4 Weeks Post-Op: Jaw exercises not working?

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leodotcom
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Joined: Fri Jul 21, 2017 8:37 am

4 Weeks Post-Op: Jaw exercises not working?

#1 Post by leodotcom » Fri Jul 21, 2017 8:59 am

Hello all!

I'm almost four weeks post-op from a double jaw surgery (6/27/17.) My top jaw came forward ~6mm (three pieces) and my bottom jaw slid back ~4mm. I was never wired shut, I've only had two rubber bands to help guide my bite. I do have an acrylic splint wired to my top teeth. At my one week checkup my surgeon told me I should be removing my elastics and doing jaw exercises at home, basically opening my jaw as wide as I could a few times a day. He wanted me to be able to fit two fingers between my jaws by week two.

Surprise! That didn't happen. My four week follow up is quickly approaching and I have been trying my hardest and I still can't fit two fingers between my jaws. I am panicking and absolutely bawling my eyes out. (And I can't even blow my nose!) I have been trying extra hard the past four days, opening my jaw as wide as I can to the point of nauseousness 10x, multiple times a day with very little to show for it. It also feels like the right side of my jaw is much tighter than my left side, which doesn't make me feel good either.

Someone please tell me they've gone through something similar and it's all going to be okay? Has anyone ended up in physical therapy because of something like this? Or maybe even something worse?

All replies are much appreciated <3

leodotcom
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Joined: Fri Jul 21, 2017 8:37 am

Re: 4 Weeks Post-Op: Jaw exercises not working?

#2 Post by leodotcom » Thu Aug 03, 2017 11:00 am

Just in case someone is Googling around for an answer to this, I'm gonna post an update.

UPDATE: Don't freak out! Take a deep breath! It's gonna be okay!

My surgeon did not cast me out during my appointment when I admitted my jaw still can't open past one finger. He did seem mildly disappointed, and mentioned physical therapy but only as a last resort. He ended up sending me home with tongue depressors and elastics. He instructed me to stack the depressors together as high as I could and while placed between my teeth slide an additional one in the stack. He told me to add a new depressor to the stack each day. I'm not gonna lie, it's a little painful at first and I can feel the muscles in my jaw stretching. But so far, so good! It's working.

The jaw exercises are important and after all the vlogs I've watched and posts I've read I never came across someone who mentioned having difficulties with it. So if this is you right now don't panic. Talk to your surgeon and I'm sure you can find a solution. Stay strong!

jaime
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Location: Southeastern Michigan
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Re: 4 Weeks Post-Op: Jaw exercises not working?

#3 Post by jaime » Thu Aug 10, 2017 6:53 am

leodotcom wrote:Just in case someone is Googling around for an answer to this, I'm gonna post an update.

UPDATE: Don't freak out! Take a deep breath! It's gonna be okay!

My surgeon did not cast me out during my appointment when I admitted my jaw still can't open past one finger. He did seem mildly disappointed, and mentioned physical therapy but only as a last resort. He ended up sending me home with tongue depressors and elastics. He instructed me to stack the depressors together as high as I could and while placed between my teeth slide an additional one in the stack. He told me to add a new depressor to the stack each day. I'm not gonna lie, it's a little painful at first and I can feel the muscles in my jaw stretching. But so far, so good! It's working.

The jaw exercises are important and after all the vlogs I've watched and posts I've read I never came across someone who mentioned having difficulties with it. So if this is you right now don't panic. Talk to your surgeon and I'm sure you can find a solution. Stay strong!
Hey leodotcom, I had this problem too. I think I talked about it a bit in my blog and vlog. I did end up needing physiotherapy and it helped quite a bit. Glad things are getting better for you. Diligence with stretching will make all the difference.
SARPE: December 19, 2013
Expander out/TPA in: May 13th, 2014
Upper and lower braces: May 21, 2014
Lefort I + BSSO + sliding genioplasty: June 11, 2015
TPA out: December 17, 2015 (due to issues)
Braces off: November 28th, 2016!!!
My blog
My ArchWired thread (last updated November 29th, 2016)

leodotcom
Posts: 4
Joined: Fri Jul 21, 2017 8:37 am

Re: 4 Weeks Post-Op: Jaw exercises not working?

#4 Post by leodotcom » Fri Aug 11, 2017 6:11 am

Hey Jaime,

Thanks so much for your reply! I started watching your vlogs on Youtube (around the 6 week mark since that's where I'm at) and it's super helpful! What was your experience with physiotherapy like? Or if there is a video/blog post where you do a deep dive let me know :)

jaime
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Joined: Mon Jun 02, 2014 8:00 am
Location: Southeastern Michigan
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Re: 4 Weeks Post-Op: Jaw exercises not working?

#5 Post by jaime » Fri Aug 11, 2017 7:38 am

I'm glad the vlogs are helpful!

I didn't talk about it TOO in-depth, but I went for about 3-4 months last year, once a week. The physiotherapist would do manual stretching which was a little awkward (think hands in mouth) but felt effective. They weren't long appointments; maybe 10 minutes maximum. I was told to do the same popsicle stick stretching at home which IMHO seems to be the most effective. He kept track of how wide I was able to open and I went from about 33mm to 40mm. I have a small mouth as it is and he figured that's probably about all I can physically do. I'm not sure where I'm at now in terms of how wide an opening I can handle, but I do still have ROM problems and tightness. The surgery made me completely unable to move my jaw forward or from side to side (I can go a bit to my right but that's all). My jaw also opens at an angle now. Pre-surgery, I subconsciously held my jaw to the side to make up for the asymmetry. Given that I was well into adulthood when I had the surgery, I think it was just a little too much to overcome 100%, especially since muscle tightness in my neck and back has always been a problem for me.

My physiotherapist and my ortho also recommended muscle relaxants, which are OTC in Canada and thus didn't require a prescription. Depending if you can get your hands on some, they're helpful too. I would take one before I went to bed.

Hopefully you fare better than I have. It's not really an issue day-to-day, but it's been the main bad side effect of getting the surgery for me.
SARPE: December 19, 2013
Expander out/TPA in: May 13th, 2014
Upper and lower braces: May 21, 2014
Lefort I + BSSO + sliding genioplasty: June 11, 2015
TPA out: December 17, 2015 (due to issues)
Braces off: November 28th, 2016!!!
My blog
My ArchWired thread (last updated November 29th, 2016)

leodotcom
Posts: 4
Joined: Fri Jul 21, 2017 8:37 am

Re: 4 Weeks Post-Op: Jaw exercises not working?

#6 Post by leodotcom » Tue Aug 15, 2017 8:21 am

Hey Jaime,

Thanks again for your reply, that information is really helpful! My surgeon gave me one more week to get to 3 fingers width or I'm going to PT. I'm currently at two fingers width. Wish me luck!

It's hard to find a balance of stretching and keeping my orthodontist-mandated elastics on. The struggle is real!

EmilyTravels
Posts: 478
Joined: Tue Jul 11, 2017 6:01 am

Re: 4 Weeks Post-Op: Jaw exercises not working?

#7 Post by EmilyTravels » Tue Aug 15, 2017 12:38 pm

I had my jaw wired after a bike accident in which I fractured my mandible in three places. I was able to open to 2 finger width after wiring, but I was only wired for two weeks. It took awhile to get up to three fingers, and now I'm at 3.5, which is probably going to be my limit. My oral surgeon was very happy with my progress.

I did read an article online that said that females can't open as wide as males, and shorter people can't open as well as taller people - this if you simply go by measurements. But it seems that three fingers is pretty much the gold standard, no matter your gender or height, as we smaller people also have smaller fingers, so it's all proportional.

I go for my first dental checkup/cleaning since my surgery next Tuesday, and I am worried about how tired my jaw is going to get having it open that long. I am going to ask her to give frequent breaks so I can close and rest for a minute or two. Crossing fingers it won't be too bad.

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