Swallowing Difficulties: Causes and Rehabilitation Options

Q: Swallowing Difficulties: Causes and Rehabilitation Options

Hello： From the perspective of fascial lines, swallowing falls within the range of the "anterior deep line," which can indeed be influenced by resistance training, considering the deep fascia. <br>In terms of the joints, insufficient mobility of the thoracic spine and ribs can le

Dysphagia

I would like to inquire about an issue I have been experiencing since September of last year.
After working out, I suddenly noticed a sensation of something being stuck while swallowing, which has gradually worsened over time.
Currently, I am unable to engage in any physical activity, as any exertion exacerbates the feeling of a foreign body in my neck.
I would like to know if muscle compensation from exercising could affect swallowing, particularly with muscles like the sternocleidomastoid.
I've noticed that carrying weight triggers the sensation in my neck, which then leads to difficulty swallowing.
Recently, I consulted a traditional Chinese medicine practitioner who mentioned that there might be an issue with my epiglottic cartilage.
I am wondering if this could be related to myofascial issues and which medical specialty I should consult for further evaluation.

Zuo, 20~29 year old female. Ask Date: 2024/05/07

Dr. Lin Ruixiang reply Rehabilitation

Hello: From the perspective of fascial lines, swallowing falls within the range of the "anterior deep line," which can indeed be influenced by resistance training, considering the deep fascia.
In terms of the joints, insufficient mobility of the thoracic spine and ribs can lead to compensation by the accessory respiratory muscles, resulting in difficulty swallowing.
Additionally, carrying a backpack may contribute to swallowing difficulties, and the scapulohyoid muscle syndrome should also be considered.
If rehabilitation treatment is pursued, I would first address the scapulohyoid muscles, then increase the mobility of the thoracic spine, and finally relax the diaphragm to see if there is any improvement.
However, this is from the perspective of manual therapy.
Other factors, such as lesions within the esophagus, should also be considered, especially when treatment is ineffective.
I recommend consulting with a physician in the rehabilitation department or otolaryngology for a more detailed evaluation and diagnosis.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2024/05/07

More Info

Swallowing difficulties, known medically as dysphagia, can arise from various causes, and understanding these can help in determining the appropriate rehabilitation options. Based on your description, it seems that your swallowing difficulties began after a workout and have progressively worsened, particularly when engaging in physical activities. This raises several important considerations regarding potential causes and treatment options.

Potential Causes of Swallowing Difficulties
1. Muscle Strain or Injury: Engaging in physical activities, especially weightlifting or strenuous exercises, can lead to muscle strain. The neck muscles, including the sternocleidomastoid and the scalene muscles, play a crucial role in swallowing. If these muscles are strained, it can lead to discomfort or a sensation of a lump in the throat, which may interfere with the swallowing process.

2. Neuromuscular Issues: Dysphagia can also stem from neuromuscular conditions where the muscles involved in swallowing do not function properly. This can be due to nerve damage or conditions affecting muscle coordination.

3. Structural Abnormalities: You mentioned that a Traditional Chinese Medicine practitioner noted potential issues with your epiglottis (the flap that covers the windpipe during swallowing). Structural abnormalities can lead to swallowing difficulties, as they may obstruct the normal pathway of food and liquids.

4. Muscle Tension and Myofascial Pain: Chronic muscle tension in the neck and throat can lead to myofascial pain syndrome, which can manifest as a sensation of tightness or discomfort in the throat. This can be exacerbated by physical activity, especially if the muscles are already tense or strained.

Rehabilitation Options
1. Medical Evaluation: It is essential to consult a healthcare professional who specializes in swallowing disorders. This could be an otolaryngologist (ENT specialist) or a gastroenterologist. They can perform a thorough evaluation, which may include imaging studies like a barium swallow test or endoscopy to assess the structural and functional aspects of your swallowing.

2. Physical Therapy: A speech-language pathologist (SLP) specializing in swallowing therapy can provide exercises to strengthen the muscles involved in swallowing and improve coordination. They can also teach you techniques to manage your swallowing difficulties effectively.

3. Posture and Positioning: Sometimes, adjusting your posture while eating or drinking can significantly impact swallowing. An SLP can guide you on the best positions to minimize discomfort and improve swallowing efficiency.

4. Relaxation Techniques: Since muscle tension can exacerbate swallowing difficulties, incorporating relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness can help alleviate some of the tension in your neck and throat.

5. Dietary Modifications: Depending on the severity of your dysphagia, modifying the texture of your food and liquids may be necessary. Soft foods and thickened liquids can be easier to swallow and may reduce the sensation of choking or obstruction.

6. Avoiding Strain: If you suspect that your exercise routine is contributing to your swallowing difficulties, it may be wise to modify your activities. Avoid heavy lifting or exercises that strain your neck until you have a clearer understanding of the underlying issue.

Conclusion
In summary, swallowing difficulties can arise from a variety of causes, including muscle strain, neuromuscular issues, and structural abnormalities. Given your symptoms and their progression, it is crucial to seek a comprehensive evaluation from a medical professional. Rehabilitation options, including therapy with a speech-language pathologist, can provide effective strategies to manage and improve your swallowing difficulties. Remember, early intervention is key to preventing further complications and improving your quality of life.

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