Jaw Pain (TMJD = Temporomandibular Joint Dysfunction)

What is TMJD?

Temporomandibular Joint Dysfunction is the proper name for a malfunctioning or misaligned jaw joint found directly in front of a patient’s ear. Patients who suffer from TMJD quite often experience headaches, ear, neck and jaw pain, and restricted head, neck and jaw movements. It can also involve an abnormal bite, teeth and face pain, and difficulty chewing and swallowing.

How can a Physiotherapist Assist in the Treatment of TMJD?

Nose Creek Physiotherapists are keenly positioned to treat TMJD. In addition to screening patients for cervical spine dysfunction – a possible contributor to TMJD – all Nose Creek Therapists have specialized, post-graduate training to address this dysfunction.

As a way to improve flexibility and release tension, we provide Manual Therapy that can treat the spine and the TMJ. Nose Creek Physiotherapists also offer anatomical Acupuncture and Intramuscular Stimulation, or Dry Needling, which relieves pain and stiffness. Most extended health plans will cover the cost of this type of Physiotherapy.

Nose Creek Sport Physiotherapy will also work closely with referring Dentists or Physicians to fully address patient needs and concerns.

How can TMJD be Managed?

Nose Creek Sport Physiotherapists educate all patients on optimal posture and provide comprehensive range of motion, flexibility and strength exercises tailored to specific conditions. We also make a series of behavioral recommendations that will help to prevent TMJD from returning.

Avoid yawning, yelling and singing with extreme jaw movements to prevent symptoms of TMJD pain. Try not to rest the chin on the hand or hold the phone with your jaw and shoulder. Good posture can reduce the risk of pain from TMJD. Try to keep the teeth apart slightly to take pressure off of the jaw. This will keep you from clenching and grinding the teeth, placing the tongue between the teeth may help with this. Try to adhere to relaxation techniques when you find yourself clenching your jaw as stress reduction will help in this process.

Preventing TMJD from Progressing

There are some things you can do to prevent TMJ from getting worse:   

  • Reduce stress by stretching throughout the day.
  • Apply relaxation techniques to your bedtime routine to reduce stress and help you sleep better.
  • Avoid chewing gum, chewing on your fingernails, chewing on pencils or pens and crunching on foods that are difficult to chew.
  • Make sure to keep good posture and use chairs and equipment that is ergonomic throughout the work day.   

TMJD Diagnosis – Now What?

Anyone suffering from TMJD in Calgary can get positive results with Physiotherapy and muscle relaxation at Nose Creek Sport Physiotherapy. Some of these therapies may include Manual Therapy, exercise prescription, ultrasound, TENS and stretching. Applying warm compresses during therapy can also help with pain relief.   

Other therapies from our TMJD Therapists can include relaxation skills, stress management skills, meditation, re-educating your Temporomandibular joint on the “home” position, IMS Dry Needling and Acupuncture. Keeping control of stress will keep your TMJD from getting worse. Learning to relax your body will benefit in other areas as well as with the TMJD.     

Jaw Relaxation Exercises

The healthiest posture for the jaw and the associated muscles is generally with the neck and shoulders in a relaxed upright position (not slouching posture). Additionally, the tongue should rest on the roof of the mouth with the teeth very gently touching. We refer to this as the “home” position for the jaw joint. Relaxed breathing through the nose can help relax the jaw muscles. Physiotherapists recommend 15 minutes of relaxation to help to reduce jaw pain. Application of ice or heat for 15 minutes can also help manage neck and jaw pain. Use heat for dull aches and ice for sharp pains.

Exercises for Jaw Pain

  • Doorway Stretch

    Place arms on doorway at elbow height. Place one foot through the doorway, and lean chest and hips through doorway until you feel a stretch. Hold for 30 seconds, repeat twice.

    TMJ Doorway stretch

  • Wall Stretch

    Standing against a wall/post, raise your straight arm as high as possible until you feel a stretch, with palms facing the ceiling then the wall above you. Hold at end range for 10 seconds then slowly lower arms. Repeat 10 times.

    TMJ Wall stretchStart

    TMJ Wall stretchFinish

  • Lateral Movement Exercise for Jaw

    Standing in front of a mirror in an upright posture, place a tongue depressor on the bottom of your top row of teeth. Now bring your teeth together so the top and bottom rows touch the tongue depressor. Gently slide the bottom row of teeth along the tongue depressor until you have moved up to 2 tooth widths side to side slowly and gently within your pain free range. Start off with 10 repetitions on the first day, and add 5 repetitions per day up to 30 repetitions maximum. Do this 2 times a day, in the morning and evening after you brush your teeth. Your goal is to get equal movement on both sides.

    TMJ - lateral movement exercise-start position

    TMJ - lateral movement exercise-Deviation left

    TMJ - lateral movement exercise-Deviation left(1)

  • Resisted Opening Exercise for the Jaw

    Standing in front of a mirror in an upright posture, place the palm side of your thumbs under the front of your chin. Slowly open your mouth and resist the movement gently with your thumbs. Opening distance is 2 knuckle widths apart maximum or within your pain free range of motion. Start off with 10 repetitions on the first day, and add 5 reps per day up to 30 repetitions maximum. Do this 2 times a day, in the morning and evening after you brush your teeth. Your goal is straight opening and closing that is pain free without clicks. Manual resistance with your thumbs should be medium intensity – never maximum intensity. Think of 50% of your maximum and slowly work up to 75% over 3 to 6 weeks depending on your pain experience during and after this exercise. Initially for the first 2 weeks stay within your “click/snap” free range of motion.

    TMJ Resisted opening-start

    TMJ Resisted opening-end