TMJ Physiotherapy Exercises and Self-Massage: A Daily Routine
The core of TMJ physiotherapy is a short daily routine of gentle jaw exercises, self-massage of the jaw muscles and a few changes to everyday habits. UK hospital guidance gives clear repetitions and timings for each, and they take about ten minutes spread across the day. This guide sets out that routine step by step, shows where people go wrong, and explains when a physiotherapy assessment at Parks Therapy Centre is the sensible next move.
TL;DR
Do the exercises in front of a mirror, slowly and without forcing the jaw. Stop if anything becomes sharply painful.
Typical NHS trust guidance: chin tucks and Goldfish openings 8 to 10 times, 4 to 5 times a day; the “end stretch” 20 times, three times a day.
Massage the temporalis (temple) and masseter (cheek) muscles for about a minute each, two to three times a day, with clean hands.
Consistency matters more than force: the routine works when it is done daily, including on pain-free days.
Locked jaw, inability to eat or drink, or no improvement after six to eight weeks needs a clinician, not more exercises.
Table of Contents
What the routine is for
Temporomandibular disorders (TMD) are problems with the jaw joint, the muscles that move it, or the tissues around it. The NHS lists the usual symptoms: pain around the jaw, ear and temple, clicking, popping or grinding when you move your jaw, headaches around the temples, difficulty opening your mouth fully, and sometimes the jaw locking. Pain is often worse when chewing or when you feel stressed.
The most common form is muscle-related. Leeds Teaching Hospitals describes tightness or pain in the jaw, trouble chewing, pain in the teeth, face or around the eyes, earache or headaches, and pain in the neck, shoulders or back. That is why exercise and massage are first-line: they aim to relax overworked muscles and restore smooth movement.
The outlook is encouraging. TMDs affect up to 1 in 15 people in the UK, are common and largely non-progressive, and most cases improve when treated early with simple, reversible measures. The 2025 national guideline from NHS England’s Getting It Right First Time programme and the Royal College of Surgeons names supported self-management as essential, with self-exercise, self-massage, heat or cold, diet and habit change as its core parts.
The guideline also explains why exercise helps: it encourages relaxation of the chewing muscles, supports jaw function and reduces pain, and regaining confidence in using the jaw normally lowers fear and anxiety.
Before you start
A few ground rules make every exercise safer and more effective.
Use a mirror. Both the Royal Free London leaflet and Leeds guidance recommend one, so you can see whether the jaw opens straight rather than drifting to one side.
Start from the relaxed jaw position. Worcestershire Acute Hospitals advises resting the tongue lightly on the roof of the mouth with the teeth slightly apart and the jaw loose.
Go slowly and stay within comfort. A gentle stretch or mild awareness is fine. Sharp pain, a catch or a new lock means stop.
Wash your hands before any massage, especially if you use a finger inside the cheek.
If you are unsure which exercise suits your type of jaw problem, that is a good reason to be assessed first. Clicking from the joint, muscle pain and restricted opening are not all managed identically.
The exercises
The repetitions below come from NHS hospital guidance. Different trusts give slightly different numbers, which is normal: the principle is regular, gentle, controlled movement. Pick one trusted set and keep to it.
1. Relaxed jaw position
Tongue lightly on the roof of the mouth, teeth slightly apart, lips closed, facial muscles soft. Check it several times a day, at your desk, in the car, in front of the television. Many people clench without noticing, so this is as much a habit as an exercise.
2. Chin tucks
Sit upright, look straight ahead and draw your chin gently backwards, as if making a double chin, keeping the jaw relaxed. Worcestershire’s leaflet suggests holding for 3 to 5 seconds and repeating 8 to 10 times. Do not tilt the head up or down. The movement also helps with neck posture, which matters if you work at a screen. Our guide to desk neck pain covers that side in more detail.
3. Goldfish exercises (partial and full opening)
Place one finger on the joint just in front of your ear and another on your chin, with the tongue on the roof of the mouth. For the partial Goldfish, drop the jaw about halfway and close it again. For the full Goldfish, open as wide as is comfortable, then close. The same leaflet advises doing these in front of a mirror, 8 to 10 repetitions, four to five times a day.
Common mistake: opening fast or past the point of comfort. Keep the movement smooth and even on both sides.
4. The end stretch (relaxation exercise)
Open the mouth, curl the tongue up towards the top and back of the mouth, let the jaw hang loose, then close slowly. Leeds Teaching Hospitals describes this as 20 repetitions, three times a day. The same guidance suggests combining it with coordination practice: open in front of a mirror while keeping the jaw aligned with a straight object such as a toothbrush or pen held vertically to check you are opening in a straight line.
5. Resisted opening (isometric exercise)
Isometric means the muscle works without the joint moving. For muscle-based pain, Leeds suggests placing the back of your hand under the lower jaw and giving gentle upward resistance while trying to open, holding for five to six seconds, five to six times, up to four times a day. Royal Free London gives a similar version using a fist, holding for four seconds, four times a day. The resistance is light. You are not trying to push the jaw open.
6. Forward isometric hold for clicking
Where the jaw clicks because the disc moves in and out of place (disc displacement with reduction), Leeds describes ten repetitions of gently pushing the jaw forwards, holding each for ten seconds. This can reduce discomfort and sometimes how often it clicks. Painless clicking on its own does not usually need treatment.
Jaw self-massage: how to do it
Self-massage targets the two muscles that most often ache. The patient support document from GIRFT and the Royal College of Surgeons describes the technique.
Temporalis (the fan-shaped muscle at your temple). Use the index and middle fingers to apply gentle pressure to the temple area in small circular movements.
Masseter (the thick cheek muscle). Place your thumb inside the cheek and a finger outside, then gently squeeze. Stretch the muscle from top to bottom and from back to front.
How long and how often. The document suggests one minute per muscle, three times a day. Leeds gives a similar range of two to three times a day, with the palm or knuckles pressing down on sore areas and fingertips rubbing any small knots. For the masseter, it describes slight rolling movements for around a minute, then working back towards the ear and downwards along the muscle’s length.
Pressure should feel like a firm, tolerable ache that eases, never sharp. Pressing harder does not speed things up, and bruising or a flare of pain means you have overdone it. If you cannot tolerate the inside-the-cheek technique, work from the outside only and mention it when you are assessed.
Heat or cold
Thermal treatment helps muscles settle before exercise. Worcestershire advises a heat or ice pack over the sore area for no longer than 10 to 15 minutes, with a towel between the pack and the skin. It is not advisable if you have facial numbness, or sensory or circulation problems. Heat before massage and exercise suits many people; cold can suit a flare-up. Use whichever feels better.
Habits that decide whether the exercises work
Exercises done for ten minutes cannot offset hours of clenching. The patient support document recommends:
keeping the teeth apart except when eating;
not chewing gum, pen tops, pencils or nails;
eating a softer diet while the jaw is sore;
cutting back on caffeine, which can raise stress and muscle tension;
keeping an upright posture, head up and shoulders back;
setting aside time for relaxation and self-care exercises each day.
If stress drives your jaw tension, a pain-management approach that includes relaxation and pacing helps. Our overview of pain management strategies sets out the options.
A simple daily plan
Time | What to do | Approximate time |
Morning | Warm pack (10 to 15 minutes), massage temporalis and masseter, end stretch 20 times | 5 to 8 minutes plus warm pack |
Midday | Relaxed jaw check, chin tucks 8 to 10 times, Goldfish 8 to 10 times | 3 to 4 minutes |
Late afternoon | Resisted opening 5 to 6 times, massage for one minute per muscle | 3 minutes |
Evening | End stretch 20 times, gentle massage, relaxed jaw position | 4 to 5 minutes |
This combines the ranges in the guidance above. You do not need every exercise. Choose two or three that suit your symptoms and do them reliably.
On frequency, Leeds advises doing heat or cold, massage and exercises every day, even when you have no pain. The national guideline says building a routine of massage and myofascial release twice daily is likely to bring symptom relief in the short and long term.
When to stop and get checked
Self-care suits most jaw problems, but some symptoms need a clinician.
Urgent. The NHS advises an urgent GP appointment or a call to 111 if you cannot eat or drink, your jaw is locked or you cannot open fully, you have jaw, ear or head pain with frequent severe headaches, tenderness of the scalp or temples, or any vision problems. Details are on the NHS TMD page.
Not improving. Guidance for clinicians says that if there is no improvement or symptoms worsen after six to eight weeks, an earlier specialist opinion should be sought. The same document lists reasons for faster referral, including mouth opening under 30 mm, or pain that limits what you can eat.
Warning signs. National clinician guidance lists red flags such as unexplained weight loss, a lump in the face or neck, neurological symptoms, persistent mouth ulcers or hoarseness lasting three weeks or more, a sudden marked inability to open the mouth, or new jaw pain in people taking bisphosphonates. Do not self-treat these. See your GP or dentist promptly.
The NHS also notes that a GP may suggest a dentist if teeth grinding could be involved, or a psychologist if stress and anxiety are making pain worse, and a physiotherapist for advice on jaw exercises and massage.
When a physiotherapy assessment helps
A physiotherapist can check how your jaw opens, which muscles are tender, how your neck and posture contribute, and which exercises suit you, then adjust the programme as you progress. NICE’s clinical knowledge summary lists physiotherapy and acupuncture among the services considered alongside self-management, depending on clinical judgement.
At Parks Therapy Centre a physiotherapy assessment costs £76 and a follow-up physiotherapy treatment £67, as listed on our prices page. We also offer acupuncture (assessment £60, treatment £50) and sports massage at £60 per hour. We treat patients across Bedfordshire and Buckinghamshire, including Biggleswade, St Neots, Bedford and Milton Keynes, and we accept all major health insurance plans.
If you want a clear plan rather than guesswork, book a physiotherapy assessment online. Our guide to manual therapy explains the hands-on techniques a physiotherapist may use alongside your exercises.
Our view on TMJ rehabilitation
Jaw pain is rarely only about the jaw. Neck posture, stress, clenching and sleep all feed into it, which is why a multidisciplinary approach makes sense. We have been treating musculoskeletal problems in Bedfordshire and Buckinghamshire since 1986, and our physiotherapists, acupuncturists and massage therapists work under one roof. Our advice is to start the home routine early and keep it simple. Choose a few exercises, do them every day and note how your opening and pain change week by week. A physiotherapy assessment gives you a plan matched to your symptoms, and it gives us the chance to show you the technique properly so that you are not guessing at pressure or range. If you are managing pain and want support, we are here to help you move and chew comfortably again. Ivan
FAQ
How long until jaw exercises work?
The guidance does not promise a fixed time. Most cases improve with early, simple management, and clinicians are advised to seek a specialist opinion if there is no improvement or things worsen after six to eight weeks. Daily consistency matters most.
Can I do jaw exercises if my jaw clicks but doesn’t hurt?
Painless clicking usually does not need treatment. If it is painful or catching, the forward isometric hold and mirror-based opening exercises described above may help. A physiotherapist can confirm which suits you.
How hard should I press when massaging my jaw?
Use gentle to moderate pressure in small circles, enough to feel a tolerable ache that eases. Guidance suggests about a minute per muscle, two to three times a day. Stop if the pain becomes sharp.
Should I use heat or ice on my jaw?
Either can be used for 10 to 15 minutes at a time with a towel between the pack and your skin. Avoid both if you have facial numbness or circulation problems. Choose what feels more soothing.
When should I see a professional about jaw pain?
See a GP or call 111 urgently if you cannot eat or drink, or your jaw is locked. Book a physiotherapy assessment if pain or clicking persists, or if you would like your technique checked.
Sources
Temporomandibular disorders (TMD), Leeds Teaching Hospitals NHS Trust
TMD patient support document, GIRFT and Royal College of Surgeons
Management of painful temporomandibular disorder in adults, GIRFT and Royal College of Surgeons
Management of painful temporomandibular disorders ultra-brief guide
TMD clinician summary document, GIRFT and Royal College of Surgeons
Temporomandibular disorders, NICE Clinical Knowledge Summaries
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