Management & Exercises for Temporomandibular Joint (TMJ) Disorder/Pain | Physical Therapy | Rehab

Learn about the management of TMJ symptoms!

Anatomy, Function, & Background Information (0:00)

The TMJ, or temporomandibular joint, is a synovial joint where the temporal bone and mandible meet. An articular disc separates the joint into superior and inferior joint cavities. You can feel the movement of both TMJs if you put your index fingers right in front of your ears and open and close your mouth.

Everyone has a TMJ so associated symptoms are referred to as TMD, or temporomandibular disorder. Issues may arise after a traumatic incident such as a car accident or blow to the face, or they may come on more gradually over time.

In addition to jaw pain, people might report neck pain, headaches, migraines, ear symptoms, popping or clicking, locking, and other problems. Since the TMJ is heavily involved with talking, chewing, and swallowing, these symptoms can be frequent, persistent, and often debilitating.

Movement of the TMJ includes elevation/closing, depression/opening, protrusion, retrusion, and lateral excursion. The primary muscles are the masseter which can be palpated externally if you clench your jaw, temporalis which can also be palpated externally, and the medial and lateral pterygoids internally. Other muscles contribute as well such as the supra and infra hyoids.

Normal opening range of motion is between 40 and 50mm and functional opening is considered to be 35mm, or the width of about 3 fingers.

Why Is My Jaw Popping? (2:23)

Lifestyle Modifications (Diet, Posture, Stress, Oral Habits, Sleep) (3:33)

It's important to discuss lifestyle modifications because if you don’t change the habits contributing to your symptoms, the exercises won’t benefit you very much. Focus on controlling what you can and be willing to work at it. Rehab isn’t always an easy, quick fix.

Exercises (6:36)

Exercise #1: Controlled Mouth Opening
You’re going to put your tongue on the roof of your mouth and slowly open and close your jaw while staying within comfort. This is helpful if you have limited mouth opening or if you’re getting pain with excessive opening.

Exercise #2: Jaw Wiggle
Put your tongue on the roof of your mouth and slowly move it side to side while staying within comfort.

Exercise #3: Cervical, Thoracic, and Scapular Movement
Most TMD exercise programs also include chin tucks and scapular retraction based on the Rocabado 6x6 routine as he’s the most influential physical therapist in this realm. I think the important components here are frequent movement and movement variability so these exercises can be easily combined. You can think about rounding your spine as you reach for the floor and then extend back up, get a bit of that chin tuck, externally rotate your shoulders, squeeze your scapulae, and hold that position for a few seconds before repeating.

So in addition to helping restore function and reduce pain, these exercises are a great way to check in with yourself regarding some of the lifestyle factors that I mentioned. For example, if you’re constantly clenching your jaw and you don’t even realize it, these exercises can help break that habit. I’d recommend 5 to 10 repetitions of each exercise every hour or two. You want to do them frequently throughout the day which is why they can be done in standing or sitting which makes them convenient. This would also be a great time for a minute or two of deep breathing to aid in relaxation.
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Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only. If you are experiencing pain, please seek the appropriate healthcare professional.
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