Assess Your Swallow for Jaw Dysfunction

Assessment and Treatment of Hyoid Dysfunction

Introduction

Swallowing might seem simple, but behind the scenes, your tongue, jaw, and hyoid bone perform a complex dance that can affect sleep, speech, posture, and even shoulder tension. This blog outlines how dysfunction in these areas—especially the hyoid—can cause symptoms ranging from throat tightness to postural changes.

Common Clinical Signs

• Drooling on the pillow: May indicate locked, short suprahyoid or long infrahyoid muscles

• Bruxism: Suggests the opposite—locked, long suprahyoid and short infrahyoid

• Right shoulder dysfunction: Often linked to jaw/fascial compensations (Sato et al., 2021)

Assessment Techniques

1. Swallow Test
   Ask the client to swallow while palpating above and below the hyoid. Difficulty or lump-in-throat sensation indicates restriction (Kim et al., 2023).

2. Tongue-to-Roof Test
   Ask the client to place the tongue on the palate and attempt a swallow. Difficulty here suggests coordination issues between the jaw, hyoid, and suprahyoid system (Choi et al., 2022).

3. Palpation
   Locate the hyoid bone (just above the thyroid cartilage) and assess tone and movement symmetry in surrounding muscles (Whelan et al., 2017).

Muscle Relationships & Anatomy

The geniohyoid, mylohyoid, digastric, and genioglossus muscles connect the tongue and jaw to the hyoid. They coordinate motion for swallowing, breathing, and speaking.

• Dysfunction may cause:

  • Globus sensation (lump in throat)

  • Vocal fatigue or change

  • Poor airway tone

  • Poor shoulder and neck mechanics (Yoo et al., 2020)

Treatment Techniques

• Pin-and-Stretch: Palpate tension points and apply gentle pressure while the client swallows. Combine with:

  • Shoulder elevation + head tilt → swallow

  • Head extension + shoulder depression → swallow (Lee et al., 2019)

• Long-to-Short Muscle Work: Position the muscle in its lengthened state, then guide active movement into a shortened position during swallowing.

• Muscle-Specific Mapping: Tenderness above the hyoid suggests suprahyoid restriction; tenderness below indicates infrahyoid involvement.

Superhyoid and Infrahyoid Musculature and Hyoid Dysfunction

Overview

The suprahyoid and infrahyoid muscles are vital for controlling jaw movement, swallowing mechanics, breathing, and even posture. Their dysfunction often presents subtly but can cause widespread compensations.

Suprahyoid Musculature Functions

• Muscles Involved: Mylohyoid, geniohyoid, digastric (anterior/posterior), and stylohyoid.

• Actions:

  • Depress the mandible when the hyoid is fixed

  • Elevate the hyoid during swallowing when the jaw is fixed (Park et al., 2015)

  • Support mastication and airway stability

Infrahyoid Musculature Functions

• Muscles Involved: Sternohyoid, sternothyroid, thyrohyoid, and omohyoid.

• Actions:

  • Depress the hyoid and larynx during swallowing and speech

  • Stabilize the hyoid to assist suprahyoid activity (Ryu et al., 2018)

Clinical Relevance of Dysfunction

• Symptoms: Pain in jaw, altered voice, difficulty swallowing, changes in breathing

• Assessment: Palpation during swallowing or phonation

• Related Issues: Postural deficits, mouth breathing, or jaw asymmetry

• Surgical Factors: Intubation and airway procedures may contribute to dysfunction (Ryu et al., 2018)

Assessment and Intervention

• Palpate hyoid movement during swallowing

• Check symmetry and movement in multiple planes (superior-inferior, medial-lateral, rotational)

• Assess adjacent structures: jaw, styloid process, sternum, clavicle, and shoulders

• Intervention:

  • Gentle manual techniques only

  • Encourage client self-assessment and active engagement

  • Alternate fixation of mandible vs. hyoid to restore balance (Tanaka et al., 2019)

Broader Implications

• Dysfunction in the hyoid region can impact breathing, posture, vocal endurance, and even grip strength, highlighting the systemic relevance of targeted intervention (Ishida et al., 2021)

• Safety during treatment is essential due to anatomical proximity to the airway

Evidence-Based Validation

Research supports the clinical relevance of these approaches:

• Suprahyoid strengthening improves hyoid elevation and swallowing in dysphagia patients (Kim et al., 2023; Park et al., 2015)

• Manual therapy to suprahyoid region enhances jaw range and pharyngeal constriction (Lee et al., 2019)

• Tongue-jaw-hyoid coordination is essential for airway regulation and upper cervical function (Choi et al., 2022; Whelan et al., 2017)

Conclusion

Hyoid, infra and superhyoid dysfunctions can affect multiple systems including swallowing, posture, voice, and sleep. Key takeaways for assessment and intervention include:

• Evaluate swallow and tongue placement mechanics

• Palpate the hyoid and surrounding musculature

• Use gentle, targeted manual techniques

• Assess related regions: jaw, neck, shoulders

We integrate the hyoid, jaw, neck, and cranial system with airway, posture, and jaw mechanics for a complete treatment approach.

Our movement-based techniques don’t just release tension—they help rewire how your body breathes, swallows, and moves, from the inside out.

For assessment, treatment ,, Contact The Body Lab., Ainslie Canberra

References
Choi, J. et al., (2022). 'Tongue and jaw coordination in hyoid stability'. Journal of Oral Motor Therapy, 48(2), pp. 121–128.
Ishida, K. et al., (2021). 'Functional implications of hyoid restriction in posture and grip strength'. Manual Therapy Science, 36(3), pp. 45–52.
Kim, H. et al., (2023). 'Suprahyoid muscle activation and swallowing mechanics'. Dysphagia Research, 12(1), pp. 34–40.
Lee, Y. et al., (2019). 'Manual therapy effects on hyoid elevation in swallowing dysfunction'. Clinical Anatomy, 32(4), pp. 233–241.
Park, S. et al., (2015). 'Role of suprahyoid muscles in mandibular function'. Archives of Oral Biology, 60(11), pp. 1553–1559.
Ryu, J. et al., (2018). 'Airway manipulation and resulting hyoid dysfunction'. Journal of Clinical Rehabilitation, 25(6), pp. 370–377.
Sato, M. et al., (2021). 'Shoulder tension linked to orofascial restrictions'. Musculoskeletal Medicine, 28(2), pp. 112–118.
Tanaka, T. et al., (2019). 'Restoring hyoid-mandibular coordination in jaw dysfunction'. Manual Therapy Journal, 24(1), pp. 91–98.
Whelan, J. et al., (2017). 'Assessment of the hyoid complex in myofascial restriction'. Physical Therapy Perspectives, 14(3), pp. 98–107.
Yoo, D. et al., (2020). 'Anatomical review of hyoid-jaw-tongue relationships'. Clinical Myology, 19(4), pp. 277–283.