Temporomandibular Joint Dysfunction (TMJD)

Temporomandibular Joint Dysfunction (TMJD) affects millions of people each year. Although this is a commonly occurring condition, it is actually a very complex problem.

Individuals suffering from TMJD may experience similar symptoms, and yet from individual to individual, the affected anatomical structures and causes of injury can be quite different. The good news is that this complex problem can be treated effectively if one is willing to take the time to evaluate and customize each treatment to address that individual’s specific needs.

The TMJ (temporomandibular joint) is one of the most complex joints in the human body. The temporomandibular joint (TMJ) lies just in front of the ears, where the lower jaw hinges. Restrictions or imbalances of one (or both) joints and their related soft-tissues can lead to headaches, tinnitus, facial pain, vision problems, eye pain, dental problems, balance issues, dysphagia, neck pain, and dizziness.

The key to effectively treating TMJD is to formulate a treatment that is specific to that individual. This requires the collection of a comprehensive history and a complete physical examination. Some cases of TMJD require more of a localized approach (Local Tensegrity), while others require a more systemic approach (Global Tensegrity).  In all cases of TMJD, the practitioner must consider kinetic chain connections, tissue remodeling of previous injuries, muscle imbalances, postural stresses, and even the neurological effects of long-term stress.

The Kinetic Chain of the Shoulder, Neck, and Jaw

From a kinetic chain perspective, it is important to recognize that the movements of your jaw, neck, and shoulders are directly linked to each other to form a Kinetic Web. For example, the structures of your shoulder, neck, and jaw are connected to each other to form a Kinetic Web. Believe it or not, even your head also has a web of fascial and muscular connections, which can transmit tension from one region, through the web, to create a dysfunction in the next area.

In turn, you can visualize the Kinetic Web as a linked series of kinetic chains. Each kinetic chain is made up of individual links (the various structures of your body). A weak link in any kinetic chain will not only generate its own set of problems, but will also create problems and compensations within the entire Kinetic Web.

Myofascial Restriction and TMJD

At the first International Fascia Congress Robert Schleip and Thomas Findley defined fascia as,

 “The soft tissue component of the connective tissue system that permeates the human body, forming a whole body continuous three-dimensional matrix of structural support”.

An easy way to understand of how this fascia affects your TMJD is to visualize the complex web of fascia that surrounds and innervates your shoulders, neck, and skull. Even though we tend to think of these areas as separate anatomical sections, they are actually all part of one continuous web.

For example, the TMJ’s have a number of muscles that can be involved. These include:

• Masseter muscles

• Temporalis muscles

• Lateral Pterygoid muscles

• Medial Pterygoid muscles

• Digastric Muscles

Tension at any point in this web creates dysfunctions or imbalances that place increased stress on the TMJ.

Motion Specific Release – 10-Point TMJ Protocol

It is interesting to note that many concurrent conditions are often resolved when combining the MSR 10-Point TMJ Protocol with other MSR techniques. These concurrent conditions can include tinnitus, trigeminal neuralgia, trouble swallowing (dysphagia),neck pain, peripheral neuropathies, and even thoracic outlet syndrome. (Dr. Abelson has submitted a paper about this subject to the Fifth International Fascia Congress taking place this fall in Berlin, Germany in November of 2018.)

Dr. Abelson has found that by combining the MSR 10-Point TMJ Protocol with other MSR procedures, and by integrating a customized functional exercise programs, our patients often see rapid increases in active range-of-motion, immediate decreases in pain, and a considerable increase in their ability to function at a higher level.

Global Tensegrity – Addressing the Larger TMJD Kinetic Web

In addition to the MSR 10-Point TMJ Protocol we often find that we need to address restrictions in regions of Global Tensegrity – the cervical spine, shoulders, and diaphragm.  For example, most people don’t see the correlation between their diaphragm and their temporomandibular joint dysfunction, but there is one.

Many TMJD patient suffer from concurrent conditions such as sleeping problems, tinnitus, neck pain, and headaches, all of which can be related to dysfunctional breathing and the autonomic nervous system. The autonomic nervous system (ANS) is responsible for the control of bodily functions which are not consciously directed, such as breathing, the heartbeat, and digestive processes.

Some of the hallmarks  indicating that there are problems within the sympathetic nervous system (SNS) include rapid heartbeat, shallow rapid breathing, and tense muscles.

Basically, dysfunctional breathing patterns can increase levels of inflammation (increased cortisol, oxidative stress), lead to increased scar tissue formation (cytokines TGF-B1), and even vascular dysfunction.

We have shown a substantial effect on improving overall systemic function by combining the MSR 10-Point TMJ Protocol with the MSR Diaphragmatic Release Procedures, specific breathing exercises, and self-myofascial release procedures .

 

Exercise Recommendations

Click on the following images to see examples of some of the exercise procedures that we prescribe to our patients as part of our TMJ treatment protocols (exercise recommendations vary with the specific patient) .

Come see us at Kinetic Health or Join us for a MSR Course

If you are suffering with problems related to your TMJ joints, we hope you will come and see us a Kinetic Health (403-241-3772). Let us help!

If you are a Practitioner, we invite you to join us at one of our upcoming courses in Motion Specific Release™.  At these courses we welcome Chiropractors, Physiotherapists, Registered Massage Therapists, and other manual therapists to learn techniques such as the MSR 10-Point TMJ Protocol. Our courses are approved by the ACAC and CRMTA for Continuing Education Units. We hope to see you soon.