Jaw Region Pain / Hypermobility – Locking Open
Jaw Region Pain / Hypermobility – Locking Open
Case Description: The patient is a 72 y/o female with a ~2 month history of intermittent sharp jaw pain and 5 episodes of an experience described as her jaw “locking open wide” (2 of which had occurred in the week prior to starting PT). She notes that the episodes happened with wide opening and had occurred with yawning or after opening wide to eat. Her jaw felt as if it dislocated and on one instance remained locked open for nearly 5 minutes before her husband was able to forcefully shut her jaw. She was very fearful to open and was restricting her diet and fearful with basic dental hygiene, like brushing her teeth.
Intervention: The patient was seen for 6 physical therapy visits over 3.5 wks
| Mobility | Treatment / Function | |
| Initial Evaluation (IE) | 35+ mm opening, strong L deflection indicating R sided TMJ hypermobility | Diet medication to reduce strain on jaw and reduce need for wide opening. Education on rest, heat, self-massage to reduce pain |
| 2 week after IE | 35+ mm, reduced L deflection – apprehension still present | Education on gradual re-introduction to her typical diet. Continued modification to yawning to reduce risk of re-injury. Able to have dental exam without issue. |
| 3 weeks after IE /Discharge | 40+ with minimal apprehension, notable reduction in L deflection | Able to resume her normal diet and had no instances of “locking open” for nearly 1 month |
Summary: This patient had classic signs of R sided TMJ hypermobility and resultant subluxation/dislocation as her mandibular condyle progressed beyond her maxillary articular eminence during wide opening. With technique to reduce inflammation and initially limit instances of wide opening, she was able to go without episode of locking open for the entirety of her care and had tools to continue managing on her own.
Patient Comments at Discharge: “With Luke’s help, I’ve learned a lot for how to help avoiding getting pain…the clinic was upbeat – friendly – a nice atmosphere…Luke did a good job to help me. He was someone I could talk to. He listened to me and did a great job.”