Swallowing Exercises- Lip-Closure-Lip-Seal Exercises
What are lip-closure/lip-seal exercises?
Lip-closure exercises are also known as lip-seal or lip press exercises. They are
done to help improve swallowing. These exercises are a type of treatment when you
have trouble swallowing (dysphagia) . Lip-closure exercises may help increase lip
strength and mobility over time. They may also help the ability to swallow and help
prevent drooling. These exercises are sometimes used with other types of swallowing
Before you swallow, you chew your food to a size, shape, and texture that can be swallowed.
When you swallow this material, it passes through your mouth and down through parts
of your throat called the pharynx and larynx. From here, the food or liquid passes
through a long tube (esophagus) before entering your stomach. This movement requires
a series of actions from the muscles in these areas.
Muscle weakness in these areas can make proper swallowing difficult. A speech-language
pathologist (SLP) may prescribe specific swallowing exercises to improve your swallowing.
Swallowing exercises can give increased strength, mobility, and control to these muscles.
Over time, this may help you to swallow normally again and help prevent drooling.
Why might I need lip-closure/lip-seal exercises?
You might need to use lip-closure exercises if you have dysphagia. Dysphagia can lead
to food or fluid going into the airways or lungs (aspiration). This can lead to pneumonia
and other problems. Because of this, it’s important to promptly identify and treat
your dysphagia if you have it. Symptoms of dysphagia may include:
Trouble "starting to" swallow
Gagging or coughing when swallowing
Problems with or poor tongue-control
Choking due to the feeling of food getting stuck in your throat
Food getting caught in the lungs
Liquid or fluids coming from the nose when trying to swallow
Health conditions can lead to dysphagia. Some examples are:
Brain or spinal cord injury
Conditions that reduce saliva such as Sjögren syndrome
Parkinson disease or other nervous system conditions
Blockage in the esophagus such as from a tumor
History of radiation, chemotherapy, or both to the neck or throat for cancer
An SLP may be more likely to prescribe lip closure exercises if he or she thinks you
are having trouble with your first phase of swallowing. For example, this might happen
from a mouth lesion or after a stroke.
What are the risks of lip-closure/lip-seal exercises?
Lip closure exercises are safe. If you have any discomfort during the exercises, you
can stop doing them. Let your healthcare provider and/or therapist know right away.
Don’t practice these exercises unless someone from your medical team prescribes them
How do I get ready for lip-closure/lip-seal exercises?
Before you start lip-closure exercises, you and your SLP will determine the body position
for each exercise. Your SLP will also give you instructions on how to do this, if
needed. For example, it may be better to do these exercises while out of bed.
It's also helpful to remove distractions from your environment. Turn off the television,
and do them at a time when you won’t have visitors. This will let you focus on your
exercises and get the most benefit from them. You and your SLP can determine when
is the best time to do these exercises. . Your SLP will let you know if there is anything
else you need to do before getting started.
What happens during lip-closure/lip-seal exercises?
The exercises will depend on the exact nature of your swallowing problem. For example,
you may have a problem with the first phase of swallowing, before the food material
leaves your mouth. If so, you may benefit from working the muscles in this region.
This includes your cheeks, tongue, and lips. In this case, lip closure exercises may
help you keep your food inside your mouth, manipulate your food, and move the material
into your pharynx. If you have a problem with later stages of swallowing, your SLP
might give you different swallowing exercises.
You can do these exercises in your hospital room or at home. Often you can do them
on your own, but you may also work with a health professional to practice these exercises.
Your SLP can show you the exercises you should do and explain how often to do them.
For example, you may be asked to:
Press your lips tightly together for 5 seconds. Relax and then repeat 5 times.
Tightly press your lips around a tongue depressor, lip-closure spoon, or other approved
devices in the center of your lips while someone tries to remove it, for 5 seconds.
Relax and then repeat 5 times. Don't hold the tongue depressor with your teeth or
gums. Repeat this exercise on the left side and the right side of the lips.
Fill your cheeks with air and move the air from one cheek to the other 5 times, with
no air escaping from the lips or nose. Relax and then repeat 5 times.
Your SLP can tell you 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
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.
What happens after lip-closure/lip-seal exercises?
You can go back to your normal activities right after you finish practicing your lip-closure
and other exercises.
As part of your treatment plan, your doctor and SLP may prescribe other treatments.
These may include changes to your diet, changes in eating position, medicine, or surgery.
It’s a good idea to keep a record every time you do your swallowing exercises. This
serves as a reminder to you to do your exercises as prescribed. It also provides helpful
feedback on your progress to your SLP. Make a note of what exercises you did and when
you did them. Also note any problems, so you can discuss them with your SLP.
Your SLP and medical team may change your exercises as they watch your progress over
time. You may have bedside swallowing exams. And you may have imaging tests, such
as a fiberoptic evaluation of swallowing (FEES) test. It may take a few weeks to notice
an improvement in your swallowing.
As your ability to swallow improves, your risk of aspiration will decrease. Your SLP
may be able to change your diet and allow you 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 regularly.
Your SLP will tell you what kind of progress to expect.
Continue to practice all of your swallowing exercises as prescribed by your SLP. If
you skip practice sessions, your progress will slow. Work closely with all the members
of your healthcare team. This will help your chance of having a good outcome.
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