between the teeth – swallow your saliva. Feel the tight squeeze at the back of the tongue as the tongue moves backwards to squeeze against the throat.
10. Squeeze all the muscles at the back of your throat and tongue – hold for a count of 3.
11. Repeat the sounds ‘k – k – k’ ‘g – g – g’ ‘t-t-t’ and ‘d – d -d’ Try to increase the speed of this exercise gradually.
12. Open your mouth and keep it open. Lift your tongue tip up behind your top teeth and push hard. Then put it down behind your bottom teeth and push hard. Try to increase the speed of this exercise gradually.
13. Open your mouth and lick all around your lips in a circle.
14. Lift the middle of your tongue to the roof of your mouth and press hard. To help you do this, tuck the tip of the tongue behind your lower teeth.
15. Inside your mouth push your tongue into one cheek. Hold for a count of 3. Then the other cheek. Hold for a count of three.
16. As above. This time use your finger to touch the spot on your cheek where your tongue is pressed. Push against the finger with your tongue.

Lip exercises

• Hold each exercise for a count of 5
• Repeat each exercise three times
• Carry out all of the exercises three times a day

1. Spread your lips into a wide smile – put more effort into the weaker side, trying to get the smile as even as possible. Pull the weak side with your finger if necessary.
2. Purse your lips as if you were going to kiss a baby. Push your lips as far forward as you can.
3. Alternate the above exercises by saying ‘eee’, ‘ooo’. Try to increase the speed of this exercise gradually.
4. Push your lips together and blow out both cheeks – hold for a count of five, without letting any air escape through your lips or nose.
5. Push lips together and blow out one cheek, then the other. Hold each side for a count of five, without letting any air escape through your lips or nose.
6. Hold a spoon or straw between your lips (not between your teeth). Hold it as long as possible.
7. As above but gently tap the spoon downwards as you try to keep holding it between your lips.
8. Take a deep breath and gently blow out through rounded lips. Hold one ply of a tissue, cut into a strip, in front of your mouth so the movements of the paper show how well you are blowing.
9. Hold your lips together with your finger and thumb. Now try and open your lips while still holding them together.
10. Hook your index finger around one cheek. Try and purse your lips. Repeat on the opposite cheek.
11. Open your mouth. Hold the bottom of your chin. Now try to close your lips together but don’t close your jaw.

Shaker Exercise

• Lie down on your back on the bed/floor. Your shoulders need to be flat against the surface
• Keep your shoulders flat against the bed or floor and lift up your head, bringing your chin down to your chest (until you can see your toes)
• Keep your head lifted for 60 secs and then lower your head and rest for 60 secs
• Repeat 3 times

Contact Information

Address:
The Link Centre
140 Union Street
Oldham
OL1 1DZ
Telephone:
0161 770 2300 Option 5

Email:
saltoldhamadults@nca.nhs.uk

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If you have comments or concerns about the service we provide, you can contact PALS which is a free and confidential service for patients, families, carers, and friends.

How to contact PALS

There are PALS offices located on each of the NCA hospital sites at (Fairfield General Hospital, Rochdale infirmary, Royal Oldham Hospital and Salford Royal Hospital. The PALS departments are open between 09:30 and 16:30, Monday to Friday.

You can contact the team by telephone or email: Telephone: 0161 778 5665
Email: pals@nca.nhs.uk

Alternatively, you can write to:

PALS Department
The Northern Care Alliance NHS Foundation Trust
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Southlink Business Park,
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Oldham,
OL4 1DB