Many patients who undergo jaw (orthognathic) surgery ask this question after some time has passed:
"When should I start jaw physiotherapy, and what am I allowed to do, so my mouth opens better and my jaw doesn't stay stiff?"
If done at the right time and with the correct plan, jaw physiotherapy after surgery can help with:
Reducing jaw joint stiffness,
Gradually improving mouth opening,
And better recovery of chewing and speech function
In this article, we speak generally and educationally about the role of physiotherapy after jaw surgery, its goals, and important points you should coordinate with your surgeon and physiotherapist.
This text is for informational purposes only and is not a substitute for your own examination and personalized treatment plan.
Why is physiotherapy important after jaw surgery?
After orthognathic surgery, your jawbone, muscles, and joint:
Are placed in a new position,
Become more immobile than before in a controlled way for a period,
And are usually accompanied by swelling and sensitivity.
If jaw physiotherapy is started at the timing and in the form specified by your surgeon, it can help with:
Gradually increasing the jaw joint's range of motion,
Reducing muscle stiffness,
And reducing the likelihood of permanent movement limitations
But if done without a plan and on your own, it may put excessive pressure on the joint or bones that are still healing. For this reason, when it comes to physiotherapy after jaw surgery, you should always coordinate with your surgeon.
Goals of jaw physiotherapy after orthognathic surgery
In general, jaw physiotherapy after surgery pursues these goals:
1. Helping to reduce pain and the feeling of pressure
After surgery, feeling:
Mild to moderate pain,
Pressure or stiffness in the jaw joint area and muscles,
is normal. Part of the physiotherapy program after jaw surgery can include methods your physiotherapist uses for:
Gradually reducing pain,
Reducing muscle spasm,
And improving local blood circulation
2. Gradually increasing the range of mouth opening and closing
One of the most important goals of jaw physiotherapy is that:
Opening the mouth,
Closing the mouth,
And controlled jaw movements,
gradually approach a more functional state, within the range your surgeon allows. The extent and timing for starting these movements differ for each patient and depend on the type of surgery and the state of jaw fixation.
3. Coordinating the facial and jaw muscles with the new position
After surgery, muscles that have worked with a specific pattern for years are suddenly placed in a new position. Physiotherapy after jaw surgery helps:
The chewing muscles,
The muscles around the joint,
And the facial muscles,
become coordinated with the bones' new position, so movements happen along the correct path.
4. Preventing stiffness and permanent joint limitation
Prolonged jaw joint immobility without a plan can cause:
Joint stiffness (limited mouth opening),
A feeling of locking or catching,
and, in some cases, long-term pain.
Proper jaw physiotherapy planning helps reduce the likelihood of these issues occurring — provided it is done under the guidance of your jaw and facial surgeon.
General principles of jaw physiotherapy after surgery (never on your own)
In many cases, once the surgeon determines that the condition of the bones and joint allows it, simple, controlled jaw exercises are taught to the patient. These exercises usually:
Start at low intensity,
Gradually increase,
And are aimed at movement within a safe range, without excessive pressure.
A very important point is that:
The type of movement, timing of starting, number of repetitions, and the permitted range of mouth opening must be determined individually for each patient by the surgeon and physiotherapist.
Below, purely for general familiarity, we discuss general categories of exercises — not as an implementation instruction.
General examples of jaw physiotherapy exercises (for familiarity only)
1. Controlled mouth opening and closing exercise
Goal: to help gradually increase the range of mouth opening within the permitted limit.
The general movement is that the patient, in front of a mirror, slowly opens the mouth without sudden pressure and then closes it.
The movement should be done in a straight line, and the jaw should not deviate to the sides.
This exercise, if permitted by the surgeon, is one of the foundations of jaw physiotherapy.
The extent of mouth opening, number of repetitions, and timing to start must be determined by your treatment team.
2. Gentle side-to-side movements (if approved by the doctor)
In some patients and at certain stages of recovery, very gentle jaw movements to the left and right may also be part of physiotherapy after jaw surgery, to:
Activate the jaw's lateral muscles,
And allow the joint to move along its natural axis.
But this movement isn't suitable for everyone, and in some types of surgery, it's prohibited for a period; therefore, it should not be performed without the surgeon's approval.
3. Forward and backward jaw movements (protrusion/retraction)
Sometimes, at more advanced stages of the program, and depending on the condition of the joint, controlled forward and backward jaw movements are also included in the jaw physiotherapy program.
4. Jaw muscle massage exercise
- How to do it: using your fingers, gently massage the jaw muscles in the area below the ear and over the cheek. Make small circular motions and apply gentle pressure. - Duration: 5 to 10 minutes per session. - Frequency: twice daily.
This massage helps increase blood flow and reduce inflammation, and provides pain relief. These exercises must be prescribed by your doctor or physiotherapist, and doing them on your own is not recommended.
The physiotherapist's role in jaw physiotherapy after surgery
A physiotherapist familiar with jaw surgery and the temporomandibular joint can, alongside the surgeon, make your program more complete. They may use:
Manual techniques on the chewing muscles,
Specialized exercises to correct movement patterns,
Teaching correct head and neck posture during rest and work,
to make your physiotherapy process after jaw surgery more targeted.
Massage or pressure applied on your own to the joint or the operated area, without specialized training, may not be suitable for some patients; therefore, this part of the treatment must also be carried out under the guidance of your treatment team.
Duration of jaw physiotherapy: from a few weeks to a few months
The length of the jaw physiotherapy period after surgery isn't the same for everyone. This duration depends on several important factors:
The type of surgery (one jaw / both jaws / combined with other procedures)
The condition of the jaw joint before surgery
The healing process of the bone and soft tissue
The patient's level of cooperation in doing home exercises
In many patients:
The first few weeks focus mostly on protecting and controlling movements,
and gradually, depending on the surgeon's assessment, more active, broader exercises are added to the program.
The number of in-person sessions with the physiotherapist and how long home exercises should continue can only be decided through examination and monitoring of your recovery.
Three key points for the success of physiotherapy after jaw surgery
1. Full coordination with your jaw and facial surgeon
Any change in:
The type of exercise,
The intensity of the exercise,
Or the timing of starting jaw physiotherapy
must be coordinated with your jaw and facial surgeon. They have the most accurate information about the current state of your bones, joint, and fixation.
2. Consistency and continuity (even with simple exercises)
Physiotherapy exercises after jaw surgery aren't necessarily complex; but:
Being consistent,
Proper repetition,
And doing them as prescribed
has a much greater effect than doing them sporadically and irregularly.
3. Patience, and not comparing yourself to others
The speed at which mouth-opening range increases and jaw stiffness decreases varies from person to person. Comparing your progress with other people's experiences (for example, on social media) can cause unnecessary anxiety.
It's better to compare your progress only against the treatment plan designed for you, and to raise any concerns with your surgeon and physiotherapist.
Conclusion: jaw physiotherapy is the logical continuation of surgical treatment
Physiotherapy after jaw surgery is part of your treatment, not an extra task. If it's done:
At the right time,
With appropriate exercises,
And under the guidance of your surgeon and physiotherapist,
it can help with:
Reducing joint stiffness,
Improving mouth opening,
And better recovery of chewing and speech function.
During post-operative follow-up visits, Dr. Alireza Sadighi assesses the state of jaw movement and, if needed, refers you to physiotherapy to complete your treatment with a program suited to your own condition.
Booking a follow-up appointment after jaw surgery
If you've had jaw surgery and have questions about:
When to start jaw physiotherapy,
What types of exercises are allowed,
Or the current limitations of your jaw joint,
you can get in touch with us for a follow-up visit and assessment of your jaw movement.
Dr. Alireza Sadighi's practice locations:
📍 Tabriz, Valiasr, Roudaki Square, Farid Building, next to Dr. Zarei Pharmacy, 4th floor
📍 Tehran – Saadat Abad, above the municipality, Jouriki Street, Davoud Hosseini Street, 1st alley, North Ceremony Tower, 6th floor, unit 21
📞 041-33334539 | 09120149500
🌐 Book an appointment online: https://dralirezasadighi.com/contact/
1. When should physiotherapy after jaw surgery begin?
The timing for starting physiotherapy after jaw surgery isn't the same for everyone and depends on the type of surgery, the condition of the bones and jaw joint, and the healing process. In some patients, only very limited, controlled movements are allowed in the first few weeks, while in others, starting exercises is postponed until certain restrictions are lifted. Your jaw and facial surgeon should determine the best time to start jaw physiotherapy after an examination and review of your imaging.
2. Do all patients need physiotherapy after jaw surgery?
The need for physiotherapy after jaw surgery isn't the same for every patient. In some cases, regularly doing the simple exercises taught by the surgeon is enough; in others, especially if: The range of mouth opening remains limited, Or the jaw joint has a history of problems, your surgeon may refer you to a physiotherapist for a specialized physiotherapy program. The final decision about the need for physiotherapy is made after an in-person examination and observation of your recovery process.
3. Can I take jaw physiotherapy exercises from the internet and do them myself?
No. Although you may find various exercises for jaw physiotherapy online, doing these exercises on your own may not be suitable for some patients. The type of surgery, the condition of the joint, the degree of jaw fixation, and bone condition differ from person to person. For this reason, physiotherapy exercises after jaw surgery must be prescribed by your surgeon and/or physiotherapist, and adjusted if needed.
4. Is pain normal while doing jaw physiotherapy exercises?
A feeling of stretching or slight discomfort while doing certain jaw physiotherapy exercises (within the range specified by your surgeon) can be somewhat normal; but severe, sharp, or lasting pain after exercise is not normal and should be taken seriously. If severe pain occurs, it's best to stop the exercise and discuss it with your surgeon or physiotherapist so the exercise program can be adjusted if needed. This material was prepared to provide a general introduction to the principles of physiotherapy after jaw surgery, and is not a substitute for an examination, diagnosis, or personalized prescription from your doctor or physiotherapist. The type, timing, and intensity of exercises must be determined by your jaw and facial surgeon and/or physiotherapist. Doing any exercise on your own may not be suitable for some patients.