Eating with a broken jaw: the weeks nobody plans for

A broken jaw is one of the most common serious injuries in this sport, and almost nothing has been written about how to eat through one.

In December 2025 Anthony Joshua knocked out Jake Paul in the sixth round in Miami. Paul posted the X-ray himself: two fractures. Surgery followed, two titanium plates on each side, some teeth removed.

His own summary of what came next was four words.

Liquids for 7 days.

That case has a second chapter, and it is the more useful one. In February 2026 Paul announced a second operation, because the screws and plates had worked loose.

His own explanation was that he had not rested for the previous 2 months.

Hold that. We come back to it.

Two different injuries wearing one name

What happens to your eating depends on how the fracture is fixed, and the two routes are not the same.

Plates and screws, which is what Paul had, hold the bone internally. The jaw is not clamped shut. You are on a liquid and then soft diet because of pain, swelling and healing bone rather than because your teeth are wired together.

Maxillomandibular fixation is the other route, and it is what most people picture. Upper and lower jaws are wired or banded together, classically for 3 to 6 weeks and often around four.

Nothing solid goes in during that period, and even liquids pass through a gap between the teeth.

The nutritional problem is similar in both. The severity and the duration are not.

What happens by default

The default outcome is well documented and it is not good.

The clinical literature notes that patients undergoing fixation commonly experience at least moderate weight loss and nutrient deficiencies, and that this happens even when the number and frequency of feedings is increased.

Straw and syringe feeding has long been recognised as deficient for maintaining the nutrition that healing requires.

Read the reason carefully, because people assume the opposite. Liquid food can contain enough; the failure is that the process is slow, uncomfortable and frustrating, so people stop before they have taken in what they needed.

The patient gets tired of it. That is the mechanism, and it is the thing a plan is built to defeat.

The study that should decide how you handle this

Fifty patients aged 18 to 55, undergoing 4 weeks of maxillomandibular fixation for facial fractures, were randomised into two groups.

Group one was counselled by a dietitian and given an individual diet plan.

Group two was told to take a liquid diet of their own choice, in the form of shakes, juices and milk, along with protein supplements.

At 4 weeks, group one had lost significantly less weight, at p = 0.001.

They also reported better oral health-related quality of life: less physical pain during the 2 weeks of fixation, and less physical discomfort and psychological disability in the 2 weeks after it was released.

Group two is what most fighters do. Shakes, juice, whatever protein is in the cupboard. It is a reasonable-sounding approach, it is a serious attempt rather than a straw man, and it lost the trial.

Why a fighter needs more, not less

This part inverts everybody's instinct.

Training has stopped, so the assumption is that less food is needed. The opposite is true. Surgery and a healing fracture are a metabolic stress, and the body needs more calories and more protein than before, not fewer.

Protein moves most. During immobilisation, intakes in the region of 2 to 2.5 grams per kilogram per day appear warranted, higher than a normal camp target, precisely because the tissue is not getting the stimulus of training and needs everything else working in its favour.

Getting 2 grams per kilogram through a straw takes planning. It does not happen by accident, and it does not happen by drinking a shake when you feel like it.

The practical protocol

Hospital guidance on a blended diet is consistent across the institutions that publish it. Follow it exactly.

• Six small meals, every 2 to 3 hours, rather than three normal ones. Volume per sitting is the binding constraint and frequency is the answer to it.
• Everything blended smooth and thin enough to pass through a syringe or straw, then strained. Lumps, seeds and fibres catch in wires and around hardware.
• Cooked rather than raw. Avoid fresh fruit and vegetables in whole form, tough or gristly meat, nuts, seeds, and whole grain or bran products. Same reason: particles that lodge where you cannot clean them.
• Eight to 10 glasses of fluid daily, choosing fluids that carry calories rather than fluids that fill you up for nothing.
• A liquid multivitamin, because the diet has narrowed in the direction that costs micronutrients first.
• Clean the mouth after every feed. Not cosmetic. Food trapped against hardware is how an infection starts, and an infection turns a 4-week problem into a 12-week one.

One piece of preparation that costs nothing: if the surgery is scheduled rather than an emergency, blend and freeze portions in advance in 1 or 2 cup containers. Somebody who has just had their jaw fixed is not going to want to operate a blender 6 times a day.

Where the drip fits, and where it stops being allowed

Intravenous amino acids and nutritional support are used in this situation, and a fighter should understand exactly where the line sits, because it is not where most people assume.

Intravenous infusions of more than 100 ml in any 12-hour period are a prohibited method, regardless of what is in the bag. But the rule carries an explicit exception for infusions legitimately received in the course of hospital treatment, surgical procedures or clinical diagnostic investigations.

So amino acids given intravenously in hospital, as part of your surgical treatment, sit inside that exception. Amino acids are not themselves a prohibited substance, so there is nothing extra to authorise.

That is the straightforward case, and a fighter should accept proper medical treatment without hesitating over it.

The trap is on the other side of the discharge door.

The same infusion continued at home, or arranged at a clinic afterwards because somebody suggested it would speed recovery, is no longer received in the course of hospital treatment.

The exception stops applying, and the volume rule applies in full.

Two further points that matter here. If a prohibited substance is administered intravenously, an exemption is required for that substance regardless of volume and regardless of setting. And where treatment was urgent, the route is to receive the treatment and then apply for a retroactive exemption as soon as reasonably possible.

Which produces one simple instruction. Keep the paperwork. Discharge summary, operation note, the record of what was administered and when. A medical file assembled at the time is what turns a legitimate treatment into a defensible 1 months later, and assembling it afterwards from memory is a much worse position to be in.

The trap at the end

You will come out of this lighter, and it will feel like an unearned gift.

It is not one. Weight lost across 4 weeks of no training, insufficient protein and a narrowed diet is predominantly lean tissue, from a body that has also lost training adaptation.

The scale reading conceals all of that.

A fighter who comes out of fixation 2 kilograms under his usual walking weight and treats it as a head start on the next cut has misread the situation completely.

The job after fixation is rebuilding what was lost, in the right proportions, before any weight conversation happens at all.

That takes longer than the fixation did.

And the second surgery

Which brings us back to where this started.

Plates and screws hold bone while bone knits. The hardware holds the repair still while the bone does the repairing. Load it before the bone has done its part and the fixation can fail, which is what a second operation is for.

Timelines here get quoted loosely, so separate them. 4 to 6 weeks is the figure usually given for initial healing and the end of diet restrictions. Return to contact, meaning sparring and competing, is a different question, and surgeons commonly place it at 3 to 6 months.

Paul returned to activity inside the shorter window, by his own account, and needed the hardware redone.

A fighter reading this will be tempted to be the exception. The most useful thing I can tell you is that a professional athlete with a full medical team around him, on a global stage, with every resource available, did not manage it either.

When to get somebody involved

Immediately, and not for the reason you would expect.

The trial above compared a dietitian against shakes and protein supplements, which is a genuine attempt by a motivated patient, rather than against doing nothing.

The written plan still won, on weight and on how the person felt while doing it.

If you are inside this now, or somebody in your gym is, the work is unglamorous. A calculated target. A rotation of blended meals that actually reaches it. A feeding schedule that survives contact with pain and fatigue.

A rebuild plan for afterwards, and the paperwork from the hospital kept somewhere safe.

None of that needs anybody's permission to start. It does need somebody to write it down before the third day, which is when enthusiasm runs out.