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Mastication Muscle Tears

Dr. Carolyn J. Agresti, MD - Otolaryngologist (ENT) Dr. Carolyn J. Agresti, MD - Otolaryngologist (ENT)
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Rx Musculoskeletal System (A - Z)

A mastication (chewing) muscle tear is an injury where fibers of one or more muscles responsible for chewing are overstretched or ripped. These tears can range from a mild stretch (Grade I) to a complete rupture (Grade III) of the muscle or tendon. Evidence shows that prompt diagnosis and proper treatment lead to faster healing and fewer complications.

Anatomy of the Mastication Muscles

The main muscles of mastication include the masseter, temporalis, medial pterygoid, and lateral pterygoid. They work together to move the jaw for biting, chewing, and speaking.

Component Description & Plain-English Explanation
Structure Thick, strong bands of muscle fibers; each has a tendon attachment.
Location Side of the face (masseter), over the temple (temporalis), inside the jaw (pterygoids).
Origin – Masseter: zygomatic arch (cheekbone)
– Temporalis: temporal fossa (side of skull)
– Medial pterygoid: pterygoid plate (inside skull)
– Lateral pterygoid: greater wing of sphenoid bone
Insertion – Masseter: angle and ramus of mandible (lower jaw)
– Temporalis: coronoid process of mandible
– Medial pterygoid: inner surface of mandible
– Lateral pterygoid: neck of mandible and articular disc of jaw joint
Blood Supply Branches of the maxillary artery (masseteric, deep temporal, pterygoid branches) bring oxygenated blood to these muscles.
Nerve Supply Mandibular branch of the trigeminal nerve (cranial nerve V3) controls chewing.
Six Functions 1. Elevation of Jaw: Close the mouth for biting.
2. Depression of Jaw: Open the mouth.
3. Protrusion: Push the lower jaw forward.
4. Retrusion: Pull the lower jaw backward.
5. Lateral Movement: Grind food side to side.
6. Stabilization: Hold the jaw steady during speech and swallowing.

Types of Mastication Muscle Tears

  1. Grade I (Mild): Minor stretch or microscopic tear; little pain or loss of function.

  2. Grade II (Moderate): Partial tear; moderate pain, weakness, and swelling.

  3. Grade III (Severe): Complete rupture; severe pain, loss of chewing ability, possible deformity.

  4. Intramuscular Tear: Tear within the muscle belly.

  5. Musculotendinous Tear: At the junction between muscle fibers and tendon.

  6. Acute Tear: Sudden injury, often from trauma or overstretching.

  7. Chronic Tear: Gradual overuse injury leading to microtears over time.

Causes

  1. Direct Trauma: Blow to the jaw or face (e.g., sports injury).

  2. Falls: Striking the jaw on the ground.

  3. Motor Vehicle Accidents: Whiplash or direct impact.

  4. Overuse: Excessive chewing (e.g., hard foods, gum).

  5. Bruxism (Teeth Grinding): Nighttime jaw clenching.

  6. Rapid Mouth Opening: Yawning or dental procedures.

  7. Heavy Lifting: Straining neck and jaw muscles.

  8. Inadequate Warm-Up: Jumping into intense activity without stretching.

  9. Arthritis: Weakened joint leading to muscle strain.

  10. Infection: Local infection causing pain and compensatory muscle strain.

  11. Tumors: Pressure or invasion by growths in the jaw area.

  12. Radiation Therapy: Tissue damage from cancer treatment.

  13. Malocclusion: Misaligned teeth causing uneven load.

  14. Stress: Increased muscle tension from emotional strain.

  15. Neurological Disorders: Abnormal muscle control.

  16. Cervical Spine Issues: Neck problems altering jaw mechanics.

  17. Dental Procedures: Prolonged mouth opening during surgery.

  18. Poor Posture: Forward head posture increasing muscle load.

  19. Inflammatory Diseases: Myositis causing muscle weakness.

  20. Aging: Reduced muscle elasticity over time.

Symptoms

  1. Jaw Pain: Localized at the side of the face.

  2. Swelling: Puffiness over the injured muscle.

  3. Bruising: Discoloration around the jaw.

  4. Muscle Spasm: Involuntary contractions.

  5. Limited Mouth Opening (Trismus): Difficulty opening wide.

  6. Weak Bite: Reduced chewing strength.

  7. Jaw Stiffness: Hard to move the jaw smoothly.

  8. Clicking or Popping: Sounds during jaw movement.

  9. Tenderness to Touch: Pain when pressing the muscle.

  10. Referred Pain: Ear or temple pain.

  11. Headache: Tension headaches from muscle strain.

  12. Facial Asymmetry: Uneven jaw contour if severe.

  13. Difficulty Speaking: Altered speech patterns.

  14. Difficulty Swallowing: Painful or limited swallowing.

  15. Lockjaw: Jaw locks in open or closed position.

  16. Muscle Atrophy: Wasting with chronic injury.

  17. Numbness: Rare nerve irritation.

  18. Fever: If infection is present.

  19. Fatigue: General tiredness from pain.

  20. Stress/Anxiety: Worry due to ongoing discomfort.

Diagnostic Tests

  1. Clinical History: Detailed symptom review.

  2. Physical Examination: Palpation and range-of-motion tests.

  3. Pain Provocation Tests: Reproducing pain with specific movements.

  4. Ultrasound: Visualize muscle fibers and tears.

  5. MRI (Magnetic Resonance Imaging): Gold standard for soft-tissue detail.

  6. CT Scan: Bone or complex injuries.

  7. X-Ray: Rule out fractures.

  8. Electromyography (EMG): Assess muscle electrical activity.

  9. Nerve Conduction Study: Check for nerve involvement.

  10. Blood Tests: Rule out infection or inflammatory markers (e.g., ESR, CRP).

  11. Ultrasound Elastography: Measure muscle stiffness.

  12. Dynamic Jaw Tracking: Electronic measurement of jaw movement.

  13. 3D Facial Imaging: Structural assessment.

  14. Jaw Joint Arthroscopy: Direct visualization for suspected joint injury.

  15. Thermography: Infrared to detect inflammation.

  16. Biopsy: Rare, for suspected tumors or myositis.

  17. Salivary Flow Tests: Rule out salivary gland issues mimicking pain.

  18. Dental Exam: Check for malocclusion or tooth-related problems.

  19. Orthodontic Assessment: Alignment evaluation.

  20. Functional Chewing Tests: Measure bite force and endurance.

Non-Pharmacological Treatments

  1. Rest: Avoid hard or chewy foods.

  2. Cold Packs: 10–15 minutes, 3–4 times daily to reduce swelling.

  3. Heat Therapy: Warm compresses after 48 hours to ease stiffness.

  4. Soft Diet: Mashed or liquid foods for 1–2 weeks.

  5. Jaw Exercises: Gentle range-of-motion stretches.

  6. Physical Therapy: Supervised muscle retraining.

  7. Ultrasound Therapy: Promotes blood flow and healing.

  8. Low-Level Laser Therapy: Reduces pain and inflammation.

  9. Transcutaneous Electrical Nerve Stimulation (TENS): Pain control.

  10. Massage Therapy: Improve circulation and relax muscles.

  11. Biofeedback: Learn to reduce jaw tension.

  12. Relaxation Techniques: Deep breathing, meditation.

  13. Posture Correction: Ergonomic adjustments at work.

  14. Dental Splints/Night Guards: Prevent grinding.

  15. Acupuncture: Pain relief by stimulating pressure points.

  16. Chiropractic Adjustment: Address cervical spine issues.

  17. Kinesiology Taping: Support and reduce muscle load.

  18. Myofascial Release: Manual tissue relaxation.

  19. Hydrotherapy: Warm water jaw exercises.

  20. Nutritional Support: Anti-inflammatory diet rich in omega-3s.

  21. Hydration: Maintain tissue health.

  22. Stress Management: Counseling, cognitive therapy.

  23. Ergonomic Pillows: Support proper neck alignment.

  24. Voice Therapy: For associated speech difficulty.

  25. Heat–Cold Contrast Baths: Alternate to boost circulation.

  26. Infrared Sauna: Deep tissue warming.

  27. Herbal Compresses: Arnica or comfrey for mild pain.

  28. Compression Bandages: Light support over jaw.

  29. Mind–Body Practices: Yoga, tai chi for overall muscle relaxation.

  30. Education: Teach proper jaw mechanics.

Drugs

  1. Ibuprofen: NSAID, reduces pain and inflammation.

  2. Naproxen: Longer-acting NSAID for sustained relief.

  3. Acetaminophen: For mild pain when NSAIDs are contraindicated.

  4. Diclofenac Gel: Topical anti-inflammatory.

  5. Ketorolac: Short-term, strong NSAID injections.

  6. Celecoxib: COX-2 inhibitor with fewer stomach side effects.

  7. Prednisone: Oral steroid for severe inflammation (short course).

  8. Methylprednisolone: Alternate steroid dosing option.

  9. Cyclobenzaprine: Muscle relaxant to ease spasms.

  10. Diazepam: Benzodiazepine for severe muscle spasm.

  11. Tizanidine: Centrally acting muscle relaxant.

  12. Gabapentin: Neuropathic pain control if nerve irritation.

  13. Tramadol: Weak opioid for moderate pain.

  14. Morphine: Strong opioid for severe acute pain (short-term).

  15. Lidocaine Patch: Local anesthetic over tender area.

  16. Capsaicin Cream: Depletes pain-transmitting neurotransmitters.

  17. Botulinum Toxin (Botox): Reduces muscle hyperactivity in chronic cases.

  18. Dexamethasone Mouthwash: Topical steroid rinse for oral muscle pain.

  19. Magnesium Supplements: May help muscle relaxation.

  20. Vitamin B Complex: Support nerve health and repair.

Surgeries

  1. Primary Muscle Repair: Suture torn ends together.

  2. Tendon Reattachment: Anchor tendon back to bone.

  3. Debridement: Remove damaged tissue.

  4. Fasciotomy: Release tight muscle compartments.

  5. Muscle Grafting: Replace lost tissue with a graft.

  6. Scar Release: Cut through scar tissue restricting movement.

  7. Arthroplasty: Repair or replace parts of the temporomandibular joint (TMJ) if involved.

  8. Disc Repositioning: For joint disc displacement affecting muscle function.

  9. Orthognathic Surgery: Correct jaw alignment issues contributing to tears.

  10. Free Flap Reconstruction: Complex repair using tissue from elsewhere.

Prevention Strategies

  1. Warm Up: Gentle jaw exercises before heavy chewing.

  2. Soft Diet Periodically: Avoid constant hard foods.

  3. Night Guard: Prevent grinding.

  4. Proper Posture: Keep head aligned over shoulders.

  5. Ergonomic Workstation: Avoid forward head lean.

  6. Stress Reduction: Practices to lower jaw tension.

  7. Regular Dental Checkups: Catch malocclusion early.

  8. Avoid Wide Mouth Opening: Don’t open excessively during yawning or dental work.

  9. Balanced Diet: Support muscle health with adequate protein and vitamins.

  10. Controlled Exercise: Don’t overload jaw muscles abruptly.

When to See a Doctor

  • Severe Pain that doesn’t improve with home care after 48 hours.

  • Inability to Open or Close your mouth fully.

  • Noticeable Deformity or loss of a normal jaw contour.

  • Signs of Infection: Fever, redness, warmth over the muscle.

  • Persistent Swelling beyond one week.

  • Numbness or tingling in the face.

  • Lockjaw Episodes (jaw locked open or closed).

  • Difficulty Eating or Speaking significantly affecting daily life.

Frequently Asked Questions

  1. What exactly is a mastication muscle tear?
    A tear is when muscle fibers in the chewing muscles stretch too far or rip, causing pain and weakness.

  2. How long does it take to heal?
    Mild tears heal in 2–4 weeks; severe tears may take 3–6 months or longer, depending on treatment.

  3. Can I still chew if I have a tear?
    You can chew soft foods, but avoid hard or chewy items until it heals.

  4. Are there exercises I can do at home?
    Yes—gentle jaw opening/closing and side-to-side movements help maintain mobility.

  5. Will massage help?
    Light massage can increase blood flow and reduce stiffness.

  6. Is surgery always necessary for severe tears?
    Not always. Many heal with conservative care; surgery is for complete ruptures or when function doesn’t return.

  7. Can tears occur without trauma?
    Yes—overuse, grinding teeth, or chronic tension can cause microtears over time.

  8. Do I need imaging tests?
    Mild cases diagnosed clinically; persistent or severe cases warrant ultrasound or MRI.

  9. What are the risks of NSAIDs?
    Stomach upset, ulcers, kidney issues—use as directed and for the shortest duration.

  10. Can stress cause these tears?
    Stress leads to jaw clenching and overuse, which can contribute to tears.

  11. Is it safe to take muscle relaxants?
    They’re generally safe short-term but can cause drowsiness; follow your doctor’s advice.

  12. Will Botox injections help?
    In chronic cases with muscle overactivity, Botox may reduce tension and pain.

  13. How can I prevent reinjury?
    Use warm-ups, soft diet, stress management, and night guards if you grind teeth.

  14. Can physical therapy really help?
    Yes—targeted exercises and manual therapies speed recovery and restore function.

  15. When should I consider surgery?
    If you have a complete tear or persistent loss of function after 3 months of conservative care.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

Last Updated: April 24, 2025.

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