Tongue-Strengthening Exercises for Dysphagia

How swallowing works

Before you swallow, you chew your food to a size, shape, and texture that can be swallowed. When you swallow, this material passes through your mouth and down through parts of your throat called the pharynx and larynx. From there, the food goes down through a long tube (esophagus). It then enters your stomach. This movement needs a series of actions from the muscles in these areas.

When you breathe, air passes through your pharynx and larynx too. It then travels down through a long tube (trachea) before it reaches your lungs. There is a small flap of tissue called the epiglottis that covers your larynx when you swallow food or liquid. This is so food and liquids don’t go into your trachea and lungs. Muscle weakness in any of these areas can make swallowing difficult.

When tongue-strengthening exercises are needed

You may need to use tongue-strengthening exercises if you have dysphagia. Dysphagia can lead to food or fluid going into the airways and lungs (aspiration). This can lead to pneumonia and other problems. Because of this, it’s important to treat your dysphagia right away.

An SLP will prescribe tongue-strengthening exercises if you are having trouble with your first phase of swallowing. This is before the food leaves your mouth. It may help to work the muscles in this area. Tongue-strengthening exercises can help you move food inside your mouth and toward your throat.

Many conditions can lead to trouble swallowing, such as:

• Stroke

• Dementia

• Head and neck cancer

• Radiation and chemotherapy to the throat

• Spinal cord injury

• Head injury

• Conditions that reduce saliva, such as Sjogren syndrome

• Parkinson disease or other nervous system conditions

• Muscular dystrophies

• Blockage in the esophagus, such as from a tumor or a stenosis (narrowing)

Risks of tongue-strengthening exercises

Tongue-strengthening exercises are very safe. If you have any discomfort, you can stop doing them. Let your SLP know right away if you are having pain.

Getting ready for your exercises

Before you start these exercises, you may need to change your position. Your SLP will show you how to do so, if needed. For example, it may be better if you do these exercises while out of bed.

It's best to remove distractions from your environment. Turn off the TV. Do the exercises at a time when you won’t have visitors. You'll be able to fully focus and get the most benefit from them. You can do these exercises at any time that is convenient for you. Your SLP will let you know if there is anything else you need to do before getting started.

Sample exercises

You may do the exercises in your hospital room or at home. Often you can do them on your own. They may be used with other types of exercises to help you swallow better.

Your SLP can show you the exercises you will need to do and tell you how often to do them. You may need to do them several times a day. For example, you may be asked to:

• Stick out your tongue as far as you can. Put something flat on your tongue. Try using a spoon or tongue depressor. Push against your tongue with the flat object. Push your tongue against the object. Hold for a couple of seconds. Repeat 5 times.

• Do the same exercise again, but put the flat object under your tongue instead. Repeat 5 times.

• Stick your tongue as far as you can 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 5 times.

• Curl your tongue up and back to the bumpy part on the roof 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.

You will likely be doing tongue-strengthening exercises along with other types of swallowing exercises. If so, do these in the same order each time. This will help make sure you don’t forget any exercises.

Keeping track of your progress

Keep a record of the times you do your swallowing exercises. It will remind you to do your exercises as prescribed. It will also provide helpful feedback on your progress to your SLP. Make a note of what exercises you do and when you did them. Also note any problems. Discuss them with your SLP.

Your SLP and healthcare team will watch your progress. They may make changes to your exercise therapy, if needed. You may have bedside swallowing exams or imaging tests. It may take a few weeks to notice that your swallowing is better.

As your ability to swallow gets better, your risk for aspiration may lessen. Your SLP may be able to change your diet. You may also be able to eat certain types of food again. This can improve your nutrition, your overall health, and your quality of life.

Continue to practice all of your swallowing exercises as prescribed by your SLP. You will benefit most from following the therapy exactly as prescribed. Your progress may be less if you skip practice sessions. Work closely with all the members of your healthcare team. This will help increase your chance of a good outcome.