Top 5 Fridays! 5 Exercises for TMJ Dysfunction

A theme reiterated often throughout this blog and my Modern Manual Therapy Seminars is patient reinforcement of the improvements made in the clinic.

Staying ahead of your symptoms is a new message I have been telling patients. It fits in well with ADLs and positions that contribute to their complaints being a -1 and +1 being the self resets given for HEP. Here are

5 Exercises/Resets for TMJ Dysfunction

Make sure the patient is sitting relaxed, but in an upright position with sternum elevated to start all of these exercises. Tongue should be at the roof of the mouth in the "N" sound position and teeth should be apart.

Have them perform them 10x hourly to start, more if their window of improvement closes faster than that.

1) Cervical Retraction

a commonly held prolonged position of cervical protraction may cause mandible retraction
this often sensitizes the posterior bilaminar zone of the TMJ
it also may contribute to hypertonicity in the masseters and temporalis
the +1 for the -1 of prolonged cervical protraction is the simple and effective cervical retraction
make sure the patient is able to perform this simple movement correctly and as a low threshold exercise
bonus visualization, if the patient knows who "Atlas" is, tell them this exercise also gives Atlas a rest

2) Mandible protraction

TMD patients are often ectomorphic hypermobile females
if their occlusion does not change with end range cervical protraction, extension, flexion, cervical retraction alone may not be enough to give the bilaminar zone a break
this does not have to be to end range, just have them move forward 3-4 mm

3) Isometric mandible protraction

isometrics are a great way to inhibit muscles that are held in tonic and tender states
have the patient lightly protract the mandible and hold it forward into their fist for 3-4 seconds
repeat often throughout the day and particular if they start to have posterior TMJ tenderness or referred ear symptoms
repeat 6 times

4) Isometric mandible depression

the digastrics are often in a passively insufficient state due to prolonged forward head positions
if the patient is sitting upright, have them do a light retraction to get into a bit past neutral
have the patient open just 1 finger width or less and isometrically hold the mandible depression movement - not cervical flexion into the fist for 3-4 seconds
repeat 6 times

5) Functional TMJ Mobilization - example deviation to the right

have the patient hold their right hand on the right inferior mandible and along the angle of the mandible
with tongue at the roof of the mouth, have them open, their hand can actively assist the initial rolling phase of mandible depression
overpressure using the right hand with light pressure to the left, guiding the mandible into left lateral excursion during depression
repeat 6 times

Want to learn more? Check out my two part course on Medbridge or Modern Manual Therapy below! Better yet, register for Nxt Gen PT's Certificate in Temporomandibular Management - seats still available for our next seminar!

Bonus question: Why am I choosing 6 times as the common rep number in some of the examples above?

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Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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