Mouth stretches (for a tight mouth with scleroderma)

How to move

1. Warm your face first: massage the skin around your mouth with your fingertips, or hold a warm flannel over your mouth for 30 seconds. Doing the stretches in a warm shower works too.
2. Open your mouth as wide as you comfortably can, and hold.
3. Put a thumb in each corner of your mouth and gently stretch your lips sideways, and hold.
4. Puff out your cheeks with air and hold, then pucker your lips as if blowing out a candle and hold.
5. Give a big smile that shows your teeth, and hold.
6. With your teeth slightly apart, slide your chin to the left and hold, then to the right.

Form cues

• A stretch, not pain.
• Use a mirror to keep both sides even.
• Relax your face between stretches.
• Avoid: stretching over sores or ulcers at the corners of your mouth.

Practice and cautions

Once or twice a day, for example when you brush your teeth (Scleroderma & Raynaud's UK). Start with 5 of each stretch, held for 3 to 5 seconds (the National Scleroderma Foundation, a US charity), and build to 5 of each held for 10 seconds, twice a day: the programme in a Turkish trial of 56 people, where the mouth opening widened by about 2 millimetres in a month. Keep going: in a US trial, the extra gain seen at 3 months was no longer there at 6 months, and only about half the planned exercises were done.

Aching around your mouth for a few days after you start is normal, but the stretches shouldn't hurt: ease off if they do. Don't do them if you have ulcers or sore areas at the corners of your mouth until you've had medical advice. If your jaw clicks, locks or hurts, ask your dentist, and see a dentist about any change in your mouth that lasts more than 2 weeks. This is movement education, not an assessment or treatment prescription. Stop for sharp or increasing pain, dizziness, numbness or tingling; seek individual guidance for symptoms, injury or restrictions.