Jaw Exercises

fishmanpa

Trismus/TMJ is a condition that affects many of us (raising hand) who have undergone radiation and/or surgery. Just like swallowing, "use it or lose it" is the mantra. Here are some exercises given to me by my Speech/Language Pathologist at Johns Hopkins. As always, check with your doctors before doing anything. I have an entire notebook filled with great tips on subjects from dry mouth to exercises for shoulders to diet from Johns Hopkins. I'm re-typing them and saving in MS Word to post later on. Coming from one of the top H&N centers in the country. they can only be deemed helpful.

BTW....These are especially fun to do in the car and watch the reaction of other drivers ~lol~  

"T"

 

Ideally to be performed 1-3X daily

Jaw Opening
Open your jaw as wide as you can until you feel stretching, but no pain. Hold this position for 5 seconds, Relax. Repeat 10X

Side-to-Side Movement
Move your jaw to the right as far as you can until it pulls but does not hurt. Hold it there for 5 seconds. Relax. Repeat 10X 

Same exercise to the left.

Increasing Circular Jaw Movement
Pretend to chew (as though you were chewing gum) in small circles with mouth closed, rotating to the right and then to the left. Alternate right and left for a total of 20 times.

 

Tongue Depressors (only if <30mm MIO)
Use wooden tongue depressors, adding one more each day, hold between upper and lower teeth or gums (about 1/4 of stick in mouth). Try to increase to 30 seconds.

Alternately, use one tongue depressor and slowly turn it from flat to sideways, gently stretching mouth opening to accommodate. Again, hold for 10-30 seconds as tolerated.

Mouth Opening Check
Monitor mouth/jaw opening. Insert three fingers (between thumb and pinky) into mouth. You should be able to do this easily. 

phrannie51

I'm glad you brought this up....

and I think we should bring this up (and the neck exercises) every couple months....I have faithfully done both neck and jaw exercises since the beginning and have no problems now.....but well remember when it hurt to open only as much as say, taking a bite of a sandwich.  These exercises can be done watching TV, or reading on the computer.....and everyone who has had rads to the head can benifit from them.  It would be the pits having to get a PEG simply because your jaw was locked up....

So....everybody who just finished treatment.....or has a loved one who has just finished.....do these exercises to keep flexible.

p

TracyLynn72

thanks for posting..

this is one area where I am not doing so well.  I'm very hesitant to open my mouth very wide knowing that I only am hinged on one side.  My surgeon told me I needed to start stretching my jaw open more and honestly the thought terrifies me.  I keep thinking...I only have one hinge and I don't want to hurt it!  

 

 

fishmanpa

TracyLynn72 said:

thanks for posting..

this is one area where I am not doing so well.  I'm very hesitant to open my mouth very wide knowing that I only am hinged on one side.  My surgeon told me I needed to start stretching my jaw open more and honestly the thought terrifies me.  I keep thinking...I only have one hinge and I don't want to hurt it!  

 

 

Check....

Tracy,

Run these by your surgeon before doing anything!

"T"

phrannie51

TracyLynn72 said:

thanks for posting..

this is one area where I am not doing so well.  I'm very hesitant to open my mouth very wide knowing that I only am hinged on one side.  My surgeon told me I needed to start stretching my jaw open more and honestly the thought terrifies me.  I keep thinking...I only have one hinge and I don't want to hurt it!  

 

 

Tracy...just start by using your

fingers....one or two...just till you start to feel the muscle pull a little....and leave your fingers there for a count of 5 or 10....you don't want that muscle to freeze where it's at....think what going to the dentist will be like....YIKES!!  Do talk to your Dr. .... I honestly think your one hinge will do you just fine, it's all in tact and as it was the day you were born.

p

TracyLynn72

fishmanpa said:

Check....

Tracy,

Run these by your surgeon before doing anything!

"T"

These are

pretty much what he has told me to do.  I had much better range before rads.  The radiation definitely made me swell up again and now I'm getting better so I need to do more jaw exercises.  This is a great thread!  Thank you! 

hwt

phrannie51 said:

Tracy...just start by using your

fingers....one or two...just till you start to feel the muscle pull a little....and leave your fingers there for a count of 5 or 10....you don't want that muscle to freeze where it's at....think what going to the dentist will be like....YIKES!!  Do talk to your Dr. .... I honestly think your one hinge will do you just fine, it's all in tact and as it was the day you were born.

p

Hinges

I managed to keep both hinges but still have trouble opening wide enough to eat a sandwich without a knife & fork. Wish one of my doctors had suggested the exercises or that I got "overs" on this one.

Duggie88

"T"

I do my exercises at night while watching the Phillies lose which may be the reason they are so painfull. I've been practicing putting my foot in my mouth for years so I guess I had a head start on this one before cancer.

Good post..............enjoy the day

      Jeff

SylMarie

fishmanpa, I am so glad I found your post.

I am also a patient at JH, and traveled from out-of-state to have my surgery. Are you from the Baltimore area? I am asking because other than my surgeon there, I was not referred to any other doctors or therapists at the institution while I was there during my initial consult and pre-op visit, or during the 8 days post-surgery. Maybe they just assume that if you're from out-of-state there is no point in providing other support? I am now back in my home state with a local oral surgeon (with whom the Hopkins surgeon works frequently), who only changes my gauze packing and sees me until my follow-up visit at Hopkins in August. No one gave me any exercises to do, and my jaw is very tight on my left side, which is the side my tumor was removed. 

RottiesMom

Thanks T!

My Radiation Oncologist gave me some exercises to do...you have some extra ones!  I have saved and started doing them!  I I have had tmj for years!

Joanne

Joanne  

LiseA

I was doing them after a few

I was doing them after a few weeks post surgery. Worked up to four fingers pointing inside mouth and now it's painful with two. probeen is the soreness where the lip split in the corner,  sores in inner cheek too. Feels so painful when I try to open my mouth. Maybe in a couple weeks things will be easier.   Thanks for the reminder.  What about neck exercises?  I had a neck dissection and since rads, my neck is super stiff, but again, not able to do much stretching because of the burns. They did say to wait until those "tears" in skin heal.  

RandyS

No radiation. Major surgery

I had cancer of the mouth and hard pallette I had surgery. No one informed me that Tismus was even a possibility. I got no direction at all. I have a prosthetic that protects the roof of my mouth and covers the hole to my sinus. A couple of week after getting the prosthetic, I was unable to get it out. I had an appointment with the surgeon and only then was told I ,had Tismus. They gave me tongue depressors to stretch. My next appointment was with the doctor who was going to do a new prosthetic. He was visibly angry when I said I can't get it out. He said I need to increase the opening by 5mm. I can only get one finger between my teeth.  The depressors only help a little...about 3mm. And after a few hours it always returns to it's fully contracted state. I start therapy today but given how long I've gone without doing anything, because they acted like it was normal healing, I can't help but wonder if the wait has made this a permanent problem. It's also affected my ear. First an earache and fullness and then loss of hearing in that ear. It was checked and it is clear. I was told to use an antihistamine. I tried Sudafed but it did nothing. They want to do radiation even though an MRI showed everything was clean and they said the margins were good. Radiation seems it would be a bad idea since it causes the very things I'm trying to deal with already. 

grace2017

Second opinion?

I'm sorry I'm not able to offer much help, but wanted you to know someone cares.  You may want a second opinion on the radiation if you are uncomfortable with that.  Also, my husband tried Flonase under recommendation of his radiation oncologist and it seems to help the ear a little bit.  I got the children's off-brand at Walmart which is the same dosage and ingredients as the adults (?) but much cheaper, just start with a low dosage and see if that helps a little bit since it made my husband a little nauseous (although that could have been something else too).  Slow and gentle mouth stretches several times a day, not to the point where it hurts (that could cause damage), helped my husband after his surgery.  It is still not ideal, but he can get a spoon in comfortably now.  Hang in there.

Curlyn

My jaw was very stiff and I

My jaw was very stiff and I found the tongue depressors difficult to use. I finally coughed up the money for Therabite and it's made a world of difference. And it might be an alternative for those who can't open their jaw at this point, but check with your surgeon first. I also do the the circular, side to side, and tongue exercises. Thanks for this post, a good reminder.