SWALLOWING EXERCISES: HOW TO DO TONGUE-STRENGTHENING EXERCISES

Note from PRO: We have received several questions about swallowing exercises to combat dysphagia in the past month. This explainer walks you through simple tongue exercises to improve swallowing. 

You might need to practice tongue-  strengthening exercises if you have trouble swallowing. This is a medical condition called dysphagia. With practice, these exercises may help you increase your tongue strength and mobility.

Suppose, for example, you have a problem with the first phase of swallowing, before the food leaves your mouth. If so, you may benefit from working the muscles in this region, like your cheeks, tongue, and lips. In this case, tongue exercises might be helpful. Specifically, tongue-strengthening exercises may help you manipulate your food inside your mouth and move the material into your pharynx. 

Dysphagia can lead to aspiration. This is when food or other material accidentally enters the airways or lungs. This is serious, because it can lead to pneumonia and other problems. Dysphagia requires prompt diagnosis and treatment.
As part of your treatment plan, your doctor and Speech Language Pathologist (SLP) may prescribe swallowing exercises, such as tongue-strengthening exercises. This may be in addition to other treatments such as dietary changes, changes in eating position, medicines, or surgery. Over time,  these exercises can strengthen your swallowing muscles. This, in turn, may improve your swallowing and prevent aspiration.

Your SLP can show you the specific exercises you should do and explain how often to do them. As an example, you may be asked to: 

• Stick out your tongue as far as you can. Put something flat like a spoon or tongue depressor on your tongue. Push against your tongue with the flat object, and push your tongue against the object. Hold for a couple of seconds. Repeat 5 times.
• Repeat the exercise above 5 times. This time,  put the spoon or depressor below your tongue instead.
• Extend your tongue as far as possible to the corner of your mouth while pushing against a depressor. Hold for a couple of seconds. Relax. Repeat on the other side of your mouth.Repeat the whole process 5 times.
• Extend your tongue to the bumpy part on the top of your mouth right behind your teeth. Then curl your tongue back toward the back of your mouth as far as possible. Hold for a few seconds. Repeat 5 times.

Your SLP might prescribe other exercises to improve your strength and range of motion at the base of your tongue and help you swallow in other ways. As example, you may be asked to:

• Inhale and hold your breath very tightly. Bear down like you are having a bowel movement. Keep holding your breath and bearing down as you swallow. This is called a super-supraglottic swallow. Repeat a few times.
• Pretend to gargle while holding your tongue back as far as possible. Repeat.
• Pretend to yawn while holding your tongue back as far as possible. Repeat. 
• Do a dry swallow, squeezing all of your swallowing muscles as tightly as you can. Imagine swallowing a vitamin whole, without water. Repeat a few times.

In most cases, you’ll be practicing tongue-strengthening exercises along with other types of swallowing exercises, like exercises to strengthen your cheeks and lips. If so, do these in the same order each time, so you don’t leave any exercises out. Your healthcare team can plan a series of exercises that specifically targets the source of your swallowing problem. 
Your SLP can tell you specifically how to do each exercise and how often you should practice it. In many cases, you’ll need to practice your exercises several times a day for the most benefit.