Treating TMJ issues: what massage therapists can do to help

I am going to write about what various holistic healing professions do to treat TMJ issues to help you be good consumers and know what to expect. I’m going to start with massage therapy, since I am a licensed massage therapist and that’s what I’m most familiar with.

Massage therapy generally focuses on relaxing the soft tissues — the muscles and fascia — which helps relax the nervous system.

As far as I am aware, basic massage training to get licensed does not include teaching students to work on the cranium beyond giving a relaxing facial massage. An experienced massage therapist with basic training can help your external jaw muscles relax, as well as relieve neck tension and help your pelvis get more aligned — these often accompany jaw issues.

Some LMTs may do trigger point release on the external jaw muscles. Trigger points are tender and restrict range of motion. I’ve encountered quite a few masseters with trigger points, but not everyone with TMD has them.

The internal jaw muscles (pterygoids) are difficult to locate inside the mouth without special training, so it’s likely that massage therapists who work inside the mouth have had at least a continuing education class that specializes in this.

Classical craniosacral therapists (who may be massage therapists, physical therapists, occupational therapists, RNs, and other professions) who have taken CST2 are trained in hard-palate work, which addresses the cranial bones accessible in the mouth and is gentle. This class does not include working on the pterygoids internally, and I am not aware of any Upledger Institute craniosacral therapy class that teaches that. In my opinion, it is great to do after working on the pterygoids.

Working inside the mouth (wearing gloves or finger cots, of course) to allow the pterygoids to release takes knowledge about where they are and patience because they are tight, small, slow to release, and sensitive. Releasing their tension means working at the speed that the body-mind system allows, using a little pressure but avoiding force.

It also means watching the receiver very closely for signs of discomfort and setting up a signal beforehand to let me know they need me to remove my hand from their mouth.

The results can be dramatic: before a session, tension and pain. After, spaciousness, more range of motion, and no pain.

Even though the intra-oral work always feels awkward the first time, clients request it because it makes the biggest difference in relieving TM issues.

I’ve found that three sessions 7-10 days apart often retrains the jaw to stay relaxed and for a long time, but even one session has been known to last for 6 months. Prolonged dental work is the most likely reason to return.

I can’t speak for what other LMTs do for TMJ issues, but if anyone else wants to share how they work on TM issues, please comment.

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