What is TMJ and how can Physical Therapy help me?
TMD/ TMJ Temporomandibular Dysfunction
What is Temporomandibular joint Dysfunction?
The temporomandibular joint (TMJ) guides jaw movement. Problems with the TMJ are known as temporomandibular joint disorder or dysfunction (TMD). TMDis very common; more than 10 million people in the United States have it. For most people the TMJ problem is a temporary annoyance and resolves without treatment. For some, however, the pain is ongoing and treatment is needed. The underlying causes for TMJ pain are often difficult to pinpoint in the early stages. Contributing factors include bruxism (grinding teeth), stress and problems with alignment of the teeth.
How can I tell if I have TMD? What are the symptoms?
Jaw pain
Jaw fatigue
Difficulty opening your mouth to eat ortalk
Ringing in your ears
Dizziness
Headaches & Migraines
Popping sounds in your jaw
Neck pain
Locking jaw
plus many more symptoms
How did I get TMJ/D?
Bad posture habits. One of the reasons TMD/TMJ is so common is because many of us spend a great deal of time sitting at a desk, and using our cell phones where we often hold our head too far forward. But there are many other kinds of bad posture. Sitting in the car for along commute, working at a checkout station, cradling a telephone receiver against the same shoulder for long periods of time, always carrying your child on the same hip—all can place the head in an awkward position and cause jaw problems. The "forward head position" puts a strain on the muscles,disk, and ligaments of the TMJ. The jaw is forced to "rest" in an opened position, and the chewing muscles become overused. In Physical Therapy with Robert Murdocco, not only the jaw alignment is addressed, but posture corrections are made. Other symptoms of overstretched cervical muscles, forward head posture can include headaches, neck pain, poor neck rotation, difficulty opening the mouth, popping sounds in the jaw.
Chronic jaw clenching at night ("bruxism"). Many people clench their jaws at night while they sleep, usually because of stress. This puts a strain on the TMJ because of the constant strain on the joint and surrounding muscles. Many people have no symptoms for years. Symptoms include pain and fatigue of the jaw, difficulty chewing, clicking in the joint, teeth that are ground down.. etc. Robert Murdocco will use special techniques to massage and stretch the jaw muscles and ligaments. Myofunctional Therapy can also help relax the jaw muscles and align the tongue.
Problems with teeth alignment("malocclusion"). If your teeth come together in an unusual way, greater stress is placed on your TMJ. Robert will work alongside Neuromuscular Dentists and Dentists to help correct the neck and jaw alignment. The Dentist will complete the dental side i.e. fixing the misaligned teeth or "malocclusion". Robert will complete the neck and jaw alignment. The collaboration with the Dentist is important so the long term outcomes are the best for the patient. The patients primary goal is to have no pain and be able to open/close the mouth properly.
Fracture and/ or Trauma. Ina traumatic accident involving the face or head, a fracture to the lower jaw may result, and even when the fracture is fully healed, TMJ stiffness and pain may remain. Sometimes the trauma was from years prior, even as a child with no symptoms after the event. However, over time the changes caused by the trauma (i.e. compression of the spine etc) begin to manifest. Other symptoms include neck pain, headaches, difficulty eating and opening/closing the mouth.
Surgery.Following surgery to the face and jaw, there may be a loss in mobility and function of the TMJ. Trismus ("lockjaw"). This condition—where jaw muscles spasm and the jaw cannot be fully opened—can be both a cause and a symptom of TMD. Other causes of trismus include trauma to the jaw. This requires Robert to massage and stretch the muscle spasm, relaxing the jaw.
Tongue Tie, Tongue thrust and Tongue misalignment. Having tongue ties and misalignment's can lead to chewing and resting position changes. Over time these changes can cause the jaw and neck to also change, causing TMJ, jaw pain, headaches etc..Robert uses combinations of Craniofacial, craniomandiular and myofunctional therapy on these cases.
Asthma, chronic nasal congestion, sleep apnea and other illnesses. Conditions such as Asthma and chronic nasal congestion from allergies cause mouth breathing at night. Mouth breathing at night causes the head and neck to move back to allow the jaw to stay open. This constant position causes misalignment of the jaw and neck. It can require Dental (Orthodontics) and Physical Therapy to correct. Robert uses a combination of craniocervical and myofunctional therapy in these cases.
Facial atrophy and lip changes. Muscles of the face can atrophy and change, lip closure and fullness can change causing jaw pain. Robert uses myofunctional therapy to strengthen the muscles of the face and change the lip position. Movie stars in Hollywood now use myofunctional therapy in order to improve their facial features.
How can Physical Therapy relieve my pain?
Robert Murdocco RPT, CFC will review your medical history, and discuss any previous surgery, fractures, or other injuries to your head, neck, or jaw, review x-rays, MRI's etc.
Conduct a physical examination of your jaw and cervical spine/ neck.
He will evaluate your posture and how your cervical spine—your neck—moves. Then he will examine the TMJ to find out how well it can open and whether there are any abnormalities in jaw motion. Treatment is based on each case, includes but not limited to cervical spine alignment, jaw alignment, disc alignment, intra-oral massage, manual therapy, myofunctional therapy etc.
Each case is individualized based on Medical History and Physical Assessment, no two cases are the same.