You’ve been suffering from an ongoing shoulder issue for some time; perhaps there’s a clicking sensation within the joint or pain on certain movements? Possibly the shoulder pain is accompanied by a tingling or a numb sensation which travels down the arm and into the hand or possibly referring up into neck, upper chest and face? The pain may be constant or may flare up at certain times, such as during the night or following certain activities?
You may have tried different therapies in order to help with the problem. Painful massage and various strengthening and stretching routines have been attempted but to no avail.
You’ve searched online in the hope of finding an answer to the problem but come to the conclusion you are a complete medical mystery and you have no choice but to simply live with the pain you are suffering
…well don’t give up just yet!
There may be another area of your body where your shoulder pain may be originating from which has probably not been considered so far…the jaw…give me a chance to explain!
Although it may sound strange to link shoulder issues to the jaw, there is a direct connection between the two.
In this blog I intend to discuss this relationship further and hopefully convince some of you suffering with persistent shoulder pain that the jaw is certainly a place to investigate further in order to try and solve the issue.
The Jaw/ Shoulder Connection
There are a number of muscles which connect the jaw to the shoulder complex and any misalignment in the jaw can create lines of tension down to the shoulder – potentially creating stiffness, pain and muscle tightness.
To explain this theory a little further I’ll describe some of the muscles and tissues of the jaw and neck which form this connection, which will hopefully help to give a better understanding of this often missed relationship.
Before going into further detail we’ll first look at a bone within the neck which which serves as an attachment site to these tissues – the Hyoid bone.
The Hyoid bone is a horseshoe shaped bone situated at the front of the neck, just below the jaw. It is the only bone in the human skeleton which does not articulated with any other bone. The Hyoid is held in position by muscles both above and below which attach to the jaw above and on to the clavicle (or collar bone) below. These muscles also have a connection to the floor of the mouth and the tongue.
Image above showing position of Hyoid bone at the front of the neck. The Hyoid does not articulate with any other bone, being held in place by muscles which attach both above and below helping to form the connection between the jaw and shoulder.
The Suprahyoids are a group of muscles which are located above the Hyoid bone in the neck. These muscles attach to the Hyoid bone to the jaw. Any misalignment’s or tightness within the jaw will result in these muscles creating a pull on the Hyoid bone which will then have an affect on the muscles below the Hyoid bone – the Infrahyoids.
Suprahyoid muscles (coloured green, red and yellow) and their attachments to both the jaw and the Hyoid bone.
The Infrahyoid muscles are a group of four muscles that are located below the Hyoid bone in the neck.
This group of muscles form an attachment on the Hyoid bone and connect to the clavicle (collar bone), sternum (breast bone) and the scapulae (shoulder blade).
Infrahyoid muscles and their attachments to the shoulder via the clavicle, sternum and scapulae.
Above: Infrahyoid muscles showing their attachments to the sternum (breast bone), clavicle (collar bone) and the scapulae (shoulder blade). Any tension in these muscles can potentially alter the position of the shoulder resulting in pain.
Jaw/ Hyoid/ Shoulder Relationship
As you can imagine, if the jaw is tight or misaligned in any way, then this will potentially create a pull on the Hyoid bone (through the Hyoids attachment to the jaw via the Suprahyoid muscles). This tension on the Hyoid bone will then have an affect on the Infrahyoid muscles below. Due to the Infrahyoids attachments to the shoulder – namely the shoulder blade and collar bone – tension can then be created into the shoulder joint.
The Hyoid bone can be described in a similar fashion to that of a puppet on wires. The analogy being the Hyoid is the wooden sticks which control the puppet and the wires being the muscles and tissue which form the connection with the shoulders. When the Hyoid moves (possibly due to jaw being out of alignment in some way) this can then have an impact on the neck and shoulders below in a similar way to the puppeteer altering the position of the puppets limbs.
Above: Similarly to when a puppeteer manipulates the limbs of a puppet by altering the angles of the sticks at the top, the Hyoid bone has a similar affect on the neck and shoulder when it’s position is altered (usually as a result of tension within the jaw).
Shoulder pain can be complex and there a number of reasons why you may be experiencing pain or restriction in the area. Frozen shoulder, labrum issues, arthritis and rotator cuff tears are all common diagnosis. Often treatment may involve strengthening exercises for the rotator cuff muscles and the muscles which surround the shoulder blade – and this is often a successful treatment plan – but what if this is not having the positive effects it should and the pain remains? What if you are unable to feel the muscles working during you rehab and little progress is made? In these cases, other possible causes should be investigated and the relationship between the jaw and the shoulder should be one of those.
If a client presents with shoulder pain combined with clicking or locking of the jaw, referred pain into the arm and face or if they report grinding their teeth at night then these are usually signs the jaw is part of the issue. Releasing tension within the jaw will often go a long way to reduce pain within the shoulder and enable the client to gain the most from any stretching and strengthening program which may be required.
So, if you were about to give up on ever getting rid of that nagging shoulder or neck pain and feel as though you’d come to the end of the road, then hope this post has given you some insight into a little known link which may just have more to do with your shoulder pain than you could ever have imagined!
In the coming weeks, I’ll be looking to post some exercises and advice on various issues we look at in each of these blogs via the faebook page so keep a look out for those appearing in the coming months if you need help with any of your aches and pains!
Best wishes – Jeff
Body in Balance Therapies