This leaflet is only intended for use following the recommendation of and under the supervision of an appropriately trained speech and language therapist, following a specialist assessment of oropharyngeal swallow function. If used inappropriately, it could have a negative impact on swallowing.

Aim

To improve the safe passage of food and drink through your throat when you swallow.

Although this exercise doesn’t involve swallowing, it exercises some small muscles under your chin which play a very important part in opening the muscle at the top of your oesophagus (food pipe) and help to keep your airway safely closed when food and drink passes by.

What you need to do

Long head lift

• Lie flat on your back and keep your shoulders on the ground throughout.
• Lift your head high and forward enough to see your toes.
• It might be helpful to imagine there is a piece of Velcro under your chin that you are trying to stick to another piece on your chest.
• Hold the head lift for one minute, then relax and lower your head to the floor.
• Rest for one minute before repeating three times.

Short head lift

• This is the same as a long head lift but do not hold your head up for one minute and do not rest for a minute when you put your head down.
• Just lift your head up until it touches your chest and then lower it down straight away. Repeat 30 times.

Repeat the set of exercises three times a day for at least six weeks.

If you find the exercises too difficult

Slowly build up what you can do. You can reduce the amount of time you hold the position for, you can rest more in between exercises and you can reduce the number of repetitions to make it easier.

If you find the exercises too easy

You can make the exercises more difficult by doing more repetitions, or by increasing the amount of resistance you are pushing against, for example by getting someone to place their hand on your forehead to provide resistance for you to push against.

Modifying the exercise

Your healthcare professional may recommend modifying the exercise.

Towel tuck

Roll up a towel and place it under your chin. Squeeze down and then swallow hard. Only swallow your saliva, do not use food or drink. Repeat the exercise 10 times, three times a day for six weeks.

If you find this exercise too difficult: Slowly build up what you can do. You can rest in between exercises and reduce the number of repetitions to make it easier. You may need to take sips of water in between exercises if your mouth becomes too dry to swallow.

If you find this exercise too easy: You can make this exercise more difficult by using a thicker towel or by increasing the number of repetitions.

Exercise band

You will need a piece of stretchy but resistant material, about one metre long for this exercise. Ideally use a stretchy rubber latex exercise band which comes in different levels of resistance. Each resistance level is colour coded. These bands are sometimes known as Therabands, which is a particular brand name. If you don’t have an exercise band, you can use something like a pair of tights.

Holding one end in each hand, tie the band around your head, from under your chin to the top of your head (not too far back). Tie it with a bow on top so that you can easily undo it. It should be snug around your head but not tight.

Open your mouth as wide as you can against the resistance of the band by pushing down with your jaw. Hold your mouth open for one minute, then rest for one minute. Do this three times.

Next open your mouth as wide as you can by pushing your jaw against the band and then close it immediately. Do not hold your mouth open. Do this 30 times.

Repeat the set of exercises three times a day for at least six weeks.

If you find this exercise too difficult: Slowly build up what you can do. You can reduce the amount of time you hold the position for, you can rest more in between exercises and you can reduce the number of repetitions to make it easier.

If you find this exercise too easy: You can make it more difficult by using a more resistant band or by tying the band a little tighter. You can also increase the number of repetitions.

Hand resistance

Place a flat hand under your chin with your palm facing the floor, push gently in an upwards direction against your jaw to provide resistance.

Open your mouth as wide as you can against the resistance of your hand by pushing down with your jaw. Hold your mouth open for one minute, then rest for one minute. Do this three times.

Next open your mouth as wide as you can by pushing your jaw against the resistance of your hand and then close it immediately. Do not hold your mouth open. Do this 30 times.

Repeat the set of exercises three times a day for at least six weeks.

If you find this exercise too difficult: Slowly build up what you can do. You can reduce the amount of time you hold the position for, you can rest more in between exercises and you can reduce the number of repetitions to make it easier. You can also create less resistance by not pushing upwards too strongly with your hand.

If you find this exercise too easy: You can make this exercise more difficult by creating more resistance with your hand. Try resisting your jaw opening more by pushing your hand upwards more against your jaw opening. You can also increase the number of repetitions.