The hyoid is a U-shaped bone in the front of the neck, positioned between the chin and the thyroid cartilage. Unlike any other bone, it does not connect directly to other bones; instead, it is suspended by a complex web of muscles and ligaments. This arrangement allows the musculature attached to the hyoid to be targeted with specific exercises. This article will explore these exercises, their purposes, and how to perform them safely.
Understanding the Hyoid Bone and Its Importance
The hyoid bone’s suspension allows it to participate in swallowing, speech, and respiration. During swallowing, a process known as deglutition, the hyoid and attached muscles pull the larynx upward and forward. This motion helps to close the airway and open the esophagus, ensuring that food and liquid pass correctly.
This bone also serves as an anchor for muscles connected to the tongue, pharynx, and jaw. In speech, the hyoid supports the tongue and allows for the fine muscular movements necessary for articulating sounds. The hyoid system is also involved in maintaining an open upper airway during sleep, as the muscles attached to the hyoid help to hold the airway open.
Why Hyoid Exercises Are Prescribed
Healthcare professionals, like speech-language pathologists, may prescribe hyoid exercises for conditions that affect swallowing and airway function. A common reason is dysphagia, or difficulty swallowing, which can arise from a stroke, Parkinson’s disease, or as a result of treatments for head and neck cancer.
These exercises are designed to strengthen the suprahyoid muscles, which are located above the hyoid bone. By improving the strength and coordination of these muscles, exercises can lead to better clearance of food and liquid from the pharynx, reducing the risk of aspiration. They may also be incorporated into therapy for certain speech disorders, managing obstructive sleep apnea (OSA), or for rehabilitation by singers and other voice professionals.
Common Hyoid Strengthening Exercises
Several specific exercises are used to target the muscles that control the hyoid bone. These should be performed as directed by a healthcare professional for your specific needs.
- Mendelsohn Maneuver: To perform this, an individual initiates a swallow, and as the larynx (or voice box) reaches its highest point, they use their throat muscles to hold it in that elevated position for a few seconds before relaxing. This exercise is designed to prolong the opening of the upper esophageal sphincter, allowing more time for food to pass.
- Masako Maneuver: The Masako Maneuver involves gently holding the tip of the tongue between the teeth while swallowing saliva. This action forces the muscles in the back of the throat to work harder, thereby strengthening them. It is important that this maneuver is performed only with saliva and not with food or liquid.
- Shaker exercise: While lying flat on the back without a pillow, lift your head to look at your toes, keeping the shoulders on the surface, and hold the position for about a minute, then rest. This is followed by a series of shorter, repetitive head lifts. The Shaker exercise strengthens the suprahyoid muscles and improves the opening of the upper esophageal sphincter.
- Chin Tuck Against Resistance (CTAR): The Chin Tuck Against Resistance (CTAR) exercise is an alternative to the Shaker that can be done while sitting. An individual places a small, soft ball under their chin and tucks their chin down against the ball, creating resistance. This can be done as a sustained hold (isometric) or as repeated compressions (isokinetic) to strengthen the suprahyoid muscles.
Performing Hyoid Exercises Safely
Before beginning any hyoid exercise regimen, it is important to seek guidance from a qualified professional, such as a speech-language pathologist or physician. A professional can provide a correct diagnosis and ensure the selected exercises are appropriate for your specific issue.
Correct technique is necessary to ensure the exercises are effective and to prevent strain or injury to the neck muscles. A therapist can provide instruction and feedback to confirm the movements are being performed correctly. Seeing improvement often requires patience and consistent practice.
Individuals should pay attention to their body and stop if they experience any sharp pain or discomfort beyond mild muscle fatigue. If such symptoms occur, consult with the healthcare provider who prescribed them.