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Swallowing after Treatment

Surgery or radiation therapy in the head and neck area can affect your ability to eat and drink safely and effectively. Difficulty swallowing is also known as dysphagia.

 

When there is difficulty swallowing, you may encounter problems with:

  • Chewing harder or larger pieces of food
  • Coughing when you are eating and drinking
  • Getting food and drinks aspirated into your airway
  • Maintaining your weight

The following are some exercises that can help with strengthening the muscles used in swallowing. It is important to work with your speech therapist to choose the exercises that are suitable for you.

Swallowing Exercises

You should aim to do these exercises multiple times a day.

Tongue Hold Swallow (Masako exercise)

 

  1. Place your tongue between your front teeth.
  2. Swallow in this position.
  3. Relax and move your tongue back.

Do this exercise multiple times a day as instructed by your speech therapist.

Effortful Swallow

  1. Swallow normally, but squeeze your throat and tongue muscles hard when you swallow.
  2. You can pretend to be swallowing something sticky like peanut butter.

Do this exercise multiple times a day as instructed by your speech therapist.

Mendelsohn’s Manoeuvre

  1. Swallow normally, but hold your Adam’s apple at the highest point for 2 seconds when you swallow.
  2. You can squeeze your throat muscles hard to do this, or pretend to hold your breath for 2 seconds midway through your swallow.

Do this exercise multiple times a day as instructed by your speech therapist.

Shaker’s Exercise

  1. Lie flat on your bed or on the floor.
  2. Relax your shoulders and lift your head to look at your toes.
  3. Lie back down.
  4. Repeat 30 times.
  5. Now, lift your head up and hold this position for 30 seconds.
  6. Repeat this 2 times.
Do this exercise multiple times a day as instructed by your speech therapist.

 

Breath Hold Swallow (Supraglottic Swallow)

  1. Breathe in and hold your breath.
  2. While holding your breath, swallow.
  3. Cough and let go of the breath.
Do this exercise multiple times a day as instructed by your speech therapist.

Tongue Exercises

You should aim to do these exercises multiple times a day.

Stretch: Tongue Protrusion

  1. Stick out your tongue as far as you can feel a stretch.
  2. Hold for 5 seconds.
  3. Do this 5 times.

Stretch: Tongue Retraction

  1. Pull your tongue back in your mouth like you are yawning.
  2. Hold for 5 seconds.
  3. Do this 5 times.

Stretch: Tongue Lateralisation

  1. Move your tongue to one side as far as you can feel a stretch.
  2. Hold for 5 seconds.
  3. Now do the same on the other side.
  4. Do this 5 times.

Stretch: Tongue Elevation

  1. Push the tip of your tongue on the roof of your mouth.
  2. Hold this position and open your mouth wide.
  3. Hold for 5 seconds.
  4. Do this 5 times.

Stretch: Tongue Back

  1. Pull your tongue back in your mouth against your throat.
  2. Now say a strong ‘kuh’.
  3. Do this 5 times.

Strength: Tip of Tongue

  1. Place a tongue depressor or spoon just outside your mouth.
  2. Push the tip of your tongue against this.
  3. Push for 5 seconds, then relax.
  4. Do this 5 times.

Strength: Sides of Tongue

  1. Place the tongue depressor or spoon along one side of your tongue.
  2. Push the whole side of your tongue against this.
  3. Push for 5 seconds, then relax.
  4. Now do the same for the other side.
  5. Do this 5 times.

Strength: Body of Tongue

  1. Push down on your tongue with the tongue depressor or spoon.
  2. Push your tongue up against it.
  3. Push for 5 seconds, then relax.
  4. Do this 5 times.

If you have had surgery, please check with your doctor or therapist before starting these exercises.
If these exercises cause pain or numbness, stop doing them immediately and inform your doctor or therapist.