TMJ dysfunction has been found to occur more frequency in younger individuals and can affect 5-12% of the population. If you or someone you know experiences discomfort in your jaw, pain, clicking, or popping, you could be dealing with TMJ dysfunction. Understanding the fundamentals of TMJ and the symptoms related to it is the first step in learning to manage the condition. And did you know that physical therapy can help treat TMJ dysfunction!? This article aims to teach you about what TMJ dysfunction is and how physical therapy can help alleviate jaw pain, including TMJ exercises to start implementing today!
TAKE ME STRAIGHT TO THE EXERCISES!
*This post includes links to items I recommend, but are not sponsored. It is simply here as a recommendation based on what I have tried and used and have found helpful through experience and hope that this information might help someone else.
**This is not medical advice. Please consult your medical provider for more information.
What is TMJ Dysfunction?
Most people are familiar with the term “TMJ.” But what exactly is it?
TMJ refers to the temporomandibular joint. It is the joint located where the temporal bone and mandible meet. It is where your lower jaw connects to your skull, located right in front of the ear.
TMJ dysfunction is a disorder that affects this particular joint. Temporomandibular dysfunction, or TMD, can come from an injury to the jaw, excessive clenching or grinding of teeth, or even poor posture.
Symptoms of TMJ Dysfunction
Symptoms of TMJ dysfunction can range from jaw pain, restricted mobility, difficulty moving your jaw, and audible clicking when moving your jaw. These symptoms can also contribute to headaches, earaches, and facial tension.
Jaw pain is usually one of the more common symptoms, although pain can also occur in other areas, like in the neck, face, shoulders, and suboccipital region.
Restricted motion can occur in one direction or multiple. You may notice its hard to open your mouth, especially if trying to take a large bite of your food. You might also have a hard time closing your mouth. On occasion, the jaw can lock and get stuck. These are all signs of TMJ dysfunction.
Causes of TMJ Dysfunction
There can be multiple causes of TMJ dysfunction. It can range from inflammation, to a direct injury, and even from poor posture.
Inflammation can lead to issues at the temporomandibular joint. This can come from grinding teeth at night, jaw clenching, or excessive chewing. Injury may also lead to inflammation. Injuries can be direct or indirect in nature. An indirect injury could come from whiplash, whereas a direct injury could be a punch to the face. Inflammatory cases may lead to synovitis, where the synovium/capsule becomes inflamed, causing pain at rest and with end ranges of motion.
Arthritis can occur within the TMJ. An x-ray can show arthritic changes, but an MRI will be able to show greater detail. It can take images with both the mouth open and closed to determine what the joint and disc look like in different positions.
Internal derangement occurs with structural changes within the joint, often related to the articular disc. There is an articular disc within the TMJ which provides cushion between the surfaces of the temporal bone and the mandible. Think of this disc as the “meniscus” of the TMJ. A hallmark sign of abnormal biomechanics occurs when the disc anteriorly displaces, leading to an audible click when opening the mouth. The click is the disc repositioning itself. If this progresses, internal derangement without reduction occurs, and the jaw will lock.
Dislocation of the jaw is raw and commonly occurs due to trauma. This results in the articular disc becoming posteriorly displaced and the jaw is unable to close.
How TMJ Exercises Through Physical Therapy Can Help
Based on the cause of your TMJ symptoms, a physical therapist can help get you back to functioning normally again. Whether you’re getting an achy jaw when chewing, experiencing clicking or locking, or having difficulty opening or closing your mouth, TMJ exercises can be helpful.
The goal here is not to exacerbate the condition, but to introduce you to movements that support proper biomechanics and address posture that could be contributing to your symptoms.
Physical therapy can help with the preparatory steps to lay the groundwork for reducing your jaw pain and clicking. Specialized exercises will help stretch muscles that are tight, strengthen muscles to help fix your posture, and encourage proper biomechanics of the TMJ.
TMJ Exercises for Pain Relief and Better Function
These are exercises you can incorporate into your daily routine to assist with opening and closing your jaw. Remember, posture plays a huge role in this and cannot be ignored. Many of these exercises will help improve postural awareness, which can, in turn, ease TMJ discomfort and improve jaw mobility.
Jaw Opening/Closing (Using a Mirror)
You will need a mirror for this exercise, that way you can watch how you are opening and closing your mouth.
Slowly open your mouth as wide as you comfortably can. Pay attention to your mandible (your lower jaw). You want it to open and close in a straight line. In other words, you don’t want to see your lower jaw deviate to either the right or left.
If this is challenging, it is okay to start in a partial range. Work your way up to fully opening, as long as you maintain good control.
Perform 20-30 reps, focusing on slow and controlled motion.
Chin Tuck
This exercise targets the deep neck flexors, placing the neck in a good position to reduce forward head posture.
To appropriately target the deep neck flexors, sit up tall and think about pushing your chin straight back as if you were creating a double chin. At the same time, imagine a string is pulling the top of your head towards the ceiling. You will feel a slight rotational movement of the head and neck from the combined movements of creating the double chin as well as “lifting” your head/neck towards the ceiling. Think like you are elongating your spine upwards. Make sure to avoid flexing your neck forward and looking down towards the floor when performing your chin tuck.
Perform 3 sets of 10 reps, holding for 5 seconds each time.
Resisted Mouth Opening (Partial and Full Range)
Place a few fingers under your chin. With control, slowly open your mouth, pushing against slight resistance from your fingers.
Start with only opening your mouth in a partial range. Perform 10-15 reps in this partial range. Then, if you feel like you can progress, open your mouth as wide as you can comfortably go. Remember to continue pushing against slight resistance from your fingers throughout the entire range. Perform 10-15 reps at full range.
Tongue Posture
Tongue posture? What!? YES, this is the thing!
Tongue posture is important for facial structure, breathing, and improved sleep (believe it or not, but this will be addressed another time).
To find the correct tongue posture, place the tip of your tongue on the hard palate, just behind your top teeth at the roof of your mouth. Allow the the rest of your tongue to then rest at the roof of your mouth by using slight suction. If it isn’t already, let your mouth close.
Take 5 normal breaths through your nose while you let your tongue rest in this position. Once this is complete, keep your tongue where it is resting on the roof of the mouth as you slowly open your mouth and close. Open and close your mouth 10 times.
Repeat this a few times throughout the day. Not only is it good for the jaw, but it will also help teach proper tongue posture, if this is something that you struggle with.
Other Treatments and Helpful Advice
While the TMJ exercises above are great for helping with TMJ dysfunction, there are many other techniques are can be helpful and easy to implement. As stated earlier, posture and tension will be a key factor in TMJ function.
Learning how to relax specific muscle groups, strengthen others, and incorporate self massage to key areas can also help you perform TMJ exercises and provide temporary pain relief when you need it.
Relaxation Techniques
Incorporating relaxation techniques can offer a holistic approach to alleviate jaw pain and improve mobility. Understanding how to ease tension not only in the jaw, but also in the broader facial and neck regions, is pivotal. This is where the power of relaxation techniques comes into play, serving as a complement to your TMJ exercise routine for effective pain management.
Stress can exacerbate TMJ symptoms. When we get stressed, the body will start to do things you aren’t always conscious of. Have you ever noticed then when you’re feeling stressed beyond normal, do you clench your teeth? Are your shoulders elevating? Do you tend to get headaches or migraines? Recognizing this can guide you towards methods that reduce facial tension and offer some stress relief. Engaging in deep breathing exercises, for instance, can significantly impact your ability to relax the jaw, reducing jaw tension and contributing to overall TMJ relief techniques.
If you start to notice that you are clenching your jaw or you feel a lot of facial tension, take note and try to relax; unclench your jaw. Place your tongue at the roof of your mouth and take some slow breaths in and out through your nose. Become more mindful about what you are feeling in your face, jaw, head, neck, and shoulders.
Furthering your mindfulness, you can try some meditation practices or deep breathing exercises. These are both meant to complement mindfulness to become more consciously aware about what we are feeling in the body. If you can start to recognize what you are feeling, it will be easier to incorporate other techniques to help not only reduce your stress, but the pain and tension that might be coming along with it.
Pay Attention to Posture
Once you have checked in with what you are feeling in your body, start to pay attention to your posture. This also has a lot to do with tension in areas throughout the body. With proper alignment, tension should ease away.
Sometimes it can be easier to start with a mirror to start to learn where you body naturally likes to rest. Are your head and chin forward? Are you shoulders rounded forward and is your upper back folding forward? These are all things that need to be corrected.
Maintaining a neutral spine and avoiding slouching forward can significantly reduce undue pressure on the TMJ. You should also notice that this also helps reduce facial and neck tension, as well as headaches. Posture is what sets the foundation for everything. You will notice that working on improving your posture and help with pain relief in multiple areas of the body, not just the jaw.
Consider how you sit, stand, and even sleep. Simple adjustments to promote better posture can serve as a great complement to your TMJ exercises.
How to Incorporate Self Massage
Many overlook the profound impact of incorporating self massage alongside posture and TMJ exercises. All of these means can be combined to help aid and ease your TMJ pain.
There are many ways to incorporate self massage. There is no “better way” as they all contribute to the same thing and they all do the same thing. It just comes down to personal preference.
With no added cost, your own fingers can do the trick! Take two fingers and place them on your temples. Add some pressure and gently massage in circular motions. Then, work your way to your forehead working above and between your eyebrows. Come down to where you TMJ is, right in front of your ear. Use circular motions here and across your cheeks, just under your cheek bones. You can spend as little as 30 seconds in each area or up to a few minutes! When you are done, take a moment to check in with yourself and notice if you feel any less tension in your face. Chances are you’ll notice a big difference, one you never really even knew was there!
If you would like to see a video of me demonstrating this, leave me a comment below!
I have also used a gua-sha tool for this and it works great! I incorporate it into my skincare routine. After washing my face and placing whatever serums I am using, I take the gua-sha tool and go over these same exact areas. The serums allow the tool to glide over my skin and the tool gives me this cooling effects over the muscles that feels nice. I got my gua-sha tool from Target and it was only $10-15 (not sponsored). Again, this all works perfectly fine with just your fingers, but sometimes its nice to have a small tool to help out.
Now this next option is an investment. And by no means am I trying to say you need this tool to do any of this that I have just listed. But both my partner and I have use this tool and it is AMAZING! It is the SmartGoggles from Therabody (again, not sponsored). Both of us have a history of TMJ dysfunction and my partner, Alex, also struggles with really bad tinnitus. The SmartGoggles help with way more than just TMJ dysfunction. It uses science-backed research to help gentle massage different facial areas around the forehead and eyes to help reduce eye strain, relieve headaches, and improve sleep. On occasion, we have found that it can help Alex with both his tinnitus and TMJ!
Once, his jaw locked up badly and we couldn’t get it to unlock. 20 minutes on the SmartGoggles and he could open his mouth again! There was also one time it completely got rid of his tinnitus (which NEVER happens). It doesn’t work like that every single time, but its nice to have an option to test out to help with some temporary relief.
I have found the SmartGoggles really helpful for stress relief and winding down at the end of the night. Not sponsored, I just really stand behind Therabody and their tools as I have used and own many as a physical therapist and use them on myself!
References
Runci Anastasi M, Cascone P, Anastasi GP, et al. Articular Disc of a Human Temporomandibular Joint: Evaluation through Light Microscopy, Immunofluorescence and Scanning Electron Microscopy. J Funct Morphol Kinesiol. 2021;6(1):22. Published 2021 Feb 25. doi:10.3390/jfmk6010022
TL;DR
Understanding the fundamentals of TMJ and the symptoms related to it is the first step in learning to manage the condition of TMJ dysfunction. Physical therapy can help alleviate the pain associated with TMJ dysfunction. TMJ exercises, as well as other techniques and awareness, can help alleviate your pain. This article shows you TMJ exercises to try and reviews other advice to help educate you on how to manage the condition.
Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.
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