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The Effortful Swallow Exercise


   By Jan C. Pryor M.A., CCC-SLP, BRS-S

Exercise of the Month: The “Effortful” Swallow (aka the Modified Valsalva maneuver, or the “Hard Swallow”)

Sometimes the best practice for swallowing is swallowing itself. How you do it, can make all the difference. The exercise is just as the name implies, you swallow with effort or HARD! That’s right, with GUSTO. The goal of this technique is to recruit more motor units, increase the demand and create a muscle training/strengthening effect. This technique is used to protect the airway. How does using this technique protect the airway? When there is muscle weakness due to various conditions, such as head and neck cancer, stroke or general de-conditioning, the muscles of the tongue and pharynx may not be doing their part to push, lift or squeeze to propel food out of the mouth and throat. The result of a weak muscle contraction(s) is often that food or liquids “pool” in the mouth or pharynx (throat) after the swallow. After swallowing, residual food and liquid in the mouth and throat are likely to overflow into the unprotected airway and cause what is known as aspiration.

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