Move Forward Guide
Physical Therapist's Guide to
Jaw Fracture (Temporomandibular Joint Fracture)
Fracture requires emergency medical treatment.
What Is Temporomandibular Joint Fracture (Jaw Fracture)?
Like any other joint in the body, the temporomandibular joint (TMJ) can be broken, most likely due to a fall or trauma to the face. The jaw most commonly breaks along the condyles, which are rounded projections on the jaw bone. Fracture also may occur with a dislocation of the joints.
Signs and Symptoms
Following the trauma and the fracture, you'll have pain, some swelling, and possibly bruising. Even after emergency medical care and after the healing process, you may still have symptoms, including:
- Jaw pain
- Jaw fatigue
- Difficulty opening your mouth to eat or talk
- Ringing in your ears
- Popping sounds in your jaw
- Neck pain
- Locking jaw
How Is It Diagnosed?
If you suspect you've broken your jaw, you should go to an emergency department or an emergency family medicine clinic. X-rays will be ordered to determine the severity of the fracture.
There are several approaches to help a jaw fracture heal. Depending on the location and severity of the fracture, you will:
- Have a liquid diet
- Talk as little as possible
- Generally limit the use of your jaw
If the fracture is severe, your physician may consider a form of splint therapy, which rests the jaw in a position for healing. In the case of very severe fractures, the jaw can be set and wired closed to prevent any movement and ensure complete healing.
How Can a Physical Therapist Help?
Once you have completed a course of rest or splinting, your physical therapist can help restore the natural movement of your jaw and decrease your pain. During your first visit, the physical therapist will:
- Review your medical history, and discuss any previous surgery, fractures, or other injuries to your head, neck, or jaw
- Conduct a physical examination of your jaw and neck
- Evaluate your posture and how your neck moves
- Examine the TMJ to find out how well it can open and whether there are any abnormalities in jaw motion following the fracture
The therapist might place his or her hand in your mouth in order to examine your jaw movement.
Following the examination, the physical therapist will select the appropriate treatments to improve your jaw movement and relieve your pain.
Improve Your Jaw Movement
Physical therapists also use skilled hand movements called manual therapy to increase movement and relieve pain in tissues and joints. Your therapist also might use manual therapy to "stretch" the jaw in order to:
- Restore normal joint and muscle flexibility (so that you won't feel tight)
- Break up the scar tissues ("adhesions") that may occur when disease or injury limits movement for a period of time
Your physical therapist may teach you special "low-load" exercises. These are exercises that don't exert a lot of pressure on your TMJ but can strengthen the muscles of the jaw and restore a more natural, pain-free motion. The therapist will also teach you exercises that help you increase the opening of your jaw and improve the way it works.
Relieve Your Pain
In addition to manual therapy, if your pain is severe, the physical therapist may decide to use treatments such as electrical stimulation or ultrasound to reduce pain.
Real Life Experiences
During the first warm spring day, you decide to go for a bike ride with your family. While looking over your shoulder to see how your daughter is doing on her new bike, you notice your balance shifting, and, before you know it, you are on the ground. Despite the fact you were wearing your helmet, you notice pain in the right side of your jaw and a decrease in hearing in your right ear—and you can't move your jaw to talk to your children.
What do you do next?
One of your children calls an ambulance. At the hospital, an x-ray is taken to confirm that you fractured your right TMJ. Fortunately, the break isn't severe and can be treated with conservative rest of the jaw and a 3- or 4-week diet of soft foods. The emergency physician explains to you that, during the healing phase, the jaw will stiffen, and you'll need a physical therapist to help you reduce the stiffness and restore natural movement.
This story was based on a real-life case. Your case may be different. Your physical therapist will tailor a treatment program to your specific case.
What Kind of Physical Therapist Do I Need?
All physical therapists are prepared through education and experience to treat patients who have bone fractures. You may want to consider:
- A physical therapist who is experienced in treating people with orthopedic or musculoskeletal problems. Some physical therapists have a practice with a craniofacial focus, meaning that they focus on movement disorders related to the skull and facial structures.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopaedics physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you're looking for a physical therapist (or any other health care provider):
- Get recommendations from family and friends or from other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with osteomyelitis.
- During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.
Authored by Eric S. Furto, PT, DPT, MTC, FAAOMPT. Reviewed by the MoveForwardPT.com editorial board.