TMJ. Everyone has one. Well, two, really. Your temporomandibular joint is where your temporal bone articulates with your mandible, and that’s just a fancy set of words for ‘it’s your jaw’. Temporomandibular joints are kinda bananas, being double-hinged joints that you use to talk and chew and grin and laugh and sing…
Lots of different sized muscles are attached to the bones of the TMJ to make it move. Several of them are attached to a small floating bone called the ‘hyoid’ bone. Some of those muscles do several different movements, too, which can make figuring out what’s wrong with someone’s grumpy jaw a bit tricky. Good palpation skills, observation, and some detective work are key.
How does a person develop a TMJ disorder? Well, that’s tricky too. It can happen because of something like stress, grinding or clenching your teeth, chewing only on one side, or even having teeth that don’t fit together properly. Your teeth WANT to fit together and your jaw will move around and microadjust trying to get them to fit. Developing postural habits that take your head and neck out of optimal alignment can cause dysfunction in the TMJ. So can mouth breathing, especially in your sleep. Arthritis can be the cause of TMJ dysfunction OR be caused by it. And weirdly, improper tongue resting position can factor in.
Hang on. Your tongue has a proper resting position? It sure does! I know a lot of ‘self care’ memes tell you to unstick your tongue from the roof of your mouth, but the problem is, that IS its proper resting position.
Massage
What can you do about it if you have TMJ disorder? One thing you can do is get a massage (you must have known I was going to go there). I often get asked if I do TMJ disorder treatment, and the answer is: I do! Wanna know how? Because I have different methods of addressing a person’s jaw pain depending on what their comfort level is.
Intra-oral Massage
The first method of TMJ massage I was taught was the good old General Swedish Massage intra-oral treatment. I put on a pair of medical gloves (I use powder-free nitrile gloves, so if you have allergies remember to let me know) and I get my fingers right inside my client’s mouth and sort of ‘pinch’ the muscles in their cheek from both inside and out. I promise it is less icky than it sounds. There are a bunch of little muscles that are difficult (but not impossible, as you will learn soon) to reach from only the outside, like the medial and lateral pterygoids. They can feel a bit pins-and-needley while they are being worked on, but when they release? Divine. Intraoral is not for everyone though, and so…
Myofascial Treatment
Myofascial work is my favourite style of TMJ treatment. It’s gentle, deep, effective, relaxing, and my fingers stay outside of all facial cavities. Palpation helps me feel the deeper muscles (those pterygoids) *through* the outer muscles and skin. As with the other myofascial work, my client’s fascia knows where it needs help, and it will tell my hands what to do. There should be a gentle tissue stretch, but no pain.
Joint Mobilization
Decompaction or peripheral joint mobilization are great for when the movement of the joint itself is causing the pain. Joint mobilization by massage therapists is slower and more gentle than what chiropractors are allowed to do. Carefully pushing the joint surfaces into alignment or applying traction–sometimes with oscillating movement–can get those double-hinges hinging the way they were meant to.
Suikodo™
Suikodo™ is great for when I’m not sure exactly what is causing the TMJ dysfunction. Because Suikodo™ works on neuromeridians, your body is doing all the figuring-out and correcting on its own, just from cues that I’m giving it. There’s a few different head and face specific cues, one catch-all manoeuvre, and one very specific TMJ-related movement that always makes me think of Vulcan mind-melding.
Cranial-Sacral Therapy
Remember the Canadian Massage Conference from my last post? One of the workshops I attended was 4 hours of cranial-sacral therapy for head, neck, and jaw. Which means I now have a bunch of gentle new tools to work on TMJ dysfunction! Of course, several of these techniques are intraoral again, so I need to glove up.
Self Care
Self care! Always and forever, self care can help prevent problems and help lock in treatments you’ve just had from a health care provider, so please do your self care. You can do self-massage. Or hydrotherapy: eating popsicles to help reduce pain and inflammation in the joint area. There are exercises such as ‘chicken neck’ for your cervical posture or sucking on (not crunching!) hard candy or lollipops for tongue strengthening. When you do strengthening exercises, it is best to do as many as you can do WELL, which means if you get shaky, start to hurt, or have to clench your jaw to help motivate the movement, it’s time to rest and try again later. ‘No pain, no gain’ is a self care myth and it’s up to us to put it to sleep. Pain is NOT weakness leaving the body, it’s a warning sign that something isn’t in its best working condition.
Now that you know the tea on TMJ dysfunction, you can make a more informed decision on what to do about it! Massage, physio, dentistry, better pillows, more lollipops, all fantastic options. Which one will you choose?