Pilates guide
Temporomandibular disorder (TMD, usually called TMJ) is common and usually gets better with simple care. Only one small trial has tested Pilates for it, with real weaknesses: women who added Pilates to a night splint had better jaw function after 15 weeks, though their posture didn't change. For jaw pain that lasts, the treatments with the strongest support are CBT, hands-on jaw treatment and supervised posture and jaw exercises, so Pilates works best as the posture, neck and relaxation part, with your teeth apart and your jaw soft.
This guide covers what TMD is, how Pilates fits beside jaw exercises, the neck and posture, stress and clenching, which moves to change, what the evidence shows, and the classes to follow. Jaw pain with chest pain needs 999, and a jaw that is stuck open or locking needs help the same day: the warning signs are below.
The NHS says TMD is "not usually serious and generally gets better on its own". With simple care started early, 75% to 90% of people improve, the UK's patient summary says, and jaw joint problems very rarely lead to arthritis.
In 40 women, adding Pilates twice a week for 15 weeks to a night splint improved jaw function, but posture and neck and back pain didn't change. More than a quarter dropped out, its main jaw pain result was never published, and its journal isn't in PubMed. In a 30-person pilot, a Pilates-based core programme did less than manual therapy. No recommendation can rest on these.
For jaw pain lasting 3 months or more, a 2023 guideline strongly recommends cognitive behavioural therapy (CBT), hands-on jaw mobilisation, trigger point therapy, supervised posture exercise, supervised jaw exercise and stretching, and home exercise with reassurance. Pilates can carry the posture, neck and relaxation parts; the jaw exercises come from our jaw pain guide.
Posture training plus self-care cut TMD symptoms by 41.9%, against 8.1% with self-care alone, at 4 weeks. People with TMD have weaker neck muscle endurance than people without it, but similar head posture, so the neck work matters more than a new shape.
Stress, distress, clenching and poor sleep all predicted who developed TMD in a large US study. In class, keep your teeth apart and your tongue resting on the roof of your mouth through every effort (our suggestion, from the NHS's advice that apart from when eating, your teeth should be apart).
Jaw pain with chest pain could be a heart attack: call 999. A jaw stuck open needs emergency care, and a jaw that locks, or not being able to eat or drink, needs help the same day. The full list, in the words of our jaw pain guide, is below.
TMD is "a condition affecting the movement of the jaw", the NHS says, with pain around the jaw, ear and temple, clicking, popping or grinding noises, a headache around the temples, difficulty opening your mouth fully and sometimes locking. The pain is often worse when you chew and when you feel stressed.
The UK's patient summary, from NHS England's Getting It Right First Time (GIRFT) programme and the Royal College of Surgeons' dental faculty, says it affects about 1 in 15 people in the UK, mostly aged 20 to 40. The British Association of Oral and Maxillofacial Surgeons says jaw joint problems "typically only last a few months before getting better" and are "not sinister". Pain that lasts 3 months or more affects 6% to 9% of adults, a 2023 guideline says.
Clicking is one of the commonest TMD symptoms, and usually comes with nothing else. The NHS TMD page, which is past its review date, lists clicking, popping or grinding noises among reasons to ask for an urgent GP appointment or call 111, while our jaw pain guide treats painless clicking as common and keeps the same-day list for a jaw that locks or won't open fully, not being able to eat or drink, frequent severe headaches, a tender scalp and vision problems. So with clicking alone, see a GP or dentist if it hasn't settled after a few weeks of self-care, and get help the same day if it comes with locking or you can't open your mouth.
Across 17 studies, migraine went with about six times the odds of TMD, and TMD with about two and a half times the odds of migraine. TMD is commoner in migraine and tension-type headache too, mainly the painful, muscle kind. The international headache classification has its own category for headache caused by TMD, worse with jaw movement and chewing and usually at the temple. Our Pilates for headaches guide covers the headache side.
In the only randomised trial, 40 women aged 18 to 35 with TMD all wore a night-time splint for 15 weeks, and half also did Pilates twice a week (30 classes of 50 minutes, up to 4 people, taught by a physiotherapist). A jaw function score (0 to 5) fell from 1.8 to 0.8 with Pilates, against 2.1 to 2.2 without. Neck pain, back pain, posture and postural habits didn't change in either group.
Its problems are serious. 11 of 40 (28%) dropped out, and their starting scores were carried forward; the Pilates group came to 19 of 30 classes on average and started with milder symptoms. The paper gives the study period as 2016 but says the classes ran from August to November 2017. Jaw pain, the main result in its registration, is said to be reported elsewhere, and we couldn't find it. The journal isn't in PubMed, the main medical database. Read it as a weak signal, not a reason to choose Pilates.
In a 30-person pilot, manual therapy plus home exercise did better than a Pilates-based core programme plus home exercise for head posture, and better than no treatment for jaw function; both active groups had less pain over time. We could read only the abstract, which gives no numbers. Three more Pilates trials in TMD or teeth grinding are registered and haven't reported results.
Adding core stability training to jaw exercises gave no clear extra benefit in one trial, whose groups differed in age by 15 years. Neck core exercises were "as effective as" a standard set of jaw exercises in 59 women, and adding neck stabilisation training to education and home exercise eased pain at rest only, in 30 young adults.
For jaw pain lasting 3 months or more, the BMJ guideline strongly recommends CBT (with or without biofeedback or relaxation), hands-on jaw mobilisation by a therapist, trigger point therapy, supervised posture exercise, supervised jaw exercise and stretching, and usual care with home exercises, stretching, reassurance and education. It recommends against reversible splints, relaxation therapy on its own and biofeedback on its own, conditionally.
In the analysis behind it (153 trials, 8,713 people), CBT with biofeedback or relaxation, and jaw mobilisation, each gave an important pain reduction to about 36 more people in 100 than a placebo or sham; supervised jaw exercise and stretching gave the biggest gain in jaw function (43 more in 100, moderate certainty). Two corrections to that paper have been published, in 2024 and 2026; we couldn't read them, so these figures are as its abstract gives them. Pilates isn't among the treatments tested.
Across 16 trials (812 people), jaw exercise reduced pain by a moderate amount and improved how wide people could open. Another review of 6 trials found moderate short-term pain relief and better range, but not clearly better function. Overall quality is low, and most results are short term.
In 60 people, posture training plus self-care cut TMD symptoms by 41.9%, against 8.1% with self-care alone, at 4 weeks, and neck symptoms by 38.2% against 9.3%. Neck-focused rehabilitation reduced jaw muscle pain in the short term across 7 trials, and neck manipulation and exercise reduced pain across 14.
Across 21 studies, people with TMD had less endurance in the muscles at the back of the neck and less turning at the top of the neck, but "their cranio-cervical posture is similar to individuals without TMD"; an earlier review called the link with posture "still controversial and unclear". So the neck work seems to matter more than the shape.
A 2025 review of 12 studies found that jaw exercise and whole-body exercise (aerobic, core, relaxation and posture work) "may improve" activity and quality of life, with very low confidence; none of the studies was Pilates. A Cochrane review of exercise for TMD is under way but not yet published.
Our jaw pain guide has six numbered jaw exercises from two NHS trust leaflets: the rest position, guided opening, opening without help, a tongue stretch, straight-line opening in a mirror and gentle resisted opening. Start with the first two daily, as its first stage says. They can't be shown on the 3D figure, so they are written out there rather than repeated here.
The jaw release drill on our moves pages has a dose too: "Two 5-minute sessions a day: open, hold about 5 seconds, close and rest a few seconds, then repeat." (the move page's dose). Its own caution: "It can make jaw pain a little worse for the first few days while the muscles get used to it: keep to the starting dose for the first week."
The NHS says "apart from when eating, your teeth should be apart", and not to chew gum or yawn too wide. An NHS physiotherapy leaflet starts its exercises with the tongue resting lightly on the roof of the mouth and the teeth slightly apart, and the UK patient summary adds diaphragmatic breathing for relaxation. Pilates is a good place to practise all three.
Pilates doesn't train the jaw. It can carry the supervised posture exercise and neck work the guideline recommends, and a calm place to practise breathing and keeping the jaw soft, alongside the jaw exercises, not instead of them. A suggested week (our editorial starting point): jaw steps 1 and 2 daily, our Pilates for neck pain or posture class 2 or 3 times a week, and slow breathing on most days.
In the US OPPERA study, which followed 3,263 adults without TMD, stress, distress and other bodily symptoms predicted who developed it, and the authors call these the most robust risk factor. About 4% a year developed TMD; clenching and grinding that people reported themselves predicted it more strongly than an examiner's findings, and worsening sleep did too. Across 20 studies, teeth grinding and clenching went with about twice the odds of TMD, and about a quarter of people report possible daytime clenching or grinding.
Behavioural approaches, such as reminders, habit reversal and biofeedback, are the main tested treatment for daytime clenching, on limited evidence. Grinding itself isn't usually painful, but may make headaches with TMD worse. The NHS says teeth grinding is often linked with stress or anxiety; a dentist is the person to see about it.
Our suggestion: keep your teeth apart and your tongue resting on the roof of your mouth through planks, the teaser, the hundred and standing balance; breathe out through soft lips rather than a wide-open mouth; rest your forehead, not your chin, on a towel when you lie face down; and don't hold a water bottle in your teeth or chew gum in class.
Slow-paced breathing, 5 minutes once or twice a day, tongue resting on the roof of your mouth and teeth apart (our jaw pain guide); the move page's dose is "At least 5 minutes, done regularly as part of your daily routine". Lateral breathing at the start of every class, "5 to 8 breaths at the start of every session" (the move page's dose), breathing out through soft lips.
Chin tucks, 8 to 10, holding 3 to 5 seconds, the dose in an NHS physiotherapy leaflet for jaw pain; later, the lying chin tuck, up to 10 holds of 10 seconds with very light effort, the chin tuck head lift, 3 to 5 holds of 5 seconds, and neck holds, 5 holds of 10 seconds each way at about half effort (our jaw pain guide, for each). Upper trap release, "2 slow holds of 30 seconds per side"; shoulder circles, "10 to 15 slow circles each way, once or twice through, as part of a warm-up (our editorial starting point)"; neck circles, "3 slow circles each way, once or twice a day (our editorial starting point)" (the move page's dose for each), using separate turns, tilts and nods first, as our jaw pain guide does.
3D demoChin tuckBeginner · No equipment
3D demoNeck CARs (controlled articular rotations)Beginner · No equipment
3D demoUpper trap releaseBeginner · No equipment
3D demoShoulder rollsBeginner · No equipment
3D demoLying chin tuckBeginner · No equipment
3D demoChin tuck with head liftIntermediate · No equipment
3D demoIsometric neck holds (four-way)Beginner · No equipmentThe kind of supervised posture work the guideline recommends. Band rows, 2 to 3 sets of 10 to 15; wall angels, 8 slow slides; doorway chest opener, 2 to 3 holds of 30 seconds; seated upper back lift, 5 holds of 3 to 5 seconds; later, Y-T-W raises, 8 of each shape, 2 rounds (our jaw pain guide, for each).
Knee fold, "2 sets of 5 to 10 each side, every other day"; the hundred, head down, "50 beats to start, building to 100 (the classical count)"; single-leg stretch, head down if your neck or jaw tightens, "6 to 10 each side"; the swan, forehead (not chin) on a towel, "5 to 6 reps"; swimming, "2 to 3 sets of 20 to 30 seconds"; the open book, "8 to 10 slow openings each side, pausing 2 seconds at the end (our editorial starting point)"; spine twist, "3 to 4 each side" (the move page's dose for each).
3D demoKnee foldBeginner · No equipment
3D demoHundred (Pilates)Intermediate · No equipment
3D demoSingle-leg stretch (Pilates one leg stretch)Intermediate · No equipment
3D demoSwan (Pilates swan dive)Intermediate · No equipment
3D demoSwimming (Pilates)Intermediate · No equipment
3D demoSide-lying open bookBeginner · No equipment
3D demoSpine twist (Pilates)Beginner · No equipmentOur suggestions, unless a move's own caution is quoted.
Cue "teeth apart, tongue resting on the roof of your mouth" in planks, the teaser, the hundred and standing balance. The NHS advises against clenching apart from when eating, and clenching that people noticed in themselves predicted new TMD.
The chest lift, the hundred and the stretch series can tighten the jaw and neck. The moves' own lines: the hundred, "Rest your head on the mat if your neck aches."; the single-leg stretch, "If your neck tires, rest the head down." Do them with your head down, or with a towel sling behind your head.
Rest your forehead on a folded towel, not your chin. An NHS physiotherapy leaflet for jaw pain advises against sleeping face down, because it "puts excess strain on the neck".
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Breathe out through soft lips, and support your chin with your hand if you yawn. The NHS says not to yawn too wide.
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With a sore neck as well, the roll-over: "Do not do it with a neck problem: a Pilates teacher advises against putting weight over the neck with a cervical spine condition." Rolling like a ball: "Skip it with a neck problem or a sore tailbone, and never roll on a hard floor."
Keep the headrest up, keep your teeth apart, and don't clench against heavy springs. No study has tested the reformer for TMD.
Our 20-minute head-supported Pilates for neck pain class, or the posture class, 2 or 3 times a week, with your teeth apart and your tongue resting on the roof of your mouth. Do the jaw exercises from our jaw pain guide separately. The yoga class for TMJ and the breathing session are for the relaxation side.
A 20-minute Pilates class for neck pain: head-supported core work, upper-back and shoulder-blade strength, gentle neck movement and slow breathing.
20 minBeginner15 movesA wallA 20-minute Pilates routine for posture: breathing, head and shoulder-blade control, back strength and upper-back mobility, with no loaded rounding.
20 minBeginner13 movesA wall, A bandA 20-minute yoga class for jaw pain and clenching: slow breathing, a relaxed jaw position, gentle neck and upper-back moves, and a long rest.
20 minBeginner11 movesA wallA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentDeep neck holds and shoulder-blade strength in under 20 minutes: one of the best-supported kinds of exercise for a stiff, sore neck.
18 minBeginner11 movesA band, An anchor pointThese are the same warning signs as our jaw pain and yoga for TMJ guides, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Emergency care through NHS 111 (NHS 24 in Scotland): your jaw is stuck in an open position and you can't move it. Scottish dental guidance treats this as a dislocated jaw that needs emergency care.
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Jaw exercises should be pain-free: an NHS dental leaflet says open only as wide as you can without causing pain. Stop any jaw exercise that hurts, makes the jaw lock or makes clicking painful, and don't push opening past comfortable; the NHS says don't yawn too wide.
For the neck, shoulder and posture moves, use NHS inform's scale for neck exercise: 4 to 5 out of 10 during exercise is acceptable, 6 or more is too much, and your neck should be no worse the next morning.
Your jaw should be no worse the next day. If it is, go back a step (our suggestion).
Call 999 if:
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
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Clicking is one of the commonest TMD symptoms, TMD usually gets better on its own, and jaw joint problems are "not sinister". Clicking with pain, locking or trouble opening is different and needs checking.
In the one Pilates trial, jaw function improved but posture didn't change, and the trial had serious weaknesses. People with TMD have head posture similar to people without it.
Adding core stability training to jaw exercises gave no clear extra benefit, and a Pilates-based core programme did less than manual therapy in a pilot.
Pilates doesn't train the chewing muscles: the jaw exercises are a separate, written set. Even strength training for the jaw muscles rests on 3 very low-quality studies.
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The 2023 guideline makes a conditional recommendation against reversible splints for jaw pain lasting 3 months or more. Ask your dentist what suits you.
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The guideline strongly recommends CBT that can include relaxation, but makes a conditional recommendation against relaxation therapy on its own. Breathing and relaxation in class are worth doing as part of the package.
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It may help a little, alongside the treatments with the best evidence. In the one small trial, women who added Pilates twice a week to a night splint had better jaw function after 15 weeks, though their posture didn't change and many dropped out. CBT, hands-on jaw treatment and supervised posture and jaw exercise have the strongest support.
Indirectly. Stress and clenching go with TMD, and a calm class with slow breathing is a good place to practise keeping your teeth apart and your jaw soft. Reminders and habit reversal are the main tested treatments for daytime clenching, and a dentist can help with grinding.
Breathing with your jaw relaxed, chin tucks and deep neck holds, shoulder-blade work such as rows, wall angels and Y-T-W raises, and upper-back moves such as the swan and the open book. Add the written jaw exercises from our jaw pain guide.
It can if you clench through hard moves, hold your head up in curls when your neck and jaw tighten, or lie face down with your chin on the floor. Keep your teeth apart, your head down when your neck tires, and your forehead on a towel.
Probably not on its own: people with TMD have head posture similar to people without it, though their neck muscles tire sooner. Posture training still helped symptoms in a trial, most likely through the neck rather than a new shape.
Painless clicking is common in TMD and isn't a reason to stop. Stop a move that makes clicking painful or makes your jaw lock, and get a jaw that locks or won't open fully checked the same day.
Usually, with the same changes: headrest up, teeth apart, and no clenching against heavy springs. No study has tested the reformer for TMD.
TMD and headaches often go together, and the neck, posture and relaxation work suits both. Our Pilates for headaches guide has the headache side, including which moves to change.
They do different jobs. Jaw exercises work the jaw, and supervised jaw exercise gave the biggest gain in jaw function in the large 2023 analysis; Pilates works the neck, posture and breathing. Do both.
The Pilates trial ran for 15 weeks, and a posture training trial saw changes by 4 weeks. Most TMD gets better with simple care, often within a few months.
That's what the one Pilates trial tested, and jaw function improved more with Pilates added, but the trial was weak. The 2023 guideline makes a conditional recommendation against reversible splints for jaw pain lasting 3 months or more, so ask your dentist.
Call 999 for jaw pain with chest pain, or a swollen face with trouble breathing or swallowing. Get emergency care if your jaw is stuck open, and same-day help if you can't eat or drink, your jaw is locking, or you have frequent severe headaches, a tender scalp or vision problems. See a GP or dentist if it hasn't settled after a few weeks.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
