Swallowing Exercises: Closure of the Larynx Exercises

What are closure of the larynx exercises?

Larynx-closure exercises can help you swallow better. With practice, they may help strengthen the muscles of your larynx. Your larynx is the part of your throat that is also known as your voice box.

Before you swallow, you chew your food to an appropriate size, shape, and consistency. 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 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 block the entrance of food particles into your larynx and lungs. The muscles of the larynx pull upward to assist with this movement. They also tightly close during swallowing. That prevents food from entering your lungs.

Swallowing needs a series of coordinated actions from your muscles in these regions. 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. Swallowing exercises can improve the strength, mobility, and control of these muscles. Over time, they may help you to swallow normally again.

Your healthcare provider or a speech-language pathologist (SLP) may prescribe swallowing exercises to improve your swallowing. The exact exercises will depend on why you are having trouble swallowing. For example, you may have a problem when the food is in your pharynx. If so, you may benefit from working the muscles in that region. Specifically, larynx-closing exercises may help you keep food moving normally down through the pharynx and into the esophagus.

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 professional to practice them.

Why might I need closure of the larynx exercises?

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 foods you eat, your saliva, or material that comes up from your stomach and intestines enters into your respiratory tract. This serious situation can lead to pneumonia and other problems. As a result, dysphagia should be diagnosed and treated promptly.

As part of your treatment plan, your healthcare provider and SLP may prescribe swallowing exercises. (They are usually in addition to other treatments, such as dietary changes, medicines, or surgery.) Over time, practicing these exercises can strengthen your swallowing muscles. You will be able to swallow better. That, in turn, can prevent aspiration.

Different conditions can lead to swallowing problems. Some examples are:

• Stroke

• Significant dental problems

• Conditions that reduce saliva such as Sjögren syndrome

• Mouth lesions

• Parkinson disease or other nervous system conditions

• Muscular dystrophies

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

• History of radiation, chemotherapy, or both to the neck or throat for cancer

What are the risks of closure of the larynx exercises?

Swallowing exercises, such as those for the larynx, are very safe. If you feel pain or discomfort while doing them, temporarily stop. Tell your healthcare provider or therapist right away. Don’t practice these exercises unless they have been prescribed for you.

How do I get ready for closure of the larynx exercises?

Before you start these exercises, determine if you need to change your positioning. Your SLP will show you how to do so, if needed. (For example, 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 television. 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 tell you if there is anything else you need to do before starting.

What happens during closure of the larynx exercises?

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 the following 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. There is no need to use food or liquid with either of these exercises. This exercise should be done with caution. People with uncontrolled blood pressure should not do this exercise as bearing down can increase blood pressure. 

• 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 “ah” 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 “ah” while your head is still turned. Relax. Repeat a few times.

All these exercises help close the larynx. This 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 healthcare team will plan a series of exercises that specifically targets the source of your swallowing problem.

Your SLP can give very specific instructions about how to do each exercise and how often you should practice it. In many cases, you’ll need to practice your exercises several times a day for the most benefit.

What happens after closure of the larynx exercises?

You can resume your normal activities right after doing your swallowing exercises.

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 do them. Also note any problems. Discuss them with your SLP.

Your SLP and medical team will monitor 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 an improvement in your swallowing.

As your ability to swallow improves, your risk of 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 nutritional intake, your overall health, and your quality of life.

Continue to practice all your swallowing exercises as prescribed by your SLP or healthcare provider. You will benefit most from following the prescribed therapy. If you miss practice sessions, your progress will slow. To maximize your chance of a good outcome, work closely with all the members of your healthcare team to properly treat your condition.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure