EXERCISES TO IMPROVE SWALLOWING

Here are some exercises for different parts of the swallowing system to help you.

To produce these lasting changes, the muscles have to be worked with a progressive load or resistance, of sufficient intensity and with the right frequency and duration.

You'll need to do them systematically: few exercises, but done consistently, in short sets, to avoid both muscle fatigue and tiredness and lack of motivation.

Overexertion is never advisable, so you'll need to do them progressively, gradually learning what your optimal resistance is.

Recommendations

It's best to do them sitting down, with your head at 90 degrees to the floor, keeping good posture and, if possible, in front of a mirror. This is to control possible involuntary movements of other parts of the body that could be counterproductive for the treatment.
DON'T GET OBSESSED OR GIVE UP QUICKLY!!
It's important to bear in mind that the effects aren't immediate; they'll start to be noticed after two or three weeks of repeated practice. All the exercises should be repeated about 3-5 times a day at least. The length of treatment will depend on the degree of impairment, and can range from weeks to months, adapting and modifying the exercises according to progress and response.

EXERCISES TO STRENGTHEN THE TONGUE MUSCLES

Do 10 to 30 repetitions lasting 1 to 3 seconds, 3 times a day, 3 days a week.

Sustained and fluctuating tongue resistance exercises

Stick your tongue out ventrally and overcome the force the therapist applies inwards, to the sides, up and down, for about 5 seconds, using a tongue depressor. To avoid associated movements, the therapist will stabilise and control the jaw and neck with their hand. When doing the forward projection with sustained or fluctuating contraction, the tongue should not rest on the lips or teeth.

DOUBLE CHIN EXERCISE

Place the tip of the tongue on the palatal folds and press steadily upwards for five seconds. By touching the double chin area, you can feel the base of the tongue contracting.

TONGUE WEIGHT EXERCISE

Tie a lead weight to a plastic washer with silk or strong thread, so that the washer is at one end and the weight at the other. With the tongue fully protruded, without touching the lips or teeth and with the tip of the tongue inserted in the washer, hold the weight attached by the speech therapist for about five seconds, in three sets.
The weight and holding time will be gradually increased

TONGUE BUTTON EXERCISE

Place a small button tied with silk thread on the palatal folds; the patient must hold it firmly with the tip of the tongue while the speech therapist pulls the thread steadily for ten seconds or intermittently, doing three sets of five contractions.

DUMMY SUCKING EXERCISE AGAINST RESISTANCE

Suck on a dummy steadily for 10 seconds, or do three sets of five fluctuating sucks. A pull will be applied in the opposite direction to the sucking.

SYRINGE SUCKING EXERCISE

Suck on the syringe while holding it with the lips. You can also suck different volumes of air from the syringe while counter-resistance pulls are applied by drawing the plunger outwards.

JAW EXERCISES

JAW OPENING EXERCISE

This helps balance the fascia and the muscles that open the mouth.
The aim of this exercise is to open the mouth slowly without the jaw shifting to the sides. Do the exercise in front of a mirror to avoid sideways movements of the jaw. Open your mouth slowly, without reaching the point of pain. Gently push your jaw forward as far as possible. Close your mouth while keeping it pushed forward (don't close your mouth to the point where your teeth touch). Gently pull your jaw back as far as possible. Repeat this exercise slowly 10 times.

JAW OPENING AGAINST RESISTANCE

We resist with our hand, preventing the jaw from opening. We'll progress the resistance according to the patient's needs. Apply a sustained opening force for 5 seconds and rest for 5, repeating 12 times.

INCREASING THE OPENING

This exercise will help relax the opening muscles, stretch the closing muscles and increase how wide the mouth opens. Don't do this exercise if there's pain, clicking or catching in the joint. We'll gradually increase the mouth opening by placing a knuckle or an object of the same size between the teeth (tongue depressors, clothes pegs, etc.). Rest the teeth on the knuckle or object for 60 seconds. Gradually increase to two knuckles and finally three, or as many as you can. Do this for one or two minutes, twice a day.

EXERCISES TO INCREASE TONE AND IMPROVE MOBILITY OF THE SOFT PALATE

BALLOON EXERCISE

To increase muscle tone and mobility of the soft palate, as well as the palatal sphincter action. Blow up a balloon without holding it with your hands, and once it's inflated hold it with the buccinator muscles while holding your breath. We'll work the muscle tone of the buccinator complex and the muscle tone, mobility and sphincter action of the soft palate, holding the air in the mouth and letting it out through the nose, producing the downward and forward movement of the soft palate.

SHAKER EXERCISE

Lie on your back on a firm surface and lift your head enough to see your toes. Hold this position for one minute, then the patient rests for another minute. The exercise is repeated three times.
After this sequence, the patient lifts their head, looks at their toes and lowers their head, 30 times in a row.
Progress gradually if there's neck discomfort.

FLOOR OF MOUTH EXERCISES

The aim is to work the suprahyoid muscles. Sucking exercises are used, with as much force as possible:
1) Suck hard through a straw while covering the bottom opening with your finger.
2) Suck hard on a syringe so that we can move the plunger inwards.
3) Suck hard without a straw.

Neck exercises

Neck exercises