There are few educational courses you can sink your teeth into… Puns aside, last Tuesday I took a one-day course on an area of massage I am immensely interested in: the TMJ.
The TMJ, also known as the temporomandibular joint, is, at its simplest, the jaw. Made up of the mandibular fossa of the temporal bone and the condylar process of the mandiblei, the TMJ is a very important joint but like all joints, is susceptible to both normal wear and tear and repetitive strain. Either of these can lead to dysfunctionii and this also can mean pain to surrounding bones and muscles.
When we think of jaw pain, one group that often springs to mind are those who have had or are going in for dental work. When we get braces put on or taken off, fix that root canal, book in for implants or extraction surgery, or even just go for a cleaning, we ask a lot from our jaws – keep the mouth wide, keep the head and neck as still as possible, keep that tongue out of the way, and of course, remember to keep breathing.
Other groups whose jaws are similarly at risk from overuse, misuse, or even abuseiv might include actors, singers, mouth-instrument players, athletes who wear mouth guards, nightly-teeth grinders, and people involved in motor vehicle accidents. This is because, like their dental counterparts, these people continually put emphasis on specific jaw movement and/or are dealing with jaw recovery.
Now back to pain. Pain is a very subjective concept so I will not try to define it here but what I can review is how pain might present itself in someone experiencing TMJD:
- Limitation in opening the jaw
- Limitation in closing the jaw
- Headaches (frontal, temporal, occipital)
- Tenderness on the muscles surrounding or on the joint itself
- Ear ache
- Teeth sensitivity
- Postural issues (how a person ‘carries’ themselves when sitting and standing)
- Trigger pointsv
- Clicking, popping or other noises when opening/closing the jaw
- (to a lesser extent) Ringing in ears
So if this is sounding somewhat familiar, what should you do?
Book in for an assessment and treatment, of course!
What can you expect at your first visit?
- The first time we meet, I will review your online health history intake form (whether you are a returning or new client).
- Then I will take 10-15 minutes to do a specific TMJ assessment. I have many tools to use such as asking you questions, taking measurements of your jaw, palpating (specific, external touch) around the muscles and bones affected, performing a test for jaw function, etc.
- If I believe there is a possible dysfunction in the TMJ, a 45-minute treatment will follow.
- Although the components of the treatment can vary, it usually starts with the massaging of external areas like the pecs, shoulders, neck, cheeks and jaw. This is because these areas, often postural in nature, can have a huge influence on our jaw’s position. Like a typical massage, this “pre-work” is used to warm up but also assess the tissues and structures involved.
- After the external components have been massaged, I will use a gloved hand (latex free!) to work inside the mouth. Please note that before any work is done inside the mouth, we will discuss hand gestures so that you may stop treatment at any time, ask questions, give feedback, etc. Once inside the mouth, I will work on the main muscles that affect jaw dysfunction: the masseter, temporalis, and pterygoids. I don’t expect you to know what each of these do but I will explain why I am working on each one when in treatment.
- Again, as with any type of massage you receive from Inglewood Massage, our aim is always to keep you comfortable, confident and informed.
- After the treatment, you can expect some homecare. If you have any questions, please do not hesitate to ask at the treatment or email/call later.
Follow-up appointments will depend on the severity of the issue(s) found but you should expect that jaw work, like most treatments, relies partly on the therapist and partly on the client. I will do everything to make/keep you educated and empowered in your health journey.
And, as I learn more about assessing and treating TMJD and take further classes to become fully certifiedvi (please note, I can still work on you without this!), I am excited to add this new modality to our roster of services!
Yours in Health,
Carly Turner, RMT
i 2019 Mara Boaru for Seminars for Health
ii When someone says TMJD, they are referring to temporomandibular joint dysfunction
iv It isn’t to say that misuse is always conscious. Instead, I am suggesting that when we are in pain doing an action or using our body in a certain way/position, we often create new habits that decrease the pain/discomfort and that becomes our new “normal”. However, misuse can also lead to abuse and by ‘abuse’ I mean when we are conscious of our actions when we know better.
v “a localized usually tender or painful area of the body and especially of a muscle that when stimulated gives rise to pain elsewhere in the body” – as defined by Merriam-Webster.com.
vi Carly completed the Seminars for Health one-day course called TMJ Level 1 – Intraoral. She plans to take Level 2 in November 2019 and become fully certified.