Jaw pain and TMJ: Stretches, Part 2


Jaw pain, Stretches, TMJ pain / Thursday, September 17th, 2009

This is a series on jaw pain and TMJ. If you missed the beginning, go back to Part 1.

These stretches for the jaw and TMJ are effective and must be done gently at first. If your jaw hurts afterward, wait a day and do them again. Start with the unassisted stretches and move to the assisted ones as your body allows. After doing the jaw-opening stretches, if your throat feels sore or tight, or if it feels like there’s a lump in your throat, do the “anterior neck” stretches to loosen the muscles causing that sensation. The following are stretches I give my patients in my Neuromuscular Therapy office near Boston.

PART 2: OPENING TWO WAYS AND NECK STRETCHES

OPENING: This stretch is done two ways.  The first is with the joint opening and closing like a hinge. The second is with joint unhinged and opening wider. Note the cautions.
For the first, position your tongue behind your front teeth. This will help keep the condyle of the mandible seated in the socket so the joint stays closed and acts like a hinge. Drop your chin downward toward your throat to open your mouth. Check to be sure your jaw is staying in place by placing your fingers over the joint. When open it should be flat. If it comes unhinged you will feel bumps press outward. Those bumps are the condyles of the mandible. Once you understand where the jaw should be, you can relax  your tongue during the stretch if you wish.
So, open your jaw like a hinge, stretch it as far as you can. Exhale and hold for a few seconds. Close your jaw to relax the muscles and repeat 10 times.
Once you can do this comfortably, you can assist the stretch by pressing down on your chin with the fingers of both hands or the angle between your thumb and hand. Open first, then exhale as you assist for two seconds. Relax and repeat 10 times.

OPENING WIDE: This is trickier, especially for those of you with one side that pops out. Start by relaxing your tongue into the floor of your mouth and protruding your jaw like an underbite. In that position with your jaw sticking out, open slowly and as wide as you can. Check your jaw position the whole time by placing your fingers at the joint to be sure both sides stay even. If you feel one side popping out, slowly deviate your jaw to the opposite side until both are aligned equally as you open.
When you are comfortable with this stretch, assist to open it farther by using your fingers or the angle at your thumb to press downward on your chin. Exhale as you actively stretch using the power of your own muscles, then assist for two seconds, release and repeat 10 times.
Because you are using the muscles under your chin and at the front of your throat to open your mouth, these muscles may cramp up or tighten so that you feel as if you’ve suddenly gotten a sore throat or have a lump in your throat.

STRETCH YOUR THROAT, THE MUSCLES UNDER YOUR CHIN AND THE FRONT OF YOUR NECK (anterior cervicals, suprahyoid, infrahyoid, digastric, platysma): In a seated position, lean slightly forward and stick your chin out (protrude your jaw), checking the position of your TMJ (temperomandibular joint) as above. Point your chin up toward the ceiling, tilting your head backward. Focus on pointing your chin up and be sure you are leaning forward to keep your head from falling back. It should just tilt at the base of your skull. Stretch for a few seconds, then lower your chin to relax the muscles. Repeat 10 times. To assist the stretch, go as far as you can using the power of your muscles, then press upward on your chin with the fingers of both hands. Exhale through your nose as  you assist for two seconds. Relax and repeat 10 times.

TWO OTHER NECK STRETCHES that help are rotating in both directions and forward flexing your head to stretch the muscles at the base of your skull (suboccipitals). Both of these stretches also address some of the myofascial Trigger Points that refer pain into your jaw and behind your ear.

The next posts will be about self-treatment.