TMJ Exercises Guidelines Introduction ➢ Surgery and Radiation treatment are both common forms of interventions for patients with Head & Neck Cancer. ➢ What happens with surgery & radiation treatment? • These treatments can make your muscles and soft tissue (e.g., ligaments, skin) stiff and tight. • If muscles and soft tissues tighten, it can cause pain, change in posture and affect joint mobility. • Stiffness and tightness can be seen immediately after radiation has ended, but can also last for a long time (months and even years) after radiation is completed. ➢ Why should exercises be done? • To prevent restricted mouth opening (known as trismus). • To improve range of motion and movement restrictions to help with eating, brushing teeth, talking, etc. • To minimize stiffness and tightness in the muscles, joints and soft tissue exposed to surgery and radiotherapy. • To improve lymphatic system flow to minimize head and neck lymphedema (swelling). • To strengthen head & neck muscles and prevent postural issues from developing. • To improve independence in activities of daily living (i.e. talking, eating).
1. Good Postural Alignment ➢ Imagine a string pulling your head up tall: • Sit or stand tall with feet firmly planted with weight equally distributed. • Keeping the chin slightly tucked, lengthen the back of the neck, focusing on an object at eye level. • Lift up chest to straighten out your trunk. • Tuck in belly button towards your spine. • Try to keep this good posture for all the following exercises. Image: Physiotec
2. Soft Tissue Manual Release ➢ Sitting on a chair/standing in front of mirror with good postural alignment. ➢ Place your washed thumb (and/or using gloves) inside the mouth (cheek level).
Reps Sets X / day
8-10 circles 2-3 sets 1-2x/day
➢ Open slightly your mouth. ➢ Make gentle circles with your thumb inside and fingers outside to release the cheek muscles. Image: Physiotec
©MUHC Lymphedema Clinic
TMJ Exercises Guidelines 3. Mouth Opening ➢ Sitting on a chair/standing in front of mirror with good postural alignment. ➢ Open slightly your mouth. ➢ Criss-cross using either your washed index or thumb (or using gloves) inside the mouth on lower teeth. ➢ Use fingers to hold the mouth open, pull down gently, then relax.
Hold Reps Sets X / day
10-15 sec 8-10 times 2-3 sets 1-2x/day
Image: MUHC
4. Right Lateral Mouth Opening ➢ Sitting on a chair/standing in front of mirror with good postural alignment. ➢ Move your jaw to the right without opening it. ➢ Come back to the center. ➢ Relax your jaw.
Reps Sets X / day
8-10 times 2-3 sets 2-3x/day
➢ Repeat. Image: Physiotec
5. Left Lateral Mouth Opening ➢ Sitting on a chair/standing in front of mirror with good postural alignment. ➢ Move your jaw to the left without opening it. ➢ Come back to the center. ➢ Relax your jaw. ➢ Repeat.
Reps Sets X / day
8-10 times 2-3 sets 2-3x/day
Image: Physiotec
6. Jaw Protraction ➢ Sitting on a chair/standing in front of mirror with good postural alignment. ➢ Do not open your mouth while doing the exercise. ➢ Push and maintain your jaw forward (protraction). ➢ Come back to the center. ➢ Relax your jaw. ➢ Repeat.
©MUHC Lymphedema Clinic
Hold Reps Sets X / day
10-15 sec 8-10 times 2-3 sets 1-2x/day
Image: Physiotec