TMJ Disorders: 6 Helpful Exercises for Jaw Pain

Temporomandibular joint (TMJ) disorders are a common source of jaw and head pain.  TMJ disorders are also associated with neck pain, chronic headaches, ear-related problems, and poor posture.  People with TMJ pain often experience limitations chewing certain foods, speaking, yawning, and sleeping.  It is estimated that 15% to 50% of people suffer from at least some mild jaw-related pain.  Braces and surgeries are available to treat severe cases.  Also, certain exercises have been proven to be very effective for treating symptoms related to TMJ disorders.

Anatomy of the TMJ

The TMJ is the name of the jaw joint located on either side of your head, just in front of your ears. These joints connect your mandible (jawbone) to your temporal bone (skull).  Your TMJ can rotate and move forward, backward and side to side.  It is considered one of the most complex joints in the body.  The joint includes a disc which helps guide movement as the mouth opens and closes.  The function of the jaw and surrounding muscles are highly dependent on the posture or position of your neck and head.  This joint in combination with the surrounding muscles, allows you to chew, swallow, speak and yawn.

TMJ Anatomy

Signs and Symptoms of TMJ Disorders

Symptoms of TMJ problems include pain around your ear and jaw.  Pain may also be present around the muscles of your jaw, face, temples, and back of your head. Other symptoms include problems opening or closing your mouth, and a clicking, popping, crunching or grinding noise when you chew, yawn or open your mouth.  You may also experience neck pain and headaches as a result of a TMJ disorder.

Exercises to Help TMJ Disorders

World-renowned TMJ expert, Dr. Mariano Rocabado has popularized the 6×6 exercise program for people with TMJ problems.  These exercises address the postural relationships between your head, neck, and jaw. The objective of the home exercise program is for you to learn a new resting position, promote muscle relaxation, improve coordination of your jaw movements, and restore normal jaw function.  Your pain will subside once the exercises are mastered.  Dr. Rocabado advocates 6 fundamental exercises for TMJ disorders. He recommends you complete each activity 6 times each session 6 times per day.

Resting Position of the Tongue

Sit upright with a tall posture.  Place the front 1/3 of your tongue on the roof of your mouth with mild pressure.  Your mouth is closed but your teeth are slightly apart.  This rests the tongue and jaw muscles and promotes diaphragmatic breathing.  From this position, take 6 breaths in and out through your nose.   Focus on breathing slowly from your belly.

Controlled Opening

Start from the resting position of the tongue.   This rests your tongue and jaw muscles and promotes diaphragmatic breathing.  Slowly open and close your jaw with your tongue maintained on the roof of your mouth.  This helps restore normal mechanics of the TMJ and improves coordination of your jaw muscles.  Perform 6 repetitions 6 times per day.

Isometrics in Resting Position

Isometric exercises promote muscle relaxation and an improved resting position of the jaw.  Assume the resting position and apply gentle resistance to your jaw with one hand.  Perform 6 repetitions for 6 seconds each in the directions of opening, closing, and side to side.  Maintain the resting position throughout the exercise.

Chin Tuck

This exercise relaxes tension in the neck muscles and improves posture.  Gently tuck your chin straight back while maintaining your eyes level with the horizon.  Perform 6 repetitions holding each for 6 seconds.

Shoulder Blade Squeezes

Stand with your neck relaxed and jaw in the resting position.  Perform shoulder blade squeezes.  This involves pulling the shoulder blades down and back to facilitate an erect posture.  Perform 6 repetitions holding each for 6 seconds.

Stabilized Head Flexion

Sit or stand with your neck relaxed and jaw in the resting position.  Lace your fingers behind your neck for stabilization.   Gently nod your head as if you are indicating “yes”.  Feel the stretch in the back of your upper neck.  Perform 6 repetitions holding each for 6 seconds.

Start Your Road to Recovery Today

TMJ problems are extremely common.  Symptoms range from an annoyance to debilitating.  Many people experience problems chewing, speaking, and yawning.  Exercise can alleviate much of the distress.  In order to achieve the best results, exercises should be performed frequently each day.  Infrequent or random exercise will do little to improve your pain.  Give these 6 exercises a shot for a few weeks and see how things are going.  If you want more help give us a call.  Our physical therapists can help you find the right exercises for you and supplement these with massage and other manual therapy treatments. You don’t have to live with pain forever.

Neck Pain and Dizziness

Each year many people suffer from neck pain and dizziness. The number of patients who visit their doctor and the emergency room for dizziness is on the rise.  Dizziness accounts for 7% of doctor visits for people over the age of 45 and is the leading reason to see a doctor in those over the age of 65.  Most people with dizziness are looking for a straightforward diagnosis.  However,  those who present to the emergency department only receive a confirmatory diagnosis in 49.2% of cases.  The purpose of this article is to describe how a physical therapist examines a person suffering from one particular form of dizziness called cervicogenic dizziness.

Cervicogenic dizziness occurs as a result of pain originating from the neck or cervical spine. This occurs because of faulty signaling from the neck to the brain about where your head is in space.  This faulty signaling results in the sensation of dizziness. There is no gold standard test for this type of dizziness.  Instead, the diagnosis is made by excluding other causes of dizziness ranging from cardiovascular causes to metabolic causes, and inner ear causes.

Examination of the Patient with Dizziness

When performing an examination for a person with dizziness there is a 5 step process.  Part 1 includes listening to the patient’s history and determining if their symptoms are consistent with cervicogenic dizziness . Next, part 2 includes testing to see if this patient is appropriate for physical therapy.  Part 3 includes testing the inner ear. The inner ear, or vestibular system, consists of structures connecting with your brain which tell your head where it is in space.  Finally, steps 4 and 5 involve testing the cervical spine.

Testing of the cervical spine may include testing range of motion of the neck, strength of deep neck muscles, and performing a variety of special tests. These tests may include tests for motor control, the neck’s awareness of position sense and the mobility of each vertebra in your neck.  Oftentimes, an examination of one spinal vertebra (shown below) will reproduce the person’s complaints of dizziness.  A treatment plan is developed based on the results of these tests.

neck pain

Treatment of Neck Pain and Dizziness

There are various research papers showing manual physical therapy and exercise reduces neck pain and dizziness. The videos below illustrate two of these exercises.  Thankfully, research shows a year after physical therapy patients who complete these programs are able to maintain their improvements.

Final Thoughts on Neck Pain and Dizziness

Cervicogenic Dizziness is a condition described as neck pain and dizziness originating from the cervical spine. The diagnosis is made by first ruling out other problems.  Successful treatment includes manual physical therapy and exercise.  Thankfully, when a proper diagnosis is made by your physical therapist, this simple approach significantly reduces neck pain and dizziness.  Contact us today if you have neck pain and dizziness or simply have questions about which treatments are right for you.

Neck Pain and Headache: Exercises to Help You Manage

Headaches coming from the neck muscles, joints, and nerves are estimated to account for 20% of all recurrent headaches. Head pain originating from the neck is referred to as cervicogenic headache. This is often felt in the neck, back of the head, or around the eyes. Pain is mostly on one side of the head and neck. Neck movements or sustained postures, such as sitting at a desk, exacerbate the pain. Medications are mostly ineffective. Thankfully, research over the last 10 to 15 years shows exercise is effective for managing headaches.

Research Supports Exercise for Managing Headaches and Neck Pain

In 2010, researchers from Finland investigated the effectiveness of 3 different types of exercise programs in patients with cervicogenic headache. One group performed stretching and strengthening exercises for the neck and shoulders. The other group performed stretching and endurance exercises. The third group performed only stretching.

After 12 weeks, headaches decreased by 69% in the strengthening group, 58% in the endurance group and by only 37% in the stretching group. This study showed endurance and strengthening exercises, and not stretching exercises, are effective for managing headaches from the neck. The exercises which follow in this article are endurance and strengthening exercises which can easily be incorporated at home.

Deep Neck Flexor Exercises

The deep neck flexors are small muscles deep in the front of your neck. The longus coli and longus capitis are the two primary deep neck flexor muscles. The movement they are involved with is nodding the head as if you are saying “yes”. However, they also play a very important role in supporting the spine and controlling movement in all directions.

Research shows people with neck pain have small and poorly functioning deep neck flexor muscles. The craniocervical flexion exercise is first performed with the goal of improving endurance. After several weeks of building endurance of these muscles, the cervical flexion exercise is added to improve strength. Both of these exercises can be performed on the floor or flat on your bed.

Neck Extensor Exercises

The neck extensors are equally important for the rehabilitation of patients with neck pain and headache. These small deep muscles lie on the back of the neck.  They are active when lifting the head to look up but also play an important role is supporting the spine and head.

Changes in cervical extensor muscle size, structure, and function have been observed in people with neck pain. Muscle loss is often associated with a build-up of fatty tissue in the same area. Control and coordination of movement becomes impaired. This often results in difficulty picking up the head or changing positions. Similar to training the flexors, exercise is first performed with the goal of improving endurance. After several weeks of building endurance of these muscles, exercise is progressed to improve strength.

Final Thoughts on Exercise for Neck Pain and Headache

Neck pain and headaches can be debilitating and negatively impact your quality of life.  Not everyone with headaches has to suffer. These 4 exercises are only a small sample of the types of exercises that can help.  Meet with your physical therapist and get started on the road to recovery. Your physical therapist will continually assess your injury and progress your exercise program based on your goals. The objective is to decrease pain and give you your quality of life back as quickly as possible. Contact us today if you have headaches or neck pain or simply have questions about which treatments are right for you.

Sign Up To Download This Free Ebook
10 Keys to Achieving Your Goals in Physical Therapy.

Evidence for Exercise and Neck Pain

Neck pain can be debilitating and limit your quality of life. It may impact your ability to drive, participate in activities you enjoy, and enjoy activities with your family. Luckily physical therapy can have profound impacts on reducing disability and limitations associated with neck pain. Evidence for strengthening of your neck muscles including the longus capitis and longus colli as well as manual therapy provided by a licensed physical therapy can help improve your neck mobility and even improve numbness/tingling in your arms associated with neck pain.

A Case Study using Exercise for Neck Pain

In a clinical case of a 28-year-old individual with neck pain and left arm symptoms, a physical therapy program consisting of manual therapy directed at the mid back, neck, and left arm reduced pain and improved the overall quality of life in just 10 visits of therapy services. The patient also benefited from stretching exercises for the cervical musculature and strengthening of the longus capitis and longus colli. Treatments to improve the mobility of your nervous system can help decrease the numbness/tingling you may experience with neck pain, this is known as a cervical radiculopathy.

Posture can influence neck pain
Exercise for neck pain

Conclusion

See a physical therapist today if you are experiencing neck pain with arm symptoms associated with a cervical radiculopathy to determine if you can benefit from physical therapy treatment, even without a referral from a physician. The physical therapist is trained to determine if treatment is indicated, ask your local therapist today.

-Dr. Steven Ferro, PT, DPT

Reference

Cleland, J. A., Whitman, J. M., Fritz, J. M., & Palmer, J. A. (2005). Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. Journal of Orthopaedic & Sports Physical Therapy, 35(12), 802-811.