Tongue Exercises for Dysphagia Therapy

Dysphagia is a condition characterized by difficulty with properly chewing and swallowing food or liquid. The action of chewing and swallowing involves coordination between the brain, nerves, and muscles. Damage to the brain from a stroke, dementia, brain tumor, or another brain disease can impair chewing and swallowing. Damage to the cervical spine (the upper part of the spine) can also cause dysphagia by impairing the nerves that control the muscles of chewing and swallowing.

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How the Tongue Is Involved in Chewing and Swallowing

There are a number of muscles that work together in different phases of chewing and swallowing, and the tongue is one of those muscles.

The tongue is a key participant in the mechanism of swallowing. It moves food around the mouth and helps to form an adequate food bolus (chewed and lubricated food). The tongue is also needed for transporting the food bolus back toward the pharynx (back of the throat), where it can be further channeled into the esophagus by other similarly important muscles.

After the tongue aids in the process of swallowing, the rest of the muscles and nerves take over.

Strokes and other brain injuries can impair tongue movement, which invariably impairs the ability to swallow. Lack of normal swallowing ability is a serious problem and can result in pneumonia or severe choking, potentially blocking air from getting into the lungs.

Like all of the other muscles in the body, the tongue has the ability to recover, at least partially, with appropriate exercise. In fact, the effectiveness of tongue exercises for dysphagia caused by stroke has been demonstrated by scientific research studies. One study showed that eight weeks of special tongue exercises induced significant improvements in swallowing and quality of life.

The exercises described below are meant to serve as a standard way of strengthening tongue function. For some survivors of brain injury and stroke, these exercises will be fairly easy to do. For others, performing them may feel as challenging as running an Olympic marathon.

As each exercise becomes easier to do, you can set higher strength and repetition goals by applying more strength to each repetition, or increasing the number of repetitions.

Tongue Exercises

  1. Open your mouth as wide as you can, and touch the tip of your tongue to your upper teeth or to the front of the palate. Do this for 3 to 5 seconds, and repeat 5 to 10 times.
  2. Again, open your mouth and touch the tip of your tongue to the back of the roof of your mouth. Keep your tongue back for 3 to 5 seconds, and repeat 5 to 10 times.
  3. Stick your tongue out as far as you can, and leave it there for approximately 10 seconds. Do this 5 to 10 times.
  4. Bring the tip of the tongue to the very back of the roof of your mouth, and keep it there for about 10 seconds. Repeat this exercise 5 to 10 times.
  5. Move the tip of your tongue across the roof of your mouth from the very front (just behind your upper teeth) to the very back (to where the soft palate is located). Do this 10 times, bringing it as far back as possible each time. Repeat the exercise 5 to 10 times.
  6. Press the inside of each cheek with the tip of your tongue. Repeat the exercise 5 to 10 times.
  7. Stick your tongue out as far as you can. Using its tip, press up against a spoon or some other clean object. Do this for 5 seconds. Repeat this exercise 10 times.

Depending on how weakened your tongue muscles have become after a stroke, you might or might not be able to perform one or more of the exercises.

Beyond tongue exercises, jointly published clinical guidelines for stroke recovery from the American Heart Association and American Stroke Association also recommend upright positioning for feeding, using safe swallowing advice, and appropriate dietary modifications for people having difficulty with swallowing.

A Word From Verywell

A stroke can have some unexpected effects, such as trouble swallowing, muscle spasticity, and incontinence. While these effects are not disabling, they can interfere with your life. It is important that you discuss each of your stroke problems with your medical team so that you can get help and recover as fully as possible.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lee JH, Kim HS, Yun DH, et al. The relationship between tongue pressure and oral dysphagia in stroke patientsAnn Rehabil Med. 2016;40(4):620–628. doi:10.5535/arm.2016.40.4.620

  2. 3. Adams V, Callister R, Mathisen B. Using tongue-strengthening exercise programs in dysphagia interventionAsia Pacific Journal of Speech, Language and Hearing. 2011;14(3):139-146. doi:10.3109/17549507.2012.752864

  3. Winstein CJ, Stein J, Arena R, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.

  4. Kuptniratsaikul V, Kovindha A, Suethanapornkul S, Manimmanakorn N, Archongka Y. Long-term morbidities in stroke survivors: A prospective multicenter study of Thai stroke rehabilitation registryBMC Geriatr. 2013;13:33. doi:10.1186/1471-2318-13-33

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.