Your physician or speech-language pathologist will select which exercises are useful to improving your swallowing function. If an exercise is not selected, do not attempt it without consulting your medical team. They will develop a program customized and unique to the needs of each patient. This includes the number of repetitions, the number of seconds each exercise should be performed, and the rest period between exercises. A two page PDF (located at the bottom of this webpage) should be printed by your clinician where they will customize your swallowing exercise routine.
This information (instruction and videos), unless other noted, have been provided to the NFOSD by the UC Davis Health System, Department of Otolaryngology and Nancy Swigert, CCC-SLP, BCS-S, F-ASHA and colleagues. The material is copyrighted. All rights associated with this copyrighted material will be enforced. It is being made available free of charge to all physicians and speech language pathologists to be used by their patients. Some of this material is also available on the iPhone and iPad using the iSwallow™ app.
1. Effortful Swallow: Collect all the saliva in your mouth onto the center of your tongue. Keep your lips closed and tight together. Pretend you are swallowing a grape whole in one big, hard swallow. The number of repetitions is patient specific. Click here for Video.
2. Isokinetic (dynamic) Shaker: The number of repetitions defined by your clinician is considered a set. You should perform the set twice (resting briefly between each set). You should then rest for two minutes and then repeat this exercise as many times as directed by your clinician. Ignore the number of repetitions and sets as directed in the video. Click here for Video. The number of repetitions and sets are patient specific.
3. Isometric (static) Shaker: Click here for Video. The length of each repetition and the number of repetitions is set by your clinician. Rest for one minute between repetitions.
4. Jaw Thrust: Move your lower jaw as far forward as you can. Your lower teeth should be in front of your upper teeth. Click here for Video. Note, patients with jaw replacement should use extra caution before performing this exercise so as not to stress the jaw bone. The length of time for each repetition and number of repetitions is patient specific.
5. Lollipop Swallowing: Click here for Video. Place a sugarless lollipop in your mouth and lick. Lick three times and then do an effortful swallow with your lips firmly pressed together. Swallow as hard as you can. The number of repetitions is patient specific.
6. Masako Maneuver: Stick your tongue out of your mouth between your front teeth and gently bite down to hold it in place. Swallow while keeping your tongue gently between your teeth. You can let go of your tongue between swallows and repeat. Click here for Video. The number of repetitions is patient specific.
7. Mendelsohn Maneuver: Place your middle three fingers (index, middle, ring) on your Adam’s Apple (the skin in front of your neck beneath your chin). Swallow once to practice. Feel your Adams Apple slide upward as you swallow. Now, swallow again and when your Adam’s Apple gets to its highest position in the throat, squeeze your throat muscles and hold it as high as you can for as long as your clinician has directed for this exercise (or as long as you can if you can’t hold it for this length of time). Click here for Video. The length of time for each repetition and number of repetitions is patient specific.
8. Yawn: The goal of this exercise is to increase the strength of the back of the tongue and throat muscles. Yawn and when you get into a big stretch, hold that position for as long as indicated. Click here for Video.
9. Supraglottic Maneuver: Perform this exercise if and only if directed by your clinician. Your clinician should also provide direction as to the position of your head (tucked, right, left, straight). Collect a small bit of saliva in mouth. Take a deep breath and hold your breath (if the vocal folds are not closed then try to inhale and say ah, turn off your voice and hold your breath). Keep holding your breath while you swallow. Immediately after you swallow, cough. Practice with saliva prior to food or liquid. Click here for Video. The number of repetitions is patient specific.
10. Tongue Strength Exercise: Using a tongue depressor, press the tip of your tongue out against the tongue depressor. Put the tongue depressor on the tip of your tongue and push up. To exercise the middle part of your tongue, put the tongue depressor towards the middle of your tongue and push up against the roof of your mouth. To exercise the back of the tongue, say the “k” sound, then put the tongue depressor on the spot of the tongue that made contact with the roof of your mouth and push up. Next, sweep the tip of your tongue from the very front of your mouth to the back along the roof of your mouth. Lastly, lateralize your tongue from one corner of your mouth to the other. The number of repetitions is patient specific. Click here for Video.
11. Tongue Range of Motion: First, stick your tongue out as far as possible and hold as instructed. Then pull the tongue back into the mouth as far as you can. Then, lateralize the tongue tip to one corner of your mouth and hold. Then switch to the opposite side and hold. Lastly, open your mouth put your tongue tip behind your top teeth and hold the stretch. The number of sets is patient specific. Click here for Video.
12. Tongue Retraction Exercise: Don’t use the tip of your tongue. Instead, pull the back of your tongue as far into the mouth as you can and hold. Click here for Video.
13. Effortful Pitch Glide: Say “eee” in as low a pitch as possible and then gradually raise the pitch of your voice until the highest tone possible. Hold this tone for the length of time directed by your clinician. Click here for Video.
14. Lip Range of Motion: Pull your lips into a smile and hold the stretch. Next, open your jaw wide and then stretch your lips into a smile and hold. Click here for Video.
Additional resources for swallowing specialists:
1) Click Here to open a two page PDF which can then be printed and customized for each patient. Although you could save a copy of this on your computer, the NFOSD is requesting that you not do so for two reasons.
A) We are continually evolving this set of exercises, videos, and tools. If you save a version on your computer, you will be less apt to come to our website for each patient and may miss out on important updates.
B) We are trying to raise the awareness of swallowing disorders to the patient, professional, and congressional (and other potential research funding sources) communities for a variety of reasons. Building up our ongoing website traffic is a demonstration to potential research funding sources that dysphagia is a disorder that is generally misunderstood, under-diagnosed, and improperly treated.
2) If you have suggestions on how to make this tool easier to use or to add additional exercises (which will be vetted by our foundation board and medical advisors), please click to be directed to our “contact” page. We are striving to make this a tool which will work for all SLPs and their respective patients which could benefit from a set of oral exercises.