Jaw Dysfunction is complex and I highly recommend seeing a manual therapist for some assessment and treatment. That being said, most people with jaw dysfunction will benefit from the following routine. Be gentle on yourself. Start with fewer reps, a less intense stretch...make this feel good and you'll be more likely to continue and less likely to flare up jaw pain. See an RMT, physio, chiro, osteopath, acupuncturist...whoever you like for some good jaw work and if any of this is causing you pain...stop doing it and get some help first!
Stretching: Neck and Shoulder Stretch/Lateral Flexion & Rotation Stretch To stretch the L E F T shoulder and side of the neck: - Keep your left shoulder down. Sit on your left hand or stretch your left hand down and away from your shoulder.
1. Tilt your head to bring your right ear toward your right shoulder. Hold this position for about 20 seconds.
2. Rotate your head to the right so you are pointing your chin at your armpit crease. To deepen the stretch, breathe in and raise your shoulders, breathe out and lower your shoulders and tuck your head down farther. Hold this position for about 20 seconds
3. Rotate your head to the left so your chin is pointed toward the sky (but keep your head tilted to the right.) You can re-set the head tilt in between movements if this feel awkward…just come back to centre, tilt your right ear toward your right shoulder and then rotate your chin to point to the sky. Hold this position for about 20 seconds.
Chin tucks
To stretch the back of the neck at the base of the skull:
1. Stand with your back against a wall. (Your heels don’t have to be touching the wall but hips and shoulder blades are on the wall)
2. Bring your head straight back to touch the wall (or as close as you can)
3. Tuck your chin down toward your chest with the back of the head still on the wall
4. To deepen the stretch, hold the chin down and back and use the other hand to pull the head forward slightly so the chin lowers slightly and the back of the neck lengthens. (You should have multiple chins!)
Nervous System massage:
The purpose of this is to calm the nerve (Trigeminal nerve) that deals with the jaw muscles and face sensation. With Jaw dysfunction, it's usually inflamed. This should be light massage and pain free.
Trigeminal Nerve Massage:
1. Place your thumbs at the inner eyebrows pressing up on the orbital bone gently (use whatever pressure feels good to you, this shouldn’t hurt.)
2. Hold that pressure for a few seconds then pull the thumbs along the orbital bone toward the outer corner of the eye. You can do this a few times.
3. Next place your fingers on your cheekbones next to your nose on either side. Give some gentle pressure here and then work across the cheekbone toward the ears. You can repeat this several times.
4. Next place your fingers (2 or 3 fingers on each hand) on the centre of your chin just below your bottom lip, rolling outward to place gentle pressure under the outer corners of your bottom lip. Press and hold here and then work your way out along the jaw bone just above the lower edge. Gently drag the fingers toward the earlobe.
Self massage:
1. Place your fingers at the angle of the jaw (below your earlobes). Drag your fingers upward toward your cheek bones and then all the way to your temples and hairline. Use pressure
that feels good (not painful, but good sensation). Stop anywhere that feels like it needs more time.
2. Repeat with your jaw open as far as feels comfortable for you.
Exercises:
Breathing:
Seated:
1. shift your hips all the way forward and then all the way back, try to find a position in between these two extremes so you feel like you are sitting up straight, but comfortable.
2. Place one hand on your sternum and one on your belly. Raise your sternum just a little so you are just slightly bending the spine backwards through the rib cage area. Play around with the position of the hips and the ribcage to find the position where you feel like you can take the deepest and free-est breath for you.
3. Take 6 - 8 long easy breaths, feeling your rib cage expand outwards and a little upwards (try to keep your shoulders quiet) and feel your belly expand on your inhale, letting the belly sink back down and rib cage shrink and fall on your exhale. Check in on your jaw and make sure it's relaxed.
Jaw Range of Motion exercises:
The Oxford University Hospital Exercise
Set aside two five minute periods each day at a time when you are relaxed – e.g. just before you get up or go to bed. Sit upright to perform all of the following exercises:
1. Close your mouth and make sure your teeth are touching. Do not ‘clench’ your teeth. Rest the tip of your tongue on your palate, just behind your upper front teeth.
2. Run the tip of your tongue backwards towards your soft palate at the back of your mouth as far back as it will go. Keep your teeth gently together.
3. Hold your tongue back in this position to keep contact with the soft part of your palate and slowly open your mouth until you feel your tongue being pulled away. Do not open your
mouth any further. Stay in this position for five seconds then close your mouth and relax.
4. Repeat this whole procedure slowly but firmly for the next 5 minutes.
As you open your mouth you should feel the tension in the back of your neck and under your chin. The first few times you perform the exercise do it while looking in a mirror, to check that your lower teeth move vertically downwards and do not go off to one side.
If you are performing the exercise correctly there will be no clicks or noise from your joints. If there is, re-start the exercise and continue practicing, adjusting your position until it is click-free.
Jaw CARs (Controlled Articular Rotations)
1. Slowly move your jaw to the left as far as you can with no pain, then lower your jaw slowly, keeping it to the left. Once at the bottom of your jaw opening, slide your jaw to the right as far as you can with no pain and return to a closed position, while keeping your jaw as far to the right as you can, then return to neutral. Repeat going to the right. Try for 3 reps each side once a day. If this is feeling great, you can add in more reps or do this morning and night.
2. Slowly move your jaw back as far as you can, then down as far as you can, forward as far as you can, up as far as you can and then back to a neutral position. Repeat going forward first. Again, try for 3 reps each direction, once a day and build up to more reps or 2 sets. None of this should be painful, keep it in the range you can do pain free and click free.
CARs come from Functional Range Systems by Dr Andreo Spina and you can do them for any joint! Pain free range of motion is one of my favourite recovery and rehab tools.
Jaw Strength:
Resisted Open and Close:
1. Place your fingers below your bottom jaw and gently resist while you slowly open your jaw. Be gentle!
2. Come back to a closed jaw position and repeat 5 times to start. (Gently!!)
3. Slowly open the jaw as far as you comfortably can. Place the web of your thumb and first finger on your chin and gently hold your jaw, providing some easy resistance to closing your jaw. (Be gentle to start! Have I mentioned that yet? These muscles are annoyed and probably inflamed and we need to get them stronger without stressing them out. Be nice to your jaw!)
Neck Stability
From a table top position (hands and knees):
1. Let your head drop down, relaxing your neck.
2. Tuck your chin toward your throat. Try to keep this tucked position throughout.
3. Bring your head up to a level position with your shoulders. Don't arch through the neck to look forward, look between your hands on the ground.
4. With the chin still tucked, rotate your head to the right and the left. come back to neutral.
5. Now bring your ear toward your right shoulder and then your left and come back to neutral. (If either head rotation or side bending hurts or makes you dizzy, stop and consult with a manual therapist like a Chiropractor...I know a couple of good ones I can recommend!)
6. Repeat the whole sequence another 4-5 times. I like to relax my neck in between each rep.
7. If this hurts the next day or gives you headaches we need to take it slow to build up or find you another way of doing these! There are lots of options.
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