TMJ exercises: the jaw exercises with evidence, and how to do them

TMJ exercises are one of the better-supported treatments for jaw joint and jaw muscle pain. A 2023 BMJ clinical guideline gave supervised jaw exercise and stretching a strong recommendation for chronic temporomandibular disorder (TMD) pain,^[1] and pooled trials show less pain and better mouth opening.^[2]

They’re also gentle, much gentler than a lot of what comes up when you search “jaw exercises”. That search mixes in plenty of jawline training, which is close to the opposite of what a sore jaw needs.

Below: what the evidence actually shows, the exercises as NHS physiotherapy and surgical leaflets describe them, a simple routine, what to avoid during a flare, and when to stop and get seen.

What is TMD?

The temporomandibular joint (TMJ) is the hinge in front of each ear where your lower jaw meets your skull.^[10] TMD is the umbrella term for problems with that joint and the muscles that move it, though plenty of people say “TMJ” for both. The BMJ guideline calls TMD the second most common chronic musculoskeletal pain condition after low back pain, affecting 6–9% of adults worldwide.^[1]

The usual symptoms are pain around the jaw, ear and temple; clicking, popping or grinding when you move your jaw; headaches around the temples; difficulty opening fully; and the jaw locking when you open. Pain tends to be worse when chewing and when you’re stressed.^[3]

The reassuring part: the NHS describes TMD as not usually serious, and says it generally gets better on its own.^[3] Exercises aren’t a cure you have to find. They’re one of several things that help a jaw settle, and stay settled.

Do TMJ exercises actually work?

Yes, moderately, on evidence that’s decent rather than strong. Three bodies of research tell the story.

The positive case. A 2023 meta-analysis pooled 16 randomised trials with 812 participants. Exercise therapy reduced pain (a standardised mean difference of −0.58, a moderate effect) and improved how far people could open their mouths, both on their own and with assistance (around 0.4, small to moderate). Adding exercise to a splint beat a splint alone on both pain and opening.^[2]

The cautious case. An earlier review of 48 randomised trials, published in the American Physical Therapy Association’s journal, rated the overall evidence low. Most trials had unclear or high risk of bias, effect sizes were low to moderate, and there was no clear sign that exercise beat other conservative treatments. Manual therapy, alone or combined with jaw or neck exercise, looked promising. The authors’ bottom line was “great uncertainty”.^[4]

The guideline. In 2023 an international panel of patients, clinicians and methodologists produced a BMJ guideline built on a network meta-analysis. For chronic TMD pain, meaning three months or more, it made strong recommendations for supervised jaw exercise and stretching, supervised postural exercise, therapist-assisted mobilisation, manual trigger point therapy, cognitive behavioural therapy, and usual care such as home exercises, stretching, reassurance and education. It recommended conditionally against reversible occlusal splints and botulinum toxin injections, among others, and strongly against irreversible splints and disc removal surgery.^[1] If Botox for the jaw is on your mind, we go through that evidence in masseter Botox.

Two details are easy to miss. The strongest recommendations were for supervised exercise, done under a clinician’s eye. And the guideline covers chronic pain, not a jaw that started hurting last week.

Three smaller studies fill in the picture.

Named routines aren’t magic. Rocabado’s “6×6” exercise program is a well-known example of a branded jaw routine. In a double-blind trial, 45 people with jaw muscle pain were randomised to self-care alone or self-care plus the 6×6 exercises for four weeks. Both groups improved significantly, by more than two points on a pain rating scale, and there was no difference between them.^[5] Self-care basics did a lot of the work.

Posture seems to matter. In a trial of 60 people with muscle-type TMD, adding posture training to self-care instructions for four weeks cut reported TMD symptoms by 41.9%, against 8.1% with self-care alone. Neck symptoms fell 38.2% against 9.3%.^[6] That’s the rationale for the chin tucks below.

Heavy resistance isn’t established. A 2025 systematic review of resistance training for the chewing muscles in people with TMD found three studies and 108 participants. There were improvements in pain and muscle performance, but the evidence was graded very low quality and couldn’t show that resistance training beat the comparison treatments.^[7] So the resisted exercises below are kept light.

My read of all this: exercise is worth doing, gently and consistently, alongside the self-care basics that carry much of the benefit. The exact routine matters less than doing something sensible regularly, and a physiotherapist’s supervision is where the strongest evidence points.

How to do TMJ exercises, step by step

The instructions below follow NHS hospital physiotherapy and surgical leaflets. Use a mirror for the opening exercises, so you can see that your jaw drops straight down rather than drifting to one side.^[8] Every movement is slow and gentle. If a physiotherapist who has examined you has given you different instructions, follow theirs.

1. Relaxed jaw position. Rest your tongue lightly on the roof of your mouth, relax your jaw muscles and let your teeth come slightly apart.^[8] One leaflet has you hold it for 10 seconds, five times.^[9] More importantly, it’s your default all day: apart from when you’re eating, your teeth shouldn’t be touching.^[3]

2. Tongue-up controlled opening (the “goldfish”). With your tongue on the roof of your mouth, open slowly, keeping your lower jaw moving down in a straight line and your neck straight. Repeat 10 times.^[9] The Worcestershire version adds one finger on the jaw joint to feel the movement and another on your chin to guide it, doing a partial opening and then a full one, 8 to 10 times, ideally four to five times a day. Once that’s comfortable, do it with a finger on each joint and no guiding finger.^[8]

Oxford’s version is stricter, and a good way to learn it. Run the tip of your tongue back along the roof of your mouth towards the soft palate, as far as it will go, with your teeth gently together. Keep it there and open slowly, only until you feel your tongue being pulled away, and no further. Hold five seconds, close and relax. Done correctly, there’s no click; if there is, start again and adjust until the movement is click-free. For the first week they cap it at five minutes, twice a day.^[10]

3. Resisted opening. Push your lower jaw down while resisting the movement with your hand. Hold 5 seconds, and repeat 10 times.^[9] Keep the resistance light.

4. Resisted side-to-side. Move your lower jaw to one side while your fingers gently resist the movement. Hold 5 seconds, and repeat 10 times on each side.^[9]

5. Stabilisation holds. Start with your jaw partly open, about a knuckle’s width, then apply gentle pressure with your fingers to the left and right sides of your chin, and underneath it, while your jaw stays where it is.^[8]

6. Chin tucks. Sitting or standing tall, draw your chin straight back as if making a double chin, without tipping your head down towards your chest. Hold 3 to 5 seconds, and repeat 8 to 10 times.^[8] You should feel a stretch in the back of your neck.^[9]

7. Assisted stretch. With your tongue on the roof of your mouth, use your fingers to ease your chin back and down. Hold 5 seconds, and repeat 10 times.^[9] Longer, firmer stretches exist, but they’re best learned under supervision, which is how the guideline’s strong recommendation for jaw exercise and stretching is framed.^[1]

A simple routine

A simple TMJ exercise routine, with doses from NHS leaflets

Exercise	How	Reps and holds in the leaflets
Relaxed jaw position	Tongue lightly on the roof of the mouth, teeth slightly apart, jaw loose	Hold 10 seconds, 5 times; then use it as your default all day
Tongue-up opening (goldfish)	Tongue up, open slowly in a straight line, close	8 to 10 times, 4 to 5 times a day; Oxford's version: 5 minutes, twice a day for week one
Resisted opening	Open against light pressure from your hand	Hold 5 seconds, 10 times
Resisted side-to-side	Move the jaw sideways against light finger pressure	Hold 5 seconds, 10 times each side
Stabilisation holds	Jaw a knuckle's width open, gentle finger pressure from the sides and below	No set dose given; keep it gentle
Chin tucks	Draw the chin straight back, head level	Hold 3 to 5 seconds, 8 to 10 times
Assisted stretch	Tongue up, fingers ease the chin back and down	Hold 5 seconds, 10 times

The leaflets don’t agree on frequency. Worcestershire suggests the opening exercises four to five times a day;^[8] Oxford starts with two five-minute sessions a day for the first week, then more.^[10] The sensible reading of both is to start at the low end and build.

What should you avoid with TMJ pain?

The NHS list is short and practical. Don’t chew gum or pen tops, don’t bite food with your front teeth, don’t yawn too wide, don’t bite your nails, and don’t clench. Do eat soft food like pasta, omelettes and soup, take paracetamol or ibuprofen, use an ice pack or heat pack wrapped in a tea towel, massage the sore muscles, and find ways to relax.^[3]

The physiotherapy leaflets add a few more:

• Hard, crunchy and chewy foods, such as apples, steak, corn on the cob and chewy toffee. Cut tough food into small pieces.^[8]
• Holding a phone between your shoulder and ear.^[8]
• Sleeping face down, which strains the neck.^[8] Our guide to the best sleeping position for neck pain covers the alternatives.
• Night-time grinding. If you clench or grind in your sleep, a dentist can assess you for a mouth guard.^[9]

Chewing gum deserves its own line, because the reason is the whole point: extra chewing stops your jaw getting periods of rest.^[8] That includes the hard “jawline” gums and firm resin gums like mastic. During a flare, they’re the wrong kind of exercise.

Are jawline exercises the same as TMJ exercises?

Search “jaw exercises” and you’ll find plenty of the other kind: hard chewing, resistance devices and bite trainers, aimed at building the masseter for a squarer face. That’s a different goal with a different load. TMJ rehab is small, slow and light, aimed at comfortable, straight movement. Jawline training is heavy loading aimed at muscle growth. The first is what a sore jaw needs; the second is what the leaflets above tell you to cut back on.

Even in people with TMD, the evidence for heavier resistance work is graded very low quality.^[7] Whether chewing builds the masseter at all, and what a bigger one does to the shape of your face, is its own question, which we cover in our guide to the masseter muscle.

There’s one overlap worth untangling. The relaxed jaw position puts your tongue on the roof of your mouth, which sounds like mewing. The difference is the effort: the TMD rest position asks for a light touch and a loose jaw.^[8] What firmer tongue posture can and can’t do for your face is in our mewing guide.

Can jaw exercises make TMJ worse?

Doing TMJ exercises correctly means doing them within comfort. These are the signs, from the NHS guidance and the leaflets above, that you’ve gone past that:

• Pain that builds, or symptoms that worsen. Stop and get advice. Worcestershire’s leaflet tells patients to contact their GP if their symptoms or condition get worse.^[8]
• Catching, locking or losing range. If your jaw locks or you can’t open fully, the NHS says to ask for an urgent GP appointment.^[3]
• A click during the opening exercise. That’s a signal to reset and adjust the movement until it’s click-free, not to push through it.^[10]
• Forcing the range. Oxford’s instruction is to open only until your tongue starts to pull away, and no further.^[10]