TMJ and the Problem With Specialists

Jennifer came to me about three weeks ago in an effort to identify and eliminate the chronic pain in her left shoulder and the ongoing tension in the right side of her neck. As with all of my clients, we discussed her injuries and overall health. I thought I was up to speed regarding her medical history and any other health concerns, so you can imagine my surprise when she revealed to me that she has struggled with TMJ for fifteen years.

“Do you think my TMJ has something to do with my neck and shoulder pain?” she asked. “Why, yes,” I told her,” it most certainly does”.

TMJ (temporomandibular joint) disorder is a painful condition affecting the lower jaw (mandible), the temporal bone of the skull, and the soft tissue that surrounds the joint. The joint itself is packed with nerves and muscles that govern complex movements of the jaw. When TMJ symptoms are triggered, typical actions of the jaw, such as chewing and speaking, can become deeply painful. More of a collection of symptoms than an identifiable syndrome, TMJ disorder can spring from arthritis or injury, but a specific cause is unknown.

Treatment for TMJ disorder is similarly vague. Most medical and dental professionals suggest avoiding surgery, as it is invasive and is reported to produce no reduction in pain. In its place is a gentler ‘less is best’ approach. Heat, ice, and soft foods are the recommended techniques for managing painful TMJ flare-ups, but there is no recommended method for countering TMJ.

Most online resources focus only on the muscles of the jaw and the joint itself. What is not explored is the relationship between the position of the shoulders and the facial muscles. “Specializing” TMJ as a dental or jaw disorder eliminates a wealth of treatment options that address TMJ as a whole body issue. TMJ is not the only condition that is treated in isolation. Most people go to their general practitioner for a referral to a specialist when soreness or discomfort becomes chronic pain, whether it is back pain, knee pain, TMJ, or migraines.

Most of us want to hear from an expert who has devoted a lifetime to studying the very spot where we feel pain. It’s a natural impulse towards specificity that sustains the notion that a specialist can offer relief. The only problem with that line of thinking is that the different areas of the body do not operate in isolation. Our bodies are not a series of unrelated parts functioning independently but a complex of overlapping systems that affect each other in large and small ways.

The musculoskeletal system is a series of pulleys and levers that coordinate joints throughout the body to create motion. Any muscle within that system that is misused through faulty movement patterns will have an effect on the rest of the system. Sometimes the effect is painful. However, initially, it’s often not. When muscular pain triggers immobility in a joint, it’s useful to study not just the joint but also the neighboring muscles that are likely to play a role in the condition and in the recovery. Without their inclusion, relief is likely to be short lived.

Like many of my clients, Jennifer has rounded shoulders. Her pectorals (chest muscles) are tight and her lavator scapulae (shoulder blade lifters) aren’t as strong as they should be. This notorious combination triggers the upper trapezius muscles to overwork. Once the upper traps are hot, it becomes increasingly difficult to position the head above the spine. The result is “forward head position” or “text neck”. This effectively doubles the weight of the head as it relates to the traps. When the head is just a few degrees forward of the spine, the upper traps have to work twice as hard to hold the head at all, creating even more tension in the neck and, often, the jaw. The temporomandibular muscles tighten in response, which in time can result in TMJ.

As a plan of treatment to release Jennifer’s shoulders (and in effect, free her from her TMJ symptoms), we are strengthening her mid and lower trapezius muscles and softening her pecs. This will discourage an overreliance on her upper traps, which will bring her skull above her spine and in time will release her jaw. We are also addressing some ankle mobility issues that limit ankle dorsiflexion and disproportionally position her weight on the balls of her feet, thereby exacerbating the pain in her neck and shoulders (see Anita’s blog for more on that topic). As Jennifer’s body is becoming more aligned overall, the TMJ symptoms are diminishing. Eventually they will disappear.

Chronic pain is a whole body issue. A global, not specialized, approach is in order to yield lasting relief. Whether the pain is in the jaw, neck, lower back, or feet, you can be sure that the entire body is playing a role. At BodyFix Method™, we analyze a person’s alignment from head to toe. We study movement patterns and teach our clients to move efficiently and with ease. If limiting treatment to the sight of your pain has delivered minimal results, then it’s time for you to widen your scope and address your whole body.

 

If you struggle with TMJ symptoms, try this short program for rounded shoulders. After, Check out our TMJ Pain Program in our Shop, to maintain proper alignment and prevent TMJ pain in the future. Rounded Shoulders can also cause Foot Pain. Read last week’s blog, Got Foot Pain? Fix Your Rounded Shoulders to learn more.

 

 

Blandine’s Pec Minor Stretch

 

Upper Spinal Floor Twist

 

 

 

 

Seated Knee Pillow Squeezes

 

 

 

Standing Shoulder Shrugs at Wall

 

 

Standing Ankle Opener on Half Dome

 

 

Standing Arm Circles

 

 

 

Always feel free to reach out to me at elaine@bodyfixmethod.com for questions or to schedule and evaluation.