The TMJ stands for the temporomandibular joint is more commonly known as our jaw. It is an amazing and complex joint. The jaw is involved in multiple activities thru our daily routine including talking, eating, chewing, swallowing, singing and kissing.
Due to its complexity, treating dysfunctions in the TMJ is challenging and typically slow. This slow progress is in part due to the fact that it does not rest overnight. In fact, we swallow hundreds of time a night and even more if we are sleeping more superficially or not getting into the deep stages of the sleep cycle.
Anatomy of the TMJ:
The temporal condyle of the skull connects with the mandible which is the part that moves up and down when you open and close your mouth. We have a disc between these two bones which helps to fill the space between the two bones. This disc is held in place by ligaments. This disc moves more than cartilage in other joints. The disc is a shock absorber, protects bones from rubbing together especially with chewing. There are many muscles thru the jaw, face and neck which impact the alignment and mechanics of the TMJ.
There are 5 common impairments or contributing factors for jaw pain. These include:
Hypermobility meaning there is too much movement and not enough muscle support
Hypomobility meaning stiffness and decreased mobility in the joint and surrounding muscles
Disc dislocation and relocation
Arthritic changes
Traumatic
Symptoms that can be associated with TMJ Dysfunction:
Headaches
Ringing or pressure in the ears
Jaw pain
Locking of jaw
Neck, shoulder, upper back pain
Tooth pain when other causes have been ruled out
Treatment for each of these categories include postural correction, decreasing any inflammation, pain management, reviewing habits thru daily routine that may limit healing / progress, avoiding eating chewy foods or taking large bites of food. Hypermobility will include more muscle strengthening to support the joints better. Hypomobility can include joint mobilizations and manual therapy for tightness in muscles and myofascial layers in neck and fact. Arthritic changes will include more inflammatory management. Disc dislocation can be more challenging to treat but includes all of the above listed approaches.
The TMJ is impacted significantly by our posture. Forward head posture contributes to abnormal pressure on the joint and disc by pinching the pad behind the disk, reducing blood supply to the joint, stretching the ligaments that support the disc and joint, stretch and strain certain muscles that support the joint which can start to spasm, and general wear and tear thru the disc.
I mentioned the complexity of these joints, meaning treatment is challenging and complex. Treatment may need to include assessing and treating your tongue position and strength, teeth alignment in our mouth, retraining for more nasal breathing with your tongue resting in the correct location from mouth breathing, mouth guard/night guard to help with clinching or grinding thru the night; swallow statue; stress management, sleep hygiene.