Physical Therapy Exercises for TMJ Pain

Exercises can be an essential component for reducing jaw and facial pain due to temporomandibular joint disorder (TMD), commonly referred to as TMJ. This condition may cause pain, clicking in your jaw, and difficulty with basic functional tasks like eating and yawning. Treatment for TMD typically involves working to decrease joint pain and inflammation and restore normal motion to your jaw joint. Exercises for TMD can help restore normal motion and decrease pain or clicking and locking sensations in your jaw.

Starting Treatment for TMD

Many people with TMD benefit from a physical therapy exercise program to restore normal movement to their jaw. Your physical therapist will assess your condition and teach you the proper things to do to safely get things moving again. He or she can provide anti-inflammation treatments, massage, and exercises. Your PT will also tell you what to avoid if you have TMD.

How Frequently Should I Do TMJ Exercises?

Your PT can show you how to do your exercises and tell you how often to do them.

For your specific program, be sure to speak with your PT or doctor to ensure you know exactly what to do for your TMD.

Many people benefit from performing TMD exercises two or three times a day. One exercise program for TMD called Racobado's 6x6 exercises, suggest you perform six exercises for six repetitions, six times a day. (The first six movements of this TMD program are Rocabado's 6x6 exercises.)

What if Things Get Worse?

If you are performing an exercise program for TMD and your symptoms are feeling worse, stop the exercise and check in with your doctor or PT. The exercises may cause slight increases in pain, but overall your symptoms should be improving as you keep performing the TMD exercises.

Before starting any exercise program for your TMJ, see your doctor to ensure that exercise is safe for you.

1

Tongue on Hard Palate and Clucking

This first exercise to perform for TMD is to place your tongue on the hard palate of your mouth. This is located just behind your teeth. Simply place your tongue behind your teeth on the hard palate and relax there. Your teeth should be slightly apart with your lips closed. Breathe slowly through your nose. Hold this position for six seconds, and perform this for six repetitions.

Variation

Some PTs recommend their patients make a clucking sound with their tongue as well. Simply attain the resting position with your tongue behind your teeth, and then cluck down with your lips slightly apart. Again, cluck six times.

2

Controlled TMJ Rotation While Opening

Controlled TMJ opening ensures that your jaw is only moving through rotation and not moving forwards through protrusion. To perform this exercise, simply place your tongue on your hard palate just behind your teeth. Keep it in place while slowly opening your mouth. Your tongue should not leave the hard palate behind your teeth.

Once your mouth is opened, keep it in position for six seconds. Then slowly close your mouth while keeping your tongue on your hard palate. Repeat the exercise six times.

3

Jaw Opening with Resistance

Adding light resistance to your jaw opening and closing can help improve muscular function around your jaw. To perform this exercise, simply place two fingers on your chin and slowly open and close your mouth. Your fingers should put slight pressure on your jaw as you move; careful not to use too much force. Open and close your mouth with manual resistance six times.

You should also use your hands to provide manual resistance while moving your jaw laterally. To do this, place two fingers on the side of your jaw. Maintain your jaw in a slightly opened position, and gently press sideways on your jaw. Hold for six seconds and perform six repetitions in one direction. Then, repeat on the other side of your jaw.

Stop doing this exercise if you experience any lasting pain from this movement.

4

Upper Cervical Distraction

Performing upper cervical distraction can help relieve neurovascular compression in your upper neck. This may help relax muscles, decrease tension, and ensure that your jaw can move properly.

To perform the exercise, place both hands behind your neck and interlace your fingers. Keep your hands there, and then nod your head down to flex your upper cervical spine. Gently provide a mild traction force with your hands by pulling up. Hold the flexed position for six seconds, and then return to the neutral position. Repeat the exercise six times.

5

Cervical Retraction

It is recommended that you attain and maintain proper posture if you suffer from TMD. Keeping upright posture with your head directly over your shoulders ensures that your jaw can open and close fully with no obstructions.

Cervical retraction is a great exercise for improving posture and helping with TMD symptoms. To perform the exercise, simply sit in a chair and draw your chin back. Be sure not to tip your head; imagine your head is on a shelf and you are simply pulling it straight back.

Once your neck is fully retraced, hold this position for six seconds, and repeat it six times.

6

Shoulder Retraction

Another great exercise to do for TMD (and for improved postural awareness) is the shoudler scapular retraction. To perform this exercise, sit upright in a chair and draw your shoulder blades together. Imagine you are trying to squeeze a pencil between your shoulder blades. Once your shoulder blades are pulled together in the back, hold the position for six seconds, and then relax. Repeat six times.

Variation

This exercise can be made more challenging by using a resistance band and performing a rowing exercise with it. (You can get a resistance band from your physical therapist.)

7

Neutral Posture Relaxation Exercises

If you have TMD, it can be helpful to utilize relaxation techniques to keep your neck and jaw muscles relaxed. This can help maintain your jaw in the neutral position with your tongue rested gently on your hard palate just behind your teeth. To do this exercise, simply try to keep your jaw in the relaxed position and perform slow and rhythmic nasal breathing. This exercise can be done any time you are relaxing.

8

Jaw Opening Self Mobilization

Some people with TMD benefit from gently mobilizing their own jaw. This can help improve the way your jaw opens and allows the small disc between your jaw and temporal bone to glide and slide normally. The mobilization can also help reduce pain and clicking sensations while moving your mouth and jaw.

Your physical therapist may perform jaw joint mobilizations as part of your PT program. He or she should wear gloves to prevent any infection, both to you and your PT. Your therapist may also teach you how to do it to yourself.

To perform a self TMJ mobilization:

  1. Wash your hands.
  2. Place one thumb in your mouth and rest the pad of your thumb on your bottom teeth. If mobilizing the left TMJ, use your right hand.
  3. Rest your fingers outside your mouth on the bottom of your jaw.
  4. Gently pull your jaw down. Do not use too much force; a slow, simple pull will do.
  5. Hold the mobilization for one second, and then release.
  6. Repeat ten times.
  7. When completed with the mobilization, wash your hands.

This intra-oral mobilization should not cause pain and should only be done under the direction of your PT or doctor and dentist.

9

Lateral Jaw Mobilization

Your physical therapist may have you perform a lateral self-mobilization of your jaw to treat your TMD. To perform this:

  1. Wash your hands.
  2. Sit with upright posture.
  3. Place the palms of your hands on either side of your jaw. Your fingers should be resting comfortably on your ears.
  4. One palm should be on your jaw, and the opposite hand should rest just above your jaw on your temporal bone.
  5. Press on your jaw with your palm while using your opposite hand to stabilize your head. The mobilization should be gentle; slow and steady force is all that is needed.
  6. Hold the mobilization for one second, and then slowly release. Repeat ten times.

Be sure to only perform this mobilization under the direction of your doctor, dentist, or physical therapist.

10

Self-Stretch Opening

Sometimes it may be necessary to use manual over-pressure to improve opening range of motion of your jaw. To do this, sit in a relaxed position and open your mouth with your tongue resting on your hard palate. Then, use your fingers and thumb to add mild over-pressure. You should feel a gentle stretch in your jaw. Hold this position for ten to 15 seconds, and return to the neutral position. Repeat five times.

Keep in mind that TMD exercises may cause slight discomfort, but they should not cause pain. If they do, you must stop the exercise and check in with your doctor or PT. Your TMD exercise program may need to be adjusted or tailored for your specific condition.

A Word From Verywell

Temporomandibular joint disorders and TMJ pain can prevent you from enjoying normal activities like eating and talking. It can make opening your mouth difficult or impossible. Most people with TMD can learn to manage it properly with postural correction and specific jaw exercises.

If you have TMD, visit your doctor and then get started on exercises to get your jaw and neck moving in the right direction. That way you can get back to your normal function and activity with little or no pain.

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Article Sources

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