Speech and Swallowing Exercises

Patients with head and neck cancer may be treated with surgery, radiotherapy, chemotherapy or a combination of these modalities. Each treatment type may have a negative impact on post-treatment swallowing function.

How Often Should You Complete the Exercises?

Aim to complete each exercise 4 times per day with 10 repetitions each time, unless advised otherwise by your healthcare provider.

Instructions for Swallowing Exercises

1. Strap Muscle Exercises

The strap muscles in your neck help move the larynx (voice box) up and out during swallowing to protect your airway and guide food and liquids into the oesophagus. These exercises help improve strength and flexibility.

Shaker Exercise:

• Part 1:

  • Lie flat on your back (on the floor or bed), keeping your shoulders on the floor or bed.

  • Raise your head to look at your toes.

  • Hold this position for 1 minute (you may need to gradually build up to this time), then relax for 1 minute.

  • Repeat 2 more times.
    

• Part 2:

  • Raise your head to look at your toes, then relax your head back down.

  • Repeat 30 times in a row.
    

Mendelsohn Manoeuvre:

• Place your fingers on your larynx (voice box).

• Swallow your saliva. You will feel your larynx lift and lower.

• Swallow again, but this time, when your larynx lifts, don’t let it drop. Hold it in that position with your throat muscles for several seconds.

• Relax and breathe normally.
  

Falsetto:

• Take a deep breath and let it out on an "ee" sound.

• Slide up the scale as high as you can until you reach a high squeaky voice.

• Hold that high voice for as long as possible, then rest.
  

2. Base of Tongue Exercises

These exercises strengthen the base of your tongue, which creates pressure to initiate swallowing and push food toward your oesophagus.

Masako (Tongue Hold) Exercise:

• Hold your tongue firmly between your teeth.

• Swallow your saliva (you may feel tension in the throat and difficulty starting the swallow).

• This exercise can be modified by your speech and language therapist (SLT) if needed.

Effortful Swallow:

• As you swallow, squeeze hard with all your throat muscles.

• Focus on putting extra effort into your swallow.

Tongue Retraction:

• Pull your tongue back in your mouth as far as possible.

• Hold for one second, then relax.

Gargle:

• Pull your tongue back in your mouth and pretend to gargle as hard as possible.

• Hold for five seconds, then relax.
  

3. Voice Exercise

These exercises help maintain laryngeal flexibility.

Pitch Glides:

• Hum gently while moving up and down a scale.
  

Benefits of Swallowing and Voice Exercises

While further research is needed, completing these exercises during and/or after radiotherapy treatment may offer the following benefits:

• Improved swallowing and voice function.

• Shorter duration of non-oral feeding.

• Improved weight maintenance or gain.

• Reduced restrictions on an oral diet.

• Enhanced swallowing-related quality of life.

• Reduced or delayed impact of radiation-induced fibrosis (thickening and scarring of tissue that causes stiffness and reduced flexibility).
  

Additional Tips

In addition to performing swallowing rehabilitation exercises, it’s important to continue swallowing food, fluids, and saliva as much as possible, as swallowing itself is an effective exercise.

Read More:

• Swallowing Exercises for Patients with Head and Neck Cancer Receiving Radiation Treatment

• Rehabilitative Swallowing Exercises: Head and Neck Radiation Therapy Patients © 2008 The University of Texas M.D. Anderson Cancer Center

• Research Article on Swallowing Exercises

• Another Research Article on Swallowing Rehabilitation

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