Swallowing Exercises: How to Do Tongue-Strengthening Exercises

What are tongue-strengthening exercises?

Tongue-strengthening exercises can help improve your swallowing. With practice, these exercises may help you increase your tongue strength and mobility. This may improve your ability to swallow, especially when used with other types of swallowing exercises.

Before you swallow, you chew your food to a size, shape, and consistency that can be swallowed. When you swallow, this material passes through your mouth and into a part of your throat called the pharynx. From there, the chewed food passes through a long tube (esophagus) before entering your stomach and the rest of your digestive tract.

This movement requires a series of coordinated actions from your muscles along this path. If something doesn't work right, it can lead to problems swallowing. Muscle weakness in these areas can make proper swallowing difficult. Swallowing exercises can increase strength, mobility, and control of these muscles. Over time, this may help you to swallow normally again.

A speech-language pathologist (SLP) may prescribe certain swallowing exercises to improve your swallowing. The specific exercises will depend on your swallowing problem.

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.

Your SLP might advise different swallowing exercises if your problem is in later stages of swallowing.

You can do these exercises in your hospital room or at home. Often you can do them on your own. But you may also work with a health provider to practice these exercises.

Why might I need tongue-strengthening exercises?

You might need to practice tongue-strengthening exercises if you have trouble swallowing. This is a medical condition called dysphagia.

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 needs prompt diagnosis and treatment.

As part of your treatment plan, your healthcare provider and 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.

Different health conditions can lead to swallowing problems. Some examples are:

• Stroke

• Dementia

• Head and neck cancer

• Head injury

• Conditions that reduce saliva such as Sjögren syndrome

• Parkinson disease or other nervous system conditions

• Muscular dystrophies

• Blockage in the esophagus such as from a tumor or a stricture

• History of radiation, chemotherapy, or both to the neck or throat for cancer

Your healthcare provider or SLP may be more likely to prescribe tongue-strengthening exercises if they suspect you are having trouble with your first phase of swallowing. For instance, this might happen from a stroke or with dementia.

What are the risks of tongue-strengthening exercises?

Tongue-strengthening exercises and other swallowing exercises are safe. If you have pain or discomfort during these exercises, temporarily stop doing them. Let your healthcare provider or therapist know right away. Don’t practice these exercises unless someone from your healthcare team specifically prescribes them to you for your health condition.

How do I get ready for tongue-strengthening exercises?

Before you start your tongue-strengthening exercises, you may need to change your positioning. Your SLP will give you specific instructions on how to do this, if needed. For instance, it may be better if you do these exercises while out of bed.

It's also helpful to remove distractions from your environment. Turn off the TV and do them at a time when you won’t have visitors. This will let you fully focus on your exercises and get the most benefit from them. You can do these exercises at any time that is convenient for you.

Your SLP can let you know if there is anything else you need to do before getting started.

What happens during tongue-strengthening exercises?

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 the tip of 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. For instance, 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 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 exactly how to do each exercise and how often you should practice it. In many cases, you’ll need to practice your exercises a few times a day for the most benefit.

What happens after tongue-strengthening exercises?

You can resume your normal activities right after practicing your tongue-strengthening and other swallowing exercises.

It’s a good idea to keep a record every time you do your swallowing exercises. This serves as a reminder to you to do your exercises as prescribed. It also provides helpful feedback on your progress to your SLP. Make a note of what exercises you did and when you did them. Also note any problems, so you can discuss them with your SLP.

Your SLP and healthcare team may change your exercises, as the team monitors your progress. This monitoring may include bedside swallowing exams or more imaging techniques, like fiberoptic endoscopic evaluation of swallowing (FEES) or modified barium swallow study (MBSS). It may take a few weeks to notice an improvement in your swallowing.

As your ability to swallow improves, your risk of aspiration will decrease. Your SLP may be able to change your diet and allow you to eat certain types of food again. This can improve your nutritional intake, your overall health, and your quality of life.

Keep practicing all your swallowing exercises as prescribed by your SLP. If you miss a practice session, you may have less improvement. Work closely with all the members of your healthcare team to properly treat your condition.

Next steps

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