TMJ – A Whole Body Approach

 

Many clients come to me suffering from symptoms such as jaw pain or popping, grinding teeth, or have ringing in their ears, perhaps chronic headaches or other issues related to muscle tension and misalignment in the temporomandibular joint (TMJ).

When presented with these symptoms it’s quite natural to treat the TMJ, including the muscles you use to clench the jaw and probably the muscles around your neck and shoulders – which all seems very logical as these are the muscles which might be causing the pain. But what happens when following the treatment the tension in the jaw returns a short while later…again…and again? What if I told you that by treating only the TMJ, neck and shoulders then we may be looking in the wrong place? When treating TMJ (or any condition for that matter) it’s important to consider looking at the whole body including gait, posture, and perhaps even hip alignment.

TMJ disturbances can potentially arise from imbalances anywhere in the body – from the face, cranium, neck, right down to your diaphragm, pelvis and feet. The body functions at it’s optimum when all of its joints, bones and muscles are in harmony, and its the fascia that holds everything in balance. But what is fascia?
Fascia is the soft tissue component of the connective tissue system. It surrounds every major structure in the body including muscles, muscle fibres, blood vessels, nerves, bones and organs. Fascia is everywhere, meaning if we have an injury or trauma anywhere in the body, the fascia will be effected. This can cause the fascia to harden, become less fluid and restricted, binding down as it looks to protect the injured area. Often clients will describe a feeling of constriction in the area – almost as if they are wearing tight clothing which restricts their movement.

How does this affect the different areas of the body?

As mentioned earlier, fascia envelopes all the muscles in the body; as the fascia spans across these groups of muscles, they create ‘fascial chains’ throughout the body. These fascial chains span the joints and can reach the whole length of the body. Anything which affects the fascia (such as injury) at any point along the pathway can potentially create a pull on the rest of chain, which in turn will create tension at another distant point in the body. There are at total of 12 fascial chains throughout the body and were first discovered and mapped out by structural integration expert, Tom Myers (Anatomy Trains).

To try and give a demonstration of how the fascial lines affect the body I have chosen to discuss one of the lines ( I thought all twelve may be a bit much!) which can have a direct impact on the TMJ – the superficial front line. The superficial front line runs the whole length of the front of the body; from the feet all the way through the body up to the muscles at the front and sides of the neck. Along it’s path (starting at the feet for this example), the superficial front line covers the muscles at the front of the lower legs (shin area), over the the knees and then travels up through the thigh muscles. From there, the superficial front line continues its journey through the abdomen and then on to the sternal area (chest/ breastbone) eventually coming to an end at the muscles on the front and sides of the neck.

 

The superficial front line (shaded blue): As you can see the line is continuous from the tops of the feet all the way up to the muscles of the neck and jaw. Tension exerted at any point along the line can create a pull along the whole of the chain potentially creating pain at another site elsewhere along the chain. 

If we imagine these muscles wrapped entirely in cling film (or fascia), it’s easy to see how tugging on one part of the cling film would pull and tug elsewhere in the chain. For example if there is tightness or restriction in the fascia surrounding the thigh muscles (possibly due to an old injury) then this can create a pull along the chain tugging on the fascial line as it travels through the abdomen, the chest wall and eventually creating a pull on the muscles at the front and side of the neck at the end of the chain.
These neck muscles have a connection to the jaw and if they become tight will exert a pull on the jaw muscles and potentially cause a misalignment of the jaw and begin to cause the symptoms of TMJ. The reason for the tension on the TMJ could be due to the tight restriction in the thigh which is creating the pull!

How can the superficial front line affect the body?

The pull asserted by the front line will often result in common compensatory patterns which affects posture and movement; some of the potential effects of this include:

  • Limited ability to point the toes downward.
  • Hyperextended knees (knees bending backward)
  • Pelvis tilted downward in the front (which creates a large curve in the lower back)
  • Forward head posture
  • Rib and breathing restrictions

As you can see in the example above, tension in the front line can create a pull on the front of the body causing the head and neck to be pulled forward, rounded shoulders, slumped chest and a forward tilt of the pelvis 

Some of the symptoms commonly associated with these postural changes include:

  • Breathing can become restricted.
  • Excess tension in the abdominal region restricts both rib movement and diaphragmatic breathing.
  • Forward rotation of the hips causes compression in the region. This affects the balance between the respiratory and pelvic diaphragms and results in only the front of the respiratory diaphragm being used in breathing.
  • Headaches due to the forward head carriage.

It’s often fascinating when working on a client with TMJ to discover that by releasing restrictions in the chest, diaphragm or abdomen you can find a release happening in the jaw. Often this will create the long lasting results which had been previously alluding us when simply working the muscles around the neck and the jaw.

I hope this blog has offered some insights into how looking at the body as a whole, rather than simply concentrating on the area of the pain, can have more favourable results for the client. Does the client have a forward head posture and rounded shoulders, an unbalanced walk or do their feet turn inwards? These are all things which can potentially have an impact on the condition and can be the difference between providing short term relief and long lasting or permanent results.

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