Have you or someone you know ever dealt with jaw pain? What about popping/clicking of the jaw or problems with fully opening or closing the mouth? This could possibly involve the Temporomandibular Complex (TMC). While not commonly known, physical therapy can help with these symptoms, deficits or limitations. The TMC is made up of the Temporomandibular Joint (TMJ) and the surrounding structures and muscles. Thus, it allows opening and closing of your mouth, talking, chewing and yawning.
Symptoms that can be associated with Temporomandibular Dysfunction or Disease (TMD) are:
- Jaw pain
- Neck pain
- Difficulty opening or closing the mouth
- Ringing or fullness sensation of the ear
Physical Therapy Approaches
Deficits in the neck, specifically the upper cervical spine, are often found and related to these symptoms or problems of the TMJ. The upper cervical spine relates to the chewing muscles. This means the cervical spine must be addressed in many cases.
Physical therapy aims to address these deficits with several approaches:
- Manual therapy (joint mobilizations to the neck and/or TMJ)
- Soft-tissue mobilization of the chewing muscles and/or neck
- Patient education about how posture/positions impact the TMJ and the associated muscles
- Targeted exercises and stretches
The best posture is a moving posture (any prolonged position/posture is typically not a good position/posture). However, a forward-head posture specifically can increase muscle activation and tone of the muscles that chew and close the mouth. This can lead to more compression of the TMJ and teeth grinding. This could potentially cause pain, headaches or joint dysfunction.
Dentists will work to help with teeth alignment. When the teeth fit together better, this can reduce the surrounding muscle tone. An “occlusive approach” refers to approaching TMD from a teeth alignment standpoint. When necessary, your physical therapist will work closely with your dental clinician. This ensures both approaches (joint specific and occlusive) are appropriate and addressed correctly.
Some common work-related activities can tend to worsen TMD and its associated symptoms. These can add compression at the TMJ.
- Forward-head posture
- Resting your chin on your hand
- Cradling the phone in between your shoulder and ear
- Prolonged positions of any kind (specifically with head tilted or rotated to one side, e.g., two monitors)
This is just a small list of commonly seen positions/activities that can influence the TMJ. As always, it depends on the person. Again, no perfect posture exists (“the best posture is a moving posture”). Not all of the activities listed above will be problematic for everybody. Having a physical therapist who specializes in TMJ treatment is important. They can help guide a person through the process, in addition to manual therapy and targeted exercises. In addition, they can coordinate care with other providers to ensure the most effective care is provided.
If you have any questions or would like to be evaluated by a skilled physical therapist, please contact us!