Many people have heard of TMJ, but don’t actually know much about it. The temporomandibular joint (TMJ) is a joint located just in front of each ear and is where the jaw bone meets the skull. It is one of the most frequently used joints in the body, as it moves every time we talk, eat, yawn, or clench our teeth. Try placing your fingertips just in front of the ear and open and close your mouth. You should be able to feel movement at the joint.
Like any other joint in the body, the TMJ needs to move well or we can experience pain or have other problems. The joints themselves need to have enough mobility and the muscles need to be able to contract and relax to allow us to open and close our mouth appropriately. Patients with TMJ pain may have limited motion, popping, or clicking near the TMJ. They can also have pain, headaches, or other symptoms that refer to the temples, forehead, cheeks, teeth, or ears.
In physical therapy, we take a look at not just a patient’s TMJ, but the whole person. Patients may have stiffness through the neck and the surrounding muscles that contribute to the person’s pain or limitations. Addressing these areas with hands-on treatment can have a big effect on pain and function. Posture affects how the TMJ works and making small changes can improve pain. We also spend a lot of time educating our patients on ways that they can help reduce their symptoms. Addressing stress and reducing muscle tension via diaphragmatic breathing can help. Many habits can also contribute to pain – nail biting, biting on a straw or pen, chewing on the inside of cheeks or lips. These activities can increase the amount of work the muscles of the TMJ have to do during the day and can cause tightness and pain.
What about clenching? Some patients know that they clench their teeth at night and sometimes benefit from a mouth guard to help reduce this pain. Many people also do some low-level clenching during the day by frequently holding their back teeth together. Even if they don’t think they are actively clenching or squeezing their teeth together, this position requires the work of the jaw muscles and often contributes to pain and muscle tightness.
One of the first things we work on with patients is finding a resting position of the jaw – a position where the joint is less compressed and the muscles can relax. There are a few steps we will walk our patients through:
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Move your bottom teeth right under your top teeth (not behind) with a little bit of space between.
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Rest your tongue gently on the roof of your mouth – not actively pushing into your teeth
In this position, you should be able to gently wiggle the jaw back and forth, as the muscles are much more relaxed than they are with the back teeth resting together. Frequently checking in with yourself and checking to see what position your TMJ is in is often one of the first steps to reducing jaw pain and TMJ-related headaches.
Check in with your posture and TMJ position for a couple of days and see how you feel. In physical therapy, we are experts at seeing and feeling mobility restrictions in your body and resolving these issues with hands-on manual therapy and specific individually designed exercises to that improve your mobility and pain.
Do you have questions or want to discuss your own issues? No need to continue suffering or putting up with symptoms. We are ready and able to help you!
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