Monday, June 16, 2008

Ask Bella: Physiotherapy and range of motion

Q: I was curious about the "opening of the jaws" predicament you've been having. I was wondering, if you had tried harder or more often during the beginning of your recovery, do you think you would have needed to visit a physiotherapist at all? At what point did your oral surgeon suggest you see one? Do you have any advice about these exercises?

A: Once my jaw was unwired, my surgeon gave me jaw opening exercises to do. You put your index fingers on your bottom teeth, close together in the middle, and your thumbs on your upper teeth, far apart. You use your fingers to push your mouth open as far as you can, and then you hold it for ten seconds and do four repetitions, four times a day.

My surgeon wasn't the one who told me to go to physio, though I'm sure he would have at some point. I had been having problems with jaw pain for years, so I have a physiotherapist who is a jaw specialist; he was the one who recommended I start going as soon as possible after the surgery. My surgeon didn't want anyone putting pressure on the jaw for one month after the surgery, so I waited exactly one month and started going every week ever since.

At physio, they did stretching exercises and massaged my jaw muscles, and I did the finger exercises at home. A few weeks or a month in, they gave me the jaw jack to help. The thing with "the opening of the jaws" is no pain, no gain, so the rehabilitation is not fun.

I would take it slow at first, because your body is healing and you don't want to do anything to damage your jaw so soon after the surgery. Do some research in your area to find a physiotherapist who specializes in jaws and just talk to them and see what they think. Your surgeon or orthodontist might be able to refer you as well.

Q: I am six weeks post-surgery and have an opening of 27 mm, which my oral surgeon is not thrilled about. I try every day to do the exercises, but I do experience a lot of pain, particularly on one side of my jaw. Do you think 27 mm is that horrible? I've read about your struggles with that device your physiotherapist gave you. Do you have any recommendations to make the exercises easier? Or to help me get a bigger opening, without using any kind of device?

A: When I was at six weeks post-surgery, I had an opening of 25 mm as well, and my surgeon said that this was average. So, if you're at 27 mm, you're on track in my surgeon's world.

I'm a very big fan of physiotherapy, myself. My physiotherapist will massage my jaw muscles and do milder stretches before getting into the bigger ones. This helps with the pain and also advances my mouth opening far more than I could myself. You could always do some massaging of your own muscles before and after the exercises to help make them easier.

I've also taken painkillers before doing the exercises on my own and gotten good results. Though you do have to be careful not to push yourself too far and injure your jaw. Good luck!

Oh, and in case you were wondering, I'm now at four months post-surgery and I have a 38 mm opening. Two to seven millimetres to go. Hooray!

*To ask Bella a question about her jaw surgery, email her at smilingbella at gmail dot com or leave a comment on this post. Go ahead: ask away!!


Anonymous said...

Thanks for the advice! Was that "jaw jack" thing expensive? I was at the oral surgeon yesterday and he was telling me about a very expensive thing called 'TheraBite' - but your jaw jack looks much more usable. Do you think I could order one from online? Just curious. Thanks!

Bella said...

My physiotherapist made the jaw jack, so I'm not sure you would be able to order it online. Perhaps if you find a physio, they can help you find something that will help?

I'm currently waiting for them to make me a bigger jaw jack, so in the meantime, my surgeon gave me an envelope full of wooden tongue depressors. I stack as many as I can on top of each other and put them in my mouth, and then everyday, I try to add one more to the stack. Last night, I got 24 in there!

Good luck to you ;)

chinderella said...

One question - at which point did you manage to ...drum with a spoon?


Bella said...


I was eating with a spoon the second week I had my jaw wired shut. I would kind of use my lips to slurp pudding or soup off the spoon. So, when my jaw was unwired, I was eating with a spoon immediately.

How about you?


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