Swallowing Exercises: How to Do Closure of the Larynx Exercises
Larynx-closure exercises can help you swallow better. They are used if you have trouble swallowing (dysphagia). Your larynx is the part of your throat that is also known as your voice box. Swallowing exercises can improve the strength and control of these muscles, and how well they move. Over time, they may help you to swallow normally again.
A speech-language pathologist (SLP) may prescribe swallowing exercises to improve your swallowing. You can do these exercises in your hospital room or at home. Often you can do these exercises on your own. But you may also work with a health provider to practice them.
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 requires 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 larynx-closing exercises if you have trouble swallowing. Not being able to swallow properly is called dysphagia.
Dysphagia may lead to aspiration. That’s when material from your stomach and intestines enters into your airways. This serious situation can lead to pneumonia and other problems. As a result dysphagia should be diagnosed and treated as soon as possible.
Different conditions can cause swallowing problems. Some examples are:
Significant dental problems
Conditions that reduce saliva, such as Sjogren’s syndrome
Mouth sores (lesions)
Parkinson disease or other neurologic conditions
Blockage in the esophagus, such as from a tumor
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 concentrate and get the most benefit from them. You can do these exercises at any time that is convenient for you.
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 do these exercises:
Take a deep breath and hold it. Keep holding your breath while you swallow. Immediately 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. This is called a super-supraglottic swallow. Repeat a few times. You do not 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 be practicing the larynx-closing exercises along with other types of swallowing exercises. If so, do these in the same order each time. Don’t leave any exercises out. Your health care team will plan a series of exercises that specifically targets 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 medical team will watch your progress. They may make changes to your exercise therapy, if needed. This monitoring may include 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 modify 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.
Continue to practice all your swallowing exercises as prescribed by your SLP. You will benefit most from following the prescribed therapy. Your gains may be less if you miss practice sessions. To make it more likely for you to succeed, work closely with all the members of your health care team to properly treat your condition.
March 21, 2017
Kotz, Tamar. Prophylactic swallowing exercises in patients with head and neck cancer undergoing chemoradiation: a randomized trial. JAMA Otolaryngology–Head & Neck Surgery. 2012: 138; 4, pp. 376-382., Sura, Livia. Dysphagia in the elderly: management and nutritional considerations. Clinical Interventions in Aging. 2012: 7; pp. 287-298.
Dozier, Tennille, RN, BSN, RDMS,Jothi, Sumana MD