Helping Yourself With TMJ Issues
If you are just joining us, we are half way through our series on addressing TMJ Issues. This is the first of a larger series on Tech Syndrome (how our bodies and brains are impacted by technology). You can catch up on this series at our web-site.
Last week we went over some self tests to determine if you might have a problem coming from your TMJ. TMJ Issues usually have pain in and about the mouth and jaw, but not always. Things like: headaches, crackling in the ears, fullness in the ears, snoring, neck pain, balance issues, pain in and about the face other than the jaw line, Trigeminal Neuralgia (very intense pain along the course of a nerve in the face), grinding the teeth at night and stress and anxiety can also be the presenting symptom of a TMJ problem.
The three easiest checks to do on your own to see if you issue may be coming from the TMJ itself are:
- Limited or painful opening (Less than three fingers, or three fingers with pain and strain)
- Side shift of the TMJ when opening often accompanied by a pop or crack
- Painful and tender muscles that are associated with jaw movement, often on just one side If you have any of the symptoms related to TMJ, and or you if you noted a problem with any of the self tests above, there is a good chance you have a TMJ problem.
Oftentimes TMJ problems (called TMD = Temporomandibular Disorder) can be self limiting, at least as far as pain goes. That is both good and bad. Good if your pain goes away AND you have a full restoration of normal jaw opening and closing, as well as a reduction in the muscle tension around the jaw. The absence of pain does not mean you are fixed it just means your pain is off doing something else! If your pain disappears and your normal opening and closing is restored you are good to go. If your pain disappears and your opening and closing is still compromised it may be worth your time to work through the steps outlined in this article and attempt to regain as much function as possible, it may prevent future problems.
Step One....Knock Down The Trigger Points!
A Trigger Point is a focal area of muscle that stays tight even when the fibers around it are relaxed. This can not only be painful, but can effectively shorten the muscle length and effect the joint it attaches to, in this case the jaw. Any stretches or exercises done around a trigger point usually just irritates the area and causes it to lock down further. For this reason, some light muscle work and the judicious use of moist heat prior to actually attempting to increase or normalize jaw motion can go a long way. Moist heat most commonly takes the form of either hot water running on your face in the shower, or applying hot compresses over the sides of the face in the form of a washcloth soaked and rung out in hot tap water. You will actually do the moist heat and muscle work at the same time. It looks like this:
Basically you are going to gently rub your temples for 30 seconds then just above your jaw for 30 seconds, both sides at the same time. Pay attention to any knots or tight spots. As you rub them they should slowly start to "melt". You can repeat this two to three times if it is relieving. If it is making it feel worse, don't continue. Do this at least twice a day, more often if it is helping.
Step Two...Relax The Tight Muscles Isometrically.
One of the ways to relax tight muscles without actually stretching them (which in the case of a TMJ issue can cause locking and irritation) is by activating there opposing muscles. In effect you are using your own nervous system to "inhibit" or shut off an overactive muscle group. An example I use in the office a lot is this: If you wanted lift a gallon of milk you would have to contract the muscle on the front of your arm (bicep) in order to make that happen. If the muscle on the other side of your arm (the Tricep, the one that opens up or extends your arm) were to contract at the same time your arm wouldn't move and nothing would happen. Your brain knows this, so when you contract your bicep it actually shuts down your tricep muscle automatically. You can use this same mechanism to relax the two main closing muscles in your jaw (the massetter and temporalis) by simply pressing the tip of your tongue to the rough of your mouth just behind your front teeth!
First, open your mouth and press the front 1/3 of your tongue onto the rough of your mouth. Next run your tongue up to just behind your teeth.
Next, close your lips together, but don't quite let your teeth touch. Maintain the pressure of your tongue on the rough of your mouth for as long as you can. Once you can no longer keep the tongue on the rough of the mouth open and close your mouth a few times normally. Repeat this often throughout the day. Start out slow ( 2x) gradually increase to 6-10 times in a day.
Step Three..."Position The Head"
The last part of the home exercise equation is to get the head back over the shoulders! We discussed in the first article in this series on TMJ how the head flexed forward and the rib cage pulled back can really add additional stress on the jaw by pulling it back (retracting). Reducing trigger points, releasing muscles and normalizing jaw movement (gait) is only short lived if you don't get at the oft underlying cause Forward Head Posture (FHP) !
The exercise we use for this daily in the office is the POSTERIOR PLANK. It is easy and effective, my two favorite criteria for an exercise.
Stand with backside against a wall, feet out in front of you 8-12 inches.
Slowly roll your spine up until the back of your head is touching the wall.
Slightly tuck your chin without raising your head off the wall.
Contract your glutes and spinal muscles until everything is off the wall except your head, making sure to not let your hips get out in front of your shoulders.
Hold this position for 45-60 seconds.
Walk your feet back to the wall and allow your backside and ribcage to once again touch the wall.
(If you are having trouble getting your head to touch the wall, contact me at the office and we can go over an alternative)
Pulling The Exercises Together As One!
Believe it or not, you can actually do Steps 2 and 3 at the same time! (I suppose you could actually do 1-3 all at the same time, but hey lets not get greedy). Get into the Posterior Plank Position (Step 3) Push your tongue onto the rough of your mouth with lips closed, teeth not touching (Step 2) Hold for 60 seconds or until you can no longer maintain the plank or tongue pressure If you Google search TMJ exercises you will get quite a variety of options to follow. The two outlined above (and the pressure point therapy) all have research articles that show they improve mouth opening and reduce pain. I have found over the years it is more effective to give people one or two things to do, and then ask them to do it often throughout the day than to give them 6-10 things to do only for them to feel overwhelmed. Practice the above two exercises either separately of together 6-10 times per day, that represents really only 6-10 minutes out of your day ! Well worth it if you can improve your jaw pain. If for some reason one or the other gives you trouble, just leave it off and focus on the other one. If both bother you we should probably talk. Do the pressure point/heat treatment twice a day. Work with these over six weeks and see if that doesn't help!
If your pain is very intense or your mouth opening is limited and clicks and pops, you may need some additional professional help. Next week we will cover who might benefit from more in-depth treatment and by whom.
Yours in Health,