LDN PHYSIO
Post-TMJ Arthroscopy Rehabilitation Protocol
Alistair Foote, Specialist TMJ Physiotherapist
Nicolas Colombo, Specialist TMJ Physiotherapist
Our TMJ Rehabilitation Programme is designed to restore jaw function, improve mobility, and enhance muscle control following TMJ arthroscopy. This structured approach aims to improve jaw movement, reduce discomfort, and help you regain confidence in your day-to-day activities.
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Phases & Rehabilitation Goals
Phase 1 (0-2 Weeks)
Immediate Post-Operative Phase
Phase 2 (2-6 Weeks)
Mobility & Functional Restoration
Phase 3 (6-12 Weeks)
Advanced Functional Training
Goals:
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Reduce pain and inflammation
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Prevent muscle guarding and stiffness
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Maintain basic jaw function
Goals:
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Improve jaw mobility within a pain-free range
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Reduce muscle tightness & improve coordination
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Restore normal chewing function
Goals:
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Restore full, pain-free TMJ function
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Strengthen surrounding muscles
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Prevent reocurrence
Phase 1: Immediate Post-Operative Phase (0-2 Weeks)
Goals
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Reduce pain and inflammation
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Prevent muscle guarding and stiffness
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Maintain basic jaw function
Early Management
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Ice therapy (15 min every 2 hours)
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NSAIDs (if prescribed)
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Gentle massage around the jaw, temple, and upper cervical region
Restorative Techniques
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Resting jaw position awareness (tongue-to-palate resting posture)
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Avoid excessive chewing, talking, and hard foods
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Encourage nasal breathing
Early Mobility Exercises
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Active Assisted ROM exercises (pain-free range)
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Isometric exercises (gentle resistance without movement)
Cervical & Postural Integration
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Upper cervical mobilisation (if indicated)
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Scapular retraction and postural correction
Phase 2: Mobility & Functional Restoration (2-6 Weeks)
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2cm opening – pain free
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Normal speech
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Absence of discogenic symptoms – clicking/locking
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Pain controlled
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Managing level 6 – soft and sized diet – pain free
Criteria
Goals
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Improve jaw mobility within a pain-free range
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Reduce muscle tightness & improve coordination
-
Restore normal chewing function
Manual Therapy
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Gentle intraoral mobilisation (if tolerated)
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Soft tissue release for masseter, temporalis, and pterygoids
Jaw Mobility & Coordination
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Controlled opening & closing with mirror feedback
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Lateral excursions & protrusion-retrusion exercises
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Tongue-controlled opening to prevent overuse of masseter
Neuromuscular Re-Education
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Proprioceptive exercises
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Coordination drills for TMJ muscle balance
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Fine motor control drills
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Chewing exercises
Strength & Endurance Training
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Progressive resisted exercises (TheraBite, rubber bands)
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Gradual return to normal diet (introducing harder foods)
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Higher isometrics – if not painful can start to work through range
Phase 3: Advanced Functional Training (6-12 Weeks+)
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Opening 4cm
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Pain free talking
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Deviation 0.8cm
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Protrusion 0.8 cm
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Pain controlled
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Able to work through Level 7 – ‘easy to chew’ diet without
Criteria
Goals
-
Restore full, pain-free TMJ function
-
Strengthen surrounding muscles
-
Prevent recurrence
Advanced Manual Therapy
(if needed)
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Mobilisation for capsular stiffness
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Extra oral – protrusion mobs – deviation mobs
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Intra oral pterygoid release/masseter release
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Deep tissue release for myofascial restriction
Strength & Endurance Work
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Progressive resisted exercises for jaw control
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Functional mastication training (bilateral chewing)
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Sustained holds
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Resisted through range – but until fatigue
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Chewing hard foods – prolonged
Postural & Cervical Strengthening
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Deep neck flexor training
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Scapular stability & upper quadrant strengthening
Sport-Specific / Occupational Rehab
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Gradual return to high-demand activities (e.g., singing, sports, prolonged talking)
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Ergonomic modifications for workplace-related habits
Return to Function & Maintenance
(3+ Months)
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Monitor for residual dysfunction or asymmetry
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Address parafunctional habits (bruxism, clenching)
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Ongoing self-management strategies (e.g., relaxation, TMJ hygiene)
Find all our TMJ exercise videos on our youtube channel >
