How swallowing works

Before you swallow, you chew your food to an appropriate size, shape, and texture. When you swallow, this material passes through your mouth and a part of your throat called the pharynx. From there the chewed food goes through a long tube called the esophagus. It then enters your stomach and your digestive tract (gastrointestinal tract).

During breathing, air travels from your mouth and pharynx into the larynx (toward your lungs). When you swallow, a flap called the epiglottis moves to stop any food particles from entering your larynx and lungs. The muscles of the larynx pull upward to help with this movement. They also tightly close during swallowing. That prevents food from going into your lungs.

Swallowing needs the muscles in these regions to work together. But sometimes they may not work right. That can lead to problems swallowing. Muscle weakness in these areas can make swallowing hard to do. For example, food particles might be more likely to end up in your lungs if the muscles that close your larynx are weak.

When closure of the larynx exercises are needed

You might need to do closure of the larynx exercises if you have trouble swallowing. Not being able to swallow correctly is called dysphagia.

Dysphagia may lead to aspiration. That’s when material from your stomach and intestines gets into your airways. This is a serious issue. It can lead to problems, such as pneumonia. So it should be diagnosed and treated as soon as possible.

Many conditions can cause swallowing problems. Some examples are:

• Head injury.

• Spinal cord injury.

• Stroke.

• Major dental problems.

• Conditions that reduce saliva, such as Sjogren syndrome.

• Mouth sores (lesions).

• Parkinson disease or other nervous system conditions.

• Muscular dystrophy.

• Blockage in the esophagus, such as from a tumor or narrowing.

• Radiation treatment (with or without chemotherapy) for throat cancer.

Getting ready for your exercises

Before you start these exercises, you may need to be standing or sitting in a chair. Your SLP will show you what to do. For example, it may be better if you do these exercises while out of bed.

It is best to remove distractions from your environment. Turn off the TV. Do the exercises at a time when you won’t have visitors. You will be able to fully focus and get the most benefit from them. You can do these exercises at any time that is good for you.

Sample exercises

Your SLP can show you which exercises to do. And they can tell you how often to do them. For example, you may be asked to do these exercises:

• Take a deep breath and hold it. Keep holding your breath while you swallow. Right after swallowing, cough. This is called the supraglottic swallow. Repeat a few times.

• 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. Cough while letting go of the air to clear leftover liquid or food from your airway. This is called a super-supraglottic swallow. Repeat a few times. You don't need to use food or liquid with either of these exercises.

• Take a breath. Keep holding your breath as you bear down. Hold for a few seconds and then relax. Repeat a few times.

• Hold your breath tightly. Place both hands under your chair. Pull as if you are trying to lift up your chair with you in it. Let go of your breath and say “ahh” while you continue to pull. Relax. Repeat a few times.

• Hold your breath tightly. Turn your head to the left or to the right. Let go of your breath and say “ahh” while your head is still turned. Relax. Repeat a few times.

All of these exercises help close the larynx. That may improve your swallowing.

In most cases, you’ll do the closure of the larynx exercises along with other types of swallowing exercises. If so, do these in the same order each time. Don’t leave any out. Your care team will plan a series of exercises for you. These will target the source of your swallowing problem.

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 care team will watch your progress. They may make changes to your exercise therapy, if needed. You may also 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 drop. 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.

Keep doing all your swallowing exercises as directed. You will get the most benefit from following the therapy your SLP prescribed. Your gains may be less if you miss exercise sessions. Be sure to work closely with all the members of your care team. They can help you to correctly treat your condition. This will make it more likely for you to succeed.