Hypermobility and TMJ: A Complex but Treatable Relationship
“Up to 20% of the population has some form of joint hypermobility—but most don’t realize how it could be affecting their jaw.”
— British Journal of Sports Medicine
When we think about jaw pain, we usually blame stress or teeth grinding. But for individuals with hypermobility, the story is often more complicated. The temporomandibular joint (TMJ)—that small but crucial hinge near your ear—can be dramatically affected by increased joint laxity.
This can lead to a cascade of symptoms: jaw clicking, pain, or even sudden “locking.” For some, the jaw might shift partially out of place (subluxation) or even fully dislocate. Others may experience an open lock, where the jaw gets stuck in an open position. It’s scary, disruptive, and often misunderstood.
Let’s break down how hypermobility links to TMJ dysfunction, and more importantly, how targeted rehabilitation can help.
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Understanding Hypermobility: The Beighton Score
Hypermobility is more than just being “flexible.” It refers to an increased range of motion in joints, often due to connective tissue differences.
The Beighton Score is the most widely used tool to assess this. It’s a 9-point system evaluating things like:
Ability to touch the floor with flat palms while keeping knees straight
Elbow and knee hyperextension
Thumb to forearm opposition
Little finger extension beyond 90 degrees
A score of 4 or more out of 9 typically indicates generalised joint hypermobility. For some, this is benign. For others, it can lead to frequent joint issues—including in the TMJ.
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TMJ Dysfunction in Hypermobility: What Happens?
When the TMJ is hypermobile, the risk of mechanical problems increases. Here’s why:
The ligaments and capsule that support the joint are too lax.
The disc inside the TMJ may shift out of place more easily.
The muscles around the jaw often become overactive to compensate.
This can lead to subluxation, where the jaw partially slips out of alignment and then pops back. Sometimes it progresses to dislocation, requiring manual reduction. Even worse, patients might experience an open lock, where the jaw becomes stuck open—this often happens because the disc has moved forward and won’t let the jaw close properly.
These episodes are not just painful. They can create anxiety and lead to avoidance of normal activities like eating or yawning.
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The Role of Physiotherapy in TMJ Hypermobility
The good news? You don’t have to live with this. Physiotherapy plays a crucial role in managing TMJ dysfunction in hypermobile individuals.
Treatment focuses on:
1. Strengthening the Jaw and Surrounding Structures
Hypermobile joints need strong muscles to stabilize them. For the TMJ, this means strengthening not just the jaw muscles but also the tongue posture and strength. Believe it or not, proper tongue positioning can offload the TMJ by supporting better jaw mechanics.
Action step: Practice holding the tongue gently against the roof of the mouth behind the front teeth when at rest. This promotes natural support for the jaw.
2. Cervical Muscle Control and Posture
Neck posture directly impacts the jaw. Poor cervical muscle control and posture often exacerbate TMJ instability. Patients with hypermobility frequently adopt compensatory neck patterns that increase strain on the TMJ.
Action step: Incorporate gentle chin tucks and postural corrections during daily activities to reduce jaw strain.
3. Taping for Proprioception and Support
Specialized taping techniques can provide joint feedback and a sense of support. This is not a fix by itself, but it helps patients learn where their jaw is in space, reducing the frequency of subluxation or open lock episodes.
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Managing Dislocation, Subluxation, and Open Lock
When dislocation or subluxation happens repeatedly, early intervention is key. Here’s what to do:
Immediate Management
Do not force the jaw closed during an open lock.
Apply a cold pack to reduce inflammation.
Gently try jaw repositioning techniques taught by your therapist—never attempt this alone without guidance.
Rehabilitation Focus
Once the joint is back in place, rehab should start immediately:
Strengthening Exercises
Controlled isometric exercises are often prescribed. For example:
Place the tongue on the roof of the mouth.
Apply gentle pressure with the hand against the jaw in various directions while resisting movement.
Focus on maintaining a stable jaw without clicking or popping.
Motor Control Training
It’s not just about strength—it’s about control. Training the jaw to open and close along the correct path reduces future subluxation risks.
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Preventing Recurrence: Long-Term Rehabilitation
For hypermobile patients, rehabilitation is usually a long-term commitment. But with consistency, the frequency of dislocations or open lock events can dramatically decrease.
Key components include:
Consistent strengthening and proprioceptive training
Regular physiotherapy check-ins
Use of taping during high-risk activities (yawning, dental visits, singing)
Improving tongue posture and strength daily
Addressing cervical muscle control and posture to reduce compensatory patterns
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Final Thoughts
Living with hypermobility and TMJ dysfunction is challenging—but it’s manageable. By understanding your Beighton Score, recognizing the signs of subluxation, dislocation, and open lock, and committing to focused rehabilitation, you can take back control.
The jaw is small, but its impact on daily life is enormous. Treat it with the care and attention it deserves.
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If you’re dealing with TMJ issues related to hypermobility, working with a qualified physiotherapist is essential. Need help building a plan? Let’s start the conversation.
