Study Finds Rocabado Exercises Superior to Muscle Energy Technique for Jaw Pain Relief
India: A recent study has shown that structured physiotherapy interventions can significantly improve pain, mobility, and overall function in individuals with myogenic temporomandibular dysfunction (TMD), with Rocabado exercises demonstrating superior outcomes compared to muscle energy techniques (MET).
The research, published in Apollo Medicine, was led by Dr. Gaurav Patel from Ahmedabad Physiotherapy College, Parul University, Vadodara, India, and Dr. Rajesh Botchu, Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK, and colleagues.
Temporomandibular dysfunction affects the jaw joint and surrounding muscles, often leading to pain, restricted jaw movement, and difficulties in performing everyday activities. While conservative physiotherapy approaches such as Rocabado exercises and MET are commonly used, their comparative effectiveness has been unclear. The study directly evaluated both interventions in individuals with myogenic TMD using standardized clinical outcome measures.
The trial included 30 participants divided into two groups. One group performed Rocabado exercises, while the other underwent MET. Pain, jaw mobility, and functional disability were assessed using the Numeric Pain Rating Scale (NPRS), linear measurement techniques, and Fonseca’s questionnaire. Both groups showed significant improvements post-intervention, but the Rocabado group achieved notably greater gains in pain relief, jaw mobility, and functional outcomes.
Dr. Gaurav Patel, first author of the study, told Medical Dialogues, “Our study shows that both Rocabado exercises and MET are effective physiotherapy options for managing myogenic temporomandibular dysfunction. However, Rocabado exercises provided greater improvements in pain, range of motion, and overall function, making them a particularly valuable first-line exercise-based approach for clinicians treating myogenic TMD.”
Dr. Rajesh Botchu added further perspective on the clinical relevance of the findings: “While MET remains useful for addressing muscle tightness and joint restrictions, Rocabado exercises may be the better choice when the goal is comprehensive pain reduction, functional improvement, and postural correction. They are especially beneficial for patients with postural dysfunction, neuromuscular imbalance, or recurrent TMD symptoms.”
The study attributed the superior outcomes of Rocabado exercises to its structured “6×6” protocol, which emphasizes neuromuscular re-education, tongue posture, controlled mandibular movements, cervical alignment, and breathing control. Dr. Botchu explained, “Rocabado exercises address both TMJ mechanics and related postural factors, whereas MET primarily targets isolated muscular restrictions. This integrated approach likely explains why Rocabado exercises were more effective in improving function and reducing pain in our patients.”
While the study provides valuable insights, the authors acknowledged limitations, including a small sample size, short intervention duration, and reliance on subjective clinical outcomes. Dr. Patel emphasized the need for future research with larger randomized trials, objective assessments such as electromyography or imaging, and exploration of combined protocols integrating Rocabado exercises with manual therapy techniques.
The study offers unique comparative evidence of two widely used physiotherapy approaches for myogenic TMD. By highlighting the greater benefits of Rocabado exercises, it provides practical guidance for clinicians on selecting early, structured, exercise-based interventions to reduce pain, improve jaw mobility, and prevent long-term disability in patients with temporomandibular dysfunction.
Reference:
Patel, G., Vora, P., Panchal, R., Soni, R., Parmar, Y., & Botchu, R. (2025). Comparative Study to Find the Effect of Rocabado Exercise Versus Muscle Energy Technique on Pain, Mobility and Function in Individuals with Myogenic Temporomandibular Dysfunction. Apollo Medicine. https://doi.org/10.1177/09760016251399252
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