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, a lot of them say yes. If your pelvis is out of alignment, quite often so is your jaw.

Here’s how that relationship works: The pelvis includes the base 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 two vertebrae of your spine at the top of your neck.

Because the opening/closing motion of the jaw is both hinging and gliding, the axis of rotation is not in the actual jaw joints but is located between these two vertebrae (Guzay’s theorem, seen in the images below).

(Image source: The Heart of Listening Volume 2 by Hugh Milne)

When your jaw is misaligned, it affects these vertebrae, impacting spinal and head posture and neurological well-being. The same when your pelvis is misaligned. 

How does that happen? The dura mater is a tough, inelastic membrane that lines the inside of your cranium and forms a loose sheath full of cerebrospinal fluid surrounding the spinal cord.

The dura mater is attached to the C1, C2, and C3 vertebrae and then descends unattached all the way down to the sacrum, where it attaches to bone again. 

When the pelvis is not aligned, it torques the dura mater at the lower end of the spine, which translates all the way up to these upper neck vertebrae that affect the jaw joints, and the occipital cranial bone.

This torquing of the dura mater may be seen in scoliosis, lordosis, kyphosis, pelvic rotation, head tilt, and cranial bone misalignment, which can affect your endocrine system and nerves.

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.)

I’m pretty sure this contributes to nine times more women than men suffering from TMJ disorders, since women tend to have more pelvic floor issues than men.

The floor of the mouth, from underneath.
The floor of the pelvis, from above.

Other ways these two areas resonate:

  • The mandible (jaw bone) crosses the midline and has two joints on either side, the TMJs. 
  • The sacrum also crosses the midline and has two joints on either side, the sacroiliac joints. 
  • The front of the pelvis, the pubic bone, also crosses the midline, and the hip joints (acetabula) lie on either side.
  • The pelvic floor and the floor of the mouth are similar in structure, as seen above.
  • Fascia, which surrounds muscles, connects the pelvis and jaw.
  • Many people clench their jaws when stressed — and may also tighten their anal sphincters. 
  • At about day 15 in embryological development, two depressions form: one develops into the mouth and the other that develops into the urinary/digestive/reproductive openings. 

Any thorough evaluation for jaw pain will include an assessment of pelvic alignment and a history of injuries or trauma there.