RANGE OF MOTION EXERCISES FOR DYSPHAGY

EXERCISES FOR THE TONGUE, LIPS, AND JAW

These exercises are designed to increase the range of movement in your
tongue, lips, and
jaw, which will help your speech and/or swallow functioning. When doing
these exercises, it is
important to move the designated area as far as you can in each direction until
you feel the
muscles stretch. Stop if you feel any pain, and mention it to your speech
therapist or doctor.
*** Practice these exercises, once through, 10 times a day.
TONGUE EXERCISES
Range of Motion:
1. Tongue Extension

Protrude tongue between lips.

Sticking out tongue as far as you can.

Hold tongue steady and straight for 3 to 5 seconds.

Relax and Repeat 5 times.

2. Tongue Retraction

Retract tongue, touching the back of your tongue to the roof of your
mouth (as if producing the /k/).

Hold for 1 to 3 seconds.

Relax and Repeat 5 times.

3. Tongue Extension and Retraction

Combine the two procedures above, holding each position for 1 to 3

seconds.

Relax and Repeat 5 times. .

4. Tongue Tip Up

Place tongue on alveolar ridge, (the area behind your top teeth.)

If you don't have any teeth, move your tongue tip up to your gum where
your top teeth would be.

Open mouth as wide as possible maintaining tongue contact.

Hold for 3 to 5 seconds.

Relax and Repeat 5 times

5. Tongue Elevation Along The Palate

Tongue tip to alveolar ridge, (The area behind your top teeth.)

Move tongue front to back along the roof of your mouth.

Relax and Repeat 5 times.

6. Tongue Side To Side

Tongue tip to left side of mouth, hold for 3 to 5 seconds.

Tongue tip to right side of mouth, hold for 3 to 5 seconds.

Relax and Repeat 5 to 10 times.

7. Tongue Tip Up - Jaw Down

If you can perform exercise # 4, lower your jaw as far as you can while
keeping tongue tip behind your teeth.

Hold your jaw in that position for 3 to 5 seconds

Relax and repeat 5 times.

Tongue Resistance:
1. Tongue Push Forward

Stick out your tongue as far as you can.

Put something flat (back of a spoon or a tongue depressor) against your

tongue

Push against your tongue with the flat object at the same time as you
push against the flat object with your tongue

Hold for 1 to 2 seconds.

Repeat 5 times.

2. Tongue Push Up

Push down on your tongue with the flat object, while, at the same time,
you push up with your tongue.

Hold 1 second.

Repeat 5 times.

3. Tongue Push To The Side

Extend your tongue as far as possible to the corner of your mouth while
pressing against a tongue depressor.

Hold for 1 second.

Repeat 5 times.

(Repeat for each side of the mouth unless instructed otherwise).

4. Tongue Inside Push

Put your finger against your right cheek about 1" to the side of the
corner of your mouth.

From the inside, push your tongue against your cheek where your finger
is touching. Push as hard as you can.

Hold it for 1 to 2 seconds.

Relax and Repeat 5 times for each side of the mouth unless instructed
otherwise

JAW EXERCISES
Range of Motion:
1. Jaw Opening

Open your jaw as wide as you can until you feel a stretching, but no
pain.

Hold this furthest open position for 5 seconds then relax and close your
mouth.

Repeat this open posture 5 times.

2. Side-to-Side Movement

Move your jaw to the right side as far as you can until it pulls but does
not hurt.

Hold it there for 5 seconds then relax.

Move your jaw to the left side as far as you can until you feel a stretch
but it does not hurt.
Hold it there for 5 seconds then relax.
Alternate this right to left movement 5 times.

3. Increasing Circular Jaw Movement

Move your jaw around in a circle making it move as far in each direction
as you can until you feel a stretch but no pain.

When you have completed a full circle relax.

Repeat the circular movement 5 times.

LIP EXERCISES
Range of Motion:
1. Lip Retraction

Smile. Hold for 5 seconds.

Relax and Repeat 5 times.

2. Lip Protrusion

Pucker your lips as if you were going to give someone a kiss.

Hold for 5 seconds.

Relax and Repeat 5 times.

3. Lip Retraction and Protrusion

Smile then pucker your lips. Use exaggerated movements.

Relax and Repeat 5 times.

Lip Closure:
1. Lip Press

Press lips tightly together for 5 seconds.

Relax and Repeat 5 times.

2. Lip Press on Tongue Depressor

Tightly press lips around tongue depressor, while the clinician tries to
remove it.

Perform for 3 to 5 seconds.

Relax and Repeat 5 times.

3. Puff Cheeks

Fill cheeks with air, move air from one cheek to the other 5 to 10 times.

No air should escape from around the lips or the nose.

Relax and Repeat 5 times.

BOLUS CONTROL EXERCISES

1. Licorice Whip Chew

Place one end of candy between the tongue and hard palate.

Clinician holds the other end.

Move the candy from midline to left side of oral cavity.

Repeat at least 10 times.

Perform same motion on right side if needed.

2. Fruit Juice On Gauze Squeeze (Use only if the patient can tolerate small
amounts of liquid without aspirating.)

Take a long piece of gauze, roll it up and soak it in fruit juice.

Place gauze in patients mouth at midline,

Ask the patient to push upward and backward with his tongue.

This action will squeeze juice from the gauze, aid in bolus propulsion,
and allow the patient to practice small liquid swallow while manipulating
solids.