Shaker’s Hyolaryngeal Excursion Exercise (SHEE)


Repeated Variation:


Sustained Variation:


Purpose of Exercise:
– Increased hyolaryngeal excursion and opening of the Upper Esophageal Sphincter (UES)

Medical Contraindications (populations to avoid this exercise):
– Neck or cervical spine injury/surgery

Precautions / Tips:
– Do not do this exercise if you have eaten in the previous hour, in order to reduce the risk of vomiting.
– Some discomfort may be normal in the first few days, and should resolve over time.
– If you have high blood pressure, check with your doctor before performing any isometric exercise, and if you choose to do this exercise, do not squeeze hard.
– If this exercise is causing significant discomfort and difficulty, and you feel that the client may lack motivation or compliance, you may wish to try either the Jaw Opening exercise or modified version of this exercise.

Research Articles:*
– Logemann, J. A., Rademaker, A., Pauloski, B. R., Kelly, A., Stangl-McBreen, C., Antinoja, J., Grande, B., Farquharson, J., Kern, M., Easterling, C., & Shaker, R. (2009). A Randomized Study Comparing the Shaker Exercise with Traditional Therapy: A Preliminary Study. Dysphagia, 24(4), 403–411.
– Shaker, R., Easterling, C., Kern, M., Nitschke, T., Massey, B., Daniels, S., Grande, B., Kazandjian, M., & Dikeman, K. (2002). Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology, 122(5), 1314-1321.
– Shaker, R., Kern, M., Bardan, E., Taylor, A., Stewart, E. T., Hoffmann, R. G., Arndorfer, R. C., Hofmann, C., & Bonnevier, J. (1997). Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. American Journal of Physiology-Gastrointestinal and Liver Physiology, 272(6), 1518-1522.

*Articles cited are a limited sample only, and there may be other & more recent evidence which supports / contraindicates use of this exercise.


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