Friday, September 30, 2011

TMJ, TMD and massage

“Click.  Click.  Click.”  Is that the sound your jaw makes as you chew, or even talk?  Is it uncomfortable?  Do you clench your jaw when asleep, or in times of stress?  Do you have headaches frequently?  It’s possible that you are suffering some degree of temporomandibular dysfunction (TMD). It’s suspected that a great percentage of us have some degree of dysfunction in our temporomandibular joint (TMJ), but that it’s only severe enough in a handful of people that treatment is necessary. Personally, I suffer some degree of TMD, and I know that it is tied into my headaches (even migraines), and general neck and shoulder tension.  The temporomandibular joint is a unique (and uniquely complicated) joint, connecting our lower jawbone (mandible) to our skull (at the temporal bone). Technically, it’s a pair of joints, as there’s one on each side of the jaw, but we will refer to them as “a” joint.  

Often, TMD is a combination of issues in the TMJ, and a result of muscular imbalances.  In such a
small joint, with such tight tolerances for proper function, it doesn’t take much imbalance to contribute to major troubles.  The troubles can be widespread and incredible diverse, so will just touch on some of the more common and direct connections today.

The jaw is physically connected to our neck and shoulders, and neurologically connected to our stabilization and protection reflexes.  You may have noticed that you clench your jaw when you are stressed or focusing intently on something, or engaged in physical activity – all of these are evidence of the neurological connections.  Through the physical connections, poor upper body posture (what I call my computer posture) can create imbalances which will eventually manifest in the TMJ. If you follow the chain far enough, there are plenty of indications that TMJ dysfunction and hip imbalances are often related, as well.  These are also all 2-way streets, and the trouble can begin in the TMJ and refer elsewhere, as well.

An imbalance in the TMJ can refer to additional stress, muscle tension, poor balance or coordination, imbalanced pituitary function, headaches, jaw pain, difficulty chewing, and the list goes on and on.  It should be clear that your TMJ is something you should take care to pay attention to, and if you suffer imbalances, there’s likely something you can do about it for yourself.

There are 4 major muscles that make up the immediate TMJ: masseter, temporalis, medial & lateral pterygoids. Reaching all 4 of these muscles requires working inside the mouth (intraorally). With intraoral work, we can often get a wonderful release out of these 4 muscles, and see some improvement immediately.  My last personal experience with this was with my most recent migraine.  I performed intraoral work on myself while applying heat and stretches to my neck and shoulders, and within 25 minutes had knocked my migraine back down to the receding phase.  Without my medication.

I love this treatment as both a client and as a therapist. It’s not that it’s a really relaxing treatment (nor is it necessarily unpleasant). What I love so much about it is how profound of a difference it can make in even just a single session.  If you suffer from some sort of TMJ dysfunction then you probably can imagine what a revelation it might be to get finished with a treatment and feel like you are free to move your jaw however you’d like with much less pain or limitation.  

I think that once the intraoral work has been experienced, it is then much easier to apply it as a self-massage.  In the meantime, at the end of this post, I will link some videos by the Massage Nerd, Ryan Hoyme, with demonstration of self massage for the TMJ.

Self Massage videos for TMJ

If you'd like more detailed information, here's a wonderful article, with plenty of detail, authored by Patricia O'Rourke and Michael Hamm.