How swallowing works

Before you swallow, you chew your food to a size, shape, and texture that can be swallowed. This is called the first phase of swallowing. When you swallow, this material passes through your mouth and down through parts of your throat called the pharynx and larynx. From here, the food goes down through a long tube (esophagus). It then enters your stomach. This movement needs a series of actions from the muscles in these areas.

When lip closure exercises are needed

You might need to use lip closure exercises if you have dysphagia. This disorder can lead to food or fluid going into the airways and lungs (aspiration). This can lead to pneumonia and other problems. Because of this, it’s important to treat your dysphagia right away. An SLP will prescribe lip closure exercises if you are having trouble with your first phase of swallowing.

Many conditions can lead to trouble swallowing, such as:

• Stroke

• Brain or spinal cord injury

• Dementia

• Conditions that reduce saliva, such as Sjogren syndrome

• Parkinson disease or other nervous system conditions

• Muscular dystrophy

• Blockage in the esophagus, such as a tumor or stenosis (narrowing)

• Weak throat muscles from surgery or radiation treatment

When you have a problem with the first phase of swallowing, you may need to work the muscles in your cheeks, tongue, and lips. Lip closure exercises can help you:

• Keep your food inside your mouth

• Move the food around your mouth

• Move the food down into your pharynx

Risks of lip closure exercises

Lip closure exercises are very safe. If you have any mild pain, you can stop doing them. Let your SLP know right away if you have pain.

Getting ready for your exercises

Before you start these exercises, you may need to change your positioning. Your SLP will show you how to do so, if needed. For instance, it may be better if you do these exercises while out of bed.

It's best to remove distractions from your environment. Turn off the TV. Do the exercises at a time when you won’t have visitors. You'll 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. Your SLP will let you know if there is anything else you need to do before getting started.

Sample exercises

You may do the exercises in your hospital room or at home. Often you can do them on your own. They may be used with other types of exercises to help you swallow better.

Your SLP can show you the exercises you will need to do and tell you how often to do them. You may need to do them several times a day. For example, you may be asked to:

• Press your lips tightly together for 5 seconds. Relax and then repeat 5 times.

• For 5 seconds, tightly press your lips around a tongue depressor while your SLP tries to remove it. Relax and then repeat 5 times.

• Fill your cheeks with air. Move the air from one cheek to the other 5 times. Make sure no air escapes from your lips or nose. Relax and then repeat 5 times.

You will likely be doing lip closure exercises along with other types of swallowing exercises. If so, do these in the same order each time. This will help make sure you don’t forget any exercises.

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 give helpful feedback on your progress to your SLP. Write down what exercises you did and when you did them. Also write down any problems you had. Discuss them with your SLP.

As your ability to swallow improves, your risk of aspiration may lessen. 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.

You may still have problems with swallowing even after practicing these exercises often. Your SLP will tell you what kind of progress to expect.

Keep practicing all of your swallowing exercises as prescribed by your SLP. You will benefit most from following the therapy exactly as prescribed. Your progress may be less if you skip practice sessions. Work closely with your healthcare team. This will help increase your chance of a good outcome.