Massage therapy for jaw pain

The January/February 2019 issue of Massage & Bodywork (magazine for massage therapists) includes the article “Temporomandibular Joint Disorders: Biting Off More Than We Can Chew”. It’s full of information about the anatomy, pathology, demographics, contributing factors, symptoms, and treatment options for TMJD. The author is Ruth Werner, who wrote A Massage Therapist’s Guide to Pathology.

The article mentions that many dental professionals enthusiastically recommend massage therapy as an early intervention for TMJ disorders, which are often accompanied by dysfunction elsewhere in the body — the shoulder girdle, pelvis, and feet, for example.   Regular massage therapy sessions can also help relieve pain and tension in the external jaw muscles.

The author states, “The [internal] pterygoid muscles require more specialized skill… Work inside the mouth carries some serious responsibilities… It’s not for beginners, and it’s not for dabbling. When things go wrong in this joint, problems can reverberate through the whole body… [Massage therapists working inside the mouth should] get advanced training…

“Intraoral massage may trigger unintended responses… Emotional release in response to work in and around the mouth is also a strong possibility. It is critical that massage therapists be mindful of their scope of practice and respectful of their clients’ processes if this happens. Massage therapists must be prepared to be present, nonjudgmental, and appropriately supportive for this kind of event. Once again, it’s not for dabblers. If you want to do this work, get appropriate training.”

After reading this, I feel good about what I do. Massage therapists trained to work inside the mouth mostly follow three paths of advanced training: craniosacral therapy (like me), neuromuscular therapy, and structural integration (aka Rolfing).

Also, not all craniosacral therapists or neuromuscular therapists work with the internal pterygoid muscles, so be sure to ask beforehand if that’s what you expect. That was part of my training with Ryan Hallford, not (so far) with the Upledger Institute.

Also, I’m thanking the Upledger Institute for my training in SomatoEmotional Release as well as past experience and research in trauma recovery.

I’m grateful to see that treatment for TMJ disorders by licensed massage therapists is getting media attention, and that TMJD itself is getting more recognition. The TMJ Association recently announced that the National Institutes of Health have agreed to do more research. It’s very much needed — practitioners know what we don’t know, and it’s a lot.

Thank you for a good year, my friends. Here’s to 2019!

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I woke up this morning at year’s end, reflecting on my work in 2018. It’s been a very good year for me in so many ways, and I want to share that with you.

  • I’ve really come into my own doing the advanced integrative bodywork that I love, and of course there’s always more to learn with each person who comes in.
  • I’ve done more sessions with more people than in previous years.
  • I started working with a business coach this year, and I am very grateful for that. I’ve learned a lot.
  • I’ve continued training in craniosacral therapy, biodynamics, and Zero Balancing, deepening and integrating those skills.
  • Treating TMJ tension and pain has become a satisfying mainstay of my practice, ranging from the free 30-minute consultation to the 5-sessions-in-4-weeks program to my Facebook group Word of Mouth, as well as seeking and working with referral partners.
  • My new Heavenly Head Massage is getting a lot of traction.
  • I feel settled and at home in my office in West Lake Hills and very happy to be working with the practitioners who share the suite.
  • I’ve enjoyed feeding the birds on the hillside outside my office as well as arranging rocks just so.

I don’t know what 2019 will deliver, of course, but I have some plans:

  • I’ll be taking a course in TMJ mastery from a teacher in Canada who’s been doing TMJ and vocal cord work for over 20 years. He hasn’t posted the dates and locations for his 2019 trainings yet, but trading some of Austin’s summer heat for some Canadian cool would be nice!
  • I’m taking another craniosacral therapy course from the Upledger Institute in May, SomatoEmotional Release 2 here in Austin, and I’m slowly making progress on getting certified in craniosacral therapy techniques. I’ll continue to attend study groups and work with a mentor and will serve as a teaching assistant for CST1 in Austin next August. I feel advanced Upledger courses calling me — the brain, cranial nerves, pediatrics, the inner physician, and more.
  • I’m starting to work on certification in Zero Balancing. I continue attend study groups, advancing skills days, and taking classes, and I hope to attend founder Fritz Smith’s 90th birthday in May near Palm Springs, CA.
  • I plan to make videos for my website, Facebook page, and Facebook group.
  • I don’t have any classes in mind yet for biodynamics in 2019, but I plan to continue working on a modeling project with a mentor and trading with fellow practitioners.

May 2019 bring you more of what you want in life — health, happiness, abundance, love, opportunity, connection, peace of mind, and satisfaction. Thank you for your presence in my life!

Shorter office hours this week

I’ll be out of the office on Friday and Saturday this week — I’m participating in a night walking retreat at the Canyon of the Eagles Friday through Sunday. (I’ve done it before, so will miss the first day. There’s still room if you’re interested in (1) something different, (2) something relaxing, (3) removing yourself from the hustle and bustle, (4) learning a lifelong skill that you can use to relieve anxiety, (5) nature, trees, woods, water, dark skies, the beginning of the Geminid meteor shower,

I have openings on Tuesday, Wednesday, and Thursday, and in addition to everything else, I am offering $25 off on my Heavenly Head Massage. It’s the antidote for stress that brings relaxation like you wouldn’t believe! That discount applies to gift certificates too!

Treating TMJ issues: the role of the sphenoid in structural health

The sphenoid bone is one of the most fascinating bones in the body! If you were looking at someone and could see their bones, the sphenoid would be behind their eyes and in front of their ears, with the outermost parts (the greater wings) accessible at the temples, and the lowermost parts (the pterygoid processes) being what your internal jaw muscles attach to.

By the way, the word sphenoid comes from the Greek for wedge-shaped. Its shape has been likened to a moth, a bat, a butterfly, and a wasp.

Here’s a picture of it, as viewed from the front.

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Credit: TeachMeAnatomy

It’s a central cranial bone that does many important things:

  • it connects to your internal jaw muscles
  • muscles involved in swallowing are attached to it
  • it helps form the orbits of your eyes
  • the optic nerves meet, cross, and pass through it
  • your pituitary (master gland) sit on top of it (in a saddle!)
  • it contains two air sinuses, the sphenoidal sinuses, which open into the nasal cavity through the ethmoid bone
  • it has openings for major blood vessels and nerves of the head and neck
  • the tentorium cerebelli, part of the membranous system surrounding the central nervous system down to the sacrum, attaches to the sphenoid

The sphenoid has been called the keystone bone. It touches 12 other cranial bones: two parietals, two temporals, two zygomas, two palatines, frontal, occipital, ethmoid, and vomer.

The place where the sphenoid and occiput meet is called the sphenobasilar joint (SBJ). (The occiput is considered the base of the cranium.) You can see the SBJ in the middle of the image below where the orange and yellow bones meet.

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Credit: TeachMeAnatomy

The alignment of this joint is important. William Sutherland, DO, father of cranial osteopathy, believed that the rest of the skeletal system moves to accommodate the SBJ. If the two bones are not aligned well, it can affect the endocrine, nervous, and cardiovascular systems as well.

Misalignment of the SBJ can obviously affect other cranial bones, which fit closely together. It can contribute to TMJ pain and dysfunction.

When the SBJ is misaligned, it affects the jaw. (Remember, your internal jaw muscles attach to it.) It is also a consideration in migraines, headaches, sinus problems and allergies, pain in the head, neck, and back, scoliosis, issues with eye movements, and problems with behavior, personality, learning, coordination, hormones, and emotions.

This is how the sphenoid bone can affect the structure of the body. Craniosacral therapists pay a lot of attention to the sphenoid and can gently move it into better alignment. I like to end TMJ Relief sessions with a gentle adjustment to the sphenoid and a stillpoint to let the body integrate the new alignment.

Treating TMJ issues: the jaw-pelvis connection

The jaw-pelvis connection is real! When I ask my TMD (temporomandibular disorder) clients if they also have pelvic alignment issues, most of them say yes. If your pelvis is out of alignment, most often so is your jaw, and vice versa.

When receiving bodywork to get one area realigned, the other often follows. Sometimes I have one hand in your mouth and the other on your pelvis.

Here’s how that relationship works: The pelvis includes the root of the spine, your sacrum. Your jaw — mandible — is near the upper end of your spine, and it has a special relationship with C1 and C2, the uppermost vertebrae of your spine.

Because the opening/closing motion of the jaw is both hinging and gliding, the axis of rotation is not in the TMJs but is between these two vertebrae (Guzay’s theorem). When your jaw is misaligned, it affects these vertebrae, impacting spinal and head posture and neurological well-being.

How does that happen? The dura mater is a tough, inelastic membrane that lines the inside of your cranium and forms a loose sheath surrounding the spinal cord that is attached to C1, C2, and C3 and then descends all the way down to the sacrum.

When the jaw is not aligned, it torques the dura mater at the upper end of the spine, which translates all the way down to the sacrum. This torquing can cause scoliosis, lordosis, kyphosis, pelvic rotation, head tilt, and cranial bone misalignment, which can affect your endocrine system and spinal nerves.

Conversely, a pelvic injury can affect the jaw. If your pelvis is giving you problems, put your fingers in front of your ears and open and close your jaw. Notice if your left and right TMJs feel different or the same. You may notice one side opens first or is more restricted or otherwise moves asymmetrically. You may not have pain, however.

Maybe this is why nine times more women than men suffer from TMJ disorders. Women tend to have more issues with their pelvic floors as well as hormonal imbalances. Who knows which came first?

Coming soon: more about the relationship between the jaw and the endocrine system.